relating to BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

207.20    Section 1. Minnesota Statutes 2012, section 245A.03, subdivision 7, is amended to read:
207.21    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an
207.22initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to
207.232960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
207.249555.6265, under this chapter for a physical location that will not be the primary residence
207.25of the license holder for the entire period of licensure. If a license is issued during this
207.26moratorium, and the license holder changes the license holder's primary residence away
207.27from the physical location of the foster care license, the commissioner shall revoke the
207.28license according to section 245A.07. Exceptions to the moratorium include:
207.29(1) foster care settings that are required to be registered under chapter 144D;
207.30(2) foster care licenses replacing foster care licenses in existence on May 15, 2009,
207.31and determined to be needed by the commissioner under paragraph (b);
207.32(3) new foster care licenses determined to be needed by the commissioner under
207.33paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center, or
207.34restructuring of state-operated services that limits the capacity of state-operated facilities,
208.1or, allowing movement to the community for people who no longer require the level of
208.2care provided in state-operated facilities as provided under section 256B.092, subdivision
208.313, or 256B.49, subdivision 24;
208.4(4) new foster care licenses determined to be needed by the commissioner under
208.5paragraph (b) for persons requiring hospital level care; or
208.6(5) new foster care licenses determined to be needed by the commissioner for the
208.7transition of people from personal care assistance to the home and community-based
208.8services.
208.9(b) The commissioner shall determine the need for newly licensed foster care homes
208.10as defined under this subdivision. As part of the determination, the commissioner shall
208.11consider the availability of foster care capacity in the area in which the licensee seeks to
208.12operate, and the recommendation of the local county board. The determination by the
208.13commissioner must be final. A determination of need is not required for a change in
208.14ownership at the same address.
208.15(c) The commissioner shall study the effects of the license moratorium under this
208.16subdivision and shall report back to the legislature by January 15, 2011. This study shall
208.17include, but is not limited to the following:
208.18(1) the overall capacity and utilization of foster care beds where the physical location
208.19is not the primary residence of the license holder prior to and after implementation
208.20of the moratorium;
208.21(2) the overall capacity and utilization of foster care beds where the physical
208.22location is the primary residence of the license holder prior to and after implementation
208.23of the moratorium; and
208.24(3) the number of licensed and occupied ICF/MR beds prior to and after
208.25implementation of the moratorium.
208.26(d) (c) When a foster care recipient moves out of a foster home that is not the primary
208.27residence of the license holder according to section 256B.49, subdivision 15, paragraph
208.28(f), the county shall immediately inform the Department of Human Services Licensing
208.29Division. The department shall decrease the statewide licensed capacity for foster care
208.30settings where the physical location is not the primary residence of the license holder, if
208.31the voluntary changes described in paragraph (f) (e) are not sufficient to meet the savings
208.32required by reductions in licensed bed capacity under Laws 2011, First Special Session
208.33chapter 9, article 7, sections 1 and 40, paragraph (f), and maintain statewide long-term
208.34care residential services capacity within budgetary limits. Implementation of the statewide
208.35licensed capacity reduction shall begin on July 1, 2013. The commissioner shall delicense
208.36up to 128 beds by June 30, 2014, using the needs determination process. Under this
209.1paragraph, the commissioner has the authority to reduce unused licensed capacity of a
209.2current foster care program to accomplish the consolidation or closure of settings. Under
209.3this paragraph, the commissioner has the authority to manage statewide capacity, including
209.4adjusting the capacity available to each county, and adjusting statewide available capacity,
209.5to meet the statewide needs identified through the process in paragraph (e). A decreased
209.6licensed capacity according to this paragraph is not subject to appeal under this chapter.
209.7(e) (d) Residential settings that would otherwise be subject to the decreased license
209.8capacity established in paragraph (d) (c) shall be exempt under the following circumstances:
209.9(1) until August 1, 2013, the license holder's beds occupied by residents whose
209.10primary diagnosis is mental illness and the license holder is:
209.11(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental
209.12health services (ARMHS) as defined in section 256B.0623;
209.13(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to
209.149520.0870;
209.15(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to
209.169520.0870; or
209.17(iv) a provider of intensive residential treatment services (IRTS) licensed under
209.18Minnesota Rules, parts 9520.0500 to 9520.0670; or
209.19(2) the license holder's beds occupied by residents whose primary diagnosis is
209.20mental illness and the license holder is certified under the requirements in subdivision 6a.
209.21(f) (e) A resource need determination process, managed at the state level, using the
209.22available reports required by section 144A.351, and other data and information shall
209.23be used to determine where the reduced capacity required under paragraph (d) (c) will
209.24be implemented. The commissioner shall consult with the stakeholders described in
209.25section 144A.351, and employ a variety of methods to improve the state's capacity to
209.26meet long-term care service needs within budgetary limits, including seeking proposals
209.27from service providers or lead agencies to change service type, capacity, or location to
209.28improve services, increase the independence of residents, and better meet needs identified
209.29by the long-term care services reports and statewide data and information. By February
209.301 of each 2013 and August 1 of 2014 and each following year, the commissioner shall
209.31provide information and data on the overall capacity of licensed long-term care services,
209.32actions taken under this subdivision to manage statewide long-term care services and
209.33supports resources, and any recommendations for change to the legislative committees
209.34with jurisdiction over health and human services budget.
209.35    (g) (f) At the time of application and reapplication for licensure, the applicant and the
209.36license holder that are subject to the moratorium or an exclusion established in paragraph
210.1(a) are required to inform the commissioner whether the physical location where the foster
210.2care will be provided is or will be the primary residence of the license holder for the entire
210.3period of licensure. If the primary residence of the applicant or license holder changes, the
210.4applicant or license holder must notify the commissioner immediately. The commissioner
210.5shall print on the foster care license certificate whether or not the physical location is the
210.6primary residence of the license holder.
210.7    (h) (g) License holders of foster care homes identified under paragraph (g) (f) that
210.8are not the primary residence of the license holder and that also provide services in the
210.9foster care home that are covered by a federally approved home and community-based
210.10services waiver, as authorized under section 256B.0915, 256B.092, or 256B.49, must
210.11inform the human services licensing division that the license holder provides or intends to
210.12provide these waiver-funded services. These license holders must be considered registered
210.13under section 256B.092, subdivision 11, paragraph (c), and this registration status must
210.14be identified on their license certificates.

210.15    Sec. 2. Minnesota Statutes 2012, section 252.291, is amended by adding a subdivision
210.16to read:
210.17    Subd. 2b. Nicollet County facility project. The commissioner of health shall
210.18certify one additional bed in an intermediate care facility for persons with developmental
210.19disabilities in Nicollet County.

210.20    Sec. 3. Minnesota Statutes 2012, section 256.9657, subdivision 1, is amended to read:
210.21    Subdivision 1. Nursing home license surcharge. (a) Effective July 1, 1993,
210.22each non-state-operated nursing home licensed under chapter 144A shall pay to the
210.23commissioner an annual surcharge according to the schedule in subdivision 4. The
210.24surcharge shall be calculated as $620 per licensed bed. If the number of licensed beds is
210.25reduced changed, the surcharge shall be based on the number of remaining licensed beds
210.26the second month following the receipt of timely notice by the commissioner of human
210.27services that the number of beds have been delicensed has been changed. The nursing home
210.28must notify the commissioner of health in writing when the number of beds are delicensed
210.29 is changed. The commissioner of health must notify the commissioner of human services
210.30within ten working days after receiving written notification. If the notification is received
210.31by the commissioner of human services by the 15th third of the month, the invoice for the
210.32second following month must be reduced changed to recognize the delicensing change
210.33in the number of beds. Beds on layaway status continue to be subject to the surcharge.
211.1 The commissioner of human services must acknowledge a medical care surcharge appeal
211.2within 30 days of receipt of the written appeal from the provider.
211.3(b) Effective July 1, 1994, the surcharge in paragraph (a) shall be increased to $625.
211.4(c) Effective August 15, 2002, the surcharge under paragraph (b) shall be increased
211.5to $990.
211.6(d) Effective July 15, 2003, the surcharge under paragraph (c) shall be increased
211.7to $2,815.
211.8(e) Effective July 15, 2013, the surcharge under paragraph (d) shall be increased
211.9to $3,255.
211.10(f) The commissioner may reduce, and may subsequently restore, the surcharge under
211.11paragraph (d) (e) based on the commissioner's determination of a permissible surcharge.
211.12(f) (g) Between April 1, 2002, and August 15, 2004 July 1, 2013, and June 30,
211.132014, a facility governed by this subdivision may elect to assume full participation in
211.14the medical assistance program by agreeing to comply with all of the requirements of
211.15the medical assistance program, including the rate equalization law in section 256B.48,
211.16subdivision 1 , paragraph (a), and all other requirements established in law or rule, and
211.17to begin intake of new medical assistance recipients. Rates will be determined under
211.18Minnesota Rules, parts 9549.0010 to 9549.0080. Notwithstanding section 256B.431,
211.19subdivision 27 , paragraph (i), rate calculations will be subject to limits as prescribed
211.20in rule and law. Other than the adjustments in sections 256B.431, subdivisions 30 and
211.2132 ; 256B.437, subdivision 3, paragraph (b), Minnesota Rules, part 9549.0057, and any
211.22other applicable legislation enacted prior to the finalization of rates, facilities assuming
211.23full participation in medical assistance under this paragraph are not eligible for any rate
211.24adjustments until the July 1 following their settle-up period.

211.25    Sec. 4. Minnesota Statutes 2012, section 256.9657, subdivision 3a, is amended to read:
211.26    Subd. 3a. ICF/MR ICF/DD license surcharge. (a) Effective July 1, 2003, each
211.27non-state-operated facility as defined under section 256B.501, subdivision 1, shall pay
211.28to the commissioner an annual surcharge according to the schedule in subdivision 4,
211.29paragraph (d). The annual surcharge shall be $1,040 per licensed bed. If the number of
211.30licensed beds is reduced, the surcharge shall be based on the number of remaining licensed
211.31beds the second month following the receipt of timely notice by the commissioner of
211.32human services that beds have been delicensed. The facility must notify the commissioner
211.33of health in writing when beds are delicensed. The commissioner of health must notify
211.34the commissioner of human services within ten working days after receiving written
211.35notification. If the notification is received by the commissioner of human services by
212.1the 15th of the month, the invoice for the second following month must be reduced to
212.2recognize the delicensing of beds. The commissioner may reduce, and may subsequently
212.3restore, the surcharge under this subdivision based on the commissioner's determination of
212.4a permissible surcharge.
212.5(b) Effective July 1, 2013, the surcharge under paragraph (a) is increased to $3,679
212.6per licensed bed.

212.7    Sec. 5. Minnesota Statutes 2012, section 256B.0915, subdivision 3a, is amended to read:
212.8    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of
212.9waivered services to an individual elderly waiver client except for individuals described in
212.10paragraph paragraphs (b) and (d) shall be the weighted average monthly nursing facility
212.11rate of the case mix resident class to which the elderly waiver client would be assigned
212.12under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance
212.13needs allowance as described in subdivision 1d, paragraph (a), until the first day of the
212.14state fiscal year in which the resident assessment system as described in section 256B.438
212.15for nursing home rate determination is implemented. Effective on the first day of the state
212.16fiscal year in which the resident assessment system as described in section 256B.438 for
212.17nursing home rate determination is implemented and the first day of each subsequent state
212.18fiscal year, the monthly limit for the cost of waivered services to an individual elderly
212.19waiver client shall be the rate of the case mix resident class to which the waiver client
212.20would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on
212.21the last day of the previous state fiscal year, adjusted by any legislatively adopted home
212.22and community-based services percentage rate adjustment.
212.23    (b) The monthly limit for the cost of waivered services to an individual elderly
212.24waiver client assigned to a case mix classification A under paragraph (a) with:
212.25(1) no dependencies in activities of daily living; or
212.26(2) up to two dependencies in bathing, dressing, grooming, walking, and eating
212.27when the dependency score in eating is three or greater as determined by an assessment
212.28performed under section 256B.0911
212.29shall be $1,750 per month effective on July 1, 2011, for all new participants enrolled in
212.30the program on or after July 1, 2011. This monthly limit shall be applied to all other
212.31participants who meet this criteria at reassessment. This monthly limit shall be increased
212.32annually as described in paragraph (a).
212.33(c) If extended medical supplies and equipment or environmental modifications are
212.34or will be purchased for an elderly waiver client, the costs may be prorated for up to
212.3512 consecutive months beginning with the month of purchase. If the monthly cost of a
213.1recipient's waivered services exceeds the monthly limit established in paragraph (a) or
213.2(b), the annual cost of all waivered services shall be determined. In this event, the annual
213.3cost of all waivered services shall not exceed 12 times the monthly limit of waivered
213.4services as described in paragraph (a) or (b).
213.5(d) Effective July 1, 2013, the monthly cost limit of waiver services, including
213.6any necessary home care services described in section 256B.0651, subdivision 2, for
213.7individuals who meet the criteria as ventilator-dependent given in section 256B.0651,
213.8subdivision 1, paragraph (g), shall be the average of the monthly medical assistance
213.9amount established for home care services as described in section 256B.0652, subdivision
213.107, and the annual average contracted amount established by the commissioner for nursing
213.11facility services for ventilator-dependent individuals. This monthly limit shall be increased
213.12annually as described in paragraph (a).

213.13    Sec. 6. Minnesota Statutes 2012, section 256B.0915, is amended by adding a
213.14subdivision to read:
213.15    Subd. 3j. Individual community living support. Upon federal approval, there
213.16is established a new service called individual community living support (ICLS) that is
213.17available on the elderly waiver. ICLS providers may not be the landlord of recipients, nor
213.18have any interest in the recipient's housing. ICLS must be delivered in a single-family
213.19home or apartment where the service recipient or their family owns or rents, as
213.20demonstrated by a lease agreement, and maintains control over the individual unit. Case
213.21managers or care coordinators must develop individual ICLS plans in consultation with
213.22the client using a tool developed by the commissioner. The commissioner shall establish
213.23payment rates and mechanisms to align payments with the type and amount of service
213.24provided, assure statewide uniformity for payment rates, and assure cost-effectiveness.
213.25Licensing standards for ICLS shall be reviewed jointly by the Departments of Health and
213.26Human Services to avoid conflict with provider regulatory standards pursuant to section
213.27144A.43 and chapter 245D.

213.28    Sec. 7. Minnesota Statutes 2012, section 256B.0916, is amended by adding a
213.29subdivision to read:
213.30    Subd. 11. Excess spending. County and tribal agencies are responsible for spending
213.31in excess of the allocation made by the commissioner. In the event a county or tribal
213.32agency spends in excess of the allocation made by the commissioner for a given allocation
213.33period, they must submit a corrective action plan to the commissioner. The plan must state
213.34the actions the agency will take to correct their overspending for the year following the
214.1period when the overspending occurred. Failure to correct overspending shall result in
214.2recoupment of spending in excess of the allocation. Nothing in this subdivision shall be
214.3construed as reducing the county's responsibility to offer and make available feasible
214.4home and community-based options to eligible waiver recipients within the resources
214.5allocated to them for that purpose.

214.6    Sec. 8. Minnesota Statutes 2012, section 256B.092, subdivision 11, is amended to read:
214.7    Subd. 11. Residential support services. (a) Upon federal approval, there is
214.8established a new service called residential support that is available on the community
214.9alternative care, community alternatives for disabled individuals, developmental
214.10disabilities, and brain injury waivers. Existing waiver service descriptions must be
214.11modified to the extent necessary to ensure there is no duplication between other services.
214.12Residential support services must be provided by vendors licensed as a community
214.13residential setting as defined in section 245A.11, subdivision 8.
214.14    (b) Residential support services must meet the following criteria:
214.15    (1) providers of residential support services must own or control the residential site;
214.16    (2) the residential site must not be the primary residence of the license holder;
214.17    (3) the residential site must have a designated program supervisor responsible for
214.18program oversight, development, and implementation of policies and procedures;
214.19    (4) the provider of residential support services must provide supervision, training,
214.20and assistance as described in the person's coordinated service and support plan; and
214.21    (5) the provider of residential support services must meet the requirements of
214.22licensure and additional requirements of the person's coordinated service and support plan.
214.23    (c) Providers of residential support services that meet the definition in paragraph
214.24(a) must be registered using a process determined by the commissioner beginning July
214.251, 2009. Providers licensed to provide child foster care under Minnesota Rules, parts
214.262960.3000 to 2960.3340, or adult foster care licensed under Minnesota Rules, parts
214.279555.5105 to 9555.6265, and that meet the requirements in section 245A.03, subdivision
214.287 , paragraph (g) (f), are considered registered under this section.

214.29    Sec. 9. Minnesota Statutes 2012, section 256B.092, subdivision 12, is amended to read:
214.30    Subd. 12. Waivered services statewide priorities. (a) The commissioner shall
214.31establish statewide priorities for individuals on the waiting list for developmental
214.32disabilities (DD) waiver services, as of January 1, 2010. The statewide priorities must
214.33include, but are not limited to, individuals who continue to have a need for waiver services
214.34after they have maximized the use of state plan services and other funding resources,
215.1including natural supports, prior to accessing waiver services, and who meet at least one
215.2of the following criteria:
215.3(1) no longer require the intensity of services provided where they are currently
215.4living; or
215.5(2) make a request to move from an institutional setting.
215.6(b) After the priorities in paragraph (a) are met, priority must also be given to
215.7individuals who meet at least one of the following criteria:
215.8(1) have unstable living situations due to the age, incapacity, or sudden loss of
215.9the primary caregivers;
215.10(2) are moving from an institution due to bed closures;
215.11(3) experience a sudden closure of their current living arrangement;
215.12(4) require protection from confirmed abuse, neglect, or exploitation;
215.13(5) experience a sudden change in need that can no longer be met through state plan
215.14services or other funding resources alone; or
215.15(6) meet other priorities established by the department.
215.16(b) (c) When allocating resources to lead agencies, the commissioner must take into
215.17consideration the number of individuals waiting who meet statewide priorities and the
215.18lead agencies' current use of waiver funds and existing service options. The commissioner
215.19has the authority to transfer funds between counties, groups of counties, and tribes to
215.20accommodate statewide priorities and resource needs while accounting for a necessary
215.21base level reserve amount for each county, group of counties, and tribe.
215.22(c) The commissioner shall evaluate the impact of the use of statewide priorities and
215.23provide recommendations to the legislature on whether to continue the use of statewide
215.24priorities in the November 1, 2011, annual report required by the commissioner in sections
215.25256B.0916, subdivision 7, and 256B.49, subdivision 21.

215.26    Sec. 10. Minnesota Statutes 2012, section 256B.092, is amended by adding a
215.27subdivision to read:
215.28    Subd. 14. Reduce avoidable behavioral crisis emergency room, psychiatric
215.29inpatient hospitalizations, and commitments to institutions. (a) Persons receiving
215.30home and community-based services authorized under this section who have had two
215.31or more admissions within a calendar year to an emergency room, psychiatric unit,
215.32or institution must receive consultation from a mental health professional as defined in
215.33section 245.462, subdivision 18, or a behavioral professional as defined in the home and
215.34community-based services state plan within 30 days of discharge. The mental health
215.35professional or behavioral professional must:
216.1(1) conduct a functional assessment of the crisis incident as defined in section
216.2245D.02, subdivision 11, which led to the hospitalization with the goal of developing
216.3proactive strategies as well as necessary reactive strategies to reduce the likelihood of
216.4future avoidable hospitalizations due to a behavioral crisis;
216.5(2) use the results of the functional assessment to amend the coordinated service and
216.6support plan set forth in section 245D.02, subdivision 4b, to address the potential need
216.7for additional staff training, increased staffing, access to crisis mobility services, mental
216.8health services, use of technology, and crisis stabilization services in section 256B.0624,
216.9subdivision 7; and
216.10(3) identify the need for additional consultation, testing, and mental health crisis
216.11intervention team services as defined in section 245D.02, subdivision 20, psychotropic
216.12medication use and monitoring under section 245D.051, as well as the frequency and
216.13duration of ongoing consultation.
216.14(b) For the purposes of this subdivision, "institution" includes, but is not limited to,
216.15the Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.

216.16    Sec. 11. Minnesota Statutes 2012, section 256B.095, is amended to read:
216.17256B.095 QUALITY ASSURANCE SYSTEM ESTABLISHED.
216.18    (a) Effective July 1, 1998, a quality assurance system for persons with developmental
216.19disabilities, which includes an alternative quality assurance licensing system for programs,
216.20is established in Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice,
216.21Steele, Wabasha, and Winona Counties for the purpose of improving the quality of
216.22services provided to persons with developmental disabilities. A county, at its option, may
216.23choose to have all programs for persons with developmental disabilities located within
216.24the county licensed under chapter 245A using standards determined under the alternative
216.25quality assurance licensing system or may continue regulation of these programs under the
216.26licensing system operated by the commissioner. The project expires on June 30, 2014.
216.27    (b) Effective July 1, 2003, a county not listed in paragraph (a) may apply to
216.28participate in the quality assurance system established under paragraph (a). The
216.29commission established under section 256B.0951 may, at its option, allow additional
216.30counties to participate in the system.
216.31    (c) Effective July 1, 2003, any county or group of counties not listed in paragraph (a)
216.32may establish a quality assurance system under this section. A new system established
216.33under this section shall have the same rights and duties as the system established
216.34under paragraph (a). A new system shall be governed by a commission under section
216.35256B.0951 . The commissioner shall appoint the initial commission members based
217.1on recommendations from advocates, families, service providers, and counties in the
217.2geographic area included in the new system. Counties that choose to participate in a
217.3new system shall have the duties assigned under section 256B.0952. The new system
217.4shall establish a quality assurance process under section 256B.0953. The provisions of
217.5section 256B.0954 shall apply to a new system established under this paragraph. The
217.6commissioner shall delegate authority to a new system established under this paragraph
217.7according to section 256B.0955.
217.8    (d) Effective July 1, 2007, the quality assurance system may be expanded to include
217.9programs for persons with disabilities and older adults.
217.10(e) Effective July 1, 2013, a provider of service located in a county listed in
217.11paragraph (a) that is a non-opted-in county may opt-in to the quality assurance system
217.12provided the county where services are provided indicates its agreement with a county
217.13with a delegation agreement with the Department of Human Services.
217.14EFFECTIVE DATE.This section is effective July 1, 2013.

217.15    Sec. 12. Minnesota Statutes 2012, section 256B.0951, subdivision 1, is amended to read:
217.16    Subdivision 1. Membership. The Quality Assurance Commission is established.
217.17The commission consists of at least 14 but not more than 21 members as follows: at
217.18least three but not more than five members representing advocacy organizations; at
217.19least three but not more than five members representing consumers, families, and their
217.20legal representatives; at least three but not more than five members representing service
217.21providers; at least three but not more than five members representing counties; and the
217.22commissioner of human services or the commissioner's designee. The first commission
217.23shall establish membership guidelines for the transition and recruitment of membership for
217.24the commission's ongoing existence. Members of the commission who do not receive a
217.25salary or wages from an employer for time spent on commission duties may receive a per
217.26diem payment when performing commission duties and functions. All members may be
217.27reimbursed for expenses related to commission activities. Notwithstanding the provisions
217.28of section 15.059, subdivision 5, the commission expires on June 30, 2014.

217.29    Sec. 13. Minnesota Statutes 2012, section 256B.0951, subdivision 4, is amended to read:
217.30    Subd. 4. Commission's authority to recommend variances of licensing
217.31standards. The commission may recommend to the commissioners of human services
217.32and health variances from the standards governing licensure of programs for persons with
217.33developmental disabilities in order to improve the quality of services by implementing
217.34an alternative developmental disabilities licensing system if the commission determines
218.1that the alternative licensing system does not adversely affect the health or safety of
218.2persons being served by the licensed program nor compromise the qualifications of staff
218.3to provide services.

218.4    Sec. 14. Minnesota Statutes 2012, section 256B.0952, subdivision 1, is amended to read:
218.5    Subdivision 1. Notification. Counties or providers shall give notice to the
218.6commission and commissioners of human services and health of intent to join the
218.7alternative quality assurance licensing system. A county or provider choosing to participate
218.8in the alternative quality assurance licensing system commits to participate for three years.

218.9    Sec. 15. Minnesota Statutes 2012, section 256B.0952, subdivision 5, is amended to read:
218.10    Subd. 5. Quality assurance teams. Quality assurance teams shall be comprised
218.11of county staff; providers; consumers, families, and their legal representatives; members
218.12of advocacy organizations; and other involved community members. Team members
218.13must satisfactorily complete the training program approved by the commission and must
218.14demonstrate performance-based competency. Team members are not considered to be
218.15county employees for purposes of workers' compensation, unemployment insurance, or
218.16state retirement laws solely on the basis of participation on a quality assurance team. The
218.17county may pay A per diem may be paid to team members for time spent on alternative
218.18quality assurance process matters. All team members may be reimbursed for expenses
218.19related to their participation in the alternative process.

218.20    Sec. 16. Minnesota Statutes 2012, section 256B.0955, is amended to read:
218.21256B.0955 DUTIES OF THE COMMISSIONER OF HUMAN SERVICES.
218.22(a) Effective July 1, 1998, the commissioner of human services shall delegate
218.23authority to perform licensing functions and activities, in accordance with section
218.24245A.16 , to counties participating in the alternative quality assurance licensing system.
218.25The commissioner shall not license or reimburse a facility, program, or service for persons
218.26with developmental disabilities in a county that participates in the alternative quality
218.27assurance licensing system if the commissioner has received from the appropriate county
218.28notification that the facility, program, or service has been reviewed by a quality assurance
218.29team and has failed to qualify for licensure.
218.30(b) The commissioner may conduct random licensing inspections based on outcomes
218.31adopted under section 256B.0951 at facilities, programs, and services governed by the
218.32alternative quality assurance licensing system. The role of such random inspections shall
218.33be to verify that the alternative quality assurance licensing system protects the safety
219.1and well-being of consumers and maintains the availability of high-quality services for
219.2persons with developmental disabilities.
219.3EFFECTIVE DATE.This section is effective July 1, 2013.

219.4    Sec. 17. Minnesota Statutes 2012, section 256B.097, subdivision 1, is amended to read:
219.5    Subdivision 1. Scope. (a) In order to improve the quality of services provided to
219.6Minnesotans with disabilities and to meet the requirements of the federally approved home
219.7and community-based waivers under section 1915c of the Social Security Act, a State
219.8Quality Assurance, Quality Improvement, and Licensing System for Minnesotans receiving
219.9disability services is enacted. This system is a partnership between the Department of
219.10Human Services and the State Quality Council established under subdivision 3.
219.11    (b) This system is a result of the recommendations from the Department of Human
219.12Services' licensing and alternative quality assurance study mandated under Laws 2005,
219.13First Special Session chapter 4, article 7, section 57, and presented to the legislature
219.14in February 2007.
219.15    (c) The disability services eligible under this section include:
219.16    (1) the home and community-based services waiver programs for persons with
219.17developmental disabilities under section 256B.092, subdivision 4, or section 256B.49,
219.18including brain injuries and services for those who qualify for nursing facility level of care
219.19or hospital facility level of care and any other services licensed under chapter 245D;
219.20    (2) home care services under section 256B.0651;
219.21    (3) family support grants under section 252.32;
219.22    (4) consumer support grants under section 256.476;
219.23    (5) semi-independent living services under section 252.275; and
219.24    (6) services provided through an intermediate care facility for the developmentally
219.25disabled.
219.26    (d) For purposes of this section, the following definitions apply:
219.27    (1) "commissioner" means the commissioner of human services;
219.28    (2) "council" means the State Quality Council under subdivision 3;
219.29    (3) "Quality Assurance Commission" means the commission under section
219.30256B.0951 ; and
219.31    (4) "system" means the State Quality Assurance, Quality Improvement and
219.32Licensing System under this section.

219.33    Sec. 18. Minnesota Statutes 2012, section 256B.097, subdivision 3, is amended to read:
220.1    Subd. 3. State Quality Council. (a) There is hereby created a State Quality
220.2Council which must define regional quality councils, and carry out a community-based,
220.3person-directed quality review component, and a comprehensive system for effective
220.4incident reporting, investigation, analysis, and follow-up.
220.5    (b) By August 1, 2011, the commissioner of human services shall appoint the
220.6members of the initial State Quality Council. Members shall include representatives
220.7from the following groups:
220.8    (1) disability service recipients and their family members;
220.9    (2) during the first two four years of the State Quality Council, there must be at least
220.10three members from the Region 10 stakeholders. As regional quality councils are formed
220.11under subdivision 4, each regional quality council shall appoint one member;
220.12    (3) disability service providers;
220.13    (4) disability advocacy groups; and
220.14    (5) county human services agencies and staff from the Department of Human
220.15Services and Ombudsman for Mental Health and Developmental Disabilities.
220.16    (c) Members of the council who do not receive a salary or wages from an employer
220.17for time spent on council duties may receive a per diem payment when performing council
220.18duties and functions.
220.19    (d) The State Quality Council shall:
220.20    (1) assist the Department of Human Services in fulfilling federally mandated
220.21obligations by monitoring disability service quality and quality assurance and
220.22improvement practices in Minnesota;
220.23    (2) establish state quality improvement priorities with methods for achieving results
220.24and provide an annual report to the legislative committees with jurisdiction over policy
220.25and funding of disability services on the outcomes, improvement priorities, and activities
220.26undertaken by the commission during the previous state fiscal year;
220.27(3) identify issues pertaining to financial and personal risk that impede Minnesotans
220.28with disabilities from optimizing choice of community-based services; and
220.29(4) recommend to the chairs and ranking minority members of the legislative
220.30committees with jurisdiction over human services and civil law by January 15, 2013
220.31 2014, statutory and rule changes related to the findings under clause (3) that promote
220.32individualized service and housing choices balanced with appropriate individualized
220.33protection.
220.34    (e) The State Quality Council, in partnership with the commissioner, shall:
220.35    (1) approve and direct implementation of the community-based, person-directed
220.36system established in this section;
221.1    (2) recommend an appropriate method of funding this system, and determine the
221.2feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;
221.3    (3) approve measurable outcomes in the areas of health and safety, consumer
221.4evaluation, education and training, providers, and systems;
221.5    (4) establish variable licensure periods not to exceed three years based on outcomes
221.6achieved; and
221.7    (5) in cooperation with the Quality Assurance Commission, design a transition plan
221.8for licensed providers from Region 10 into the alternative licensing system by July 1, 2013.
221.9    (f) The State Quality Council shall notify the commissioner of human services that a
221.10facility, program, or service has been reviewed by quality assurance team members under
221.11subdivision 4, paragraph (b), clause (13), and qualifies for a license.
221.12    (g) The State Quality Council, in partnership with the commissioner, shall establish
221.13an ongoing review process for the system. The review shall take into account the
221.14comprehensive nature of the system which is designed to evaluate the broad spectrum of
221.15licensed and unlicensed entities that provide services to persons with disabilities. The
221.16review shall address efficiencies and effectiveness of the system.
221.17    (h) The State Quality Council may recommend to the commissioner certain
221.18variances from the standards governing licensure of programs for persons with disabilities
221.19in order to improve the quality of services so long as the recommended variances do
221.20not adversely affect the health or safety of persons being served or compromise the
221.21qualifications of staff to provide services.
221.22    (i) The safety standards, rights, or procedural protections referenced under
221.23subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make
221.24recommendations to the commissioner or to the legislature in the report required under
221.25paragraph (c) regarding alternatives or modifications to the safety standards, rights, or
221.26procedural protections referenced under subdivision 2, paragraph (c).
221.27    (j) The State Quality Council may hire staff to perform the duties assigned in this
221.28subdivision.

221.29    Sec. 19. Minnesota Statutes 2012, section 256B.431, subdivision 44, is amended to read:
221.30    Subd. 44. Property rate increase increases for a facility in Bloomington effective
221.31November 1, 2010 certain nursing facilities. (a) Notwithstanding any other law to the
221.32contrary, money available for moratorium projects under section 144A.073, subdivision
221.3311 , shall be used, effective November 1, 2010, to fund an approved moratorium exception
221.34project for a nursing facility in Bloomington licensed for 137 beds as of November 1,
221.352010, up to a total property rate adjustment of $19.33.
222.1(b) Effective June 1, 2012, any nursing facility in McLeod County licensed for 110
222.2beds shall have its replacement-cost-new limit under subdivision 17e adjusted to allow
222.3$1,129,463 of a completed construction project to increase the property payment rate.
222.4Notwithstanding any other law to the contrary, money available under section 144A.073,
222.5subdivision 11, after the completion of the moratorium exception approval process in 2013
222.6under section 144A.073, subdivision 3, shall be used to reduce the fiscal impact to the
222.7medical assistance budget for the increase in the replacement-cost-new limit.
222.8(c) Effective July 1, 2012, any nursing facility in Dakota County licensed for
222.961 beds shall have their replacement-cost-new limit under subdivision 17e adjusted to
222.10allow $1,407,624 of a completed construction project to increase their property payment
222.11rate. Effective September 1, 2013, or later, their replacement-cost-new limit under
222.12subdivision 17e shall be adjusted to allow $1,244,599 of a completed construction project
222.13to increase the property payment rate. Notwithstanding any other law to the contrary,
222.14money available under section 144A.073, subdivision 11, after the completion of the
222.15moratorium exception approval process in 2013 under section 144A.073, subdivision 3,
222.16shall be used to reduce the fiscal impact to the medical assistance budget for the increase
222.17in the replacement-cost-new limit.
222.18EFFECTIVE DATE.Paragraph (b) is effective retroactively from June 1, 2012.
222.19Paragraph (c) is effective retroactively from July 1, 2012.

222.20    Sec. 20. Minnesota Statutes 2012, section 256B.434, subdivision 4, is amended to read:
222.21    Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which
222.22have their payment rates determined under this section rather than section 256B.431, the
222.23commissioner shall establish a rate under this subdivision. The nursing facility must enter
222.24into a written contract with the commissioner.
222.25    (b) A nursing facility's case mix payment rate for the first rate year of a facility's
222.26contract under this section is the payment rate the facility would have received under
222.27section 256B.431.
222.28    (c) A nursing facility's case mix payment rates for the second and subsequent years
222.29of a facility's contract under this section are the previous rate year's contract payment
222.30rates plus an inflation adjustment and, for facilities reimbursed under this section or
222.31section 256B.431, an adjustment to include the cost of any increase in Health Department
222.32licensing fees for the facility taking effect on or after July 1, 2001. The index for the
222.33inflation adjustment must be based on the change in the Consumer Price Index-All Items
222.34(United States City average) (CPI-U) forecasted by the commissioner of management and
222.35budget's national economic consultant, as forecasted in the fourth quarter of the calendar
223.1year preceding the rate year. The inflation adjustment must be based on the 12-month
223.2period from the midpoint of the previous rate year to the midpoint of the rate year for
223.3which the rate is being determined. For the rate years beginning on July 1, 1999, July 1,
223.42000, July 1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006,
223.5July 1, 2007, July 1, 2008, October 1, 2009, and October 1, 2010, this paragraph shall
223.6apply only to the property-related payment rate. For the rate years beginning on October
223.71, 2011, and October 1, 2012, October 1, 2013, October 1, 2014, October 1, 2015, and
223.8October 1, 2016, the rate adjustment under this paragraph shall be suspended. Beginning
223.9in 2005, adjustment to the property payment rate under this section and section 256B.431
223.10shall be effective on October 1. In determining the amount of the property-related payment
223.11rate adjustment under this paragraph, the commissioner shall determine the proportion of
223.12the facility's rates that are property-related based on the facility's most recent cost report.
223.13    (d) The commissioner shall develop additional incentive-based payments of up to
223.14five percent above a facility's operating payment rate for achieving outcomes specified
223.15in a contract. The commissioner may solicit contract amendments and implement those
223.16which, on a competitive basis, best meet the state's policy objectives. The commissioner
223.17shall limit the amount of any incentive payment and the number of contract amendments
223.18under this paragraph to operate the incentive payments within funds appropriated for this
223.19purpose. The contract amendments may specify various levels of payment for various
223.20levels of performance. Incentive payments to facilities under this paragraph may be in the
223.21form of time-limited rate adjustments or onetime supplemental payments. In establishing
223.22the specified outcomes and related criteria, the commissioner shall consider the following
223.23state policy objectives:
223.24    (1) successful diversion or discharge of residents to the residents' prior home or other
223.25community-based alternatives;
223.26    (2) adoption of new technology to improve quality or efficiency;
223.27    (3) improved quality as measured in the Nursing Home Report Card;
223.28    (4) reduced acute care costs; and
223.29    (5) any additional outcomes proposed by a nursing facility that the commissioner
223.30finds desirable.
223.31    (e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that
223.32take action to come into compliance with existing or pending requirements of the life
223.33safety code provisions or federal regulations governing sprinkler systems must receive
223.34reimbursement for the costs associated with compliance if all of the following conditions
223.35are met:
224.1    (1) the expenses associated with compliance occurred on or after January 1, 2005,
224.2and before December 31, 2008;
224.3    (2) the costs were not otherwise reimbursed under subdivision 4f or section
224.4144A.071 or 144A.073; and
224.5    (3) the total allowable costs reported under this paragraph are less than the minimum
224.6threshold established under section 256B.431, subdivision 15, paragraph (e), and
224.7subdivision 16.
224.8The commissioner shall use money appropriated for this purpose to provide to qualifying
224.9nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30,
224.102008. Nursing facilities that have spent money or anticipate the need to spend money
224.11to satisfy the most recent life safety code requirements by (1) installing a sprinkler
224.12system or (2) replacing all or portions of an existing sprinkler system may submit to the
224.13commissioner by June 30, 2007, on a form provided by the commissioner the actual
224.14costs of a completed project or the estimated costs, based on a project bid, of a planned
224.15project. The commissioner shall calculate a rate adjustment equal to the allowable
224.16costs of the project divided by the resident days reported for the report year ending
224.17September 30, 2006. If the costs from all projects exceed the appropriation for this
224.18purpose, the commissioner shall allocate the money appropriated on a pro rata basis to the
224.19qualifying facilities by reducing the rate adjustment determined for each facility by an
224.20equal percentage. Facilities that used estimated costs when requesting the rate adjustment
224.21shall report to the commissioner by January 31, 2009, on the use of this money on a
224.22form provided by the commissioner. If the nursing facility fails to provide the report, the
224.23commissioner shall recoup the money paid to the facility for this purpose. If the facility
224.24reports expenditures allowable under this subdivision that are less than the amount received
224.25in the facility's annualized rate adjustment, the commissioner shall recoup the difference.

224.26    Sec. 21. Minnesota Statutes 2012, section 256B.437, subdivision 6, is amended to read:
224.27    Subd. 6. Planned closure rate adjustment. (a) The commissioner of human
224.28services shall calculate the amount of the planned closure rate adjustment available under
224.29subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
224.30(1) the amount available is the net reduction of nursing facility beds multiplied
224.31by $2,080;
224.32(2) the total number of beds in the nursing facility or facilities receiving the planned
224.33closure rate adjustment must be identified;
224.34(3) capacity days are determined by multiplying the number determined under
224.35clause (2) by 365; and
225.1(4) the planned closure rate adjustment is the amount available in clause (1), divided
225.2by capacity days determined under clause (3).
225.3(b) A planned closure rate adjustment under this section is effective on the first day
225.4of the month following completion of closure of the facility designated for closure in
225.5the application and becomes part of the nursing facility's total operating external fixed
225.6 payment rate.
225.7(c) Applicants may use the planned closure rate adjustment to allow for a property
225.8payment for a new nursing facility or an addition to an existing nursing facility or as
225.9an operating payment external fixed rate adjustment. Applications approved under this
225.10subdivision are exempt from other requirements for moratorium exceptions under section
225.11144A.073 , subdivisions 2 and 3.
225.12(d) Upon the request of a closing facility, the commissioner must allow the facility a
225.13closure rate adjustment as provided under section 144A.161, subdivision 10.
225.14(e) A facility that has received a planned closure rate adjustment may reassign it
225.15to another facility that is under the same ownership at any time within three years of its
225.16effective date. The amount of the adjustment shall be computed according to paragraph (a).
225.17(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased,
225.18the commissioner shall recalculate planned closure rate adjustments for facilities that
225.19delicense beds under this section on or after July 1, 2001, to reflect the increase in the per
225.20bed dollar amount. The recalculated planned closure rate adjustment shall be effective
225.21from the date the per bed dollar amount is increased.
225.22(g) For planned closures approved after June 30, 2009, the commissioner of human
225.23services shall calculate the amount of the planned closure rate adjustment available under
225.24subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).
225.25(h) Beginning Between July 16, 2011, and June 30, 2013, the commissioner shall no
225.26longer not accept applications for planned closure rate adjustments under subdivision 3.

225.27    Sec. 22. Minnesota Statutes 2012, section 256B.441, subdivision 53, is amended to read:
225.28    Subd. 53. Calculation of payment rate for external fixed costs. The commissioner
225.29shall calculate a payment rate for external fixed costs.
225.30    (a) For a facility licensed as a nursing home, the portion related to section 256.9657
225.31shall be equal to $8.86 $10.37. For a facility licensed as both a nursing home and a
225.32boarding care home, the portion related to section 256.9657 shall be equal to $8.86
225.33 $10.37 multiplied by the result of its number of nursing home beds divided by its total
225.34number of licensed beds.
226.1    (b) The portion related to the licensure fee under section 144.122, paragraph (d),
226.2shall be the amount of the fee divided by actual resident days.
226.3    (c) The portion related to scholarships shall be determined under section 256B.431,
226.4subdivision 36.
226.5    (d) The portion related to long-term care consultation shall be determined according
226.6to section 256B.0911, subdivision 6.
226.7    (e) The portion related to development and education of resident and family advisory
226.8councils under section 144A.33 shall be $5 divided by 365.
226.9    (f) The portion related to planned closure rate adjustments shall be as determined
226.10under sections 256B.436 and 256B.437, subdivision 6. Planned closure rate adjustments
226.11that take effect before October 1, 2014, shall no longer be included in the payment rate
226.12for external fixed costs beginning October 1, 2016. Planned closure rate adjustments that
226.13take effect on or after October 1, 2014, shall no longer be included in the payment rate
226.14for external fixed costs beginning on October 1 of the first year not less than two years
226.15after their effective date.
226.16    (g) The portions related to property insurance, real estate taxes, special assessments,
226.17and payments made in lieu of real estate taxes directly identified or allocated to the nursing
226.18facility shall be the actual amounts divided by actual resident days.
226.19    (h) The portion related to the Public Employees Retirement Association shall be
226.20actual costs divided by resident days.
226.21    (i) The single bed room incentives shall be as determined under section 256B.431,
226.22subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall
226.23no longer be included in the payment rate for external fixed costs beginning October 1,
226.242016. Single bed room incentives that take effect on or after October 1, 2014, shall no
226.25longer be included in the payment rate for external fixed costs beginning on October 1 of
226.26the first year not less than two years after their effective date.
226.27    (j) The payment rate for external fixed costs shall be the sum of the amounts in
226.28paragraphs (a) to (i).
226.29EFFECTIVE DATE.This section is effective June 1, 2013.

226.30    Sec. 23. Minnesota Statutes 2012, section 256B.441, subdivision 55, is amended to read:
226.31    Subd. 55. Phase-in of rebased operating payment rates. (a) For the rate years
226.32beginning October 1, 2008, to October 1, 2015, the operating payment rate calculated
226.33under this section shall be phased in by blending the operating rate with the operating
226.34payment rate determined under section 256B.434. For purposes of this subdivision, the
226.35rate to be used that is determined under section 256B.434 shall not include the portion of
227.1the operating payment rate related to performance-based incentive payments under section
227.2256B.434, subdivision 4 , paragraph (d).:
227.3    (1) for the rate year beginning October 1, 2008, the operating payment rate for each
227.4facility shall be 13 percent of the operating payment rate from this section, and 87 percent
227.5of the operating payment rate from section 256B.434.;
227.6    (2) for the rate period from October 1, 2009, to September 30, 2013, no rate
227.7adjustments shall be implemented under this section, but shall be determined under
227.8section 256B.434.;
227.9    (3) for the rate year beginning October 1, 2013, the operating payment rate for each
227.10facility shall be 65 15 percent of the operating payment rate from this section, and 35 85
227.11 percent of the operating payment rate from section 256B.434.; and
227.12    (4) for the rate year beginning October 1, 2014 2015, the operating payment rate for
227.13each facility shall be 82 20 percent of the operating payment rate from this section, and 18
227.14 80 percent of the operating payment rate from section 256B.434.
227.15     for the rate year beginning October 1, 2015, the operating payment rate for each
227.16facility shall be the operating payment rate determined under this section. The blending
227.17of operating payment rates under this section shall be performed separately for each
227.18RUG's class.
227.19    (b) For the rate year beginning October 1, 2008, the commissioner shall apply limits
227.20to the operating payment rate increases under paragraph (a) by creating a minimum
227.21percentage increase and a maximum percentage increase.:
227.22    (1) each nursing facility that receives a blended October 1, 2008, operating payment
227.23rate increase under paragraph (a) of less than one percent, when compared to its operating
227.24payment rate on September 30, 2008, computed using rates with RUG's weight of 1.00,
227.25shall receive a rate adjustment of one percent.;
227.26    (2) the commissioner shall determine a maximum percentage increase that will
227.27result in savings equal to the cost of allowing the minimum increase in clause (1). Nursing
227.28facilities with a blended October 1, 2008, operating payment rate increase under paragraph
227.29(a) greater than the maximum percentage increase determined by the commissioner, when
227.30compared to its operating payment rate on September 30, 2008, computed using rates with
227.31a RUG's weight of 1.00, shall receive the maximum percentage increase.;
227.32    (3) nursing facilities with a blended October 1, 2008, operating payment rate
227.33increase under paragraph (a) greater than one percent and less than the maximum
227.34percentage increase determined by the commissioner, when compared to its operating
227.35payment rate on September 30, 2008, computed using rates with a RUG's weight of 1.00,
228.1shall receive the blended October 1, 2008, operating payment rate increase determined
228.2under paragraph (a).; and
228.3    (4) the October 1, 2009, through October 1, 2015, operating payment rate for
228.4facilities receiving the maximum percentage increase determined in clause (2) shall be
228.5the amount determined under paragraph (a) less the difference between the amount
228.6determined under paragraph (a) for October 1, 2008, and the amount allowed under clause
228.7(2). This rate restriction does not apply to rate increases provided in any other section.
228.8    (c) A portion of the funds received under this subdivision that are in excess of
228.9operating payment rates that a facility would have received under section 256B.434, as
228.10determined in accordance with clauses (1) to (3), shall be subject to the requirements in
228.11section 256B.434, subdivision 19, paragraphs (b) to (h).:
228.12    (1) determine the amount of additional funding available to a facility, which shall be
228.13equal to total medical assistance resident days from the most recent reporting year times
228.14the difference between the blended rate determined in paragraph (a) for the rate year being
228.15computed and the blended rate for the prior year.;
228.16    (2) determine the portion of all operating costs, for the most recent reporting year,
228.17that are compensation related. If this value exceeds 75 percent, use 75 percent.;
228.18    (3) subtract the amount determined in clause (2) from 75 percent.; and
228.19    (4) the portion of the fund received under this subdivision that shall be subject to the
228.20requirements in section 256B.434, subdivision 19, paragraphs (b) to (h), shall equal the
228.21amount determined in clause (1) times the amount determined in clause (3).

228.22    Sec. 24. Minnesota Statutes 2012, section 256B.441, subdivision 62, is amended to read:
228.23    Subd. 62. Repeal of rebased operating payment rates. Notwithstanding
228.24subdivision 54 or 55, no further steps toward phase-in of rebased operating payment rates
228.25shall be taken, except for subdivision 55, paragraph (a), clauses (3) and (4).

228.26    Sec. 25. Minnesota Statutes 2012, section 256B.49, subdivision 11a, is amended to read:
228.27    Subd. 11a. Waivered services statewide priorities. (a) The commissioner shall
228.28establish statewide priorities for individuals on the waiting list for community alternative
228.29care, community alternatives for disabled individuals, and brain injury waiver services,
228.30as of January 1, 2010. The statewide priorities must include, but are not limited to,
228.31individuals who continue to have a need for waiver services after they have maximized the
228.32use of state plan services and other funding resources, including natural supports, prior to
228.33accessing waiver services, and who meet at least one of the following criteria:
229.1(1) no longer require the intensity of services provided where they are currently
229.2living; or
229.3(2) make a request to move from an institutional setting.
229.4(b) After the priorities in paragraph (a) are met, priority must also be given to
229.5individuals who meet at least one of the following criteria:
229.6(1) have unstable living situations due to the age, incapacity, or sudden loss of
229.7the primary caregivers;
229.8(2) are moving from an institution due to bed closures;
229.9(3) experience a sudden closure of their current living arrangement;
229.10(4) require protection from confirmed abuse, neglect, or exploitation;
229.11(5) experience a sudden change in need that can no longer be met through state plan
229.12services or other funding resources alone; or
229.13(6) meet other priorities established by the department.
229.14(b) (c) When allocating resources to lead agencies, the commissioner must take into
229.15consideration the number of individuals waiting who meet statewide priorities and the
229.16lead agencies' current use of waiver funds and existing service options. The commissioner
229.17has the authority to transfer funds between counties, groups of counties, and tribes to
229.18accommodate statewide priorities and resource needs while accounting for a necessary
229.19base level reserve amount for each county, group of counties, and tribe.
229.20(c) The commissioner shall evaluate the impact of the use of statewide priorities and
229.21provide recommendations to the legislature on whether to continue the use of statewide
229.22priorities in the November 1, 2011, annual report required by the commissioner in sections
229.23256B.0916, subdivision 7, and 256B.49, subdivision 21.

229.24    Sec. 26. Minnesota Statutes 2012, section 256B.49, subdivision 15, is amended to read:
229.25    Subd. 15. Coordinated service and support plan; comprehensive transitional
229.26service plan; maintenance service plan. (a) Each recipient of home and community-based
229.27waivered services shall be provided a copy of the written coordinated service and support
229.28plan which meets the requirements in section 256B.092, subdivision 1b.
229.29(b) In developing the comprehensive transitional service plan, the individual
229.30receiving services, the case manager, and the guardian, if applicable, will identify the
229.31transitional service plan fundamental service outcome and anticipated timeline to achieve
229.32this outcome. Within the first 20 days following a recipient's request for an assessment or
229.33reassessment, the transitional service planning team must be identified. A team leader must
229.34be identified who will be responsible for assigning responsibility and communicating with
229.35team members to ensure implementation of the transition plan and ongoing assessment and
230.1communication process. The team leader should be an individual, such as the case manager
230.2or guardian, who has the opportunity to follow the recipient to the next level of service.
230.3Within ten days following an assessment, a comprehensive transitional service plan
230.4must be developed incorporating elements of a comprehensive functional assessment and
230.5including short-term measurable outcomes and timelines for achievement of and reporting
230.6on these outcomes. Functional milestones must also be identified and reported according
230.7to the timelines agreed upon by the transitional service planning team. In addition, the
230.8comprehensive transitional service plan must identify additional supports that may assist
230.9in the achievement of the fundamental service outcome such as the development of greater
230.10natural community support, increased collaboration among agencies, and technological
230.11supports.
230.12The timelines for reporting on functional milestones will prompt a reassessment of
230.13services provided, the units of services, rates, and appropriate service providers. It is
230.14the responsibility of the transitional service planning team leader to review functional
230.15milestone reporting to determine if the milestones are consistent with observable skills
230.16and that milestone achievement prompts any needed changes to the comprehensive
230.17transitional service plan.
230.18For those whose fundamental transitional service outcome involves the need to
230.19procure housing, a plan for the recipient to seek the resources necessary to secure the least
230.20restrictive housing possible should be incorporated into the plan, including employment
230.21and public supports such as housing access and shelter needy funding.
230.22(c) Counties and other agencies responsible for funding community placement and
230.23ongoing community supportive services are responsible for the implementation of the
230.24comprehensive transitional service plans. Oversight responsibilities include both ensuring
230.25effective transitional service delivery and efficient utilization of funding resources.
230.26(d) Following one year of transitional services, the transitional services planning team
230.27will make a determination as to whether or not the individual receiving services requires
230.28the current level of continuous and consistent support in order to maintain the recipient's
230.29current level of functioning. Recipients who are determined to have not had a significant
230.30change in functioning for 12 months must move from a transitional to a maintenance
230.31service plan. Recipients on a maintenance service plan must be reassessed to determine if
230.32the recipient would benefit from a transitional service plan at least every 12 months and at
230.33other times when there has been a significant change in the recipient's functioning. This
230.34assessment should consider any changes to technological or natural community supports.
230.35(e) When a county is evaluating denials, reductions, or terminations of home and
230.36community-based services under section 256B.49 for an individual, the case manager
231.1shall offer to meet with the individual or the individual's guardian in order to discuss
231.2the prioritization of service needs within the coordinated service and support plan,
231.3comprehensive transitional service plan, or maintenance service plan. The reduction in
231.4the authorized services for an individual due to changes in funding for waivered services
231.5may not exceed the amount needed to ensure medically necessary services to meet the
231.6individual's health, safety, and welfare.
231.7(f) At the time of reassessment, local agency case managers shall assess each recipient
231.8of community alternatives for disabled individuals or brain injury waivered services
231.9currently residing in a licensed adult foster home that is not the primary residence of the
231.10license holder, or in which the license holder is not the primary caregiver, to determine if
231.11that recipient could appropriately be served in a community-living setting. If appropriate
231.12for the recipient, the case manager shall offer the recipient, through a person-centered
231.13planning process, the option to receive alternative housing and service options. In the
231.14event that the recipient chooses to transfer from the adult foster home, the vacated bed
231.15shall not be filled with another recipient of waiver services and group residential housing
231.16and the licensed capacity shall be reduced accordingly, unless the savings required by the
231.17licensed bed closure reductions under Laws 2011, First Special Session chapter 9, article 7,
231.18sections 1 and 40, paragraph (f), for foster care settings where the physical location is not
231.19the primary residence of the license holder are met through voluntary changes described
231.20in section 245A.03, subdivision 7, paragraph (f) (e), or as provided under paragraph (a),
231.21clauses (3) and (4). If the adult foster home becomes no longer viable due to these transfers,
231.22the county agency, with the assistance of the department, shall facilitate a consolidation of
231.23settings or closure. This reassessment process shall be completed by July 1, 2013.

231.24    Sec. 27. Minnesota Statutes 2012, section 256B.49, is amended by adding a
231.25subdivision to read:
231.26    Subd. 25. Reduce avoidable behavioral crisis emergency room, psychiatric
231.27inpatient hospitalizations, and commitments to institutions. (a) Persons receiving
231.28home and community-based services authorized under this section who have two or more
231.29admissions within a calendar year to an emergency room, psychiatric unit, or institution
231.30must receive consultation from a mental health professional as defined in section 245.462,
231.31subdivision 18, or a behavioral professional as defined in the home and community-based
231.32services state plan within 30 days of discharge. The mental health professional or
231.33behavioral professional must:
231.34(1) conduct a functional assessment of the crisis incident as defined in section
231.35245D.02, subdivision 11, which led to the hospitalization with the goal of developing
232.1proactive strategies as well as necessary reactive strategies to reduce the likelihood of
232.2future avoidable hospitalizations due to a behavioral crisis;
232.3(2) use the results of the functional assessment to amend the coordinated service and
232.4support plan in section 245D.02, subdivision 4b, to address the potential need for additional
232.5staff training, increased staffing, access to crisis mobility services, mental health services,
232.6use of technology, and crisis stabilization services in section 256B.0624, subdivision 7; and
232.7(3) identify the need for additional consultation, testing, mental health crisis
232.8intervention team services as defined in section 245D.02, subdivision 20, psychotropic
232.9medication use and monitoring under section 245D.051, as well as the frequency and
232.10duration of ongoing consultation.
232.11(b) For the purposes of this subdivision, "institution" includes, but is not limited to,
232.12the Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.

232.13    Sec. 28. Minnesota Statutes 2012, section 256B.49, is amended by adding a
232.14subdivision to read:
232.15    Subd. 26. Excess allocations. County and tribal agencies will be responsible for
232.16authorizations in excess of the allocation made by the commissioner. In the event a county
232.17or tribal agency authorizes in excess of the allocation made by the commissioner for a
232.18given allocation period, they must submit a corrective action plan to the commissioner.
232.19The plan must state the actions the agency will take to correct their over-authorization
232.20for the year following the period when the overspending occurred. Failure to correct
232.21over-authorizations shall result in recoupment of authorizations in excess of the allocation.
232.22Nothing in this subdivision shall be construed as reducing the county's responsibility to
232.23offer and make available feasible home and community-based options to eligible waiver
232.24recipients within the resources allocated to them for that purpose.

232.25    Sec. 29. Minnesota Statutes 2012, section 256B.492, is amended to read:
232.26256B.492 HOME AND COMMUNITY-BASED SETTINGS FOR PEOPLE
232.27WITH DISABILITIES.
232.28(a) Individuals receiving services under a home and community-based waiver under
232.29section 256B.092 or 256B.49 may receive services in the following settings:
232.30(1) an individual's own home or family home;
232.31(2) a licensed adult foster care setting of up to five people; and
232.32(3) community living settings as defined in section 256B.49, subdivision 23, where
232.33individuals with disabilities may reside in all of the units in a building of four or fewer
232.34units, and no more than the greater of four or 25 percent of the units in a multifamily
233.1building of more than four units, unless required by the Housing Opportunities for Persons
233.2with AIDS Program.
233.3(b) The settings in paragraph (a) must not:
233.4(1) be located in a building that is a publicly or privately operated facility that
233.5provides institutional treatment or custodial care;
233.6(2) be located in a building on the grounds of or adjacent to a public or private
233.7institution;
233.8(3) be a housing complex designed expressly around an individual's diagnosis or
233.9disability, unless required by the Housing Opportunities for Persons with AIDS Program;
233.10(4) be segregated based on a disability, either physically or because of setting
233.11characteristics, from the larger community; and
233.12(5) have the qualities of an institution which include, but are not limited to:
233.13regimented meal and sleep times, limitations on visitors, and lack of privacy. Restrictions
233.14agreed to and documented in the person's individual service plan shall not result in a
233.15residence having the qualities of an institution as long as the restrictions for the person are
233.16not imposed upon others in the same residence and are the least restrictive alternative,
233.17imposed for the shortest possible time to meet the person's needs.
233.18(c) The provisions of paragraphs (a) and (b) do not apply to any setting in which
233.19individuals receive services under a home and community-based waiver as of July 1,
233.202012, and the setting does not meet the criteria of this section.
233.21(d) Notwithstanding paragraph (c), a program in Hennepin County established as
233.22part of a Hennepin County demonstration project is qualified for the exception allowed
233.23under paragraph (c).
233.24(e) The commissioner shall submit an amendment to the waiver plan no later than
233.25December 31, 2012.

233.26    Sec. 30. Minnesota Statutes 2012, section 256B.493, subdivision 2, is amended to read:
233.27    Subd. 2. Planned closure process needs determination. The commissioner shall
233.28announce and implement a program for planned closure of adult foster care homes. Planned
233.29closure shall be the preferred method for achieving necessary budgetary savings required by
233.30the licensed bed closure budget reduction in section 245A.03, subdivision 7, paragraph (d)
233.31 (c). If additional closures are required to achieve the necessary savings, the commissioner
233.32shall use the process and priorities in section 245A.03, subdivision 7, paragraph (d) (c).

233.33    Sec. 31. Minnesota Statutes 2012, section 256B.501, is amended by adding a
233.34subdivision to read:
234.1    Subd. 14. Rate adjustment for ICF/DD in Cottonwood County. The
234.2commissioner of health shall decertify three beds in an intermediate care facility for
234.3persons with developmental disabilities with 21 certified beds located in Cottonwood
234.4County. The total payment rate shall be $282.62 per bed, per day.

234.5    Sec. 32. Minnesota Statutes 2012, section 256B.5012, is amended by adding a
234.6subdivision to read:
234.7    Subd. 9. Rate increase effective June 1, 2013. For rate periods beginning on or
234.8after June 1, 2011, the commissioner shall increase the total operating payment rate for
234.9each facility reimbursed under this section by $7.81 per day. The increase shall not be
234.10subject to any annual percentage increase.
234.11EFFECTIVE DATE.This section is effective June 1, 2013.

234.12    Sec. 33. Minnesota Statutes 2012, section 256B.5012, is amended by adding a
234.13subdivision to read:
234.14    Subd. 14. ICF/DD rate increases effective January 1, 2015, and July 1, 2015. (a)
234.15Notwithstanding subdivision 12, for each facility reimbursed under this section, for the rate
234.16period beginning January 1, 2015, the commissioner shall increase operating payments
234.17equal to one percent of the operating payment rates in effect on December 31, 2014.
234.18For the rate period beginning July 1, 2015, the commissioner shall increase operating
234.19payments equal to one percent of the operating payment rates in effect on June 30, 2015.
234.20(b) For each facility, the commissioner shall apply the rate increase based on
234.21occupied beds, using the percentage specified in this subdivision multiplied by the total
234.22payment rate, including the variable rate, but excluding the property-related payment
234.23rate in effect on the preceding date. The total rate increase shall include the adjustment
234.24provided in section 256B.501, subdivision 12.

234.25    Sec. 34. Minnesota Statutes 2012, section 256D.44, subdivision 5, is amended to read:
234.26    Subd. 5. Special needs. In addition to the state standards of assistance established in
234.27subdivisions 1 to 4, payments are allowed for the following special needs of recipients of
234.28Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
234.29center, or a group residential housing facility.
234.30    (a) The county agency shall pay a monthly allowance for medically prescribed
234.31diets if the cost of those additional dietary needs cannot be met through some other
234.32maintenance benefit. The need for special diets or dietary items must be prescribed by
234.33a licensed physician. Costs for special diets shall be determined as percentages of the
235.1allotment for a one-person household under the thrifty food plan as defined by the United
235.2States Department of Agriculture. The types of diets and the percentages of the thrifty
235.3food plan that are covered are as follows:
235.4    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
235.5    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent
235.6of thrifty food plan;
235.7    (3) controlled protein diet, less than 40 grams and requires special products, 125
235.8percent of thrifty food plan;
235.9    (4) low cholesterol diet, 25 percent of thrifty food plan;
235.10    (5) high residue diet, 20 percent of thrifty food plan;
235.11    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;
235.12    (7) gluten-free diet, 25 percent of thrifty food plan;
235.13    (8) lactose-free diet, 25 percent of thrifty food plan;
235.14    (9) antidumping diet, 15 percent of thrifty food plan;
235.15    (10) hypoglycemic diet, 15 percent of thrifty food plan; or
235.16    (11) ketogenic diet, 25 percent of thrifty food plan.
235.17    (b) Payment for nonrecurring special needs must be allowed for necessary home
235.18repairs or necessary repairs or replacement of household furniture and appliances using
235.19the payment standard of the AFDC program in effect on July 16, 1996, for these expenses,
235.20as long as other funding sources are not available.
235.21    (c) A fee for guardian or conservator service is allowed at a reasonable rate
235.22negotiated by the county or approved by the court. This rate shall not exceed five percent
235.23of the assistance unit's gross monthly income up to a maximum of $100 per month. If the
235.24guardian or conservator is a member of the county agency staff, no fee is allowed.
235.25    (d) The county agency shall continue to pay a monthly allowance of $68 for
235.26restaurant meals for a person who was receiving a restaurant meal allowance on June 1,
235.271990, and who eats two or more meals in a restaurant daily. The allowance must continue
235.28until the person has not received Minnesota supplemental aid for one full calendar month
235.29or until the person's living arrangement changes and the person no longer meets the criteria
235.30for the restaurant meal allowance, whichever occurs first.
235.31    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less,
235.32is allowed for representative payee services provided by an agency that meets the
235.33requirements under SSI regulations to charge a fee for representative payee services. This
235.34special need is available to all recipients of Minnesota supplemental aid regardless of
235.35their living arrangement.
236.1    (f)(1) Notwithstanding the language in this subdivision, an amount equal to the
236.2maximum allotment authorized by the federal Food Stamp Program for a single individual
236.3which is in effect on the first day of July of each year will be added to the standards of
236.4assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify
236.5as shelter needy and are: (i) relocating from an institution, or an adult mental health
236.6residential treatment program under section 256B.0622; (ii) eligible for the self-directed
236.7supports option as defined under section 256B.0657, subdivision 2; or (iii) home and
236.8community-based waiver recipients living in their own home or rented or leased apartment
236.9which is not owned, operated, or controlled by a provider of service not related by blood
236.10or marriage, unless allowed under paragraph (g).
236.11    (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the
236.12shelter needy benefit under this paragraph is considered a household of one. An eligible
236.13individual who receives this benefit prior to age 65 may continue to receive the benefit
236.14after the age of 65.
236.15    (3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that
236.16exceed 40 percent of the assistance unit's gross income before the application of this
236.17special needs standard. "Gross income" for the purposes of this section is the applicant's or
236.18recipient's income as defined in section 256D.35, subdivision 10, or the standard specified
236.19in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or
236.20state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be
236.21considered shelter needy for purposes of this paragraph.
236.22(g) Notwithstanding this subdivision, to access housing and services as provided
236.23in paragraph (f), the recipient may choose housing that may be owned, operated, or
236.24controlled by the recipient's service provider. In a multifamily building of more than four
236.25units, the maximum number of units that may be used by recipients of this program shall
236.26be the greater of four units or 25 percent of the units in the building, unless required by the
236.27Housing Opportunities for Persons with AIDS Program. In multifamily buildings of four
236.28or fewer units, all of the units may be used by recipients of this program. When housing is
236.29controlled by the service provider, the individual may choose the individual's own service
236.30provider as provided in section 256B.49, subdivision 23, clause (3). When the housing is
236.31controlled by the service provider, the service provider shall implement a plan with the
236.32recipient to transition the lease to the recipient's name. Within two years of signing the
236.33initial lease, the service provider shall transfer the lease entered into under this subdivision
236.34to the recipient. In the event the landlord denies this transfer, the commissioner may
236.35approve an exception within sufficient time to ensure the continued occupancy by the
236.36recipient. This paragraph expires June 30, 2016.

237.1    Sec. 35. Laws 2011, First Special Session chapter 9, article 7, section 39, subdivision
237.214, is amended to read:
237.3    Subd. 14. Assessment and reassessment. (a) Assessments of each recipient's
237.4strengths, informal support systems, and need for services shall be completed within 20
237.5working days of the recipient's request as provided in section 256B.0911. Reassessment
237.6of each recipient's strengths, support systems, and need for services shall be conducted
237.7at least every 12 months and at other times when there has been a significant change in
237.8the recipient's functioning.
237.9(b) There must be a determination that the client requires a hospital level of care or a
237.10nursing facility level of care as defined in section 256B.0911, subdivision 4a, paragraph
237.11(d), at initial and subsequent assessments to initiate and maintain participation in the
237.12waiver program.
237.13(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
237.14appropriate to determine nursing facility level of care for purposes of medical assistance
237.15payment for nursing facility services, only face-to-face assessments conducted according
237.16to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
237.17determination or a nursing facility level of care determination must be accepted for
237.18purposes of initial and ongoing access to waiver services payment.
237.19(d) Persons with developmental disabilities who apply for services under the nursing
237.20facility level waiver programs shall be screened for the appropriate level of care according
237.21to section 256B.092.
237.22(e) Recipients who are found eligible for home and community-based services under
237.23this section before their 65th birthday may remain eligible for these services after their
237.2465th birthday if they continue to meet all other eligibility factors.
237.25(f) The commissioner shall develop criteria to identify recipients whose level of
237.26functioning is reasonably expected to improve and reassess these recipients to establish
237.27a baseline assessment. Recipients who meet these criteria must have a comprehensive
237.28transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be
237.29reassessed every six months until there has been no significant change in the recipient's
237.30functioning for at least 12 months. After there has been no significant change in the
237.31recipient's functioning for at least 12 months, reassessments of the recipient's strengths,
237.32informal support systems, and need for services shall be conducted at least every 12
237.33months and at other times when there has been a significant change in the recipient's
237.34functioning. Counties, case managers, and service providers are responsible for
237.35conducting these reassessments and shall complete the reassessments out of existing funds.

238.1    Sec. 36. Laws 2012, chapter 247, article 6, section 4, is amended to read:

238.2 238.3

Sec. 4. BOARD OF NURSING HOME ADMINISTRATORS

$

-0-

$

10,000

238.4Administrative Services Unit. This
238.5appropriation is to provide a grant to the
238.6Minnesota Ambulance Association to
238.7coordinate and prepare an assessment of
238.8the extent and costs of uncompensated care
238.9as a direct result of emergency responses
238.10on interstate highways in Minnesota.
238.11The study will collect appropriate
238.12information from medical response units
238.13and ambulance services regulated under
238.14Minnesota Statutes, chapter 144E, and to
238.15the extent possible, firefighting agencies.
238.16In preparing the assessment, the Minnesota
238.17Ambulance Association shall consult with
238.18its membership, the Minnesota Fire Chiefs
238.19Association, the Office of the State Fire
238.20Marshal, and the Emergency Medical
238.21Services Regulatory Board. The findings
238.22of the assessment will be reported to the
238.23chairs and ranking minority members of the
238.24legislative committees with jurisdiction over
238.25health and public safety by January 1, 2013.
238.26 This is a onetime appropriation.

238.27    Sec. 37. PROVIDER RATE AND GRANT INCREASES EFFECTIVE JANUARY
238.281, 2015, AND JULY 1, 2015.
238.29(a) The commissioner of human services shall increase reimbursement rates, grants,
238.30allocations, individual limits, and rate limits, as applicable, by one percent for the rate
238.31period beginning January 1, 2015, and by one percent for the rate period beginning July 1,
238.322015, for services rendered on or after those dates. County or tribal contracts for services
238.33specified in this section must be amended to pass through these rate increases within 60
238.34days of the effective date.
238.35(b) The rate changes described in this section must be provided to:
239.1(1) home and community-based waivered services for persons with developmental
239.2disabilities or related conditions, including consumer-directed community supports, under
239.3Minnesota Statutes, section 256B.501;
239.4(2) waivered services under community alternatives for disabled individuals,
239.5including consumer-directed community supports, under Minnesota Statutes, section
239.6256B.49;
239.7(3) community alternative care waivered services, including consumer-directed
239.8community supports, under Minnesota Statutes, section 256B.49;
239.9(4) brain injury waivered services, including consumer-directed community
239.10supports, under Minnesota Statutes, section 256B.49;
239.11(5) home and community-based waivered services for the elderly under Minnesota
239.12Statutes, section 256B.0915;
239.13(6) nursing services and home health services under Minnesota Statutes, section
239.14256B.0625, subdivision 6a;
239.15(7) personal care services and qualified professional supervision of personal care
239.16services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;
239.17(8) private duty nursing services under Minnesota Statutes, section 256B.0625,
239.18subdivision 7;
239.19(9) day training and habilitation services for adults with developmental disabilities
239.20or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the
239.21additional cost of rate adjustments on day training and habilitation services, provided as a
239.22social service, under Minnesota Statutes, section 256M.60;
239.23(10) alternative care services under Minnesota Statutes, section 256B.0913;
239.24(11) living skills training programs for persons with intractable epilepsy who need
239.25assistance in the transition to independent living under Laws 1988, chapter 689;
239.26(12) semi-independent living services (SILS) under Minnesota Statutes, section
239.27252.275, including SILS funding under county social services grants formerly funded
239.28under Minnesota Statutes, chapter 256I;
239.29(13) consumer support grants under Minnesota Statutes, section 256.476;
239.30(14) family support grants under Minnesota Statutes, section 252.32;
239.31(15) housing access grants under Minnesota Statutes, section 256B.0658;
239.32(16) self-advocacy grants under Laws 2009, chapter 101; and
239.33(17) technology grants under Laws 2009, chapter 79.
239.34(c) A managed care plan receiving state payments for the services in this section
239.35must include these increases in their payments to providers. To implement the rate increase
239.36in this section, capitation rates paid by the commissioner to managed care organizations
240.1under Minnesota Statutes, section 256B.69, shall reflect a one percent increase for the
240.2specified services for the period beginning January 1, 2015.
240.3(d) Counties shall increase the budget for each recipient of consumer-directed
240.4community supports by the amounts in paragraph (a) on the effective dates in paragraph (a).

240.5    Sec. 38. SAFETY NET FOR HOME AND COMMUNITY-BASED SERVICES
240.6WAIVERS.
240.7The commissioner of human services shall submit a request by December 31, 2013,
240.8to the federal government to amend the home and community-based services waivers for
240.9individuals with disabilities authorized under Minnesota Statutes, section 256B.49, to
240.10modify the financial management of the home and community-based services waivers
240.11to provide a state-administered safety net when costs for an individual increase above
240.12an identified threshold. The implementation of the safety net may result in a decreased
240.13allocation for individual counties, tribes, or collaboratives of counties or tribes, but must
240.14not result in a net decreased statewide allocation.

240.15    Sec. 39. SHARED LIVING MODEL.
240.16The commissioner of human services shall develop and promote a shared living model
240.17option for individuals receiving services through the home and community-based services
240.18waivers for individuals with disabilities, authorized under Minnesota Statutes, section
240.19256B.092 or 256B.49, as an option for individuals who require 24-hour assistance. The
240.20option must be a companion model with a limit of one or two individuals receiving support
240.21in the home, planned respite for the caregiver, and the availability of intensive training
240.22and support on the needs of the individual or individuals. Any necessary amendments to
240.23implement the model must be submitted to the federal government by December 31, 2013.

240.24    Sec. 40. MONEY FOLLOWS THE PERSON GRANT.
240.25The commissioner of human services shall submit to the federal government all
240.26necessary waiver amendments to implement the Money Follows the Person federal grant
240.27by December 31, 2013.

240.28    Sec. 41. REPEALER.
240.29Minnesota Statutes 2012, sections 256B.096, subdivisions 1, 2, 3, and 4; and
240.30256B.5012, subdivision 13, and Laws 2011, First Special Session chapter 9, article 7,
240.31section 54, as amended by Laws 2012, chapter 247, article 4, section 42, and Laws 2012,
240.32chapter 298, section 3, are repealed.