Article 1: Children and Families

Sections 1-18 modify various provisions relating to CCAP to implement program integrity measures and establish provider due process rights, in accordance with federal requirements.

Section 1 (119B.011, subdivision 13b) adds a definition for “homeless” that means a self-declared housing status as defined in federal law, effective September 21, 2020.

Section 2 (119B.011, subdivision 19) makes conforming changes to the definition of “provider” and adds a requirement that child care centers must be in compliance with federal health and safety requirements, effective July 1, 2019.

Section 3 (119B.011, subdivision 20) revises the definition of “transition year families” to include families who have received diversionary work program assistance for at least one of the previous six months before losing eligibility, effective March 23, 2020.

Section 4 (119B.02, subdivision 7) directs the commissioner to conduct the next child care provider rate survey in 2021 and every three years thereafter.

Section 5 (119B.025, subdivision 1) establishes requirements for accelerated processing of applications for individuals declaring that they are homeless, effective September 21, 2020.

Section 6 (119B.025, subdivision 5) requires counties to provide notice to CCAP applicants and participants identifying the activities that constitute child care fraud and the consequences for committing fraud, effective September 1, 2019.

Section 7 (119B.03, subdivision 9) makes technical clarifying changes and removes the six-month cap on portability pool basic sliding fee assistance, effective December 2, 2019.

Section 8 (119B.09, subdivision 1) maintains the CCAP authorization eligibility of a family with one child who reaches the age of 13, or the age of 15 if the child has a disability, until the next annual redetermination, effective June 29, 2020.

Section 9 (119B.095, subdivision 2) requires the CCAP authorization for a child reaching the age of 13, or the age of 15 for children with a disability, to continue at the same or more hours until the next annual redetermination, effective June 29, 2020.

Section 10 (119B.095, subdivision 3) exempts homeless CCAP applicants from activity participation requirements for three months, makes a homeless CCAP applicant eligible for 60 hours of assistance per service period for three months from the date of application, and authorizes additional hours if the applicant participates in employment, education, or an employment plan, effective September 21, 2020.

Section 11 (119B.16, subdivision 1) makes conforming changes to the statute providing a fair hearing for CCAP applicants and recipients against whom a county agency or department takes action. The section also requires that applicants and recipients be offered an informal conference in addition to the fair hearing, and that notice of an action against a provider must be mailed to each CCAP recipient receiving care from that provider, effective February 26, 2021.

Section 12 (119B.16, subdivision 1a) provides the bases upon which a provider may request a fair hearing, requirement that fair hearing request must be submitted within 30 days of receiving notice of the action, and requirements for the contents of a provider appeal request, effective February 26, 2021.

Section 13 (119B.16, subdivision 1b) makes conforming changes to the statute regarding joint fair hearings by removing the requirement to join the family or provider but maintaining the human services judge’s discretion to join a family or provider as needed, effective February 26, 2021.

Section 14 (119B.16, subdivision 1c) requires a county agency or the commissioner to mail notice of an action being taken against a provider at least 15 days before the action’s effective date, including the basis for the department’s determination, the action to be taken, the amount of any monetary recovery, and the provider’s right to appeal, effective February 26, 2021.

Section 15 (119B.16, subdivision 3) provides a stay of a provider’s fair hearing upon appeal of the county agency or department action by the provider, effective February 26, 2021.

Section 16 (119B.16, subdivision 4) establishes that without a timely request for an appeal, an action by a county agency or the commissioner is a final department action, effective February 26, 2021.

Section 17 (119B.161) establishes the procedures for administrative review of certain department actions, effective February 26, 2021.

Subdivision 1 grants providers the right to administrative review of a suspended CCAP payment or a denied or revoked CCAP authorization.

Subdivision 2 requires that a county agency or the department to mail written notice to the affected provider within five days of suspending payment or denying or revoking an authorization. The notice must state the authority for the action, describe the allegations supporting the action, explain the length of the suspension, denial, or revocation, and inform the provider of the right to submit evidence an argument for the commissioner’s consideration. The county agency or department must also send notice of the action against the provider to each affected family.

Subdivision 3 establishes that the suspension, denial, or revocation against a provider is effective until the commissioner or law enforcement declines to pursue additional remedies, or until all criminal, civil, and administrative proceedings have concluded and any appeal rights have been exhausted.

Subdivision 4 creates a good cause exception for the commissioner to decline to take action against a provider, or to discontinue a denial, revocation, or suspension, if (1) law enforcement requests application of the exception, (2) the commissioner determines the exception should apply based on the provider’s written submission, or (3) the commissioner determines that applying the exception is in the best interests of the child care program.

Section 18 (245E.06, subdivision 3) makes a conforming change by replacing the existing statutory language with a cross-reference to the new sections establishing providers’ rights to appeal department actions, effective February 26, 2021.

Section 19 (256.01, subdivision 14b) permits the commissioner of human services to authorize projects to initiate tribal delivery of child welfare services, including alternative methods of screening child maltreatment reports. Alternative methods of child welfare services may only be authorized if they comply with the public policy of the Maltreatment of Minors Act.

Section 20 (256J.24, subdivision 5) increases the MFIP transitional standard by $100 per month per household.

Sections 21-22 (256M.41, subdivisions 3-4) require the commissioner of human services to make annual child protection performance-based payments to counties by July 10 each year, and authorize the commissioner to require an underperforming county to develop a plan to improve its child protection performance. The commissioner may redirect up to 20% of an underperforming county’s child protection payment amount toward its performance-improvement plan.

Sections 23-31 and 33 establish standards, procedures, and reporting requirements that authorize the colocation of children in foster care with a parent who is receiving treatment from a licensed residential family-based substance use disorder treatment program.

Section 23 (260C.007, subdivision 18) modifies the statutory definition of “foster care” to include a child collocated with a parent in a licensed residential family-based substance use disorder treatment program. The section also makes clarifying technical changes.

Section 24 (260C.007, subdivision 22) adds a statutory definition for “licensed residential family-based substance use disorder treatment program” that includes residential treatment facilities licensed by the department of human services that provide parents or guardians with trauma-informed parenting skills training, parent education, or individual and family counseling.

Section 25 (260C.178, subdivision 1) makes a technical conforming change by adding a cross-reference to the amended statutory definition of foster care.

Section 26 (260C.190) establishes the process and standards for placement of a child in foster care with a parent receiving services from a licensed residential family-based substance use disorder treatment program.

Subdivision 1 authorizes the responsible agency to collocate a child with a parent receiving substance use disorder treatment services in a residential family-based program, and permits the agency to visit the child as necessary, to continue providing services to the parent and child, and to terminate the placement to protect the child’s health, safety, or welfare, without a prior court order.

Subdivision 2 requires the agency’s recommendation that a child’s placement with a parent in a licensed residential family-based substance use disorder treatment program is in the child’s best interests to be included in the child’s case plan. The child’s case plan must also include a safety plan developed with the parent and the treatment program staff. The child’s out-of-home placement plan must be completed within 30 days of the child’s placement with the parent in a treatment program.

Subdivision 3 establishes court review and agency reporting requirements, as well as permanency procedures following a parent’s failure to complete treatment that vary depending on the length of time that the child has been in foster care.

Section 27 (260C.201, subdivision 1) makes a conforming change to authorize a court to issue a disposition to collocate a child with a parent in a licensed residential family-based substance use disorder treatment program. This section also updates an internal cross-reference to the statutory sections regarding permanency proceedings.

Section 28 (260C.201, subdivision 2) makes a conforming change to require written findings on the appropriateness of a child collocated with a parent in a licensed residential family-based substance use disorder treatment program.

Section 29 (260C.201, subdivision 6) makes a conforming change to require that a child’s case plan must specify the recommendation for the child to be collocated with the parent in a licensed residential family-based substance use disorder treatment program prior to the child’s placement with the parent.

Section 30 (260C.212, subdivision 2) makes a conforming change to require the agency to determine, according to statutory factors, whether colocation with a parent in a licensed residential family-based substance use disorder treatment program is in the child’s best interests. The determination must be made prior to the child’s placement and must be included in the child’s case file.

Section 31 (260C.228) establishes the procedure for a child’s foster care placement to be with a parent in a licensed residential family-based substance use treatment facility, upon agreement that such a placement is voluntary and in the child’s best interests. The placement must be specified in the child’s case plan, and is subject to judicial review within 165 days. At least five days before judicial review, the agency must submit a written report regarding the status of the placement. The agency must also give the child, the child’s parent, and the licensed treatment program the opportunity to submit information for consideration during the judicial review. A child’s disagreement with the placement must be noted in the agency’s report. The court need not conduct an in-person hearing unless requested by the parent, program, or child, and shall determine whether the placement is in the child’s best interests. A finding that the placement is in the child’s best interests must be supported by individualized findings, and a finding that the placement is not in the child’s best interests shall lead to the appointment of a guardian ad litem for the child and a hearing on the matter. Voluntary placement agreements terminate upon the parent’s discharge from the treatment program, unless the parent requests termination in writing or a later termination date is specified.

Section 33 (260C.503, subdivision 1) adds a cross-reference to the new statutory chapter governing permanency proceedings for foster children placed with parents in a licensed residential family-based substance use disorder treatment program.

Section 32 (260C.452, subdivision 4) adds a requirement that a transition plan for a child who will be discharged from foster care at the age of 18 or older must include official documentation that the youth was previously in foster care.

Section 34 (518A.32, subdivision 3) removes the statutory exception that considers a parent who is incarcerated for nonpayment of child support to be voluntarily unemployed, underemployed, or employed on a less than full-time basis, for purposes of imputing income for setting a child support obligation.

Section 35 (518A.51) increases the annual fee for child support collection services from $25 to $35, for individuals that have received at least $550 in child support payments through a county’s collection services, effective October 1, 2019. The fee must be retained by the collecting county from the collected support, but may not be retained from the first $550 of collected support.

Section 36 (Instruction to Commissioner) requires new background studies for individuals affiliated with a licensed children’s residential facility that are required to complete a background study pursuant to chapter 245C. The new background studies must be completed by March 1, 2020, for facilities that are eligible to receive federal Title IV-E funding, and by March 1, 2021, for facilities that are not eligible to receive federal Title IV-E funding.

Section 37 (Child Welfare Training Academy) directs the commissioner of human services to modify the existing Child Welfare Training System into a Child Welfare Training Academy that will be administered through five regional hubs to deliver training to child welfare workers that is targeted to the specific needs of each hub’s region. The commissioner shall collaborate with the University of Minnesota to administer the training, and may adopt rules as necessary.

Section 38 (Child Welfare Caseload Study) directs the commissioner of human services to conduct a study by October 1, 2020, that collects data on the number of child welfare workers and the amount of time spent on child welfare work. The commissioner shall report the study results to the governor and legislature by December 1, 2020, and work with counties and other relevant stakeholders to develop a process to monitor the caseloads of child welfare workers.

Section 39 (Direction to Commissioner; Homeless Youth Access to Birth Records and Minnesota Identification Cards) directs the commissioner of human services to consult with the commissioners of health and safety and report to the legislature by January 15, 2020, with recommendations on providing birth records and Minnesota identification cards to homeless youth at no cost.

Section 40 (Direction to Commissioner; Family First Prevention Kinship Services) directs the commissioner of human services to review opportunities to implement kinship navigator models that would provide guidance and support to relative foster parents and children in out-of-home placement with relatives, in anticipation of reimbursement under the Family First Prevention Services Act.

Section 41 (Direction to Commissioner; Relative Search) directs the commissioner of human services to develop and issue a guidance bulletin to assist local social services agencies with conducting relative searches relating to placement of children as part of child protection proceedings. The guidance shall include understandable methods of relative notification, resources for social services staff engagement and communication with relatives, and information to provide to relatives regarding permanency process and options.

Section 42 (Revisor’s Instruction) instructs the Revisor of Statutes to replace the terms “food support” and “food stamps” with “Supplementation Nutrition Assistance Program” or “SNAP” throughout statute, where appropriate, effective July 1, 2020.

Section 43 (Repealer) repeals statutory sections and rules relating to CCAP program integrity and provider due process that have been modified to achieve federal compliance, effective February 26, 2021.

Article 2: Operations

Section 1 (13.46, subdivision 2) authorizes the Department of Human Services to share welfare data about child care assistance program participants, applicants, and providers with the Department of Education.

Section 2 (13.46, subdivision 3) authorizes disclosure of investigative data to welfare system agents or investigators, unless the disclosure may compromise an ongoing DHS investigation.

Section 3 (13.46, subdivision 4) makes child care provider correction orders or fines due to licensing violations private or nonpublic if the correction order or fine is at least seven years old.

Section 4 (13.461, subdivision 28) provides cross-references in chapter 13 (Minnesota Government Data Practices Act) for data classified in the sections governing the child care assistance program.

Section 5 (15C.02) sets the penalties for violation of the Minnesota False Claims Act at the same levels as the penalties for violations of the federal False Claims Act.

Section 6 (16A.055, subdivision 1a) adds definitions for the results first evaluations conducted by the commissioner of management and budget on grant programs administered by the commissioner of human services.

Sections 7-11, 50, 82, and 107-109 relate to Child Care Assistance Program integrity measures.

Section 7 (119B.02, subdivision 6) defines “child care assistance program data” as data for a specific time period showing that a child care assistance program payment was made and the amount of the payment to the child care center. Certain payment data is public but any data identifying a child is private.

Section 8 (119B.09, subdivision 7) sets retroactivity for CCAP reimbursement at a maximum of three months from the date of application.

Section 9 (119B.125, subdivision 6) requires that accurate and legible CCAP attendance records be provided at the time of request by the department, and records produced at a subsequent date are not admissible for purposes of contesting an overpayment or disqualification, and modifies the calculation for overpayments so that if a record is insufficient to support the billing, an overpayment results.

Section 10 (119B.13, subdivision 6) permits child care providers to bill for CCAP reimbursement only for services documented in attendance records, and permits a county or the commissioner to suspend a provider’s authorization or stop a reimbursement payment if the provider fails to report decreases in child attendance.

Section 11 (119B.13, subdivision 7) sets the CCAP provider reimbursement cap for absent days at 25 per calendar year, defines “absent day” to mean any day that the child is authorized and scheduled to be in care but is absent for the entire day, sets the holidays limit at 10 full days per child per calendar year, requires providers to bill absent days or holidays when they occur, and dictates that a failure to bill an absent day or holiday constitutes an overpayment.

Section 50 (245A.24) requires all individuals conducting licensing activities, whether at the county level or the Department of Human Services, to report suspected fraud to county or department investigators.

Section 82 (245E.02, subdivision 1a) clarifies that the definition of “provider” for purposes of CCAP financial misconduct investigations includes individual providers or entities, including the owners and controlling individuals of an entity.

Section 107 (256.046, subdivision 3) establishes the procedures for the department or a local agency to pursue administrative disqualification of a child care provider receiving CCAP that commits an intentional program violation, where a criminal action has not been pursued, as well as appeal rights for affected providers.

Section 108 (256.98, subdivision 1) adds a cross-reference to the housing support chapter to the section prohibiting wrongfully obtaining assistance.

Section 109 (256.98, subdivision 8, paragraph (c)) sets the disqualification period for child care providers receiving CCAP that have been found to have wrongfully obtained assistance at three years for the first offense, and a permanent disqualification for a subsequent violation.

Sections 12, 64, 74, and 75 establish set-aside criteria for individuals working or seeking employment in the substance use disorder field.

Section 12 (144.057, subdivision 3) requires the commissioner to use the same set-aside criteria as the commissioner of human services with respect to individuals employed or seeking employment in the substance use disorder field.

Section 64 (245C.02, subdivision 20) defines “substance use disorder treatment field” as a licensed, registered program exclusively service individuals 18 years old and older for substance use disorder treatment or recovery.

Section 74 (245C.22, subdivision 4) specifies the criteria for setting aside a disqualification for an individual seeking employment in the substance use disorder field.

Section 75 (245C.22, subdivision 5) provides an exception for a set aside for a person employed in the substance use disorder field, where the individual received a previous set aside for a different program or agency.

Section 13 (245.095) strengthens the authority of the Commissioner of Human Services to prevent individuals and providers from receiving state funds through a DHS administered program after being excluded from any program administered by DHS.

Sections 14-20, 22-29, 31, and 33-39 modify DHS licensing provisions, including new requirements for change of ownership and modifications to licensing sanctions.

Section 14 (245A.02, subdivision 3) adds government entities to the definition of “applicant” in the human services licensing statutes, and makes other technical clarifying changes, effective January 1, 2020.

Section 15 (245A.02, subdivision 3b) defines “authorized agent” as a controlling individual designated to communicate with the commissioner of human services on licensing matters, effective January 1, 2020.

Section 16 (245A.02, subdivision 8) amends the definition of “license” to mean a license issued under section 245A.04, effective January 1, 2020.

Section 17 (245A.02, subdivision 9) adds government entities to the definition of “license holder” in the human services licensing statutes, and makes other technical clarifying changes, effective January 1, 2020.

Section 18 (245A.02, subdivision 10c) adds a definition of “organization” for purposes of the human services licensing statutes.

Section 19 (245A.02, subdivision 12) modifies the definition of “private agency” for purposes of the human services licensing statutes by making a technical conforming change and adding the private agency designated to perform licensing functions under section 245A.16.

Section 20 (245A.02, subdivision 14) adds a definition for “residential program” providing home and community-based services under a medical assistance waiver, effective January 1, 2020.

Section 22 (245A.03, subdivision 1) makes a technical conforming change.

Section 23 (245A.03, subdivision 3) makes technical conforming changes.

Section 24 (245A.04, subdivision 1) modifies the list of entities required to be licensed, updates application requirements for controlling individuals, authorized agents, and government entities, and expands what information must be submitted with an application for an individual or organization, effective January 1, 2020.

Section 25 (245A.04, subdivision 2) permits the commissioner to use electronic communication to notify a municipality or other political subdivision that would be affected by issuance of a new license, effective January 1, 2020.

Section 26 (245A.04, subdivision 4) removes the requirement that a program must be evaluated by its consumers prior to being issued a license, effective January 1, 2020, precludes the commissioner from issuing a correction order or negative licensing action for violations not discussed in an exit interview, and provides a process for a family child care license holder to dispute a county licensor’s interpretation of a licensing requirement, effective September 30, 2019.

Section 27 (245A.04, subdivision 6) modifies the list of factors that the commissioner must consider before taking a licensing action to include the applicable requirements of statutes and rules, as well as the applicant or license holder’s knowledge of the applicable requirements of statutes and rules, effective January 1, 2020.

Section 28 (245A.04, subdivision 7) makes conforming changes to accommodate the new provisions regarding a temporary change of ownership license, effective January 1, 2020.

Section 29 (245A.04, subdivision 7a) requires a license holder to notify the commissioner before altering license information or changing the license holder’s authorized agent, controlling individual, information on file with the secretary of state, program location or service, and tax identification numbers. License holders may provide the information within ten days of the change if circumstance outside of the license holder’s control preclude immediate notification. License holders must also provide updated articles of incorporation and other documentation of changes when altering information on file with the secretary of state. This section is effective January 1, 2020.

Section 31 (245A.04, subdivision 10) makes a conforming change to incorporate the updated definition for “organization.”

Section 33 (245A.043) establishes the circumstances, procedures, and requirements for a license application after change in ownership, including requirements for providers to notify the commissioner of proposed changes in ownership and procedures to issue of a temporary change in ownership license where necessary, effective January 1, 2020.

Section 34 (245A.05) permits the commissioner to deny a license application if the applicant fails to demonstrate competent knowledge of applicable rules and statutes, has a history of noncompliance, or is prohibited from holding a license, effective January 1, 2020.

Section 35 (245A.055) permits the commissioner to close a license if the program has not served any client for at least 12 consecutive months, establishes a process for the commissioner to notify the license holder of the license closure, and permits the license holder to request reconsideration of the closure, effective January 1, 2020.

Section 36 (245A.07, subdivision 1) makes technical conforming changes.

Section 37 (245A.07, subdivision 2) permits a temporary immediate suspension of a license where the holder is criminally charged for fraud or theft against a program administered by the commissioner, effective January 1, 2020.

Section 38 (245A.07, subdivision 2a, paragraph (d)) establishes that the burden of proof on the commissioner in expedited hearings is a preponderance of the evidence that a criminal action against a provider involving fraud or theft against a program administrated by the commissioner was not dismissed.

Section 39 (245A.07, subdivision 3) makes conforming changes to the list of circumstances for which the commissioner may suspend or revoke a license, or impose a fine, effective January 1, 2020.

Section 30 (245A.04, subdivision 9a) establishes the circumstances under which the commissioner may issue a variance for a licensed family foster parent to allow additional foster children, effective October 1, 2019.

Section 32 (245A.04, subdivision 18) directs the commissioner of human services to consult with relevant child care stakeholders to develop, publicly post, and distribute a plain-language handbook for family child care providers to understand the application and licensing process, and all applicable rules and statutes, by January 1, 2020.

Section 40 (245A.14, subdivision 4) clarifies portions of the fire code that are applicable to special family day care homes, permits two or more licensed programs operated as separate programs to share a location, and allows variances for collaborative child care models, effective September 30, 2019.

Sections 21, 41-49, 51-52, and 59-60 modify statutory provisions relating to licensed child care center licensure, training, and service standards.

Section 21 (245A.02, subdivision 18) modifies the activities that constitute “supervision” in a licensed child care center, and provides specific definitions of supervision for when a school-aged child uses the restroom or uses the child’s personal storage space, effective September 30, 2019.

Section 41 (245A.14, subdivision 8) makes a conforming change to the first aid and CPR training requirements for experienced aides, effective September 30, 2019.

Section 42 (245A.14, subdivision 16) requires a driver with a current, valid driver’s license appropriate to the vehicle driven to transport children served by a licensed child care center, effective September 30, 2019.

Section 43 (245A.14, subdivision 17) permits a child care center to provide drinking water with reusable bottles or cups, provided that the center implements a written policy for daily sanitization of the bottles or cups, labeling of each child’s bottle or cup, proper storage of the bottles or cups, and assurance that the bottle or cup is only used for water, effective September 30, 2019.

Section 44 (245A.145, subdivision 1) requires the department of human services to develop plain-language policies and procedures for reporting suspected child maltreatment, to be distributed to all licensed child care providers, effective September 30, 2019.

Section 45 (245A.145, subdivision 2) requires that child care license display the licensing agency’s telephone number.

Section 46 (245A.149) permits relatives of a family child care license holder to be present and provide care to the license holder’s own child, provided that the relative is not a designated caregiver, helper, or substitute for the program, cares only for the related child, and does not have direct, unsupervised contact with any unrelated children. Relatives who do not reside in the household are not required to undergo a background study. This section is effective September 30, 2019.

Section 47 (245A.151) makes a conforming change to add license-exempt child care centers to the statute regarding fire marshal inspections prior to licensure, effective September 30, 2019.

Section 48 (245A.16, subdivision 1) establishes that variances to the requirements for substitutes and may only be issued by the commissioner and require notice to all parents and guardians of children in care at the site of the variance, and requires county agencies to report all fires at family child care providers requiring fire department services to the commissioner within 48 hours of the fire and to the state fire marshal within two business days, effective September 30, 2019.

Section 49 (245A.18, subdivision 2) requires child passenger restraint system training for all licensed programs that serve children under the age of eight, removes the requirement that the training must be at least one hour, removes the exemption for providers who only transport school-age children, and establishes a variance for emergency relative placements who complete a child seat safety check up, effective September 30, 2019.

Section 51 (245A.40) makes substantial revisions to the training requirements for licensed child care centers, effective September 30, 2019.

Subdivision 1 establishes the timing and content requirements for initial orientation of center workers.

Subdivision 1a provides definitions for “substitute,” “staff person,” and “unsupervised volunteer.

Subdivision 2 requires at least two hours of training on child development and learning every second calendar year.

Subdivision 3 requires first aid training for a center director or staff prior to having unsupervised direct contact with a child, but no later than within 90 days of employment, unless the training has been completed within the previous two years. The training must be repeated at least once every second year.

Subdivision 4 requires pediatric CPR training for a center director or staff prior to having unsupervised direct contact with a child, but no later than within 90 days of employment, unless the training has been completed within the previous two years. The training must be repeated at least once every second year.

Subdivision 5 requires at least a half hour of training on sudden unexpected infant death prior to caring for infants and once a year thereafter.

Subdivision 5a requires abusive head trauma training for all staff prior to providing care and once a year thereafter.

Subdivision 6 requires child passenger restraint system training prior to providing transportation for staff who will transport children under the age of eight, at least once every five years. Previous training from prior center employment is transferrable for purposes of fulfilling this requirement.

Subdivision 7 establishes the timing and content requirements for annual in-service training for the center director and all staff, including volunteers. Staff working more than 20 hours per week must complete 24 hours of in-service training each year, and staff working fewer than 20 hours per week must complete 12 hours. Individuals who are not employed for the full year may have their training hours prorated.

Subdivision 10 requires all training to be documented and maintained on site in each personnel record, including each staff person’s first date of direct contact and first date of unsupervised contact with a child in the program.

Section 52 (245A.41) makes additional revisions to the training requirements for licensed child care centers, effective September 30, 2019.

Subdivision 1 clarifies that a child care center must update a child’s individual child care program plan at least once each calendar year.

Subdivision 2 requires license holders to ensure that each staff person follows precautions to reduce the risk of spreading infectious disease.

Subdivision 3 requires a center’s written emergency plan to include accommodations for infants and toddlers.

Subdivision 4 requires compliance with all statutory seat belt and child passenger restraint system requirements

Subdivision 5 requires access to a working telephone in a child care center at all times, which may be satisfied by having a sufficiently charged cell phone stored in an accessible central location.

Section 59 (245A.66, subdivision 2) adds a requirement that a child care center’s risk reduction plan include policies and procedures with particular emphasis on supervision of school-age children when using the restroom and visiting the child’s personal storage space.

Section 60 (245A.66, subdivision 3) replaces the requirement for license holders to conduct an orientation on the program’s risk reduction plan with a requirement for license holders to review the program’s risk reduction plan each calendar year, and to document notification of staff following any changes to the risk reduction plan as a result of the review.

Sections 53-58 modify statutory provisions relating to family child care provider licensure and service standards.

Section 53 (245A.50, subdivision 1) requires family child care providers who relocate within the state to continue to satisfy their annual, ongoing training requirements, but relocating providers are not required to complete initial training requirements that the provider completed prior to licensure. If the provider relocates to a new county, the county may not require the relocating provider to complete orientation or training required for new providers. This section is effective September 30, 2019.

Section 54 (245A.51, subdivision 3) requires that a family child care provider’s emergency preparedness plan to include accommodations for infants and toddlers, and eliminates the requirement for a licensed child care provider to post its emergency preparedness plan in a prominent location and provide a physical or electronic copy to a child’s parent or legal guardian upon enrollment, effective September 30, 2019.

Section 55 (245A.51, subdivision 4) requires licensed family child care providers to comply with all statutory seat belt and child passenger restraint system requirements, effective September 30, 2019.

Section 56 (245A.51, subdivision 5) exempts family child care providers from the requirement to post emergency numbers, and allows family child care providers to satisfy the emergency telephone rules with a cell phone that is sufficiently charged at all times, effective September 30, 2019.

Section 57 (245A.52) moves existing physical space requirements from rule to statute and updates the requirements to align with current fire code, effective September 30, 2019.

Section 58 (245A.53) permits use of a substitute caregiver in a family child care program for a maximum of 500 hours annually, and establishes the circumstances and requirements for family child care providers to use emergency replacement substitute caregivers, effective September 30, 2019.

Sections 61-63, 65-73, and 76-81 modify statutory provisions relating to background studies for child care providers, children's residential facilities, and licensed family child foster care.

Section 61 (245C.02, subdivision 5a) adds a definition for “license-exempt child care center certification holder” by incorporating the definition provided in section 245H.01, subdivision 4.

Section 62 (245C.02, subdivision 6a) expands and clarifies which individuals are subject to a background study related to providing child care at a licensed or certified program.

Section 63 (245C.02, subdivision 6b) defines “children’s residential facility” as a facility licensed by the commissioner of correctors or human services under Minnesota Rules, chapter 2960.

Section 65 (245C.03, subdivision 1) makes a conforming change to incorporate the revisions to section 245C.02, subdivision 6a, adds a requirement that any adult working in a children’s residential facility be subject to a background study, and removes the requirements applicable to legal nonlicensed child care and certified license-exempt child care programs.

Section 66 (245C.05, subdivision 4) makes a conforming change to add the results of a national criminal history record check to the data that must be transmitted by a secure electronic system.

Section 67 (245C.05, subdivision 5) adds children’s residential facilities to the group of adult background study subjects who must provide the commissioner with fingerprints for a national criminal history record check. The section also establishes that the FBI shall not retain background study subjects’ fingerprints.

Section 68 (245C.05, subdivision 5a) requires background study subjects that are younger than 17 years old to submit non-fingerprint-based data if the commissioner has reasonable cause to require a national criminal history record check, or the subject is employed by or supervises children served by a legal nonlicensed child care provider or a licensed family child care program.

Section 69 (245C.08, subdivision 1) makes a conforming change to for background studies of children’s residential facilities, and to permit the commissioner to review information obtained using non-fingerprint-based data as part of a background study.

Section 70 (245C.08, subdivision 3) permits the commissioner to review arrest and investigative information from the commissioners of health and human services, permits the commissioner to review a background study subject’s FBI records more than once when specifically required by law, establishes that national criminal history record check information used to make a disqualification determination is private data, and establishes that the entity that submitted the background study is not required to obtain a copy of the subject’s disqualification letter where the disqualification determination was made based on national criminal history record check information.

Section 71 (245C.10, subdivision 14) sets the fee for background studies for children’s residential facilities at no more than $51 per study.

Section 72 (245C.13, subdivision 2) requires that the notice indicating that more time is needed to complete the background study for individual affiliated with a licensed or certified license exempt child care center must also indicate that the individual must be under continuous direct supervision prior to completion of the study. The section also establishes that direct contact with children served by a licensed or certified license exempt child care center is prohibited prior to receipt of the commissioner’s notice regarding background study results.

Section 73 (245C.13, subdivision 3) allows the commissioner to issue a notice of background study results where the only reason preventing issuance of the notice is that the commissioner has not received certain records from other states within ten days of requesting the information.

Section 76 (245C.24, subdivision 1) makes a technical conforming change.

Section 77 (245C.24, subdivision 2) permits the commissioner to consider a set aside for an individual who was disqualified from providing nonemergency medical transportation services for a crime or conduct from which 40 years have passed since discharge of the imposed sentence.

Section 78 (245C.24, subdivision 5) prohibits granting a set aside for a individual affiliated with a children’s residential facility who was convicted of a felony for physical assault or battery, or a drug-related offense, within the past 5 years.

Sections 79-81 (245C.30, subdivisions 1-3) permit the commissioner to grant a variance for license-exempt child care centers under certain circumstances and provided that certain requirements are met.

Section 83 (245G.11, subdivision 7) modifies the supervision requirement for county care coordinators to require one hour of supervision monthly by an alcohol or drug counselor, or a mental health professional who has substance use treatment and assessments within the scope of their practice.

Section 84 (245G.19, subdivision 4) adds the statutory physical space requirements to the licensing requirements for chemical dependency treatment facilities, effective September 30, 2019.

Sections 85-103 modify statutory provisions relating to certification of license-exempt child care centers, effective September 30, 2019.

Section 85 (245H.01, subdivision 7) defines a “substitute” as an adult temporarily serving as a staff person due to the absence of a regularly employed staff person, for fewer than 240 total hours per calendar year.

Section 86 (245H.01, subdivision 8) defines a “staff person” as a employee of a certified license-exempt center providing direct contact services to children.

Section 87 (245H.01, subdivision 9) defines an “unsupervised volunteer” as an individual who is not employed by the center who assists in providing child care and is not under continuous direct supervision by staff.

Section 88 (245H.03, subdivision 4) permits applicants to request reconsideration of a certification denial within 20 days of receiving the certification denial.

Section 89 (245H.07) adds revocation of CCAP authorization to the bases for which the commissioner may decertify a certified license-exempt child care center, provides procedures by which a provider may request reconsideration of the decertification, and provides that the decertification reconsideration shall be stayed until resolution of a maltreatment determination or CCAP revocation appeal.

Section 90 (245H.10, subdivision 1) replaces existing background study requirements with cross-references to child care background study requirements as established in chapter 245C.

Section 91 (245H.11) requires written policies for staff compliance with reporting abuse and neglect.

Section 92 (245H.13, subdivision 5) requires compliance with the state fire code for certification, which can be completed either by providing documentation of a fire marshal inspection within the previous three years, or by complying with the fire marshal inspection requirements in section 245A.151.

Section 93 (245H.13, subdivision 7) requires development of a risk reduction plan that identifies, assesses, and provides policies and procedures to minimize risks to children.

Section 94 (245H.13, subdivision 8) requires written health and safety policies that cover the statutory topics.

Section 95 (245H.13, subdivision 9) requires that staff use positive behavior guidance and do not commit certain prohibited acts.

Section 96 (245H.13, subdivision 10) requires continuous supervision of children, based on upon each child’s age, abilities, and physical environment.

Section 97 (245H.14, subdivision 1) requires first aid and CPR training for the director and staff prior to unsupervised contact with a child, within 90 days of employment, and within 90 days of the first contact with a child for substitutes and unsupervised volunteers, unless the training has been completed in the previous two years. Staff are required to complete the training at least every other calendar year thereafter.

Section 98 (245H.14, subdivision 2) clarifies that training on the risk of sudden unexpected infant death is required for the director, staff, substitutes, and all volunteers that care for an infant younger than one year of age.

Section 99 (245H.14, subdivision 3) clarifies that training on abusive head trauma is required for the director, staff, substitutes, and all volunteers before caring for a child younger than school age.

Section 100 (245H.14, subdivision 4) requires a director and all staff persons to complete at least two hours of child development and learning training within 90 days of employment and every other year thereafter. Substitutes and unsupervised volunteers must complete child development and learning training of no specified minimum length within 90 days of the first direct contact with a child and every other year thereafter.

Section 101 (245H.14, subdivision 5) requires programs to provide an orientation on the statutory health and safety topics within 14 days of the first date of contact with a child.

Section 102 (245H.14, subdivision 6) requires the program to ensure that the director and all staff receive training at least annually on the statutory health and safety topics, which may contribute toward the six-hour total annual training requirement.

Section 103 (245H.15, subdivision 1) adds accommodations for infants and toddlers to the list of topics to include in a program’s written emergency plan.

Section 104 (254B.05, subdivision 1) makes a technical conforming change to a cross-reference to accommodate modifications to county mental health worker qualifications.

Section 105 (254B.05, subdivision 1b) adds a cross-reference to the statutory section setting a cap on county liability.

Section 106 (256.046, subdivision 1) makes a conforming change limiting the applicability of the subdivision to individuals accused of wrongfully obtaining assistance or committing intentional program violations.

Section 110 (256.983, subdivision 5) permits county human services agencies to conduct investigations of intentional program violations or financial misconduct by child care providers, after the county agency has verified that the provider is not currently being investigated by the Department of Human Services. A county agency may immediately suspend a provider’s CCAP authorization if the investigation uncovers a preponderance of evidence of financial misconduct. Affected providers are granted the right to administrative review.

Section 111 (256B.02, subdivision 7) modifies the definition of “vendor of medical care” to include all licensed service providers, thereby clarifying the commissioner’s authority to exclude and sanction these providers for violations of medical assistance requirements.

Sections 112-126 modify Medical Assistance program integrity provisions, including billing and documentation requirements for home and community-based services.

Section 112 (256B.04, subdivision 21) provides an exception to provider enrollment requirements under medical assistance for pediatric therapy providers if the only reason the provider would be denied enrollment is that the provider has not billed the Medicare program.

Section 113 (256B.064, subdivision 1b) specifies the length of exclusion for medical assistance for a provider sanctioned by a court for a violation of medical assistance requirements at a minimum of 5 years.

Section 114 (256B.064, subdivision 2) establishes that funds that are the subject of medical assistance fraud shall be forfeited to the commissioner of human services, either as a result of a criminal conviction or a repeat violation.

Section 115 (256B.064, subdivision 3) requires the commissioner of human services to maintain and post a list of each excluded individual and entity that was convicted of a crime related to medical assistance fraud, and prohibits medical assistance payments for items or services provided directly or indirectly by an excluded individual or entity. Vendors are required to check the exclusion list, must immediately terminate any payments to excluded individuals or entities, and must refund any payment issued for items or services provided by an excluded individual or entity. In addition, vendors issuing payment to excluded individuals or entities may be subject to administrative sanctions or a civil penalty of up to $25,000.

Section 116 (256B.064, subdivision 4) requires notice to the affected vendor to be sent by certified mail, and requires that notice to a recipient placed on the restricted recipient program to be sent by first class mail. Recipients may contest placement on the restricted recipient program by submitting a written request for a hearing to the department within 90 days.

Section 117 (256B.064, subdivision 5) provides civil and criminal immunity for individuals making good faith reports of fraud or abuse in public assistance programs, as well as investigators, and requires the reporter’s identity to be kept confidential, unless a court finds that evidence that the report was false and made in bad faith, or the identity of the reporter is relevant to a criminal prosecution.

Section 118 (256B.0646) permits the commissioner to place a recipient of PCA or CFSS services in the Minnesota restricted recipient program upon evidence of abusive or fraudulent billing. Placement in the program is subject to appeal.

Section 119 (256B.0651, subdivision 17) clarifies the authority of the commissioner to notify recipients of services that their provider will be terminated as a medical assistance provider.

Section 120 (256B.0659, subdivision 12) modifies the service delivery documentation requirements of PCAs.

Section 121 (256B.27, subdivision 3) permits the commissioner of human services to demand immediate access to medical records from a vendor suspected of a Medicaid overpayment, without prior notice and during regular business hours, provided that the commissioner has documented the need for immediate access to the records. Denying access to records is cause for immediate suspension of payment or termination of the vendor’s eligibility.

Sections 122-126 (256B.4912, subdivisions 11-15) expand the service delivery documentation requirements for home and community-based services offered through the disability waivers.

Section 127 (Results First Evaluation of Grant Programs; Proven-Effective Practices) requires the commissioner of management and budget, in consultation with the commissioner of human services, to establish a schedule to review each grant program administered by the commissioner of human services to determine if the grant uses or promotes proven-effective or promising practices and can be evaluated using experimental or quasi-experimental design.

Section 128 (Direction to Commissioner; Correction Order Enforcement Review) directs the commissioner of human services to develop and implement a process to review licensing inspection results at the county level, to identify trends of over- or under-enforcement and issue additional guidance and training as needed to correct any imbalance or inaccuracy in correction order enforcement. The commissioner shall include the results of this work in the annual report on child care.

Section 129 (Direction to Commissioner; Responsibility for Fraud Investigations in Public Programs) directs the commissioner of human services to consult with counties and report to the legislature by January 15, 2020, with recommendations for legislation to identify and clarify the responsibilities of the department and of county agencies for fraud investigations in public programs.

Section 130 (Direction to Commissioner; Self-Employment Income in Public Assistance Programs) directs the commissioner of human services to consult with counties and other relevant stakeholders and report to the legislature with a proposal for how to count self-employment income for purposes of eligibility determinations and program integrity in public assistance programs.

Section 131 (Direction to Commissioner; Substance Use Disorder County Staff Qualifications) directs the commissioner of human services to consult with county agencies to develop qualifications and resources for county employees that are not alcohol and drug counselors to perform comprehensive assessments and treatment coordination. The commissioner must provide the legislature with an update on this project by December 1, 2019.

Section 132 (Family Child Care Task Force) establishes a 25-member task force intended to increase the number of family child care providers and improve the quality of family child care services throughout the state, to be comprised of legislators, child care providers, family child care associations, child care licensors, and business associations. The task force will begin meeting by August 15, 2019, and must identify licensing requirements that have led to the closure of family child care programs, propose regulatory reforms to improve licensing efficiency, review county variance authority, recommend business development and technical assistance resources to promote provider recruitment and retainment, identify alternative child care provider delivery systems, identify and recommend family child care regulatory reforms that improve licensing efficiencies, review Parent Aware participation to identify obstacles and suggest improvements, review family child care provider training, and consider improved access and understanding of family child care regulations. The task force’s interim report is due by March 1, 2020, and the final report is due February 1, 2021.

Section 133 (Instruction to Commissioner; Child Care Licensing and Background Study Review) instructs the commissioner of human services to review the rules and statutes relating to child care provider licensing and background study requirements and propose legislation to eliminate unnecessary and duplicative record keeping or documentation requirements. The commissioner is also directed to create a process for child care providers to electronically submit information requested by the department of human services for these purposes.

Section 134 (Repealer) repeals rules relating to child care fire safety requirements and rules relating to child care telephone requirements that have been moved to statute, a statutory subdivision relating to child care provider overpayment claims for failure to comply with access to attendance records, and the statutory subdivision relating to license-exempt child care center direct contact, all effective September 30, 2019, as well as the rule relating to foster care capacity limits, effective October 1, 2019.

Article 3: Direct Care and Treatment

Section 1 (246.54, subdivision 3) establishes an administrative review process for a county to dispute the cost of care for clients in state-operated facilities, when the client’s discharge is delayed due to lack of notice that the client no longer qualifies for the facility’s services, due to the facility’s disagreement with the county’s recommended discharge plan, or due to incomplete paperwork. The section also precludes the commissioner of human services from recovering from the client any remaining cost following the administrative review.

Section 2 (246B.10) sets the county share for the cost of care for a civilly committed sex offender at 10% per day for individuals admitted to the Minnesota Sex Offender Program prior to August 1, 2011, and 25% per day for individuals admitted or receiving services while on provisional discharge on or after August 1, 2011. The section also makes technical conforming changes to the conditions requiring the county to pay the remaining amount for the cost of care, to accommodate the county share percentages.

Section 3 (Direction to the Commissioner; delayed discharge reduction) directs the commissioner of human services to report to the legislature by January 1, 2023, regarding efforts to reduce the number of days that clients spend in state-operated facilities after discharge is determined to be appropriate. The report must also include the fiscal impact of these discharge delays.

Section 4 (Repealer) repeals statutory sections relating to the State-Operated Services Account and 2010 session laws relating to outdated state-operated services appropriations.

Article 4: Continuing Care for Older Adults

Section 1 (144A.071, subdivision 1a) modifies definitions for the purposes of the nursing home bed moratorium.

Paragraph (b) strikes a cross-reference to a repealed definition of “building” in rules and inserts a cross-reference to an updated definition of “building” in 256R.261.

Paragraph (c) strikes a cross-reference to an existing definition of “capital asset” in statute and inserts a cross-reference to an updated definition of “capital asset” in 256R.02.

Paragraph (h) strikes a definition of “depreciation guidelines” and inserts a cross-reference to a new definition on 256R.261.

Paragraphs (j) and (k) strike obsolete definitions of “project construction costs” and “technology.”

Section 2 (144A.071, subdivision 2) strikes obsolete language and clarifies that nursing homes must submit estimated and total construction project costs to the commissioner of human services.

Section 3 (144A.071, subdivision 3) specifies that a nursing facility completing a moratorium exception projects in designated hardship areas of the state that result in 50 percent or more of the beds in the facility being newly licensed shall be reimbursed according to the newly enacted property payment rate under 256R.26.

Section 4 (144A.071, subdivision 4a) strikes cross-references to obsolete interim and settle-up payment provisions in Rules for certain statutorily permitted exceptions to the nursing home moratorium for replacement beds and inserts cross-references to updated interim and settle-up payment provisions in 256R.27.

Section 5 (144.071, subdivision 4c) strikes cross-references to obsolete interim and settle-up payment provisions in Rules for certain statutorily permitted exceptions to the nursing home moratorium for replacement beds and inserts cross-references to updated interim and settle-up payment provisions in 256R.27.

Section 6 (144A.071, subdivision 4d, paragraph (g)) modifies a nursing facility’s payment rate following a consolidation project approved on or after March 1, 2020 by eliminating the facility’s eligibility for a consolidated rate adjustment to its external fixed costs payment rate; also statutorily redirects 35% of the savings derived from a consolidation project to moratorium exception funding.

Paragraph (h) subjects all consolidation projects not approved prior to March 1, 2020 (or under certain circumstances, prior to August 1, 2020) to the moratorium exception review process under 144A.073.

Section 7 (144A.071, subdivision 5a) requires the commissioner of human services to estimate the property payment rate that would result for any proposed moratorium exception project approved on or after March 1, 2020; also limits the actual building valuation to the lesser of 105% of the estimate or the limited depreciated replacement costs as determined under 256R.26, subdivision 3.

Old paragraph (b) strikes language regarding a facility’s option to select an interest rate for the purposes of estimating the costs of a moratorium exception project.

Section 8 (144A.073, subdivision 3c, paragraph (a)) modifies the circumstances under which the commissioner of health may approve bed relocation projects under this subdivision by removing the requirement that projects approved under this subdivision be cost neutral and instead requiring that the cost not exceed the threshold project cost limits under 256R.267; also eliminates the cost-neutral bed relocation rate adjustment under 256R.50 for a facility receiving relocated beds.

Paragraph (b) requires bed relocation threshold projects that exceed the moratorium limit to apply for a moratorium exception through the moratorium review process.

Section 9 (144A.073, subdivision 16) authorizes the commissioner of health to approve nursing home construction projects such as renovations of, or additions to existing facilities provided the annualize increased costs to medical assistance does not exceed $1.250 million dollars. (See also, Section 6 (144A.071, subdivision 4d, paragraph (g))).

Section 10 (256B.434, subdivision 1) deletes obsolete language and clarifies that all nursing facilities enrolled as medical assistance providers must have a contract with the commissioner of human services. (See also, section 29 (Revisor instruction) requiring revisor to recodify this subdivision as part of 256R).

Section 11 (256B.434, subdivision 3) deletes obsolete language concerning nursing facility contracts with the commissioner of human services. (See also, section 29 (Revisor instruction) requiring revisor to recodify this subdivision as part of 256R).

Section 12 (256R.02, subdivision 8) modifies the definition of “capital assets” for the purposes of nursing facility payment rates.

Section 13 (256R.02, subdivision 19) modifies the definition of “external fixed costs” for the purposes of nursing facility payment rates.

Section 14 (256R.02, subdivision 25a) creates a new definition of “interim payment rates” for the purposes of nursing facility payment rates.

Section 15 (256R.02, subdivision 33) modifies the definition of “nursing facility.”

Section 16 (256R.02, subdivision 47a) creates a new definition of “settle-up payment rates” for the purposes of nursing facility payment rates.

Section 17 (256R.21, subdivision 5) specifies that the total payment rate for nursing facility newly constructed under the nursing home moratorium exception process shall be the interim and settle-up payment rates determined under 256R.27.

Section 18 (256R.25) modifies the calculation of the portions of the external fixed costs payment rates related to real estate taxes and PERA; also makes conforming changes related to the rate add-on for border city facilities under 256R.481.

Section 19 (256R.26) establishes a new total property payment rate based on fair rental value property rate and an equipment allowance rate for a facility that has a proposal approved on or after March 1, 2020 for: (1) a moratorium exception project in designated hardship areas of the state that results in 50 percent or more of the beds in the facility being newly licensed; (2) a consolidation project, (3) a moratorium exception project, or (4) a facility new to medical assistance.

Section 20 (256R.261) establishes new definitions for the new property payment rates.

Section 21 (256R.265) specifies how the commissioner shall determine the values used to determine the total property payment rate under 256R.26.

Section 22 (256R.267) specifies a total property payment rate adjustment for a facility that completes threshold projects during the time between the facility’s triennial physical appraisals.

Section 23 (256R.27) specifies an interim and settle-up total payment rate for newly constructed facilities or for facilities with an increased licensed capacity of 50% or more.

Section 24 (256R.44) clarifies that the rate adjustment for private rooms for medical necessity will continue for facilities that have property rates determined under the newly enacted total property payment rates.

Section 25 (256R.481) establishes an external fixed costs payment rate add-on effective for rate years beginning on or after January 1, 2021, for nonprofit nursing facilities located in the border cities of Breckenridge and Moorhead. The rate add-on is equal to the difference between the median rate paid in the adjacent North Dakota city for the lowest acuity level residents and the rate paid to the Minnesota facility for residents of the same acuity.

Section 26 (256R.50, subdivision 6) specifies that rate adjustments for relocated days expire three full years after the effective date of the rate adjustment.

Section 27 (Clean energy projects) directs the commissioner of human services to develop a two-year pilot project to reduce overall energy consumption in nursing facilities by making time-limited payments not to exceed the debt service for energy improvement projects to nursing facilities with PACE program approved applications and higher than average utility costs.

Section 28 (Elderly waiver customized living service providers) directs the commissioner to develop an incentive-based grant program from elderly waiver customized living service providers with an elderly waiver census of 75% or greater.

Section 29 (Revisor instruction) directs the revisor of statutes to recodify two subdivisions concerning nursing facilities contracting with the commissioner of human services from 256B to 256R.

Section 30 (Repealer) 

Paragraph (a) repeals the nursing facility full rental reimbursement alternative rates from 1990; the nursing facility capital repair and replacement cost reporting and rate calculation provisions; and the nursing facility equity incentive payment provisions.

Paragraph (b) repeals obsolete interim contract rate provisions; and repeals provisions exempting certain nursing facility construction projects from the moratorium process.

Paragraph (c) repeals the existing language related to a rate exception for non-profit nursing facilities in Breckenridge. Any facility covered by the repealed language is also covered by the new language in 256R.481.

Paragraph (d) repeals interim and settle-up payment rates from Rules. These rules are replaced by statutory language in 256R.27.

Article 5: Disability Services

Section 1 (237.50, subdivision 4a) updates the definition of “deaf” for the purposes of the Telephone Equipment Distribution Program.

Section 2 (237.50, subdivision 4c) defines “discounted telecommunications services or Internet services” for the purposes of the Telephone Equipment Distribution Program.

Section 3 (237.50, subdivision 6a) modifies the definition of “hard-of-hearing” for the purposes of the Telephone Equipment Distribution Program.

Section 4 (237.50, subdivision 6b) defines “interconnectivity product” for the purposes of the Telephone Equipment Distribution Program.

Section 5 (237.50, subdivision 10a) updates the definition of “telecommunications device” for the purposes of the Telephone Equipment Distribution Program.

Section 6 (237.50, subdivision 11) updates the definition of “telecommunications relay services” for the purposes of the.

Section 7 (237.51, subdivision 1) expands the devices distributed through the Telephone Equipment Distribution Program to include interconnectivity products.

Section 8 (237.51, subdivision 5a) makes conforming changes and requires the commissioner under the Telephone Equipment Distribution Program to assist a person with completing an application for discounted telecommunications services.

Section 9 (237.52, subdivision 5) makes conforming changes to the permitted uses of the Telecommunications Access Minnesota special revenue fund.

Section 10 (237.53) makes conforming changes related to expanding the types of devices distributed by the Telephone Equipment Distribution Program; requires the commissioner of human services to assess the person’s telecommunications needs and provide information about assistive communications devices and products and where a person might obtain or purchase such devices; lists assistive communications devices and products; and requires the commissioner of human services to assist a person applying for discounted telecommunications services.

Section 11 (245D.03, subdivision 1) clarifies which services are governed by Minnesota Statutes, chapter 245D (Home and Community-Based Services Licensing Standards), by specifying which the services are provided by each waiver, and changes the name of behavioral support services to positive support services; upon federal approval expands the lists of basic support services and intensive support services licensed under 245D.

Section 12 (245D.071, subdivision 1) makes conforming changes to a cross-reference.

Section 13 (245D.071, subdivision 5) amends the home and community-based services standards related to service planning for intensive support services.

Paragraph (a) is editorial.

Paragraph (b) requires a licensed provider of intensive home and community-based services, when conducting a service plan review, to include and document a discussion of how a person receiving intensive services might use technology to help the person meet the person’s goals.

Section 14 (245D.09, subdivision 5) removes the minimum required hours of annual training for direct care staff providing licensed home and community-based services and removes the option for relevant training received from a source other than the license holder to count toward the annual training requires.  The requirement for annual training remains.

Section 15 (245D.09, subdivision 5a) removes the discretion of the commissioner to approve online training and competency-based assessments as an alternative to orientation training provided by individual license holders.

Section 16 (245D.091, subdivision 2, clause (12), item (vi)) allows an individual with master’s degree or higher and a demonstrated expertise in positive supports to qualify as a positive supports professional.

Section 17 (245D.091, subdivision 3) Paragraph (a), clause (3) permits a board-certified behavior analyst or assistant behavior analyst to qualify as a positive support analyst.

Paragraph (b), Clause (1) modifies additional qualifications for a positive support analyst be requiring four years of supervised experience that includes specific tasks.

Clause (2) allows a person who meets the other positive support analyst qualifications to qualify as a positive support analyst if the person receives the required training within 90 days following hire and adds additional training requirements.  Under current law, such a person does not qualify as a behavior analyst until after the training is completed.

Paragraph (c) allows a person who qualifies as a positive support professional to qualify as a positive support analyst without meeting the training requirements of paragraph (b).

Section 18 (245D.091, subdivision 4) Paragraph (b) allows a person who meets the other positive support specialist qualifications to qualify as a behavior specialist if the person receives the required training within 90 days following hire.  Under current law, such a person does not qualify as a behavior specialist until after the training is completed.  The bill does change the existing training requirements.

Paragraph (c) allows a person who qualifies as a positive support professional to qualify.

Section 19 (245D.12) Paragraph (a) upon federal approval requires integrated community support license holders to submit a setting capacity report to the commissioner to ensure the service delivery location meets home and community-based services setting requirements.

Paragraph (b) lists the information the report must include.

Paragraph (c) allows only one license holder to deliver integrated community supports at a multifamily housing building.

Section 20 (252.27, subdivision 2a, paragraph (b)) reduces the parental contribution required under the MA TEFRA option by 15 percent.

Section 21 (252.27, subdivision 3) reduces the county share for semi-independent living services (SILS) grants from 30 percent to 15 percent.

Section 22 (252.275, subdivision 1a) expands eligibility for family support grants to families with a dependent with a disability under the age of 21 to under the age of 25; and specifies that family support grants are intended to support transition-related activities.

Section 23 (252.41, subdivision 3) upon federal approval, defines “day services for adults with disabilities” by expanding the existing definition of day training and habilitation to also include day support services, prevocational services, structured day services and adult day services as those services are defined in the disability waiver plans; removes the requirement that a person with a disability receiving day services under these sections must have a developmental disability; makes other conforming changes.

Section 24 (252.41, subdivision 4) updates the definition of “independence” for the purposes of day services.

Section 25 (252.41, subdivision 5) updates the definition of “integration” for the purposes of day services.

Section 26 (252.41, subdivision 6) updates the definition of “productivity” for the purposes of day services.

Section 27 (252.41, subdivision 7) updates the definition of “regional center” for the purposes of day services.

Section 28 (252.41, subdivision 9) updates the definition of “vendor” for the purposes of day services.

Section 29 (252.42) makes conforming changes to the service principles for day services for adults with disabilities consistent with removing the requirement that the adult receiving services under these sections have a developmental disability.

Section 30 (252.43) makes conforming and technical changes for the purposes of day services.

Section 31 (252.44) makes conforming and technical changes for the purposes of day services; removes obsolete language.

Section 32 (252.45) makes conforming and technical changes for the purposes of day services.

Section 33 (256.9365) conforms the program that provides health care coverage for individuals living with HIV to include the cost of health plan premiums as well as cost sharing for prescriptions including co-payments, deductibles, and co-insurance, with the exception of those portions of a premium paid for by the individual’s employer, and makes other conforming eligibility requirements for the program.

Section 34 (256B.0658) modifies the population eligible for MA housing access grant funding by removing language referencing individuals eligible for MA home and community-based services and making individuals who are aged, blind, or who have a disability eligible.

Section 35 (256B.0659, subdivision 3a) clarifies that lead agencies may continue to use legacy assessment tools for PCA assessments.

Section 36 (256B.0659, subdivision 11, paragraph (d)) specifies the requirements a personal care attendant must meet in order for the services the personal care attendant provides to qualify for an enhanced rate.

Section 37 (256B.0659, subdivision 13) requires qualified professionals to enroll as individuals with DHS.

Section 38 (256B.0659, subdivision 17a) establishes an enhanced rate of 107.5 percent of the non-enhanced rate for PCA services rendered to a client requiring 12 or more hours of services.

Section 39 (256B.0659, subdivision 19) requires PCA choice agencies to report labor market data.

Section 40 (256B.0659, subdivision 21, paragraph (a), clause (10)) requires provider agencies to document whether a personal care attendant has received the training that would qualify the services the personal care attendant provides for an enhanced rate.

Section 41 (256B.0659, subdivision 24) Clause (15) inserts a cross-reference notifying PCA agencies of their obligation to report labor market data.

Clause (16) requires a provider agency to document that it passed through the entire value of the enhanced rate in the form of wages and benefits to the personal care attendants who provide the services that qualify for the enhanced rate.

Section 42 (256B.0659, subdivision 28) requires provider agencies to document whether a personal care attendant has received the training that would qualify the services the personal care attendant provides for an enhanced rate.

Section 43 (256B.0911, subdivision 1a, paragraphs (a) and (b)) clarifies language related to assessments for developmental disabilities waiver services; removes from the MnCHOICES assessment process service eligibility determinations for home care nursing, for home care targeted case management; for adult targeted case management, and for Rule 185 case management services; also removes long-term care consultation services (otherwise known as a MnCHOICES assessment) as the required process for determining whether the family of a minor with a disability is eligible for a support grant.

Section 44 (256B.0911, subdivision 3a) Paragraph (a) makes conforming changes by striking from the MnCHOICES statute references to home care nursing.

Paragraph (c) requires the MnCHOICES assessment process to be conversational in nature.

Paragraph (d) removes a requirement that a legal representative of a person receiving a MnCHOICES assessment be physically present during an assessor’s face-to-face assessment of the person seeking long-term care, and permits the legal representative to participate in the assessment remotely instead. Also requires a provider to submit information to be considered at an assessment at least 60 days prior to an assessment.

Paragraph (e) removes the existing requirement that a MnCHOICES assessor complete a community support plan within 40 calendar days of the assessment. DHS will determine a new deadline for completing the community support plan, but the total time for the assessor to complete the community support plan and the case manager to complete the coordinated service and support plan must not exceed 60 days.

Paragraph (j), clause (9) requires a certified assessor to point out in the assessment documents the location of the statement concerning the person’s right to appeal the results of an assessment.

Paragraph (k) allows the results of a MnCHOICES assessment to establish service eligibility for developmental disability waiver services for up to 60 days from the time of the assessment. Paragraph (k) also interacts with existing paragraph (m) to permit a service eligibility update for developmental disability waiver services to extend the validity of a MnCHOICES assessment for an additional 30 days. These changes align the service eligibility timelines for developmental disability waiver services with the timelines for the other home and community-based waiver and alternative care services.

Section 45 (256B.0911, subdivision 3f, paragraph (a)) requires a certified assessor to review a person’s most recent assessment prior to a reassessment, and requires DHS to establish timelines for a MnCHOICES assessor, following an annual MnCHOICES reassessment, to complete an updated coordinated support plan and a case manager to complete an updated coordinated service and support plan.

Section 46 (256B.0911, subdivision 3g) permits a person receiving only Rule 185 case management services to decline annual MnCHOICES assessments.

Section 47 (256B.0911, subdivision 5, paragraph (c)) requires the Commissioner of Human Services, in cooperation with lead agencies, to develop and collect data on a set of measures of increasing efficiency in the MnCHOICES assessment process, and to report an analysis of that data to lead agencies and to the Legislature.  Paragraphs (a) and (b) contain existing requirements that the commissioner make the assessment process more efficient.  This paragraph requires the commissioner to demonstrate that the process is becoming more efficient.

Section 48 (256B.0915, subdivision 3a, paragraph (f)) upon federal approval, requires the commissioner to approve annually limited exceptions to the elderly waiver monthly case mix budget cap to accommodate an enhanced rate for PCA services.

Section 49 (256B.0915, subdivision 6, paragraph (a), clause (1)) removes the current ten-day deadline for case managers to complete coordinated service and support plans for people receiving any home and community-based waiver services or alternative care.  DHS will determine a new deadline for completing coordinated service and support plans, but the total time for a MnCHOICES assessor to complete the community support plan and the case manager to complete the coordinated service and support plan must not exceed 60 days.

Section 50 (256B.092, subdivision 1b, paragraph (a), clause (1)) removes the current ten-day deadline for case managers to complete coordinated service and support plans for people receiving any home and community-based waiver services or alternative care.  DHS will determine a new deadline for completing coordinated service and support plans, but the total time for a MnCHOICES assessor to complete the community support plan and the case manager to complete the coordinated service and support plan must not exceed 60 days.

Section 51 (256B.0921) modifies the name of the grant program.

Section 52 (256B.49, subdivision 13, paragraph (a), clause (1)) removes the current ten-day deadline for case managers to complete coordinated service and support plans for people receiving any home and community-based waiver services or alternative care.  DHS will determine a new deadline for completing coordinated service and support plans, but the total time for a MnCHOICES assessor to complete the community support plan and the case manager to complete the coordinated service and support plan must not exceed 60 days.

Section 53 (256B.49, subdivision 14) requires a provider to submit within 60 days prior to an assessment any information to be considered at an assessment.

Section 54 (256B.4912, subdivision 1a) establishes new labor market data reporting requirements for HCBS providers.

Section 55 (256B.4913, subdivision 4a) removes obsolete language; strikes the seventh year of banding, which the federal Centers for Medicare and Medicaid Services (CMS) did not approve.

Section 56 (256B.4914, subdivision 2) defines “comparable occupations” and “Direct care staff” for the purposes of DWRS, defines “unit of service” for the purposes of day support services; and modifies the definition of "unit of service" for the purposes of prevocational services, reducing a unit from one hour to 15 minutes.

Section 57 (256B.4914, subdivision 3) upon federal approval, makes conforming and editorial changes to the list of services reimbursed under DWRS.

Section 58 (256B.4914, subdivision 4) removes obsolete language and makes technical and conforming changes.

Section 59 (256B.4914, subdivision 5) Paragraph (a) upon federal approval, establishes new DWRS base wages for adult day services, day support services, prevocational services, individualized home supports with family training, and individualized home support staff; removes base wages for independent living skills specialist staff and supported employment staff; makes other conforming and technical changes.

Paragraphs (b) to (h) upon federal approval, establishes a competitive workforce factor of 4.7 percent for each service category and integrates new services into the appropriate service categories.

Paragraph (e) establishes new component values for adult day services.

Paragraph (i) removes obsolete language and decreases the frequency of future wage index rebasing from every 5 years to every two years; also requires use of 30-month-old data rather than the most recently available data when performing the rebasing.

Paragraph (j) requires the commissioner to report every two years to the legislature with an analysis of and recommendations concerning the competitive workforce factor beginning February 1, 2021; specifies the information that must be included in the report.

Paragraph (k) removes obsolete language; makes conforming changes to cross-references; and decreases the frequency of future inflation adjustments of certain component values from every 5 years to every two years; also requires use of 30-month-old data rather than the most recently available data when performing the inflation adjustment.

Paragraph (l) removes all after framework adjustments from DWRS rates effective July 1, 2018.

Paragraph (m) preemptively removes any rate adjustments not specified in 256B.4914 from DWRS rates each time a wage index rebasing and inflation adjustment occurs.

Section 60 (256B.4914, subdivision 6) Paragraph (a) upon federal approval, specifies the specific services categorized as residential support services.

Paragraph (b) integrates the competitive workforce factor into the DWRS rate calculation for certain residential support services and makes conforming and technical changes.

Paragraphs (e) and (f) creates a new DWRS rate calculation for integrated community support services.

Paragraph (g) specifies that the existing customized living tool must be used to set customized living rates; and requires the commissioner to modify the customized living tool to reflect the services and activities unique to recipients with disabilities and to include an adjustment for regional differences in the cost of providing services.

Old paragraph (d) deletes obsolete language.

Section 61 (256B.4914, subdivision 7) updates the services available as day services; integrates the competitive wage factor into the DWRS rate calculation for day services; and makes other technical and conforming changes.

Section 62 (256B.4914, subdivision 8) updates the services available as unit-based services with programming; integrates the competitive wage factor into the DWRS rate calculation for unit-based services with programming; and makes other technical and conforming changes.

Section 63 (256B.4914, subdivision 9) updates the services available as unit-based services without programming; integrates the competitive wage factor into the DWRS rate calculation for unit-based services without programming; creates new calculations for shared individualized home supports and shared respite care services; and makes other technical and conforming changes.

Section 64 (256B.4914, subdivision 10) makes conforming changes; strikes obsolete language; modifies the frequency of required analysis of the regional adjustment factor; delays by one year the next full report on the data analysis DHS is performing related to the DWRS; and adds a new requirement that DHS and stakeholders study value-based payment methodologies for waiver services.

Section 65 (256B.4914, subdivision 10a) deletes obsolete language, and makes technical and conforming changes.

Paragraph (f) requires providers to report the additional revenue attributable to the competitive workforce factor and prepare a written plan for distributing that revenue to direct care workers.

Paragraph (g) requires providers to submit labor market data to the commissioner.

Paragraph (h) requires the commissioner to publish an annual report based on the labor market data submitted by providers.

Paragraph (i) permits the commissioner to withhold payments until providers comply with the data reporting requirements.

Paragraph (j) allows an exemption from the labor market reporting requirements for providers who receive payments under DWRS for less than a quarter of their clients.

Section 66 (256B.4914, subdivision 14) removes obsolete language.

Section 67 (256B.4914, subdivision 15) removes obsolete language.

Section 68 (256B.4914, subdivision 17) is language moved from 256B.4913, subdivision 5.

Section 69 (256B.5014) inserts a cross-reference notifying ICFs of their obligations to submit labor market data.

Section 70 (256B.85, subdivision 8, paragraph (c)) establishes CFSS eligibility for pregnant women.

Section 71 (256B.85, subdivision 7a) establishes an enhanced rate of 107.5 percent of the non-enhanced rate for CFSS rendered to a client requiring 12 or more hours of services.

Section 72 (256B.85, subdivision 10) Paragraph (b), clause (7) requires CFSS agency-providers and FMS providers to submit labor market data.

Clause (9) requires CFSS agency-providers and FMS providers to document whether a support worker has received the training that would qualify the services the worker provides for an enhanced rate.

Section 73 (256B.85, subdivision 11) requires a CFSS agency-provider to use all the additional revenue generated by a medical assistance rate increase resulting from a labor agreement for the wages and benefits of support workers.

Section 74 (256B.85, subdivision 12) requires a CFSS agency-provider to provide to the commissioner at enrollment documentation that it is using all the additional revenue generated by a medical assistance rate increase resulting from a labor agreement for the wages and benefits of support workers.

Section 75 (256B.85, subdivision 16) specifies the training requirements a support worker must meet for CFSS to qualify for an enhanced rate.

Section 76 (256I.03, subdivision 8) amends the definition of “supplementary services” by adding a cross-reference to the requirements under Minnesota Statutes, section 256I.04, subdivision 2h.

Section 77 (256I.04, subdivision 2b) requires that providers of housing supports confirm in their housing support agreement that the provider will not limit or restrict the number of hours an applicant or recipient chooses to be employed, as specified in subdivision 5.

Section 78 (256I.04, subdivision 2h) is a new subdivision that requires providers of supplementary services to ensure that recipients have, at a minimum, assistance with services identified in the individual’s professional statement of need.  This section also requires all providers to maintain case notes with the date and description of services provided to individual recipients.

Section 79 (256I.04, subdivision 5) is a new subdivision that prohibits a provider from limiting or restricting the number of hours an applicant or recipient is employed.

Section 80 (Expansion of CDCS budget methodology exception) corrects a cross-reference.

Section 81 (Consumer-directed community supports budget methodology) allows people who have elected the consumer-directed community supports option to elect to establish a shared services arrangement with other people who have elected the consumer-directed community supports option. This subdivision specifies requirements for shared service arrangements and grants the commissioner authority to set rates for shared services.

Section 82 (Electronic visit verification) establishes electronic visit verification for PCA services and home health care services as required by federal law; specifies that the commissioner cannot enforce electronic visit verification requirements until six months after the commissioner makes available to service providers the state-selected electronic visit verification system, the data aggregator, and training on the system; prohibits reduction of reimbursement rates as a result of federal enforcement of electronic visit verification implementation requirements.

Section 83 (Individual providers of direct support services) ratifies the labor agreement between the state of Minnesota and the Service Employees International Union Healthcare Minnesota on behalf of individual providers of direct care services.

Section 84 (Rate increase for direct support services providers workforce negotiations) requires the commissioner of human services to increase reimbursement rates, individual budgets, grants, or allocations by 2.37 percent for services provided on or after July 1, 2019, to implement the minimum hourly wage, holiday, enhanced rate, and paid time off provisions of the labor agreement between the state of Minnesota and SEIU Healthcare Minnesota.

Section 85 (Direction to the commissioner; interagency agreements) requires the commissioner of commerce, the Public Utilities Commission, and the commissioner of human services to amend all interagency agreements necessary to implement the changes to the Telephone Equipment Distribution Program.

Section 86 (Disability waiver reconfigurations) requires the commissioner to submit a report to the legislature on any necessary waivers, state plan amendments, requests for new funding or realignment of existing funds, any changes to statutes or rule, and any other federal authority necessary to implement the disability waiver reconfiguration; also, by January 15, 2021, requires the commissioner to develop a proposal to reconfigure the MA disability waivers and specifies the information that must be included in the proposal. Requires the commissioner to publish a draft report with enough time for interested persons to offer additional feedback.

Section 87 (Direction to the commissioner; direct-care workforce rate methodology study) requires the commissioner to evaluate the feasibility of developing a reimbursement methodology for direct-care workers similar to the DWRS methodology, and report to the legislature by February 1, 2020.

Section 88 (Direction to the Commissioner; TEFRA application improvement) directs the commissioner of human services to develop content explaining the medical assistance-TEFRA option to online applicants. It also directs the commissioner to develop a cover letter explaining the medical assistance-TEFRA option enrollment and renewal processes to be disseminated with materials sent to applicants who may qualify for the TEFRA option. It finally directs the commissioner to convene a stakeholder group to consider improvements to the TEFRA option enrollment and renewal processes. The stakeholder group shall report to the commissioner the recommended improvements and associated costs by December 31, 2020.

Section 89 (Direction to the commissioner; residential services rate methodology) requires the commissioner to develop a new rate methodology for residential services, currently reimbursed under DWRS, provided in a setting where the provider also lives and to submit recommendations to the legislature by January 1, 2020.

Section 90 (Day training and habilitation disability waiver rate system transition grants) establishes a four–year grant program for day training and habilitation providers who serve at least 100 waiver recipients and who will experience reductions in revenue under full implementation of DWRS of at least 15 percent and $300,000. Grant recipients must develop and implement a sustainability plan to close their funding gaps, and must demonstrate progress in closing the funding gap to qualify for a grant renewal.

Section 91 (Direction to the Commissioner; Authorize redistribution of housing with services capacity) permits an existing housing with services establishment providing customized living services under the BI and CADI waivers to redistribute its service capacity to other establishments.

Section 92 (Direction to the commissioner; recommendations to increase use of technology) requires the commissioner of human services to convene the Minnesota Technology First Advisory Task Force to advise the commissioner on strategies to increase the use of supportive technology in services and programs for persons with disabilities.

Section 93 (Revisor’s instruction)

Paragraph (a) instructs the revisor of statutes to correct inconsistent terminology related to the DD waiver.

Paragraph (b) instructs the Revisor to codify existing law related to the consumer-directed community supports option.

Paragraph (c) instructs the revisor of statutes to codify the electronic visit verification language in statute.

Section 94 (Repealer) 

Paragraph (a) repeals the existing PCA service verification provisions.

Paragraph (b) repeals provisions related to supported employment for adults with developmental disabilities.

Paragraph (c) repeals the definition of “supported employment” and obsolete language related to DWRS.

Paragraph (d) repeals section 256I.05, subdivision 3, which requires housing support providers to charge the same room and board rate to all residents.

Article 6: Chemical and Mental Health

Sections 1 and 73 (13.851, subdivision 12; 641.15, subdivision 3a) permit local corrections departments to share data regarding inmates who have or may have a mental illness with the local county services agency and refer individuals for services where necessary.

Section 2 (245.4889, subdivision 1) makes a technical conforming change to accommodate a standalone section for the school-linked mental health services grant program, and imposes a requirement for recipients of children’s mental health grants to obtain all available third-party reimbursement sources, if applicable, as a condition of receiving grant funds.

Section 3 (245.4901) establishes a grant program through the department of human services for entities to provide school-linked mental health services, including identifying and diagnosing mental health conditions; providing treatment and services to students and families, including via telemedicine; supporting families in navigating the health care, social service, and juvenile justice systems; providing transportation for children when school is out of session; increasing the capacity of school staff to meet the needs of students with mental health needs; and making equipment purchases, connection charges, on-site coordination, set-up fees, and site fees in order to deliver services via telemedicine. Eligible applicants include certified mental health centers and clinics, community mental health centers, Indian health service facilities, facilities owned and operated by a tribe or tribal organization, children’s therapeutic services providers, or medical assistance-enrolled mental health or substance use disorder provider agencies. Grant recipients must also provide data to the commissioner of human services to evaluate the effectiveness of the grant program.

Section 4 (245.735, subdivision 3) modifies the statutory section governing certified community behavioral health clinics (CCBHCs) by adding licensed alcohol and drug counselors to CCBHC staff, adding substance use to CCBHC services, removing the requirement for a CCBHC to be certified to provide integrated treatment for co-occurring mental illness and substance use disorders, adding a requirement for CCBHCS providing peer services to comply with statutory peer services statutes, updating terminology and cross-references, and removing obsolete language relating to prospective payments, federal approval and financial participation, and limitations on CCBHC certifications. The section also permits the commissioner to grant a variance for a CCBHC that has been certified but not approved for prospective payment, so long as the variance does not increase the state share of costs. This section is contingent upon federal approval.

Section 5 (245F.05, subdivision 2) modifies the admission criteria for withdrawal management programs to require individuals to meet the current American Society of Addiction Medicine standards for withdrawal management.

Sections 6-39, 46-47, and 49 update, clarify, and modernize the statutes governing chemical dependency licensed treatment facilities.

Section 6 (245G.01, subdivision 8) amends the definition of “client” to include patients as defined in the Health Care Bill of Rights.

Section 7 (245G.01, subdivision 10a) defines “day of service initiation” as the day the provider begins a treatment service for a client.

Section 8 (245G.01, subdivision 13a) defines “group counseling” as psychotherapeutic substance use disorder treatment led by a professional in an interactive group setting.

Section 9 (245G.01, subdivision 20a) defines “person-centered” as having a client actively participate in planning their treatment services.

Section 10 (245G.01, subdivision 20b) defines “staff” and “staff member” as an individual working for the license holder, regardless of employment status or title.

Section 11 (245G.01, subdivision 21) clarifies the definition “student intern” to specify that the individual is enrolled in an educational program specializing in alcohol and drug counseling or mental health counseling.

Section 12 (245G.01, subdivision 28) defines “treatment week” as the seven-day period identified by a treatment program in order to calculate the services an individual receives on a weekly basis.

Section 13 (245G.01, subdivision 29) defines “volunteer” as an individual providing services without compensation at the direction of the licensed program.

Section 14 (245G.04) updates the requirements for service initiation to include completing an initial services plan within 24 hours that is person-centered, client-specific, and identifies the client’s immediate treatment needs. The section also adds a requirement that nonresidential programs determine whether a new client is a vulnerable adult within 24 hours of service initiation.

Section 15 (245G.05) updates the statutory standards and requirements for comprehensive assessments and assessment summaries, provides that a comprehensive assessment and assessment summary must be completed by the third day on which a client has received services in a nonresidential program, and clarifies that a comprehensive assessment or assessment summary is complete upon a qualified staff member’s dated signature.

Section 16 (245G.06, subdivision 1) updates the process and timeline for completing an individual treatment plan, requiring a plan to be completed within 10 days of service initiation for a residential program, by the fifth day on which a client has received services in a nonresidential program, and within 21 days of service initiation for an opioid treatment program.

Section 17 (245G.06, subdivision 2) clarifies that an individual treatment plan must include specific goals and methods to address the client’s identified needs in their comprehensive assessment summary.

Section 18 (245G.06, subdivision 4) makes technical clarifying changes to the service discharge summary requirements, and adds a requirement that a copy of the client’s discharge summary must be provided upon request by the client.

Section 19 (245G.07) updates the treatment service requirements for treatment programs by removing the requirement that a licensed drug and alcohol counselor must be present during an educational group, making peer recovery support services a discretionary additional treatment service, requiring all treatment services except peer recovery support and treatment coordination to be provided by a qualified alcohol and drug counselor, requiring the commissioner to keep a list of current qualified treatment professionals, and permitting providers to provide services off-site under certain conditions.

Section 20 (245G.08, subdivision 3) requires provider staff to be trained in the specific method of administering naloxone used by the program, including intranasal administration or intramuscular injection.

Section 21 (245G.10, subdivision 4) sets a limit on the size of group counseling at 16 clients, and moves the cap of 50 clients for opioid treatment counselors to a different statutory section.

Section 22 (245G.11, subdivision 7) makes a technical change to replace the phrase “care coordination” with “treatment coordination”, establishes that an individual is qualified to provide treatment coordination if the individual is a qualified alcohol and drug counselor, and adjusts the frequency that a treatment coordinator must receive one hour of supervision from weekly to monthly.

Section 23 (245G.11, subdivision 8) requires a recovery peer to hold a credential from the Minnesota Certification Board, the Upper Midwest Indian Council on Addictive Disorders, the National Association for Alcoholism and Drug Abuse Counselors, or a tribal nation when providing services in a tribally licensed program. The section also eliminates the option to have a recovery peer receiving ongoing supervision from an individual with a certification approved by the commissioner.

Section 24 (245G.12) adds requirements that a provider’s policies and procedures manual identify which services meet the definition of group counseling, and define the program’s treatment week.

Section 25 (245G.13, subdivision 1) makes a conforming change to replace the phrase “chemical use” with “substance use.”

Section 26 (245G.15, subdivision 1) makes a conforming change to clarify that a written statement of the client’s rights and responsibilities must be provided to each client on the day of service initiation.

Section 27 (245G.15, subdivision 2) makes a conforming change to clarify that the program’s grievance procedure must be explained to a client or client’s representative on the day of service initiation.

Section 28 (245G.18, subdivision 3) removes the requirement that at least 25 percent of a counselor’s scheduled work house be allocated to indirect services.

Section 29 (245G.18, subdivision 5) makes a conforming change to replace the phrase “chemical use” with “substance use.”

Section 30 (245G.22, subdivision 1) aligns the requirements for opioid treatment programs to comply with federal guidance, which requires registration as a narcotic treatment program with the Drug Enforcement Administration, accreditation through an approved body, certification through the Division of Pharmacologic Therapy of the Center for Substance Abuse Treatment, and licensure by the Minnesota Board of Pharmacy or equivalent agency.

Section 31 (245G.22, subdivision 2) amends the definition of “medical director” of an opioid treatment program to mean a practitioner licensed to practice medicine in the program’s jurisdiction who assumes responsibility for all aspects of the program, and adds a definition for “practitioner” that means a staff member of an opioid treatment program who is licensed to practice medicine or nursing in the jurisdiction and is registered with the Drug Enforcement Administration, and includes advanced practice registered nurses and physician assistants that receive a variance from the proper state and federal authorities.

Section 32 (245G.22, subdivision 3) makes conforming changes to replace the term “physician” with “practitioner.”

Section 33 (245G.22, subdivision 4) makes conforming changes to replace the term “physician” with “practitioner.”

Section 34 (245G.22, subdivision 6) clarifies the procedures to dispense medication for an opioid treatment program client’s unsupervised use.

Section 35 (245G.22, subdivision 7) makes a conforming change and requires any assessment resulting in an unsupervised use of methadone hydrochloride to be documented in the client file.

Section 36 (245G.22, subdivision 15) makes conforming changes that clarify the timing, procedures, and documentation requirements for nonmedication treatment services.

Section 37 (245G.22, subdivision 16) makes technical conforming changes and clarifies that a decision regarding the frequency of a client’s ongoing prescription monitoring program checks must be maintained in the client’s file.

Section 38 (245G.22, subdivision 17) updates the cross-reference used to require an opioid treatment program to develop and maintain policies and procedures regarding unsupervised use of medication, adds a requirement that the medical director must be informed of any outcome resulting in a possible diversion issue, and re-imposes the cap of 50 clients per opioid treatment counselor.

Section 39 (245G.22, subdivision 19) makes a conforming change to replace the phrase “drug screenings” with “drug testings.”

Section 46 (254B.04, subdivision 2c) clarifies eligibility for peer recovery services to align with the approved state plan.

Sections 47 and 49 (254B.05, subdivisions 1 and 5) remove unnecessary federal approval language and update a cross-reference to treatment service requirements.

Section 40 (254A.03, subdivision 3) establishes that where a screen results positive for alcohol or substance misuse, the individual may receive an initial set of substance use disorder services, which may include a combination of up to four hours of individual or group substance use disorder treatment, two hours of substance use disorder treatment coordination, or two hours of substance use disorder peer support services, effective upon federal approval.

Section 41 (254A.19) permits chemical use assessments to be conducted by telemedicine.

Sections 42-45, 48, 50-51, 53-54, and 68-70 (254B.02, subdivision 1; 254B.03, subdivisions 2 and 4; 254B.04, subdivision 1; 254B.05, subdivision 1a; 254B.06, subdivisions 1 and 2; 256B.0625, subdivisions 24 and 24a; 256I.04, subdivisions 1 and 2f; 256I.06, subdivision 8) align the billing and payment for substance use disorder services with mental health services in the medical assistance benefit set, and eliminate the county share for MA-covered chemical dependency services and for chemical dependency housing room and board, effective July 1, 2020.

Sections 52 and 57 (256B.0625, subdivision 5m; 256B.0625, subdivision 57) establish MA coverage and a payment system for CCBHC services.

Section 55 (256B.0625, subdivision 43) establishes MA coverage and provider documentation requirements for mental health provider travel time, when providing services outside the provider’s usual place of business.

Section 56 (256B.0625, subdivision 45a) authorizes the commissioner to enroll 80 additional psychiatric residential facility services beds beginning July 1, 2020, and 70 additional beds beginning July 1, 2023, prioritizing programs that serve children and youth.

Sections 58-66 (256B.0757) authorize the development of and set the standards for behavioral health home models.

Section 58 (256B.0757, subdivision 1) makes a technical conforming change.

Section 59 (256B.0757, subdivision 2) authorizes the commissioner of human services to develop health home models for individuals with a mental illness or an emotional disturbance, in accordance with federal law.

Section 60 (256B.0757, subdivision 2a) establishes the criteria to discharge an individual from a behavioral health home. An individual may be discharged if the provider cannot locate the individual for more than three months, or if the individual refuses to receive services. The provider must offer an in-person meeting with the individual and the individual’s supports to discuss the options available to the individual, which include continuing behavioral health home services.

Section 61 (256B.0757, subdivision 4) makes a technical conforming change.

Section 62 (256B.0757, subdivision 4a) lists the requirements for behavioral health home services providers to follow, including enrollment as a Minnesota Health Care Programs provider, provision of services covered by medical assistance, use of electronic records and registry, and implementation of immediate needs assessments, 60-day health and wellness assessments, and 90-day health action plans.

Section 63 (256B.0757, subdivision 4b) lists behavior health home service provider training requirements, which include training on evidence-based service practices, culturally responsive services, and practice transformation activities to support providing integrated services.

Section 64 (256B.0757, subdivision 4c) lists the qualification requirements for behavioral health home service staff, which permit use of community health workers, peer support and recovery specialists, or community paramedics in certain situations.

Section 65 (256B.0757, subdivision 4d) establishes the standards for behavioral health home service delivery, which include use of a team-based model of care, evidence-based practices tailored to each individual’s background and needs, person-centered planning practices, delivery of services in locations and settings that meet each individual’s needs, a central point of contact, provision of wellness and prevention education, health coaching, connection to support services, and a continuous quality improvement process. For individuals with a managed care plan, the provider must notify the designated contact that the individual has begun receiving services, and must follow the managed care plan. Prior to terminating services, the provider must give 60 days notice and refer all individuals receiving services to a new provider.

Section 66 (256B.0757, subdivision 4e) establishes the process for the commissioner of human services to grant a variance to the provider, training, staff, or services standard requirements for a behavioral health home program, if such a variance would relieve a hardship, is in the public interest, and would not decrease the level of services provided.

Section 67 (256B.0759) codifies the provider standards necessary for Minnesota to implement the substance use disorder demonstration waiver upon CMS approval, and increases the rates for participating providers by 15 percent for the treatment portion of the residential rate, effective July 1, 2020, and by 10% for outpatient individual and group services and comprehensive assessments, effective January 1, 2021.

Section 71 (256K.45, subdivision 2) adds a requirement for the commissioner of human services to report on the shelter-linked youth mental health grant program as part of the biennial report on the issue of homeless youth.

Section 72 (256K.46) establishes a shelter-linked mental health grant program for housing providers to partner with community-based mental health practitioners to provide mental health services to homeless or sexually exploited youth. Applicants for the two-year grants must demonstrate that they have received targeted trauma training on sexual exploitation and adolescent homelessness, and grant funds may be used to develop programming or training, to provide mental health services, or to build capacity to provide services via telemedicine. Grant recipients must promote and assist participants with obtaining health insurance, and report their activities to the commissioner annually.

Sections 74-75 (Laws 2017, First Special Session chapter 6, article 8, sections 71-72) extend indefinitely the provisions funding MA coverage for mental health services provided by children’s residential facilities that qualify as institutions for mental diseases under federal law.

Section 76 (Direction to Commissioner; Substance Use Disorder Treatment Program Systems Improvement) directs the commissioner of human services to propose a plan to identify systems improvements to minimize paperwork for substance use disorder programs.

Section 77 (Community Competency Restoration Task Force) establishes a task force to evaluate and research community competency restoration programs, beginning no later than August 1, 2019, to propose recommendations to the legislature to improve the services, resources, and diversionary programs to address the growing number of individuals deemed incompetent to stand trial. The task force must submit a report of its progress and findings to the legislative committees with jurisdiction over mental health and corrections by February 1, 2020, and a final report of its recommendations by February 1, 2021.

Section 78 (Direction to Commissioner; Improving School-Linked Mental Health Grant Program) directs the commissioner of human services to assess the school-linked mental health program to develop improvements that promote stability, effectiveness, sustainability, data evaluation, and analysis of the impact of school-linked mental health programs. The commissioner must report the findings and any recommendations to the legislature by January 15, 2020.

Section 79 (Direction to Commissioner; CCBHC Rate Methodology) directs the commissioner of human services to consult with CCBHC providers to develop a uniform statewide rate methodology for the reasonable cost of CCBHC services, by February 15, 2020. The commissioner shall also develop a rate methodology the eliminates duplication of payment for CCBHC providers that receive a separate prospective system rate.

Section 80 (Specialized Mental Health Community Supervision Pilot Project) authorizes the commissioner of human services to award a grant to Anoka County to conduct a pilot project that would provide enhanced assessment, case management, treatment services, and community supervision for offenders with mental illness on probation, parole, supervised release, or pretrial status in Anoka County.

Section 81 (Repealer) repeals the statute setting the county share for MA-covered substance use disorder services at 30 percent.

Article 7: Health Care

Section 1 (13.69, subdivision 1) requires the Department of Public Safety to provide to DHS the last four digits of a driver’s Social Security number for purposes of recovery of Minnesota health care program benefits paid.

Section 2 (16A.724, subdivision 2) makes a conforming change related to section 17, which codifies a current rider that allows for a transfer from the health care access fund to the general fund.

Section 3 (62Q.184, subdivision 1) includes in the definition of “clinical practice guidelines” a preferred drug list developed under the medical assistance program. This section also includes in the definition of health plan company managed care organizations, county-based purchasing plans, and integrated health partnerships participating in MA and Minnesota care for purposes of complying with step therapy override requirements).

Section 4 (62Q.184, subdivision 3) allows enrollees or providers to appeal the denial of a step therapy override by a health plan company (including MA and MinnesotaCare) using the administrative review process established for human services programs.

Section 5 (245A.02, subdivision 5a) updates a cross-reference.

Section 6 (245D.081, subdivision 3) updates a cross-reference and makes a technical edit.

Section 7 (256.043) makes technical changes to the new opiate epidemic response account passed this past session (Laws 2019, chapter 63).

Section 8 (256.962, subdivision 5) increases from $25 to $70 the application assistance bonus paid to navigators for enrolling individuals in MA.

Section 9 (256.969, subdivision 2b) gives the commissioner ongoing authority to make additional payment adjustments to rebased hospital payment rates.

Section 10 (256.969, subdivision 3a) provides that payments for hospital discharges shall not exceed on a per claim, rather than aggregate as under current law, basis a hospital’s charges.

Section 11 (256.969, subdivision 9) modifies the DSH payment methodology. This section also requires the commissioner to establish an additional payment adjustment for hospitals that provide high levels of administering high-cost drugs to enrollees in fee-for-service MA. Requires the commissioner to consider fee-for-service MA utilization rates and payments for drugs purchased through the 340B program and administered to fee-for-service enrollees. If the adjustment exceeds a hospital’s specific disproportionate share hospital limit, requires the commissioner to make a payment to the hospital that equals the nonfederal share of the excess amount. Limits the total nonfederal share of adjustments to $1.5 million.

Section 12 (256.969, subdivision 17) modifies the admission threshold that governs when an out-of-state hospital has rates established using the procedures and methods that apply to Minnesota hospitals. 

Section 13 (256.969, subdivision 19) provides that a payment increase related to the cost of metabolic disorder testing of newborns remains in effect until fully recognized in the base year cost.

Section 14 (256B.04, subdivision 14) prohibits the commissioner from utilizing volume purchasing through competitive bidding for incontinence products and related supplies. This section is effective the day following final enactment.

Section 15 (256B.04, subdivision 21) Paragraph (a) requires the commissioner to enroll providers and conduct screening activities as required by federal regulations and specifies related requirements.

Paragraph (b) requires the commissioner to revalidate each provider at least once every five years, and personal care assistance agencies once every three years.

Paragraph (c) specifies criteria for conducting revalidations.

Paragraph (d) allows the commissioner to suspend a provider’s ability to bill, if a provider fails to comply with any individual provider requirement or condition of participation. Provides that suspension is not subject to an administrative appeal.

Paragraph (e) requires all correspondence and notifications to be delivered electronically, or by first-class mail if a provider does not have a MN-ITS account and mailbox. States that this does not apply to communications related to background studies.

Section 16 (256B.04, subdivision 22) strikes language that is reinstated in section 256B.04, subdivision 21.

Section 17 (256B.04, subdivision 25) requires the commissioner to increase the MA and MinnesotaCare fee for service and managed care payment rates by an amount equal to the tax paid by hospitals, surgical centers or healthcare providers for the gross revenues for providers of MA and MinnesotaCare services.

Section 18 (256B.055, subdivision 2) provides MA eligibility for children who are not eligible for Title IV-E assistance (federal payments for foster care) but are determined eligible for foster care or kinship assistance under chapter 256N. Provides a January 1, 2020, effective date.

Section 19 (256B.056, subdivision 1) requires the commissioner to identify individuals who are enrolled in medical assistance and are absent from the state for more than 30 consecutive days. If the individual is still deemed a resident of Minnesota and still eligible for medical assistance then any services provided to the individual must be paid through the fee for service system and not through managed care.

Section 20 (256B.056, subdivision 3) provides that MA will disregard a designated employment incentives asset account when determining MA eligibility for a person who is age 65 or older. Allows such an account to be designated only by a person enrolled in MA as an employed person with a disability (MA-EPD) for a 24-consecutive month period. Strikes existing language which allows a higher asset disregard ($20,000 for an individual after exclusions) for persons formerly eligible under MA-EPD who turn 65 and seek MA eligibility as a person who is elderly, blind, or has a disability (an asset limit of $3,000 for a household of one/$6,000 for a household of two normally applies to this group). Specifies criteria for a designated employment incentives asset account.

Section 21 (256B.056, subdivision 5c) increases the MA spenddown standard for persons who have disabilities, are blind, or are age 65 or older to 100 percent of FPG, effective July 1, 2022.

Section 22 (256B.056, subdivision 7a) authorizes a local agency to close an enrollee’s case file if the enrollee is terminated from medical assistance for failure to complete and return the required form and information within four months of termination.

Section 23 (256B.0625, subdivision 3b) adds a community health worker as a provider eligible for reimbursement for telemedicine. This section also provides an exception from the limit on MA coverage of telemedicine (three services per enrollee per calendar week) if the:

1. telemedicine services provided by the licensed health provider are for the treatment and control of tuberculosis; and
2. services are provided in a manner consistent with the recommendations and best practices specified by the Centers for Disease Control and Prevention and the Commissioner of Health.

Section 24 (256B.0625, subdivision 13) strikes language specifying the quantity of over-the-counter medications to be dispensed.

Section 25 (256B.0625, subdivision 13e) specifies that the usual and costmary price means the lowest price charged by the provider to a patient who pays for the drug and includes prices charged to a patient enrolled in a prescription savings club or discount club administered by the pharmacy or pharmacy chain.  This section also requires that prescription drugs be reimbursed on the actual acquisition cost according to nationally recognized benchmarks.  It also increases the dispensing fee for pharmacy providers from $3.85 to $10.48 and establishes ongoing cost dispensing surveys to be conducted every three years.  It also aligns reimbursement for drugs purchased through the federal 340B program requiring that reimbursement for these drugs be at the provider’s cost. It also requires the commissioner to increase the ingredient cost reimbursement for prescription and nonprescription drugs subject to the wholesale drug distributor tax.

Section 26 (256B.0625, subdivision 13f) strikes language that prohibits the commissioner from requiring prior authorization from being used for antihemophilic factor drug where there is no generically equivalent drug in conjunction with a supplemental drug rebate program or multistate preferred drug program. This section also requires that any prior authorization for MA complies with step therapy override requirements under section 62Q.184.

Section 27 (256B.0625, subdivision 17) requires all nonemergency medical transportation drivers to be individually enrolled with the commissioner and reported on the claim as the individual providing the service. Removes language requiring consultation with the Minnesota Department of Transportation. Provides a July 1, 2021, effective date.

Section 28 (256B.0625, subdivision 17d) requires the commissioner to contract with a vendor or dedicate staff to oversee providers of nonemergency medical transportation (NEMT) services.

Section 29 (256B.0625, subdivision 17e) prohibits a terminated NEMT provider from enrolling as a NEMT provider for five years following termination. If the provider seeks reenrollment after the five-year period, requires the provider to be placed on a one-year probation, during which the commissioner shall complete unannounced site visits and request documentation to review compliance with program requirements. Provides a day following final enactment effective date.

Section 30 (256B.0625, subdivision 30) establishes an alternative payment method for FQHCs. 

Paragraph (g) provides that for services provided on or after January 1, 2021, claims for clinic services provided by federally qualified health centers (FQHCs) and rural health clinics shall be paid by the commissioner, according to an annual election by the center or clinic, under the current prospective payment system in paragraph (f) or the alternative payment methodology in paragraph (l).

Paragraph (l) establishes the alternative payment methodology. Provides that all claims for payment of clinic services provided by FQHCs and rural health clinics shall be paid according to specified requirements.

Section 31 (256B.0625, subdivision 57) exempts Indian Health Services from a provision that limits MA payment of an enrollee’s Medicare Part B cost-sharing to the MA allowed amount, when the MA rate exceeds the amount paid by Medicare. Provides a day following final enactment effective date.

Section 32 (256B.064, subdivision 1a) authorizes the commissioner to impose sanctions against a pharmacy provider for failure to respond to a cost of dispensing survey required under section 256B.0625, subdivisions 13e, paragraph (h).

Section 33 (256B.0659, subdivision 21) Paragraph (a) clarifies that personal care provider agencies must provide to the commissioner at the time of enrollment, reenrollment, and revalidation, bond coverage and other information for each business location. Also makes related changes.

Paragraph (c) requires specified employees of personal care provider agencies to complete required training before submitting an application for agency enrollment.

Paragraph (d) requires all surety bonds, fidelity bonds, workers compensation insurance, and liability insurance to be maintained continuously, and specifies related requirements.

Provides a day following final enactment effective date.

Section 34 (256B.69, subdivision 4) specifies that an individual who is absent from the state for more than 30 consecutive days but still eligible for medical assistance is not required to be enrolled in managed care.

Section 35 (256B.69, subdivision 31) reduces the maximum trend increases to the rates paid to managed care plans and county-based purchasing plans by an amount equal to the value of a 0.8% reduction in rates for calendar years 2020, 2021, 2023, and 2024.

Section 36 (256B.758) for services provided on or after July 1, 2019, sets MA payment rates for doula services provided by a certified doula at $47 per prenatal or postpartum visit and $488 for attending and providing doula services at birth.

Section 37 (256B.766) requires payment rates for durable medical equipment, prosthetics, orthotics, or supplies subject to the Medicare limit to be paid at the Medicare rate. States that the section is effective July 1, 2019, subject to federal approval.

Sections 38-42 (256B.79, subdivisions 2 to 6) modify the integrated care for high-risk pregnant women pilot program to be a continuing grant program.

Section 38 (256B.79, subdivision 2) changes the program from a pilot program to a grant program.

Section 39 (256B.79, subdivision 3) removes obsolete date. Specifies that priority in awarding grants must be given to qualified integrated perinatal care collaboratives that have received grants under the pilot program before January 2019.

Section 40 (256B.79, subdivision 4) updates language to reflect change to continuing grant program.

Section 41 (256B.79, subdivision 5) updates language to reflect change to continuing grant program.

Section 42 (256B.79, subdivision 6) requires the commissioner to report to the legislature by January 31, 2021, and every two years thereafter, about the outcomes of the grant program. Updates language to reflect change to continuing grant program.

Section 43 (256L.11, subdivision 2) provides that the alternative payment methodology described in section 30 shall not apply to MinnesotaCare services provided by FQHCs, rural health clinics, Indian Health Service facilities, and certified behavioral health clinics.

Section 44 (Study of Clinic Costs) requires the commissioner of human services to conduct a five-year comparative analysis of the actual change in FQHC and rural health clinic costs versus the CMS FQHC Market Basket inflator, and report findings to the legislature by July 1, 2025.

Section 45 (Corrective Plan to Eliminate Duplicate Personal Identification Numbers) requires the commissioner of human services to design and implement a corrective plan to address the issue of MA enrollees being assigned more than one personal identification number.  Requires any fixes or corrections to be made by June 30, 2021. This section also requires the commissioner to submit to the legislature a report on the progress of the corrective plan by February 15, 2020, and information on the number of enrollees that have been assigned two or more personal identification numbers; any possible financial effect of enrollees having supplicate numbers; and any effect on federal payments received by the state.

Section 46 (Blue Ribbon Commission on Health and Human Services) requires the commissioners of health and human services to convene a commission to advise and assist the legislature and governor in finding greater efficiencies, savings, and better outcomes for Minnesota within the health and human services system, and report to the legislature by October 1, 2020, an action plan for transforming the health and human services system.

Section 47 (Repealer)

Paragraph (a) repeals sections 256B.0625, subdivision 63 (payment to clinics for mental health or dental services provided on the same day; this concept is included in the alternative payment methodology described in section 256B.0625, subdivision 30, paragraph (l)); 256B.0659, subdivision 22 (annual review of PCA provisions); and 256L.11, subdivision 2a (provision allowing higher payment rates for FQHC services provided to MinnesotaCare families and children).

Paragraph (b) repeals sections 256B.0625, subdivision 31c (preferred incontinence product program) and 256B.79, subdivision 7, effective the day following final enactment.

Article 8: Health Coverage

Section 1 (62A.30, subdivision 4) provides health care coverage for preventive mammogram screening that includes digital breast tomosynthesis (3D) for enrollees who are at risk for breast cancer.  At risk of breast cancer included having a family history; testing positive for BRCA1 or BRCA2; having dense breasts; or having a previous diagnosis of breast cancer.

Section 2 (62A.3097) provides coverage for neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS).

Subdivision 1 defines PANDAS and PANS.

Subdivision 2 requires health plans to provide coverage to Minnesota residents.

Subdivision 3 requires health plans to provide coverage for PANDAS and PANS, including antibiotics, medication, behavioral therapies, plasma exchange, and immunoglobulin.

Subdivision 4 provides that the commissioner of commerce shall reimburse health carriers for coverage for PANDAS and PANS under this section, and limits reimbursement to coverage that would not have otherwise been provided by the carrier without the requirements of this section. Requires health carriers to report to the commission-qualified costs attributable to the additional benefit under this section. Payments made by the commissioner shall be as provided under federal regulations.

Section 3 (62D.12, subdivision 8a) requires a nonprofit health maintenance organization (HMO) to use its net earnings to provide comprehensive health care. Prohibits a nonprofit HMO from paying net earnings as a dividend or rebate to a person for any reason other than providing comprehensive health care. An exception to this is that the nonprofit HMO can make certain payments to health care providers. Requires the commissioner of health to revoke a nonprofit HMO’s certificate of authority if it violates this subdivision.

Section 4 (62D.124, subdivision 3) allows an HMO to apply for a waiver of the network geographic accessibility requirements, by submitting to the commissioner an application and an application fee of $500 per county per year. Specifies application and approval requirements. Allows the commissioner to approve a waiver if the HMO proposes to address network inadequacy through the use of telemedicine, when there are no providers of a specific type or specialty in the county. States that a waiver expires after three years and cannot be renewed; plans must instead submit a new application. Specifies review requirements for new applications. Requires application fees to be deposited in the state government special revenue fund.

Section 5 (62D.124, subdivision 7) requires an HMO to provide on the organization’s website the provider network for each product, and update the website at least once per month. Also requires the HMO to provide on the website a list of current waivers of the network geographic accessibility standard.

Sections 6 and 7 (62E.23) extend the Minnesota premium security program through benefit year 2021. Specifies in law the payment parameters for benefit year 2020. Modifies the reporting requirements.

Section 8 (62K.07) requires a health plan company to provide information to the commissioner of commerce when they file rate information on prescription drugs that are reimbursed by the health plan company under health plans issued in this state.

Section 9 (62K.075) requires health carriers to provide on the carrier’s website the provider network for each product, and to update the website at least once a month. Also requires the carrier to provide on the website a list of current waivers of the network geographic accessibility standard.

Section 10 (62K.10, subdivision 5) requires health carriers applying for a waiver of the network geographic accessibility standard to submit an application fee of $500 per county for which a waiver is sought, and provide specified information. Sets requirements for the commissioner related to reviewing and approving waiver applications. Allows the commissioner to approve a waiver if the HMO proposes to address network inadequacy through the use of telemedicine, when there are no providers of a specific type or specialty in the county. Also specifies requirements related to the submittal and review of new waiver applications. Requires application fees to be deposited in the state government special revenue fund.

Section 11 (62K.105) requires the commissioner to establish a process for accepting complaints from enrollees regarding health carrier and preferred provider organization network adequacy. Requires the commissioner to investigate all complaints.

Section 12 (62Q.01, subdivision 6b) defines nonquantitative treatment limitations, or NQTL.

Section 13 (62Q.1841) prohibits the use of step therapy for metastic cancer. Defines the following terms: health plan, stage four metastatic cancer, and step therapy protocol. Prohibits a health plan that provides coverage for the treatment of stage four advanced metastatic cancer or associated conditions from limiting or excluding coverage for a drug approved by the Food and Drug Administration (FDA) that is on the plan’s formulary, by mandating that the enrollees follow a step therapy protocol, if the use of the approved drug is consistent with: (1) a FDA-approved indication; and (2) a clinical practice guideline published by the National Comprehensive Care Network.

Section 14 (62Q.47) Paragraph (d) specifies that a health plan company must not impost an NQTL with respect to mental health and substance abuse disorders unless comparable to those applied to medical and surgical benefits in the same classification.

Paragraph (f) authorized the commissioner to require information from health plan companies to confirm that mental health parity is being implemented by the health plan company.

Paragraph (g) specifies that mental health therapy visits and medication maintenance visits shall be considered primary care visits for the purpose of applying enrollee cost-sharing requirements.

Paragraph (h) requires the commissioner of commerce to submit an annual report to the legislature on compliance with and oversight of the federal regulations regarding mental health parity, this section, and section 62Q.53.

Section 15 (62Q.48) limits the total amount of cost sharing that an enrollee is required to pay at point of sale for insulin at an amount that does not exceed the net price of the insulin.  Defines net price as the health plan company’s cost of the drug, including any rebates or discounts received on or accrued to the health plan company from a manufacturer or pharmacy benefit manager.

Section 16 (62U.04, subdivision 4) requires claims data submitted to the commissioner of health for claims incurred on or after January 1, 2019, to identify claims that are in the individual health market.

Section 17 (256B.0625, subdivision 13f) requires any step therapy protocol requirements established by the Commissioner of Human Services to comply with section 62Q.1841. Provides a January 1, 2020, effective date.

Section 18 (256B.0625, subdivision 66) requires MA to cover treatments for PANDAS or PANS according to protocols developed by the Health Services Policy Committee.

Section 19 makes a conforming change to the changes made to the Minnesota premium security program.

Section 20 (Moratorium on conversion transactions) extends the existing moratorium on conversion transactions for nonprofit service plan corporations and nonprofit health maintenance organizations from June 30, 2019, to June 30, 2023.Also provides that the transactions governed by this section include a transfer of a material amount of the entity’s assets as part of a single transaction or a series of transactions within the past 24 months, and defines material amount as the lesser of 10 percent of the entity’s total admitted net assets as of the previous December 31, or $50,000,000. Makes this section effective the day following final enactment.

Section 21 (Coverage for PANDAS or PANS) requires a health carrier to use a health plan’s coverage as of January 1, 2019, to determine whether the health carrier would not have provided coverage for PANDAS, or PANS, and states that treatments and services covered by a health plan as of January 1, 2019, are not eligible for reimbursement by the commissioner of commerce.

Section 22 specifies that the Minnesota Comprehensive Health Association must administer the Minnesota premium security plan through the 2021 benefit year.

Article 9: Prescription Drugs

Section 1 (62J.23, subdivision 2) includes prescription drugs administered through infusion and related services and supplies in the definition of “prescription drug,” for purposes of the exemption of prescription drug discounts, price reductions, a limited-time free supply, or samples, from the state application of the Medicare antikickback law.

Section 2 (62Q.528) requires a health plan that covers prescription drugs to provide coverage for a drug dispensed by a pharmacist in an emergency situation pursuant to section 151.211, subdivision 3, under the same terms that would apply if dispensed pursuant to a prescription.

Section 3 (151.01, subdivision 23) makes a conforming change.

Section 4 (151.06, subdivision 6) Paragraph (a) requires the Board of Pharmacy to publish a page on the board’s website that provides information on:

• patient assistance programs offered by drug manufacturers;
• patient assistance programs implemented by the Board on Aging;
• websites to access information on public health program eligibility;
• availability of providers participating in the 340b program;
• discussing alternatives to a prescribed drug with the pharmacist or provider; and
• any other resources the board deems useful.

Paragraph (b) requites the board to prepare educational materials based on the information provided on the website under paragraph (a).

Paragraph (c) requires pharmacists and pharmacies to make available to patients information on the availability of the website established under paragraph (a).

Section 5 (151.211, subdivision 2) makes a conforming change to section 152.211, subdivision 3 (emergency prescription refills).

Section 6 (151.211, subdivision 3) permits a pharmacist to dispense a legend drug without a current prescription drug order from a licensed practitioner if certain conditions are met.  Specifies that the amount dispensed must not exceed a 30-day supply or the quantity originally prescribed, whichever is less.  Limits a pharmacist from dispensing the same drug to the same patient as provided in this section more than one time in a 12-month period.  Requires the pharmacist to notify the practitioner no later than 72 hours after the drug is dispensed.  Requires the pharmacy to maintain a record of a drug dispensed under this section in the same manner as required for any other prescription drug orders.

Section 7 (151.555) establishes a prescription drug repository program.

Subdivision 1 defines the following terms: central repository; distribute; donor; drug; health care facility; local repository; medical supplies; original, sealed, unopened, tamper-evident packaging; and practitioner.

• “Central repository” means a wholesale distributor that meets certain requirements and enters into a contract with the Board of Pharmacy.
• “Donor” means a health care facility, skilled nursing facility, assisted living facility meeting certain requirements, pharmacy, drug wholesaler, drug manufacturer, or an individual at least 18 years of age.
• “Health care facility” means a physician’s office or health care clinic, hospital, pharmacy, or nonprofit community clinic.
• “Local repository” means a health care facility that elects to accept donated drugs and meets certain requirements.

Subdivision 2 requires the Board of Pharmacy to establish, by January 1, 2020, a drug repository program through which donors may donate a drug or medical supply, to be used by eligible individuals. Requires the board to contract with a central repository to implement and administer the program.

Subdivision 3 requires the board to select a wholesale drug distributor to act as central repository using a request for proposal process. Specifies related requirements.

Subdivision 4 states that in order to serve as a local repository, requires a health care facility to agree to comply with all federal and state requirements related to the drug repository program, drug storage, and dispensing, and maintain any required state license or registration. Specifies application requirements. Provides that participation as a drug repository is voluntary and specifies the process to be used to withdraw from participation.

Subdivision 5 states that in order to participate in the program, requires an individual to submit an application form to the local repository that attests that the individual: (1) is a state resident; (2) is uninsured and not enrolled in MA or MinnesotaCare, has no prescription drug coverage, or is underinsured; (3) acknowledges that the drugs or medical supplies received may have been donated; and (4) consents to a waiver of child resistant packaging requirements. Requires the local repository to issue eligible individuals with an identification card that is valid for one year, can be used at any local repository, and may be reissued upon expiration. Requires the local repository to send a copy of the application form to the central repository. Requires the board to make available on its website an application form and the format for the identification card.

Subdivision 6, Paragraph (a) allows a donor to donate to the central repository or a local repository prescription drugs and medical supplies that meet specified requirements.

Paragraph (b) specifies requirements for prescriptions drugs to be eligible for donation.

Paragraph (c) specifies requirements for medical supplies to be eligible for donation.

Paragraph (d) requires the board to develop a drug repository donor form, which must accompany each donation. Specifies requirements for the form and requires the form to be available on the board’s website.

Paragraph (e) allows donated drugs and supplies to be shipped or delivered to the central repository or a local repository. Requires the drugs and supplies to be inspected by the pharmacist or other practitioner designated by the repository to accept donations. Prohibits the use of a drop box to deliver or accept donations.

Paragraph (f) requires the central repository and local repository to inventory all drugs and supplies that are donated, and specifies related requirements.

Subdivision 7, Paragraph (a) specifies requirements for the pharmacist or authorized practitioner to follow when inspecting all donated drugs and supplies.

Paragraph (b) specifies storage requirements for donated drugs and supplies.

Paragraph (c) requires the central repository and local repositories to dispose of all drugs and supplies not suitable for donation in compliance with applicable federal and state requirements related to hazardous waste.

Paragraph (d) requires shipments or deliveries of controlled substances or drugs that can only be dispensed to a patient registered with the drug’s manufacturer to be documented by the central or local repository, and returned immediately to the donor or donor’s representative that provided the drugs.

Paragraph (e) requires each repository to develop drug and medical supply recall policies and procedures, and specifies related requirements.

Paragraph (f) specifies record keeping requirements related to donated drugs and supplies that are destroyed.

Subdivision 8, Paragraph (a) allows donated drugs and supplies to be dispensed if they are prescribed by a practitioner for the eligible individual. Specifies related requirements.

Paragraph (b) requires the visual inspection of a drug or supply for adulteration, misbranding, tampering, and expiration, and prohibits dispensing or administering of drugs meeting these criteria.

Paragraph (c) requires individuals to sign a drug repository recipient form and specifies form requirements.

Subdivision 9, Paragraph (a) allows a repository to charge an individual receiving a drug or supply a handling fee of no more than 250 percent of the MA dispensing fee.

Paragraph (b) prohibits a repository from receiving MA or MinnesotaCare reimbursement for a drug or supply provided through the program.

Subdivision 10, Paragraph (a) allows the central repository and local repositories to distribute donated drugs and supplies to other repositories.

Paragraph (b) requires a local repository that elects not to participate to transfer all donated drugs and supplies to the central repository, and provide copies of the donor forms at the time of the transfer.

Subdivision 11, Paragraph (a) specifies forms that must be available on the board’s website.

Paragraph (b) requires all records to be maintained by a repository for at least five years, and maintained pursuant to all applicable practice acts.

Paragraph (c) requires data collected by the program from local repositories to be submitted quarterly or upon request of the central repository.

Paragraph (d) requires the central repository to submit reports to the board as required by contract or upon request.

Subdivision 12, Paragraph (a) provides that manufacturers are not subject to criminal or civil liability for causes of action related to: (1) alteration of a drug or supply by a party not under the control of the manufacturer; or (2) failure of a party not under the control of the manufacturer to communicate product or consumer information or the expiration date of a donated drug or supply.

Paragraph (b) provides civil immunity for a health care facility, pharmacist, practitioner, or donor related to participation in the program and also prohibits a health-related licensing board from taking disciplinary action. States that immunity does not apply if the act or omission involves reckless, wanton, or intentional misconduct, or malpractice unrelated to the quality of the drug or supply.

Subdivision 13 states that this section does not allow a donation when federal or state law requires the drug to be returned to the dispensing pharmacy, for purposes of crediting the payer for the amount of drug returned.

Section 8 (214.122) requires the Boards of Medical Practice and Nursing to annually inform licensees who are authorized to prescribe drugs of the availability of the Board of Pharmacy’s website information under section 151.06, and the materials prepared by the board under section 151.06, paragraph (b).  Requires licensees to make available to patients information on sources of lower cost prescription drugs and on the availability of the website established by the Board of Pharmacy under section 151.06.

Article 10: Health-Related Licensing Boards

Section 1 (144A.39) moves the Board of Nursing Home Administrators fees from Minnesota Rules, part 6400.6970 to this section, adds fees, and increases fee amounts.

Section 2 (147.037, subdivision 1) modifies the licensure requirements for graduates of foreign medical schools by requiring the applicant to present evidence to the Board of Medical Practice of the completion of one year of graduate, clinical training in a program accredited by a national accrediting organization or other graduate training approved by the board.

Section 3 (147.0375, subdivision 1) modifies the licensure requirements for eminent physicians by requiring the applicant to present evidence to the Board of Medical Practice of the completion of one year of graduate, clinical medical training in a program accredited by a national accrediting organization or other graduate training approved by the board.

Section 4 (147D.27, subdivision 6) makes technical correction to codify all current traditional midwife licensing fees.

Section 5 (147E.40, subdivision 1) makes technical correction to codify all current naturopathic doctor licensing fees.

Section 6 (147F.17, subdivision 1) makes technical correction to codify all current genetic counselor licensing fees.

Section 7 (148.59) increases Board of Optometry annual licensure renewal fee; adds fees for state jurisprudence examination and miscellaneous labels and data retrieval.

Section 8 (148.6445, subdivision 1) increases initial licensure fee for occupational therapists and occupational therapy assistants.

Section 9 (148.6445, subdivision 2) increases biennial licensure renewal fee for occupational therapists and occupational therapy assistants.

Section 10 (148.6445, subdivision 2a) increases occupational therapy duplicate license fee.

Section 11 (148.6445, subdivision 3) increases occupational therapy late renewal fee.

Section 12 (148.6445, subdivision 4) increases occupational therapy temporary licensure fee.

Section 13 (148.4665, subdivision 5) increases occupational therapy limited licensure fee.

Section 14 (148.6445, subdivision 6) increases occupational therapy fee for course approval after lapse of licensure.

Section 15 (148.6445, subdivision 10) specifies that occupational therapy licensure fees are for the exclusive use of the board and shall not exceed the amounts listed in the section.

Section 16 (148.7815, subdivision 1) makes technical correction to codify all current athletic trainer licensing fees.

Section 17 (148.981) moves psychology licensure fees from rule to statute. Adds fee for optional post-doctoral supervised experience pre-approval. Moves fee from rule to statute.

Section 18 (148E.180) increases the licensing fees for social workers.

Section 19 (150A.06, subdivision 3) eliminates the requirement that the postdoctoral general dentistry residency program be Minnesota-based for purposes of waiving the clinical examination for licensure.

Section 20 (150A.06, subdivision 10) establishes an emeritus inactive license for a licensed dental professional who retires from active practice. Specifies that the emeritus inactive licensee may not practice in a dental profession, and that the license is a formal recognition of the completion of the licensee’s career in good standing.

Section 21 (150A.06, subdivision 11) establishes an emeritus active license for a licensed dental professional who retires, to practice only on a pro bono or volunteer basis, or limited paid consulting or supervision practice. Specifies practice limitations and renewal requirements.

Section 22 (150A.91, subdivision 19) adds application fee for emeritus inactive dental license.

Section 23 (150A.091, subdivision 20) adds application fees for emeritus active licenses in dentistry, dental therapy, dental hygiene, and dental assisting.

Sections 24 to 48 modify the Board of Pharmacy chapter.

Section 24 (151.01, subdivision 31) clarifies the definition of “central service pharmacy.”

Section 25 (151.01, subdivision 35) clarifies that for mixing or reconstituting a drug according to a product’s label or manufacturer directions, the label must be approved by the FDA or manufacturer must be licensed.

Section 26 (151.065, subdivision 1) increases Board of Pharmacy licensure and registration application fees. Modifies application fees by removing drug wholesalers and adding third-party logistics providers, and removing drug manufacturer application fees.

Section 27 (151.065, subdivision 2) increases pharmacist original licensure fee.

Section 28 (151.065, subdivision 3) increases Board of Pharmacy annual renewal fees. Modifies annual renewal fees by removing drug wholesalers and adding third-party logistics providers, and removing drug manufacturer renewal fees.

Section 29 (151.065, subdivision 6) clarifies language for Board of Pharmacy controlled substance registrant reinstatement. Modifies license reinstatement fees by adding third-party logistics providers.

Section 30 (151.071, subdivision 2) updates terminology; adds provision to actions that constitute fee splitting addressing price setting arrangements between pharmacies and physicians, and pharmacies and veterinarians.

Section 31 (151.15, subdivision 1) makes clarifying change; allows a licensed pharmacist or pharmacist intern working within a hospital to receive a prescription order and access the hospital pharmacy’s processing system through secure and encrypted electronic means to process the order.

Section 32 (151.15, subdivision 5) adds subdivision allowing a pharmacist to accept a prescription drug order when not present in a pharmacy, in specified circumstances.

Section 33 (151.15, subdivision 6) adds subdivision outlining the required processes for accepting and filling a prescription under subdivision 5, in emergency circumstances.

Section 34 (151.19, subdivision 1) clarifies provision related to inspection prior to pharmacy licensure. Specifies that pharmacy licensing requirements do not apply to manufacturers, wholesale drug distributors, and logistics providers who distribute home dialysis supplies and devices, if:

1. the manufacturer leases or owns the licensed manufacturing or wholesaling facility from which the dialysate or devices will be delivered;
2. the dialysis supplies meet certain specifications;
3. the supplies are only delivered pursuant to physician's order by a Minnesota licensed pharmacy;
4. the entity keeps records for at least three years, available to the board upon request; and
5. the entity delivers the supplies directly to a patient with end-stage renal disease or the patient’s designee, for dialysis, or to a health care provider or institution, for the same purpose.

Section 35 (151.19, subdivision 3) clarifies provision related to inspection prior to medical gas distributor registration.

Section 36 (151.252, subdivision 1) clarifies provision related to inspection prior to drug manufacturing facility licensure.

Section 37 (151.252, subdivision 1a) clarifies provisions related to inspection of outsourcing facilities for initial licensure or renewal.

Section 38 (151.252, subdivision 3) adds outsourcing facilities to the requirement for an annual report to the board.

Section 39 (151.253, subdivision 4) allows a pharmacist working within a pharmacy licensed as a veterinary pharmacy to compound and provide a drug to a veterinarian without a patient-specific prescription when:

1. the compounded drug is needed in an emergency situation;
2. timely access to a compounding pharmacy is not available;
3. no suitable commercially manufactured drug exists to treat the animal, or there is a shortage of the drug;
4. the compounded drug will be administered by a veterinarian or employee, or dispensed in an amount not to exceed a 10-day supply;
5. the pharmacy has selected the sterile or nonsterile compounding license category; and
6. the pharmacy is registered by the DEA when providing compounded products containing controlled substances.

Section 40 (151.32) modifies citation and title of the Pharmacy Practice Act.

Section 41 (151.40, subdivision 1) modifies list of persons who may possess, control, manufacture, sell, furnish, dispense, or otherwise dispose of hypodermic syringes or needles. Adds persons self-administering drugs pursuant to a prescription or practitioner direction; persons disposing of needles for certain programs; and persons who sell, possess, or handle hypodermic syringes or needles.

Section 42 (151.40, subdivision 2) clarifies provisions governing the sale of hypodermic needles or syringes. Removes provision prohibiting a pharmacy from advertising needles for retail sale.

Section 43 (151.43) modifies cross-reference and specifies that the sections apply to persons operating as third-party logistics providers.

Section 44 (151.441) defines the following terms for the purposes of sections 151.43 to 151.51:

• “Dispenser”
• “Disposition”
• “Distribute” or “distribution”
• “Manufacturer”
• “Medical convenience kit”
• “Package”
• “Prescription drug”
• “Product”
• “Repackager”
• “Third-party logistics provider”
• “Transaction”
• “Wholesale distribution”
• “Wholesale distributor”

Section 45 (151.46) adds licensed third-party logistics providers to those prohibited from dispensing or distributing drugs directly to patients.

Section 46 (151.47, subdivision 1) removes requirements for wholesale drug distributors. Requires manufacturers, repackagers, wholesale distributors, and dispensers to comply with requirements in federal law.

Section 47 (151.47, subdivision 1a) modifies the license requirements for wholesale distributors.

Paragraph (a) specifies that the board will license wholesale distributors, engaged in wholesale distribution, consistent with federal law.

Paragraph (b) prohibits a person to act as a wholesale distributor unless licensed by the board.

Paragraph (c) requires application for a license to be made in a manner specified by the board.

Paragraph (d) requires agreement to operate in compliance with state and federal law in order to be licensed.

Paragraph (e) requires a wholesale distributor facility in another state to prove licensure or registration with the FDA or the state in which the facility is located, in order to be licensed in Minnesota.

Paragraph (f) requires a license for each separate facility.

Paragraph (g) requires an inspection for licensure.

Paragraph (h) specifies additional conditions for wholesale distributor licensure.

Paragraph (i) specifies that employees of wholesale distributors do not need to be licensed.

Paragraph (j) authorizes and requires fingerprint-based criminal background checks for facility managers or designated representatives.

Paragraph (k) prohibits a licensed wholesaler from being owned by or employing individuals who have been convicted of certain felonies or who have violated federal law or certain state licensure requirements.

Paragraph (m) requires a $100,000 surety bond prior to licensing a wholesale distributor that is not government-owned and operated, and a $25,000 surety bond for an applicant with gross receipts under $10,000,000.

Paragraph (n) allows for waiver of the bond requirement in certain circumstances.

Paragraph (o) specifies the purpose of the surety bond.

Paragraph (p) specifies that a single surety bond satisfies the requirement for all wholesale distributor facilities under common ownership.

Section 48 (151.471) Subdivision 1 specifies requirements for third-party logistic providers. Requires third-party logistics providers to comply with applicable federal law.

Subdivision 2 requires board licensure for third-party logistics provider, consistent with federal law. Specifies licensing requirements.

Section 49 (152.126, subdivision 6) requires the Board of Pharmacy to conduct random audits of electronic access by permissible users to the prescription monitoring program by permissible users. This section also requires permissible users of the PBM who has delegated the task of accessing the PBM to an agent or employee to audit the use of the PBM by the agents or employees to ensure compliance with permissible use. Requires permissible users to terminate prescription monitoring program data access by former agents or employees, within three business days of the individual leaving employment.  Allows the board to conduct random audits to determine compliance.

Section 50 (152.127, subdivision 7) provides that a prescriber or dispenser authorized to access prescription monitoring program data who fails to comply with section 49 may be subject to disciplinary action by the appropriate health-licensing board.

Section 51 (152.126, subdivision 10a) allows a patient who has been prescribed a controlled substance to access the prescription monitoring program database to obtain information on access by permissible users to the patient’s data record. Requires the patient to complete, notarize, and submit a request form developed by the Board of Pharmacy. Requires the board to make the form available to the public on its website.

Section 52 (Revisor Instruction) requires the Revisor to add together the fee increases that are in this article and any other fee increases that pass during the regular or special session that are for the drug manufacturers and drug wholesalers.

Section 53 (Repealer) 

Paragraph (a) repeals Minnesota Rules, parts 6400.6970; 7200.6100; and 7200.6105 (Board of Nursing Home Administrators and Board of Psychology fees).

Paragraph (b) repeals sections 151.42, 151.44, 151.49, 151.50, 151.51, and 151.55, relating to wholesale drug distribution licensing and the cancer drug repository program.

Article 11: Health Department

Section 1 (18K.03, subdivision 2) authorizes a person licensed to grow industrial hemp under chapter 18K to sell hemp products derived from industrial hemp grown in Minnesota to medical cannabis manufacturers.

Sections 2 and 3 (62J.495) eliminate the date by which all hospitals and health care providers must have in place an interoperable health records system.

Section 4 (103I.005, subdivision 2) amends the definition of “boring” in chapter 103I (which covers wells, borings, and underground uses) to specify that it includes temporary borings.

Section 5 (103I.005, subdivision 8a) amends the definition of “environmental well,” by clarifying that it does not include an exploratory boring.

Section 6 (103I.005, subdivision 17a) defines “temporary boring” for chapter 103I. This term replaces the term “temporary environmental well” in this chapter.

Section 7 (103I.205, subdivision 1) provides that a person is not required to notify the commissioner before constructing a temporary boring (instead of temporary environmental well as in current law).

Section 8 (103I.205, subdivision 4) allows a person who is a professional engineer, hydrologist or hydrogeologist, professional geoscientist, or geologist, or who meets qualifications in rule, to construct, repair, and seal a temporary boring (in addition to an environmental well as in current law). Removes language authorizing a licensed plumber who does not have a well or boring contractor’s license under chapter 103I to repair submersible pumps or water pipes connected to water well water systems if the repair location is in an area with no licensed well contractors within 50 miles.

Section 9 (103I.205, subdivision 9) Modifies the deadline for submitting a report to the commissioner of health related to well or boring construction or sealing to within 60 days, rather than 30 days, of completing the work.

Section 10 (103I.208, subdivision 1) makes an existing $75 fee apply to the sealing of temporary borings, and provides that a single notification and $75 fee is required for all borings on a single property. Exempts temporary borings less than 25 feet in depth from the notification and fee requirements in chapter 103I. Changes a term used, from “temporary environmental well” to “temporary boring.”

Section 11 (103I.235, subdivision 3) exempts temporary borings that were sealed by a licensed contractor (rather than temporary environmental wells as in current law) from requirements to disclose to a buyer the location of wells on the property.

Section 12 (103I.301, subdivision 3a) requires the owner of a property with a temporary boring to have the temporary boring sealed within 72 hours after the start of construction of the temporary boring, and specifies who is authorized to seal the temporary boring.

Section 13 (103I.301, subdivision 6) prohibits a person from sealing a temporary boring until a notification is filed with the commissioner, except that temporary borings less than 25 feet in depth are exempt from this notification requirement. Provides that a single notification is required for all temporary borings sealed on a single property.

Section 14 (103I.601, subdivision 4) provides that one site fee of $275 must be submitted for all exploratory borings marked on the proposed boring map submitted to the commissioner of health, not $275 per exploratory boring. Also specifies the paper size for the map of proposed borings to be submitted to the commissioner.

Section 15 (144.121, subdivision 1a) requires facilities that use radiation-producing security screening systems to pay the commissioner of health a base registration fee of $100 plus $100 for each system in use. Defines security screening system for purposes on this section as radiation-producing equipment designed and used for security screening of humans who are in the custody of a correctional or detention facility, and used by the facility to image and identify contraband items concealed within or on all sides of a human body. Also defines a correctional or detention facility.

Section 16 (144.121, subdivision 9) exempts employees of correctional or detention facilities who operate security screening systems and the facilities in which these systems are operated from certain statutory and regulatory requirements (e.g., operator need not have passed a national exam for limited x-ray machine operation) enforced by the Department of Health.

Section 17 (144.1506, subdivision 2) authorizes for eligible primary care residency training programs that are longer than three years that grants may be awarded for the duration of the residency so long as an average of $100,000 per residency per slot is not exceeded.

Section 18 (144.225, subdivision 2) amends a subdivision governing access to birth data, to allow:

• a tribal health department to obtain (1) contact information for a mother who was not married to a child’s father when the child was conceived and born and (2) the child’s date of birth (current law allows this information to be disclosed to a county social services department or a public health member of a family services collaborative); and
• a tribal child support program to access birth records for child support enforcement purposes.

Section 19 (144.225, subdivision 2a) allows the commissioner of health to disclose to a tribal health department, health data associated with a birth registration that identifies a mother or child at high risk for serious disease, disability, or delay (current law allows the commissioner to disclose this information to a community health board).

Section 20 (144.225, subdivision 7) directs the state or local office of vital records to issue a certified birth or death record or statement of no vital record found to any tribal governmental agency upon request, if the certified vital record is needed for the governmental agency to perform its duties (current law allows local, state, and federal governmental agencies to obtain certified vital records needed to perform their duties).

Section 21 (144.3831, subdivision 1) increases the annual fee-for-service connection to a public water supply, from $6.36 to $9.72.

Section 22 (144.397) requires the commissioner to administer statewide tobacco cessation services to assist individuals who are seeking advice or services to help them quit using tobacco products. The commissioner must establish statewide public awareness activities to inform the public of the availability of the services and encourage the public to use the services.

Section 23 (144.412) adds to the public purpose of the Minnesota Clean Indoor Air Act (MCAA) to protect against involuntary exposure to aerosol or vapor from electronic delivery devices.

Section 24 (144.413, subdivision 1) makes a conforming citation change.

Section 25 (144.413, subdivision 4) modifies the definition of smoking to  include the burning or carrying of a lighted or heated cigar, cigarette, pipe, or any other lighted or heated product containing, made, or derived  from nicotine, tobacco, marijuana, or other plant that is intended for inhalation.  Specifies that the definition includes carrying or using an activated electronic delivery device.

Section 26 (144.414, subdivision 2) makes a conforming change.

Section 27 (144.414, subdivision 3) makes a conforming change.

Section 28 (144.416) modifies this section to permit a proprietor of a business to take more stringent measures to protect individuals from involuntary exposure to aerosol or vapor from electronic delivery services.

Section 29 (144.4165) modifies this section to prohibit carrying or using an activated electronic delivery device in public schools and in charter schools.

Section 30 (144.4167, subdivision 4) modifies the description of products sold in a tobacco products shop. Also adds electronic delivery devices to the list of products from which a tobacco products shop derives more than 90 percent of its revenue.

Section 31 (144.417) modifies this section to permit a local government to pass more stringent measures to protect individuals from involuntary exposure to aerosol or vapor from electronic delivery devices.

Section 32 (144.552) Paragraph (a) requires the commissioner to return in full payments made by a hospital to the commissioner to cover the costs of a public interest review if the commissioner fails to issue a finding within 150 calendar days of the initial submission of the hospital’s plan to increase its number of licensed beds.

Paragraph (b) requires a hospital to respond to the commissioner’s request for additional information within 14 days of the commissioner’s request.

Paragraph (c) increases the current 90-day default time limit for the commissioner to issue a public interest finding to 150 calendar days of the date from when the commissioner sends the hospital a notice of a complete application letter. It also eliminates the six-month time limit in extenuating circumstances.

Clause (1) modifies one of the conditions the commissioner is required to consider when performing a public interest review of a proposed hospital construction moratorium exception: under current practice, the commissioner considers the number of licensed beds when analyzing whether new hospitals or new licensed beds are needed “to provide timely access to care or access to new and improved services.” The amendment to paragraph (c), clause (1), requires the commissioner to consider instead the number of available beds and provides a definition of "available beds."

Section 33 (144.562, subdivision 2) increases the total number of swing bed days critical access hospitals are allowed per year, from 2,000 days to a total of 3,000 days of swing bed use in calendar year 2020, and in each subsequent calendar year until 2027, the total number of days is increased by 200 swing bed use days. Beginning 2028, a hospital is allowed a total of 4,500 days per year. Sunsets the paragraphs that allow the commissioner of health to approve swing bed use beyond 2,000 days in certain conditions, that allow a hospital to admit a limited number of additional patients to swing beds once the 2,000-day limit is reached without commissioner approval or being in violation of this section, and that allow a health system to allocate its total limit of swing bed days among the hospitals within the system, on January 1, 2020.

Section 34 (144.586, subdivision 3) requires hospitals discharging a medically fragile pediatric patient to ensure that arrangements are made and in place to implement the patients discharge plan prior to discharge.

Section 35 (144.591) requires a hospital to provide to a patient within 30 days of discharge an itemized description of billed charges that includes a notation for each drug dispensed to the patient, the charge for which was increased by 5% or more over the hospital’s acquisition cost.

Section 36 (144.966, subdivision 2) extends the newborn hearing screening advisory council until June 30, 2025. This section also adds two members to the committee.

Section 37 (144.99) allows the commissioner of health to enforce the medical cannabis sections (sections 152.22 to 152.37) using the tools and authority in the Health Enforcement Consolidation Act. (These provisions allow the commissioner to access information and property, list enforcement actions the commissioner may take, provide for contested case hearings, provide that a violation of a statute subject to enforcement under the act is a misdemeanor, and establish procedures for issuing administrative penalty orders).

Section 38 (144A.43, subdivision 11) modifies the definition of medication administration in statutes governing home care providers.

Section 39 (144A.43, subdivision 12a) for statutes governing home care providers, defines medication reconciliation as the process of identifying the most accurate list of all medications a client is taking by comparing the client record to an external list of medications.

Section 40 (144A.43, subdivision 30) modifies the definition of standby assistance in statutes governing home care providers.

Section 41 (144A.472, subdivision 5) Paragraph (a) clarifies what constitutes a change of ownership for a home care provider business. Paragraphs (b) and (c) provide that when a change in ownership occurs, employees of the business under the old owner who continue employment with the business under the new owner are not required to undergo new training, except on policies of the new owner that differ from those of the old owner.

Section 42 (144A.472, subdivision 7) adds a penalty of $1,000 for a home care provider with a temporary license that fails to notify the commissioner of health within five days after it begins providing services to clients.

Section 43 (144A.473) establishes temporary license and license renewal.

Subdivision 1 exempts temporary licenses from the requirement that home care provider licenses are valid for up to a year from the date of issuance.

Subdivision 2 adds a reference that temporary licenses can be extended according to subdivision 3. Requires the commissioner to survey temporary licensees within 90 calendar days after the provider begins providing services. Also changes terminology from license year to license period.

Subdivision 3 modifies steps the commissioner may take if a temporary licensee is not in substantial compliance with a survey: in addition to not issuing a license as provided in current law, the commissioner may terminate the temporary license, or extend the temporary license and apply conditions. Establishes a deadline by which the commissioner must receive a reconsideration request and supporting documentation from a temporary licensee. Lists the circumstances under which a temporary licensee whose license is denied may continue operating.

Section 44 (144A.474, subdivision 2) defines change in ownership survey, and requires such surveys to be completed within six months after the commissioner issues a new license due to a change in ownership.

Section 45 (144A.475, subdivision 1) permits the commissioner to refuse to grant a license as a result of a change in ownership, if a home care provider, owner, or managerial official engages in certain conduct.

Section 46 (144A.475, subdivision 2) provides that a home care provider operating under a suspended or conditional license according to this subdivision may continue to operate while home care clients are being transferred to other providers.

Section 47 (144A.475, subdivision 5) provides that a home care provider whose license is being suspended or revoked according to this subdivision may continue to operate while home care clients are being transferred to other providers.

Section 48 (144A.476, subdivision 1) requires the commissioner to conduct a background study on owners and managerial officials of a home care provider before issuing a license due to a change in ownership.

Section 49 (144A.479, subdivision 7) makes a technical change.

Section 50 (144A.479, subdivision 8) inserts a cross-reference in the home care statute notifying home care providers of their obligation to submit labor market data.

Section 51 (144A.4791, subdivision 1) clarifies that a client must receive a written notice of the home care bill of rights before the date services are first provided to the client.

Section 52 (144A.4791, subdivision 3) clarifies that a home care provider must provide the client with information about the home care provider’s license and the services the provider can provide before the date services are first provided to the client.

Section 53 (144A.4791, subdivision 6) clarifies that if a client receives services before the client receives a review or assessment, a licensed health professional or registered nurse must complete a temporary plan and orient staff to deliver services.

Section 54 (144A.4791, subdivision 7) requires an initial review of the client’s needs and preferences to be completed within 30 days after the date home care services are first provided to the client.

Section 55 (144A.4791, subdivision 8) requires an initial assessment or reassessment to occur within specified periods after the date home care services are first provided to the client.

Section 56 (144A.4791, subdivision 9) requires a service plan to be finalized within 14 days after the date home care services are first provided, rather than after the initiation of home care services. Modifies what the service plan must include regarding staffing and supervision.

Section 57 (144A.4792, subdivision 1) requires a comprehensive home care provider to have policies to ensure security and accountability for management, control, and disposition of controlled substances, if the provider stores and secures controlled substances.

Section 58 (144A.4792, subdivision 2) requires an assessment conducted before a home care provider provides medication management services, to include providing instructions to the client or a representative on interventions to manage medications and prevent medication diversion.

Section 59 (144A.4792, subdivision 5) requires medication reconciliation to occur as part of medication management.

Section 60 (144A.4792, subdivision 10) modifies requirements for medication management for clients who will be away from home:

• for unplanned time away, limits the amount of medication a client may receive to the amount needed for seven calendar days (rather than 120 hours [five calendar days] as in current law); and
• requires written procedures that apply during unplanned time away when a registered nurse is not available, to specify how unlicensed staff must document unused medications that are returned to the provider.

Section 61 (144A.4793, subdivision 6) requires treatment and therapy orders to be renewed at least every 12 months, and requires these orders to include information on the duration of the treatment or therapy.

Section 62 (144A.4796, subdivision 2) makes a technical change to a subdivision governing what must be covered in home care provider employee orientation.

Section 63 (144A.4797, subdivision 3) clarifies when supervision must take place for staff performing delegated tasks.

Section 64 (144A.4798) consolidates and updates disease prevention and infection control requirements for home care providers.

Section 65 (144A.4799, subdivision 1) allows persons who have received home care services within the past five years to be members of the home care and assisted living program advisory council.

Section 66 (144A.4799, subdivision 3) clarifies the topics on which the home care and assisted living program advisory council may provide advice to the commissioner.

Section 67 (144A.484, subdivision 1) strikes an obsolete paragraph.

Section 68 (145.908, subdivision 1) specifies that the commissioner shall provide grants for screening and treatment for pre- and postpartum mood and anxiety disorders within the limits of available appropriations (instead of within federal funds that are available).

Sections 69 and 70 (145.928) modify the goals of the health disparities grant program to include reducing ethnic and racial disparities in access to and utilization of high quality prenatal care.

Sections 71 to 75 modify the state health improvement program.

Section 71 (145.986, subdivision 1) permits grants to go for a broader purpose than just obesity and tobacco use.

Section 72 (145.986, subdivision 1a) requires projects to be proven-effective strategies and promising practices that can be evaluated with experimental or quasi-experimental designs. Permits 100 percent of tribal grants and up to 25 percent of grants to community health boards to be awarded to theory-based strategies that are culturally or ethnically focused.

Section 73 (145.986, subdivision 4) specifies that the evaluation use the most appropriate experimental or quasi-experimental design suitable to the activity or project.

Section 74 (145.986, subdivision 5) requires the reports to the legislature to include a description of the evaluation systems used.

Section 75 (145.986, subdivision 6) makes conforming changes to the broader purposes of the SHIP grants.

Section 76 (151.72) regulates the sale of certain cannabinoid products.

Subdivision 1 defines hemp and labeling.

Subdivision 2, Paragraph (a) specifies that this section applies to the sale of any product, other than food, intended for human or animal consumption that contains cannabinoids extracted from hemp.

Paragraph (b) specifies that this section does not apply to a product dispensed by a registered medical cannabis manufacturer.

Subdivision 3 permits a product containing nonintoxicating cannabinoids to be sold for human or animal consumption if all requirements are met.

Subdivision 4 requires a manufacturer of a product regulated under this section to submit representative samples to be tested by an independent accredited laboratory.

Subdivision 5 requires the product to bear a label that meets certain requirements.

Subdivision 6, Paragraph (a) specifies when a product regulated under this section would be considered an adulterated drug.

Paragraph (b) specifies when a product regulated under this section would be considered misbranded.

Paragraph (c) authorizes the Board of Pharmacy to issue cease and desist orders under the board’s current authority to embargo misbranded and adulterated drugs and to seek injunctive relief for any violations of this section.

Sections 78 to 102 modify the Minnesota medical cannabis program.

Section 78 (152.22, subdivision 5a) adds a definition of “hemp” in the medical cannabis definition section.

Section 79 (152.22, subdivision 5b) defines hemp grower for purposes of the medical cannabis statutes.

Section 80 (152.22, subdivision 6) adds hemp acquired by a medical cannabis manufacturer to the definition of medical cannabis for the purpose of the medical cannabis program.

Section 81 (152.22, subdivision 11) amends the definition of registered designated caregiver, requiring a caregiver to be 18 or older rather than 21 or older as in current law and modifying the description of a patient’s disability that necessitates a designated caregiver.

Section 82 (152.22, subdivision 13) amends the definition of registry verification, to provide that it does not list the patient’s qualifying medical condition and to list the patient’s spouse if the spouse is acting as caregiver to the patient.

Section 83 (152.25, subdivision 1) provides that a registration agreement between a medical cannabis manufacturer and the commissioner is not transferable.

Section 84 (152.25, subdivision 1a) makes a conforming change with the amendment to section 152.25, subdivision 1, which makes registration agreements not transferrable.

Section 85 (152.25, subdivision 1c) includes spouses acting as caregivers to patients enrolled in the medical cannabis program, in a subdivision requiring the commissioner to notify certain people if the commissioner takes action that may affect a manufacturer’s ability to provide medical cannabis.

Section 86 (152.25, subdivision 4) directs the commissioner to provide updates to certain legislative committees and to the task force on medical cannabis therapeutic research on (1) changes in federal law regarding the use of hemp, and (2) the market demand and supply for products made from hemp that can be used for medicinal purposes.

Section 87 (152.27, subdivision 2) requires the commissioner to create a certification for health care practitioners to use to certify whether a patient with a qualifying medical condition needs a designated caregiver, modifies the description of a patient’s disability that necessitates a designated caregiver. Permits the commissioner to add a delivery method or a qualifying medical condition upon a petition from a member of the public, the task force, or as directed by law.

Section 88 (152.27, subdivision 3) modifies the description of a patient’s disability that necessitates a designated caregiver. Also adds spouses as patient caregivers to the certification from a health care practitioner regarding the patient’s qualifying medical condition and need for a caregiver.

Section 89 (152.27, subdivision 4) In a subdivision establishing procedures and requirements for designated caregivers to be registered under the medical cannabis program, lowers the age for a caregiver from 21 to 18; modifies the description of a patient’s disability that necessitates a designated caregiver; requires a designated caregiver’s background check to be renewed every two years; and provides that a registered designated caregiver may also be a patient enrolled in the registry program and may possess and use medical cannabis as a patient.

Section 90 (152.27, subdivision 5) adds spouses of patients to the list of people who may act as a patient caregiver without having to register as a designated caregiver.

Section 91 (152.27, subdivision 6) removes a patient’s qualifying medical condition from the information listed on the patient’s registry verification. Also adds a patient’s spouse if acting as a patient caregiver, to the information included on a registry verification.

Section 92 (152.28, subdivision 1) authorizes a health care practitioner to conduct a registered patient assessment for recertification of a qualifying condition via telemedicine.

Section 93 (152.29, subdivision 1) increases the distribution facilities that a manufacturer must operate from four to eight.  Requires the commissioner to designate the geographic service areas to be served by each manufacturer and limits the manufacturer to no more than two distribution facilities in each geographic service area assigned to that manufacturer.  This section also permits a manufacturer to obtain hemp from a hemp grower licensed under chapter 18K and make the hemp available to patients in one of the permitted forms. It also clarifies that hemp acquired by a manufacturer is subject to the same quality control, security, testing and other requirements as for medical cannabis under the program.  Finally this section requires the manufacturer to include in its operating documents procedures for the delivery and transportation of hemp between hemp growers and the manufacturers.

Section 94 (152.29, subdivision 2) conforming change, requiring a manufacturer to process hemp under the same requirements as medical cannabis.

Section 95 (152.29, subdivision 3) allows a manufacturer to transport medical cannabis or medical cannabis products to another manufacturer for the receiving manufacturer to distribute. Allows a manufacturer to distribute up to a 90-day supply of medical cannabis, rather than a 30-day supply as in current law. Makes a conforming change.

Section 96 (152.29, subdivision 3a) authorizes a manufacturer to staff a transport vehicle with only one employee if transporting hemp only.

Section 97 (152.31) authorizes the commissioner to execute data sharing arrangements with the commissioner of agriculture to verify licensing information, inspections, and compliance related to licensed hemp growers.

Section 98 (152.32, subdivision 2) makes a change to conform with other language allowing patient spouses to serve as caregivers to patients enrolled in the medical cannabis program.

Section 99 (152.33, subdivision 1) specifies that transferring medical cannabis to another registered manufacturer or to a spouse caregiver of a patient does not subject a manufacturer to criminal penalties.

Section 100 (152.33, subdivision 2) adds patient spouses serving as caregivers to the list of patient caregivers subject to criminal penalties if they divert medical cannabis to a person other than the intended patient.

Section 101 (152.34) allows hospice providers, supervised living facilities, and other health facilities regulated by the commissioner of health to adopt reasonable restrictions on the use of medical cannabis.

Section 102 (152.36, subdivision 2) directs the task force on medical cannabis therapeutic research to evaluate the impact of using hemp and Minnesota’s activities involving hemp.

Section 103 (157.22) exempts from the licensure requirement under chapter 157 (food and beverage establishments) a special event food stand or seasonal temporary food stand if the stand located on private property with the property owner’s permission; has gross receipts or contributions of $1000 or less; and a sign is posted at the site that states that the products sold at the stand are not subject to state inspection or regulation if the stand offers for sale potentially hazardous food.

Section 104 (214.25, subdivision 2) makes a technical change to a subdivision classifying data collected or maintained by the commissioner in administering the HIV/HBV/HCB prevention program (a program being repealed in this article), and strikes paragraphs authorizing disclosure of certain data under this program that are obsolete if the program is repealed.

Section 105 requires a resident of a nursing facility who is conducting electronic monitoring to submit a notification and consent form to the facility if a new roommate moves into the room or unit.

Section 106 (Plan for a Working Group on Links Between Health Disparities and Educational Achievement for Children from American Indian Communities and Communities of Color) requires the commissioner of health, in consultation with the commissioner of education, to develop a plan to convene a working group to examine health disparities and disparities in educational achievement for children from American Indian communities and communities of color.

Section 107 (Community Solutions for Health Child Development Grant Program) requires the commissioner of health to establish a grant program awarding grants to community organizations that work with communities of color and American Indian communities and organizations focused on supporting health child development.

Section 108 (Domestic Violence and Sexual Assault Prevention Program) requires the commissioner of health to award grants to nonprofit organizations for the purpose of funding programs that incorporate community-driven and culturally-relevant practices to prevent domestic violence and sexual assault.

Section 109 (Skin Lightening Products Public Awareness and Education Grant Program) requires the commissioner of health to award grants for the purpose of increasing public awareness and education on the health dangers associated with using skin lightening creams and products that contain mercury.

Section 110 (Sale of Certain Cannabinoid Products Workgroup) requires the commissioner of health to convene a workgroup to advise the legislature on how to regulate products that contain cannabinoids extracted from hemp.  The results of the study must be submitted to the legislature by January 15, 2020.

Section 111 provides a Revisor Instruction.

Article 12: Miscellaneous

Section 1 (10.584) designates the month of May as Maternal Mental Health Awareness Month.