Senate Counsel, Research
and Fiscal Analysis
Minnesota Senate Bldg.
95 University Avenue W. Suite 3300
St. Paul, MN 55155
(651) 296-4791
Tom Bottern
Director
   Senate   
State of Minnesota
 
 
 
 
 
S.F. No. 1458 - Health and Human Services Budget Establishment and Provisions Modifications - the Conference Committee Report
 
Author: Senator Tony Lourey
 
Prepared By: Katie Cavanor, Senate Counsel (651/296-3801)
Liam Monahan, Senate Analyst (651/296-1791)
Joan White, Senate Counsel (651/296-3814)
 
Date: May 26, 2015



 

 Article 1 -Children and Family Services

Sections 1 and 2 (119B.125, subd. 7, 119B.13, subd. 6) establish overpayment claim procedures with regard to failure to comply with child care attendance record requirements, and authorize the commissioner to impose payment restrictionson a provider who submits false attendance records.

Sections 3 and 6 (245C.03, subd. 10, 245C.10, subd. 11) amend the background study chapter of law requiring the commissioner to conduct background studies on group residential housing (GRH) and supplementary services staff, and requires the commissioner to recover $20 per GRH or supplementary services background study.  These sections are effective July 1, 2016.

Sections 4, 5, and 7 (245C.03, subd. 11, 245C.04, subd. 10, 245C.10, subd. 12) require background studies for county social services employees who perform child protection duties, and requires the commissioner to recover $20 per study.

Section 8 (256.01, subd. 12a) establishes the Department of Human Services child fatality and near fatality review team, to assess the child protection services process, conduct on-site reviews, and identify necessary program improvements, including additional training and technical assistance needs of the local agency.  Provides that department staff shall lead the reviews, and requires summary reports of each review to be submitted to the state child mortality review panel.

Section 9 (256.017, subd. 1) adds group residential housing (GRH) to the Department of Human Services (DHS) compliance system, which permits the commissioner to supervise the administration of public assistance programs, enforce accurate distribution of benefits, and increase consistency in the delivery of public assistance programs.

Section 10 (256.741, subd. 1) removes MinnesotaCare from the definition of public assistance for purposes of a child support referral to the county, and the assignment of child support rights to the state.  These modifications are to conform to the Affordable Care Act, consistent with changes to chapter 518A.

Section 11 (256.741, subd 2.) removes a reference to MinnesotaCare to conform to the Affordable Care Act.

Section 12 (256E.28) Subdivision 1, allows the commissioner to award grants for development, implementation, and evaluation of activities to address racial disparities in the child welfare system.  Provides a list of the issues that must be addressed.

Subdivision 2.  State-community partnerships; plan.  Requires the commissioner, in partnership with culturally based community organizations; various cultural councils, counties, tribal governments, and the legislative task force on child protection, to develop a plan for awarding grants.

Subdivision 3.  Measurable outcomes.  Requires the commissioner to establish measurable outcomes before distributing any grants.

Subdivision 4.  Process.  Establishes the process for providing grants.  Limits a county grantee to spending no more than three percent of the grant for administrative costs.  Requires the commissioner to establish an administrative cost limit with all other grantees.  Prohibits a grantee from using grant funds to supplant existing federal and state funds received for child protection purposes.

Subdivision 5.  Grant program criteria.  Provides that the commissioner shall award competitive grants to eligible applicants.  Establishes the groups and entities that may be eligible for grants.  Specifies the priorities that must be considered by the commissioner in awarding grants.

Subdivision 6.  Evaluation.  Requires the commissioner to conduct biennial evaluations of the programs operated by the grantees using the outcomes under subdivision 3.  Requires the commissioner to consult with the legislative task force on the protection of children and submit a biennial report to the task force and the legislature.

Subdivision 7.  American Indian child welfare projects.  Requires the commissioner to award $75,000 to each tribe authorized to provide child welfare services under section 256.01, subd. 14b. An eligible tribe is not required to apply for these funds, and may apply for a competitive grant under this section.

Section 13 (256E.35, subd. 2) modifies the family assets for independence in Minnesota (FAIM) program by adding a definition for financial coach, and alphabetizing definitions.

Section 14 (256E.35, subd. 4a) modifies the FAIM program, by specifying the duties of a financial coach. 

Sections 15 to 40 amend section 256I, the GRH chapter of law.

Section 15 (256I.03, subd. 3) amends the definition of GRH by striking obsolete language and updating references to the new staffing and background study requirements.

Section 16 (256I.03, subd. 7) modifies the definition of “countable income” to clarify what is counted as income under the GRH program. 

Section 17 (256I.03, subd. 9) defines the term “direct contact.” 

Section 18 (256I.03, subd. 10) defines the term “habitability inspection.”

Section 19 (256I.03, subd. 11) defines the term “long-term homelessness.”

Section 20 (256I.03, subd. 12) defines the term “professional statement of need.”

Section 21 (256I.03, subd. 13) defines the term “prospective budgeting.”

Section 22 (256I.03, subd. 14) defines the term “qualified professional.”

Section 23 (256I.03, subd. 15) defines the term “supportive housing.”

Section 24 (256I.04, subd. 1) modifies individual eligibility requirements under the GRH program. This section is effective September 1, 2015.

Section 25 (256I.04, subd. 1a) provides that the county cannot approve a payment in excess of the MSA equivalent payment unless the individual has a professional statement of need, as defined in this chapter. Also, in order to be eligible for supplementary service payments, providers must enroll in the provider enrollment system, which is part of the MMIS system.

Section 26 (256I.04, subd. 2a) exempts supportive housing establishments for individuals who have experienced long-term homelessness that meet certain requirements from the licensure requirements, and imposes staffing requirements for direct staff on GRH providers.

Section 27 (256I.04, subd. 2b) clarifies that agreements between agencies and providers must be in writing, and specifies the minimum requirements that the provider must verify in the agreement.  Agreements may be terminated with or without cause by the commissioner, agency, or provider with two calendar months prior notice.

Section 28 (256I.04, subd. 2c) imposes background study requirements on GRH and supplementary services staff.

Section 29 (256I.04, subd. 2d) provides that the GRH or supplementary services must be provided to the satisfaction of the commissioner, and the commissioner has the right to suspend or terminate the agreement immediately if the health or welfare of the recipients is endangered, or when the commissioner has reasonable cause to believe that the provider has breached a material term of the agreement. 

Section 30 (256I.04, subd. 2e) clarifies staffing and background study requirements when there are multiple licenses.

Section 31 (256I.04, subd. 2f) specifies the minimum service requirements for licensed or registered settings, which include food preparation, housekeeping, and maintenance of the building.

Section 32 (256I.04, subd. 2g) is existing language that was moved from a previous subdivision.

Section 33 (256I.04, subd. 3) makes technical and conforming changes.

Section 34 (256I.04, subd. 4) removes obsolete language.

Section 35 (256I.05, subd. 1c) changes the term “county” to “agency” because the definition of “agency” includes tribes.

Section 36 (256I.05, subd. 1g) allows an agency to negotiate a supplemental services rate for individuals who have experienced long-term homelessness and who live in a supportive housing establishment.

Section 37 (256I.06, subd. 2) strikes references to countable income, to conform to changes in section 256I.06, subdivision 8, related to prospective budgeting.  This section is effective April 1, 2016.

Section 38 (256I.06, subd. 6) requires recipients to report changes in income every six months, instead of every month under current law.  This section is effective April 1, 2016.

Section 39 (256I.06, subd. 7) makes technical conforming changes. 

Section 40 (256I.06, subd. 8) provides that for an individual with earned income, prospective budgeting must be used to determine the individual’s payment for the following six-month period.  An increase in income must not affect eligibility until the month following the reporting month.  A decrease in income is effective the first day of the month after the decrease.

Sections 41 and 43 (256J.21, subd. 2, 256J.33, subd. 4) exclude from the determination of income for MFIP participants $100 of child support for an assistance unit with one child and $200 for an assistance unit with two or more children.

Section 42 (256J.24, subd. 5a) adds language requiring that the food portion of the MFIP transitional standard comply with federal waivers. 

Section 44 (256K.45, subd. 1a) amends the Homeless Youth Act by modifying the definition of the terms “homeless youth” and "youth at risk of homelessness" by changing eligibility from youth 21 years of age or younger, to youth 24 years of age or younger.  This is consistent with the federal Runaway and Homeless Youth Act.

Section 45 (256K.45, subd. 6) adds language requiring the commissioner to provide outreach, technical assistance, and program development to increase capacity to better meet the needs of homeless youth statewide.

Section 46 (256M.41) establishes the child protection grant allocation to address county staffing.  The county grant amount is based on the formula in subdivision 1, with a floor of $75,000 per county, and subdivision 2 prohibits the county from using grant funds to supplant current child protection county expenditures. Subdivision 3 withholds a total of 20 percent of the grant until the county meets certain performance outcomes.  The commissioner is required to develop recommendations for outcome measures by January 1, 2018.

Section 47 (256N.22, subd. 9) modifies language to comply with the federal requirement related successor guardians for children in a custody arrangement with a relative.

Section 48 (256N.22, subd. 10) modifies language to comply with the federal requirement related successor guardians for children in a custody arrangement with a relative.

Section 49 (256N.24, subd. 4) amends the provision related to extraordinary levels of care for children who have significant physical or mental health care needs, to include “foster care residence setting” to the settings that are eligible for difficulty of care supplemental rate payments.

Section 50 (256N.25, subd. 1) modifies language to comply with the federal requirement related successor guardians for children in a custody arrangement with a relative.

Section 51 (256N.27, subd. 2) strikes language giving the commissioner authority to transfer funds into the Northstar Care for Children account if a deficit occurs.

Section 52 (257.75, subd. 3) amends the law governing the effect of a recognition of parentage. New language refers to awards of temporary custody or parenting time. Section 518.131, which applies to marriage dissolutions, would apply to awards of temporary or permanent custody or parenting time based on a recognition of parentage.  This section is effective March 1, 2016.

Sections 53 (257.75, subd. 5) modifies recognition of parentage form requirements. The limitations of the recognition for purposes of exercising and enforcing custody or parenting time must be clear and understandable. Notification requirements with respect to the effect of a recognition on custody and parenting time are expanded, along with support obligations and other expenses for which the parent may be liable.  This section is effective March 1, 2016.

Section 54 (259A.75) modifies the reimbursement of tribal contracted adoption placement.  This section reallocates funds for tribal customary adoptions, and requires the commissioner to enter into grant contracts with Minnesota tribal social services agencies to provide child-specific recruitment and adoption placement services for Indian children.

Section 55 (260C.007, subd. 27) amends the definition of the term “relative.”

Section 56 (260C.007, subd. 32) amends the definition of the term “sibling.”

Section 57 (260C.203) modifies independent living plans so youth in foster care may start the plan at age 14 instead of age 16, updates a cross-reference, and requires the responsible agency to help the child obtain a tribal enrollment identification card prior to leaving foster care. 

Section 58 (260C.212, subd. 1) allows a child in foster care who is 14 years old or older to include two additional individuals on the team preparing the child’s out-of-home placement plan, adds language to reinforce transfer of custody to a relative, if possible, and requires that the independent living plan include objectives that allow for regular opportunities to engage in age appropriate activities typical for the child’s age group.

Section 59 (260C.212, subd. 13) is a new subdivision related to protecting missing and runaway children and youth at risk of sex trafficking. Imposes duties on the local social services agency to report and locate a missing child, determine the primary factors that contributed to the child running away, what the child experienced while absent from foster care, and appropriate services for the child.

Section 60 (260C.212, subd. 14) is a new subdivision requiring that child-placing agencies support a foster child’s emotional and developmental growth by permitting the child to participate in age and developmentally appropriate extracurricular activities.

Section 61 (260C.221) expands who is included in a relative search when a child is placed out of the home.

Sections 62 to 64 (260C.331, subd. 1, 260C.451, subd. 2, 260C.451, subd. 6) update cross-references.

Section 65 (260C.515, subd. 5) modifies the provision relating to ordering the child into permanent custody of the responsible social services agency.  Under current law, the court may order a child age 12 or older into long-term foster care.  This section changes the age to 16, and requires that the child be asked about his or her desired permanency outcome.

Section 66 (260C.521, subd. 1) requires that the child be asked about his or her desired permanency outcome as part of the agency’s reasonable efforts to finalize a permanent plan for the child.

Section 67 (260C.521, subd. 2) allows an order for permanent legal and physical custody to be modified to name a successor guardian as the custodian if the original relative is incapacitated or dies.

Section 68 (260C.607, subd. 4) makes changes consistent with section 260C.203, changing the age of the child from 16 to 14.

Section 69 (518A.26, subd. 14) amends the definition of “obligor” for purposes of establishing child support obligations by striking a presumption that a person who has primary physical custody of the child is not an obligor.  This section is effective March 1, 2016.

Section 70 (518A.32, subd. 2) modifies one of the methods for determining potential income. The amount of income a parent could earn working full-time at 150 percent of the current federal or state minimum wage is changed to working 30 hours per week at 100 percent. This section is effective March 1, 2016.

Section 71 (518A.39, subd. 1) allows a child support order to be modified for medical support.  This section is effective January 1, 2016.

Section 72 (518A.39, subd. 8) is a new subdivision allowing for a medical support-only modification of a support order.  This section is effective January 1, 2016.

Section 73 (518A.41, subd. 1) modifies the definition of “public coverage,” with regard to health care benefits by striking a reference to MinnesotaCare.

Section 74 (518A.41, subd. 3) amends the statute in which the court determines if a parent has appropriate health coverage for the child. This section adds language providing that health plans meeting the definition of minimum essential coverage under the ACA meet the definition of comprehensive medical coverage.

Section 75 (518A.41, subd. 4) modifies what a court may order related to a parent’s contribution for health care coverage in a child support case, if neither parent has appropriate health care coverage.  This section is effective August 1, 2015.

Section 76 (518A.41, subd. 14) requires the public authority to assist with modifying a medical support order.  This section is effective January 1, 2016.

Section 77 (518A.41, subd. 15) amends the remedies available for the enforcement of a child support order.  New language provides that failure to provide court-ordered coverage or provide medical support is a basis for a modification, unless it meets a presumption.  This section is effective January 1, 2016.

Section 78 (518A.43, subd. 1a) authorizes a court to elect not to order a party who has between 10 and 45 percent parenting time to pay basic support if there is such a significant disparity of income between the parties that an order directing payment would be detrimental to the joint child.  This section is effective March 1, 2016.

Section 79 (518A.46, subd. 3) strikes reference to MinnesotaCare as a public assistance program.

Section 80 (518A.46, subd. 3a) specifies the contents of pleadings for medical support modifications.   This section is effective January 1, 2016.

Section 81 (518A.51) discontinues the $25 application fee for child support IV-D services. Federal conformity part of this section strikes reference to MinnesotaCare.  This section is effective July 1, 2015.

Section 82 (518A.53, subd. 1) modifies the definition of "arrears."  This section is effective July 1, 2016.

Section 83 (518A.53, subd. 4) allows the court to order a specific monthly payback amount for child support arrears, and strikes a reference to the $25 application fee.  This section is effective July 1, 2016.

Section 84 (518A.53, subd. 10) allows the court to order a specific monthly payback amount for child support arrears.  This section is effective July 1, 2016.

Section 85 (518A.60) is a modification to conform to changes made in section 518A.53, subd. 10.  This section is effective July 1, 2016.

Section 86 (518A.685)  requires the public authority to report child support arrears information to a consumer reporting agency when an obligor is in arrears in an amount greater than three times the monthly court ordered support obligation.  Provides that before making a report, the public authority must mail the obligor written notice at least 30 days prior to making the report.  Allows the obligor, within 21 days of receipt of the notice, to pay the arrears in full or request an administrative review. If the public authority has reported the obligor to a consumer reporting agency and determines the obligor has paid arrears in full or is paying current monthly support plus the required arrearage payment, the public authority must report this to the consumer reporting agency. Requires the public authority to make monthly reports to the consumer reporting agency if the authority has reported arrearage information under this section.   This section is effective July 1, 2016.

Section 87 (518C.802) amends the Uniform Interstate Family Support Act (UIFSA), to comply to the federal Preventing Sex Trafficking and Strengthening Families Act.

Section 88 (626.556, subd. 1) modifies the maltreatment of minors public policy statement, by providing that the health and safety of the children must be of paramount concern, and intervention and prevention must address immediate concerns for child safety.

Section 89 (626.556, subd. 2) amends the definition of the following terms:  "family assessment," "investigation," "substantial child endangerment," "physical abuse," and "report."  The term “sexual abuse” is added throughout section 626.556 because the term was imbedded in the definition of “substantial child endangerment” and also defined separately.  To clarify terms, the definition of “substantial child endangerment” was modified to delete the “sexual abuse” reference, resulting in both terms being defined and referenced in this section of law.

Section 90 (626.556, subd. 3) amends the headnote to reflect the content of the subdivision, adds tribal social services agency and tribal police to the list to which a reporter of maltreatment may report, strikes language that is moved to 626.556, subd. 7 and 10, and adds a paragraph referencing the moved language regarding mandatory notification between law enforcement and local welfare agency.

Section 91 (626.556, subd. 6a) updates a cross-reference.

Section 92 (626.556, subd. 7) requires the local welfare agency to determine if a report is screened in or out, and allows the agency to consider, when relevant, all previous history, including screened out reports.  It also includes language providing for certain information regarding the disposition of reports to be given to reporters, which is moved from current law in 626.556, subd. 3.  Requires screened-out reports to be maintained according to the record retention schedule in subdivision 11c.  Paragraph (f) requires the local welfare agency to consider prior reports, including screened-out reports, when making screening decisions.

Section 93 (626.556, subd. 7a) Paragraph (a) requires staff, supervisors, and other involved in child protection screening to follow guidance issued by the commissioner of human services and immediately implement updated policies and procedures when notified by the commissioner.  Paragraph (b) provides that any modifications to the screening guidelines must be preapproved by the Commissioner of Human Services.  The county agency must consult with the county attorney before proposing modifications to the commissioner.

Section 94 (626.556, subd. 10) moves existing language from 626.556, subd. 3 to this subdivision, requiring law enforcement and local welfare agencies to immediately notify each other orally and in writing upon receipt of a report.  The law enforcement and local welfare agencies are required to designate a person responsible for ensuring that the notification duties under this section are carried out.  When the alleged maltreatment occurred on tribal land, the tribal social services agency and tribal law enforcement must be notified immediately, orally and in writing.  This section adds that prior screened out reports are relevant information in investigations and family assessments.

Section 95 (626.556, subd. 10e) strikes language that allowed counties to modify definitions or criteria under this section.

Section 96 (626.556, subd. 10j) requires the release of relevant private data to a mandated reporter who made the report and has an ongoing responsibility for the child, unless the agency determines that providing the data would not be in the best interests of the child. The agency may provide the data to other mandated reporters with an ongoing responsibility for the health, education, or welfare of the child.  New paragraph (b) provides that the reporter who receives private data under this subdivision must treat the data according to that classification.

Section 97 (626.556, subd. 10m) requires the local welfare agency to consult with the county attorney to determine the appropriateness of filing a CHIPS petition if the family does not accept or comply with a plan for child protective services, voluntary services may not provide sufficient protection for the child, or the family is not cooperating with an investigation.

Section 98 (626.556, subd. 11c) adds reports alleging child maltreatment that were not accepted for assessment or investigation to the record retention requirements of this paragraph.  Requires those reports, family assessment cases, and cases in which an investigation determines there has been no maltreatment or need for protective services to be retained for five years.  Requires that records of screened-out reports must contain sufficient information to identify the subjects of the reports, the alleged maltreatment, and the reasons the report was not accepted.  This section also clarifies that retained records can be used in future screening decisions and risk and safety assessments.

Section 99 (626.556, subd. 16) Paragraph (a) requires the commissioner to develop a plan for quality assurance reviews of local agency screening practices, and oversee and provide guidance to counties so that screening decisions are consistent throughout the state.  Requires the reviews to begin no later than September 30, 2015.  Paragraph (b) requires the commissioner to issue an annual report with summary results of the reviews.  Specifies that the report must contain aggregate data and must not include data that could be used to identify any subject whose data is included in the report.  Provides that the report must be classified as public information and be provided to designated members of the legislature.

Section 100 (626.559, subd. 1b) requires all county employees who have child protection duties who are hired on or after July 1, 2015, or who have been assigned new child protection duties on or after July 1, 2015, to undergo a background study.  A county may either use the Department of Human Services or develop an alternative process to complete background studies.

Sections 101 to 118 (Laws 2014, chapter 189, sections 5, 10, 11, 16, 17, 18, 19, 23, 24, 27,28, 29, 31, 43, 50, 51) amend UIFSA to comply to federal law.

Section 119 (Laws 2014, chapter 189, section 73) makes the UIFSA changes effective July 1, 2015.

Section 120 requires the commissioner, in coordination with stakeholders and advocates, to build on the group residential  housing (GRH) reforms made this session, and propose modifications that will result in a more cost-effective GRH program, and report to the legislative committees having jurisdiction over GRH issues by December 15, 2016. The working group shall examine the feasibility of restructuring service rates, develop a plan to fund only those services that are not funded by other programs based on individual need, and explore and recommend appropriate and effective assessment tools.

Section 121 Paragraph (a) establishes the work group to review the child support parenting expense adjustment and to identify and recommend changes to the adjustment.  Paragraph (b) identifies stakeholders and legislators who will be members of the work group.  Paragraph (c) authorizes the work group to contract with an economist to assist in creating an equitable parent expense adjustment formula.  Paragraph (d) requires the work group to submit a report to the legislature and to the commissioner of human services by January 15, 2016.  Requires the report to include recommendations for changes to the computation of child support and recommendations on the composition of a permanent child support task force.  Paragraph (e) provides that terms, compensation, removal of group members, and filling of vacancies are governed by Minnesota Statutes, section 15.059.  Paragraph (f) provides that the work group expires January 16, 2016.

Section 122 requires the commissioner to update the child maltreatment screening guidelines by October 1, 2015, to require agencies to consider prior reports that were not accepted for assessment or investigation when screening a new report.  Requires the commissioner to work with a diverse group of community representatives who are experts on limiting cultural and ethnic bias. This section also requires the commissioner to publish and distribute the updated guidelines by November 1, 2015, and ensure that agency staff have received training on updated guidelines.  Agency staff must implement the guidelines by January 1, 2016.

Section 123 requires the commissioner to establish requirements for competency-based initial training, support, and continuing education for child protection supervisors. The training must advance continuous emphasis and improvement that integrates the client's traditions, customs, values, and faith into service delivery.

Section 124 instructs the commissioner to evaluate the formula established in section 256M.41 to determine whether modifications are needed to the distribution formula.  The report is due December 15, 2016.

Section 125 establishes the legislative task force and lists its duties.  Allows the task force to provide oversight and monitoring of specified executive agencies, counties, and tribes in their efforts to assure the safety and well-being of children at risk of harm or children who are involved in the child welfare system.  Requires the task force to issue a report to the legislature and governor.  Provides that the task force expires the last day of the 2016 legislative session.

Section 126 is a revisor instructions, requiring the revisor to alphabetize the definitions in section 626.556, subdivision 2.

Article 2 - Chemical and Mental Health Services

Section 1 (13.46, subd. 2) amends the welfare data statute to specifically authorize sharing of data with personnel of the welfare system for purposes of coordinating services for an individual or family. In addition, data can be shared with a health care provider, to the extent necessary to coordinate services.

Section 2 (13.46, subd. 7) amends the welfare data provision governing mental health data to authorize disclosure to personnel of the welfare system working in the same program or providing services to the same individual or family, and to a health care provider, to the extent necessary to coordinate services.

Section 3 (62Q.55, subd. 3) adds emergency mental health services for children and adults to the definition of “emergency services” in the chapter on health plan companies.

Section 4 (144.293, subd. 6) amends the health records statute so that a consent to the release of health records to the welfare system (as provided for under sections 1 and 2) would not expire after one year.

Section 5 (144.551, subd. 1) provides an exception to the hospital moratorium for a 20-bed psychiatric hospital, within an existing facility, for patients who are under 21 years of age, if the commissioner finds it is in the public interest after a public interest review.

Section 6 (145.56, subd. 2)  instructs the commissioner of health, within available appropriations, to establish grants for community-based programs to provide evidence based suicide prevention and intervention training to education, public safety, and health professionals and to provide postvention training to mental health professionals.

Section 7 (145.56, subd. 4)  adds paragraphs (b) and (c) which require the commissioner of health to issue a report to the legislature by February 1, 2016, with a plan to identify methods to improve the gathering of suicide-related data.  Requires the plan to address how this data can help identify the scope of the suicide problem, identify high risk groups, establish priority prevention activities, and monitor the effects of suicide prevention programs.

Section 8 (245.4661, subd. 5) corrects a reference to intensive residential treatment service (IRTS).

Section 9 (245.4661, subd 6) strikes language that allows the transfer of funds from a state-operated services account for mental health specialty treatment services.  (Related to section 246.18, subdivision 8.) 

Section 10 (245.4661, subd. 9) lists the services and programs for which the adult mental health grants may fund.

Section 11 (245.4661, subd. 10) requires the commissioner to report biennially on the use of the adult mental health grant funds, specifically the amount of funding to mental health initiatives, the programs and services that were funded, and outcome data related to those services and programs.

Section 12 (245.467, subd. 6) makes conforming changes in the human services chapter with regard to the modification to access to mental health data under section 13.46, subdivision 7.

Section 13 (245.4876, subd. 7) makes conforming changes in the human services chapter with regard to the modification to access to mental health data under section 13.46, subdivision 7.

Section 14 (245.4889, subd. 1) lists the services and programs for which children’s mental health grants may fund.

Section 15 (245.4889, subd. 3) requires the commissioner to report on the use of the children’s mental health grants biennially, specifically the amount of grants awarded, the programs and services funded, and outcome data related to the funded services and programs.

Section 16 (245.735, subd. 1) requires the Commissioner of Human services to develop and execute projects to reform the mental health system by participating in the federal Excellence in Mental Health demonstration project. 

Subdivision 2 requires the commissioner to submit a proposal to the federal Department of Health and Human Services for the demonstration project.

Subdivision 3 requires the commissioner to establish standards for state certification of   certified community behavioral health clinics, and specifies what the certification standards must include. The commissioner is also required to establish standards and methodologies for a prospective payment system for MA payments for mental health services delivered in the clinics. 

Subdivision 4 requires the commissioner to consult with mental health providers, and others in developing the projects under subdivision 3.

Subdivision 5 requires the commissioner and the state chief information officer to provider information systems support to the projects as necessary to comply with federal requirements and deadlines.

Section 17 (246.18, subd. 8) strikes language that allows the transfer of funds from a state-operated services account for mental health specialty treatment services.  (Related to 245.4661, subdivision 6.)

Section 18 (253B.18, subd. 4c) requires the civil commitment special review board to review each denied petition for a reduction in custody for barriers and obstacles preventing a patient from progressing in treatment, and provide to the commissioner an annual summation of the barriers to treatment progress, and recommendations to achieve the common goal of making progress in treatment. This section is effective January 1, 2016.

Section 19 (253B.18, subd. 5) requires the head of the treatment facility to schedule a hearing before the special review board for any patient who has not appeared before the board in the previous three years, and schedule a hearing at least every three years, thereafter.  This section is effective January 1, 2016, with hearings starting no later than February 1, 2016. 

Section 20 (254B.05, subd. 5) requires the commissioner to establish a rate for high-intensity residential treatment services that provide 30 hours of clinical services each week for clients who have been committed to the commissioner who present complex and difficult care needs, and are a potential threat to the community.  This section affects CARE sites, which will remain open, transition to 16-bed facilities, and capture federal funding for services.

Section 21 (254B.12, subd. 2) strikes language requiring the commissioner to receive legislative approval before implementing the payment methodology under section 254B.05, subd. 5, or for chemical dependency services provided by a state-operated vendor. 

Section 22 (256B.0615, subd. 3) corrects a reference to intensive residential treatment services (IRTS)

Section 23 (256B.0622, subd. 1) updates the name of the services to “assertive community treatment” (ACT) and “intensive residential treatment services” (IRTS).

Section 24 (256B.0622, subd. 2) strikes an old reference, adds a definition for ACT, and strikes outdated language.

Section 25 (256B.0622, subd. 3) modifies eligibility for ACT and IRTS by changing the reference to “two or more” inpatient hospitalizations in the past year, to “recurring or prolonged” inpatient hospitalizations in the past year.

Section 26 (256B.0622, subd. 4) updates references to ACT and IRTS.

Section 27 (256B.0622, subd. 5) amends the standards for ACT and IRTS providers by modifying when the functional assessment must be updated, and when the individual treatment plan must be completed and refined.

Sections 28, 29, 30, and 31 (256B.0622, subd. 7, 256B.0622, subd. 8, 256B.0622, subd. 9, 256B.0622, subd. 10) update references to ACT and IRTS, make changes to align with state plan, allow physician services to be delivered by telemedicine, strike obsolete references related to county rate setting due to the implementation of the statewide rate methodology, and add rate language for new programs.

Section 32 (256B.0622, subd. 11) allows the commissioner to disburse grants directly to providers ACT and IRTS to maintain access to these services.

Section 33 (256B.0624, subd. 7) clarifies staffing requirements for adult crisis stabilization services.

Section 34 (256B.0625, subd. 45a) adds psychiatric residential treatment facility services for persons under 21 years of age to the services eligible for medical assistance coverage.  The commissioner is required to develop admissions and discharge procedures and establish rates consistent with the guidelines from Centers for Medicare and Medicaid Services (CMS). The commissioner is required to enroll 150 certified psychiatric residential treatment facility services beds at up to six sites. The commissioner shall select the providers though a request for proposals (RFP) process. This section is effective July 1, 2017, or upon federal approval, whichever is later.

Section 35 (256B.0625, subd. 48) amends the medical assistance benefit chapter of law, specifically the benefit that allows psychiatric consultation to primary care practitioners, to include medical assistance reimbursement for consultation done by licensed independent clinical social workers and licensed marriage and family therapists.

Section 36 (256B.7631) increases by two percent the chemical dependency provider rate for services listed under section 254B.05, subdivision 5.

Section 37 requires the commissioner of human services, in consultation with stakeholders, to develop service standards and a payment methodology for Clubhouse program mental health services to be covered under medical assistance, and seek federal approval.  Upon federal approval, the commissioner shall seek and obtain legislative approval allowing MA coverage for Clubhouse services.

Section 38 requires the commissioner to report to legislative committees on the progress of the Excellence in Mental Health demonstration project under section 245.735, and include any recommendations for legislative changes necessary to implement the reform projects.

Section 39 requires the commissioner to conduct a comprehensive analysis of the current rate-setting methodology for community-based mental health services for adults and children.  The report must include alternative payment structures, and recommendations for establishing pay-for-performance measures for providers delivering services consistent with evidence-based practices. The commissioner shall consult with stakeholders and experts in Medicaid financing. The report is due January 1, 2017.

Section 40 requires the commissioner to report on the fiscal impact, including estimated savings, resulting from the modifications to the data practices act permitting the sharing of public data to coordinate care. The report is due January 1, 2017.

Section 41 provides that in order to receive the funds appropriated for the planning and development of a comprehensive mental health program in Beltrami county, Beltrami county must submit to the commissioner a formal commitment and plan to fund, operate, and sustain the program and services after the onetime state grant is expended.  The planning and development of the program by the county must include an integrated case model for mental health and substance use disorder treatment for individuals who are under arrest, under a civil commitment transport hold, or in immediate need of mental health crisis services.  The commissioner of human services, in consultation with Beltrami County, shall report on the status of the planning and development of the mental health program by November 1, 2017.

Section 42 directs the commissioner to increase access to mental health crisis services for children and adults by developing a central phone line, providing 24-hour consultation for persons with traumatic brain injury or an intellectual disability, expand crisis services statewide, establish and implement standards, and provide grants to establish new crisis residential service capacity.   Requires the commissioner to give priority to regions unable to meet the needs of the residents in the region and to distribute at least 50 percent of the grant funds to programs in rural Minnesota.

Section 43 instructs the commissioner of human services to consult with stakeholders in order to develop funding recommendations for children’s mental health crisis residential services that will allow timely access without requiring county authorization or child welfare placement.

Article 3 - Withdrawal Management Programs

Establishes a new model for detoxification programs, called Withdrawal Management. The article establishes the comprehensive program in a new chapter of law, Minnesota Statutes, chapter 245G, and the commissioner is required to develop a payment methodology for services provided under this chapter, seek federal approval for the rate methodology, and obtain legislative approval before implementing the program.

Article 4 - Direct Care and Treatment

Section 1 (43A.241) requires the state to pay the employer contribution for health and dental benefits under the State Employee Group Insurance Program (SEGIP) for employees assaulted by a client or patient at the Minnesota sex offender program or a state-operated forensic services program, who are permanently physically disabled as a direct result of the assault. This section is effective the day following final enactment and applies to a person assaulted on or after that date.

Section 2 (246.54, subd. 1) modifies the county portion of the cost of care for the Anoka Metro Regional Treatment Center (AMRTC).  Currently, the county pays zero percent of the cost of care for the first 30 days; 20 percent for days 31 to 60; and 75 percent for over 60 days.  The proposal changes the cost of care to 20 percent for 31 days or more, provided the stay at the AMRTC is determined to be clinically appropriate for the client; and 100 percent for each day the facility determines that it is clinically appropriate to discharge the client.

Article 5 - Simplification of Public Assistance Programs

Article 5 contains language implementing the second phase of the administrative simplification of public assistance programs. Last session, Minnesota Statutes, chapter 256P, was established, which made uniform the treatment of income, assets, and household composition for MFIP, GA, MSA, and GRH.  This bill builds on chapter 256P by making uniform income calculations, reporting of income and changes to income, and correcting overpayments and underpayments, and incorporating child care assistance into chapter 256, where applicable.

Sections 1 to 21 (119B.011, subd. 15, 119B.025, subd. 1, 119B.035, subd. 4, 119B.09, subd. 4, 256D.01, subd. 1a, 256D.02, subds. 1a and 1b, 256D.02, subd. 8, 256D.06, subd. 1, 256D.405, subd. 3, 256I.03, subds. 1b and 7, 256I.04, subd. 1, 256I.06, subd. 6, 256J.08, subds. 26 and 86, 256J.30, subds. 1 and 9, 256J.35, 256J.40, 256J.95, subd. 19) amend the child care assistance, general assistance, group residential housing programs, and MFIP to define terms, incorporate references to chapter 256P, and to make conforming changes.   

Section 22 (256P.001) modifies the applicability of chapter 256P to include child care assistance programs.

Section 23 (256P.01, subd. 2a) defines the term "assistance unit."

Section 24 (256P.01, subd. 3) modifies the definition of "earned income."

Section 25 (256P.01, subd. 8) defines the term "unearned income."

Sections 26, 27, 28, and 30 (256P.02, subd. 1a, 256P.03, subd. 1, 256P.04, subd. 1, 256P.05, subd. 1) exempt child care programs from several requirements in 256P that were passed last year because the child care programs contain specific policies that are unique to that program, which include different documentation requirements related to authorized hours of care and authorized activities, and the use co-pays instead of income disregards.  Child care programs must, however, comply with the new requirements related to the calculation of income and reporting requirements in section 32.

Section 29 (256P.04, subd. 4) requires certain nonrecurring income to be verified.

Section 31 (256P.06) adds a new section of law specifying the calculation of income, and what is included in determining the income of an assistance unit

Section 32 (256P.07) adds a new section of law related to reporting income and reporting changes in income. This section requires that changes in income listed in this section must be reported within a specific period of time.

Section 33 (256P.08) adds a new section of law specifying the procedure for the correction of overpayments and underpayments, and specifies procedures for general assistance, Minnesota supplemental aid programs, and MFIP overpayments.

Section 34 repeals redundant language in law and rule.

Section 35 makes this article effective August 1, 2016.

Article 6 - Nursing Facility Payment Reform and Workforce Development

Section 1 (144.1503 – Health care workforce) establishes a new home and community-based services employee scholarship program. Under the program, home and community-based services providers that primarily serve individuals over the age of 64 and establish an employee scholarship program may apply for a grant from the Commissioner of Health. Money from a grant must be used to cover costs incurred by an employee of the provider that are related to a course of study that is expected to lead to career advancement with the provider or in the field of long-term care.

Section 2 (144A.071, subdivision 4a – Moratorium exception) modifies the moratorium on the creation of new nursing home beds and construction projects by modifying an exception for a facility in Polk County.

Section 3 (256B.0913, subdivision 4 – Increases in alternative monthly limits linked to increases in nursing facility rates) modifies the monthly limits under the Alternative Care program to be consistent with the new elderly waiver monthly limits, thereby linking increases in the AC monthly limits to the average percentage increase in nursing facility payment rates.

Section 4 (256B.0915, subdivision 3aIncreases in elderly waiver monthly cost limits linked to increases in nursing facility rates) requires any legislatively adopted percentage increase to the monthly cost limit for elderly waiver services to be further increased such that the total percentage increase is equal to the average of the statewide percentage increase in nursing facility operating payments rates, but only if the average percentage increase in nursing facility rates is greater than the legislatively adopted percentage increase in the rates for elderly waiver services.

Section 5 (256B.0915, subdivision 3eIncreases in customized living rate limits linked to increases in nursing facility rates) requires any legislatively adopted percentage increase to individual service rate limits for customized living services (aka assisted living services) to be further increased such that the total percentage increase is equal to the average of the statewide percentage increase in nursing facility operating payments rates, but only if the average percentage increase in nursing facility rates is greater than the legislatively adopted percentage increase in the rates for elderly waiver services.

Section 6 (256B.0915, subdivision 3h – Increases in elderly waiver rate limit linked to increases in nursing facility rates) requires any legislatively adopted percentage increase to elderly waiver rate limits for 24-hour customized living services to be further increased such that the total percentage increase is equal to the average of the statewide percentage increase in nursing facility operating payments rates, but only if the average percentage increase in nursing facility rates is greater than the legislatively adopted percentage increase in the rates for elderly waiver services.

Section 7 (256B.431, subdivision 2b – Special dietary needs) removes language related to reimbursement rates for special dietary needs (this language is moved to 256B.441, subdivision 51b).

Section 8 (256B.431, subdivision 36 - Health care workforce scholarships) allows nursing facilities with no employee scholarship cost per diem to request between October 1, 2015, and December 31, 2017, an optional rate add-on that must be used for employee scholarships. This section also reduces to ten the average number of hours per week an employee must work to qualify for a scholarship, expands eligible professions, and includes additional eligible costs.

Section 9 (256B.434, subdivision 4 – Suspension of inflation adjustment) extends the suspension of automatic inflationary adjustments for two additional rate years.  This section also removes obsolete language and removes language in paragraph (d) related to the performance-based incentive payment program (this language is moved to 256B.441, subdivision 46d).

Section 10 (256B.434, subdivision 4i, paragraph (a) – Additional property rate increases) provides an additional property rate increase of $4 and of $12.50 to two nursing facilities with construction projects approved in 2015 under the nursing facility moratorium exception process. Paragraph (b) specifies that money available from canceled moratorium exception projects shall be used to reduce the fiscal impact of the additional increases allowed under paragraph (a).

Section 11 (256B.441, subdivision 1 – Nursing facility payment reform) strikes nursing facility rebasing language and replaces it with the requirement that each year, beginning January 1, 2016, the Commissioner of Human Services calculate nursing facilities’ annual operating payment rates on the basis of the facilities’ cost reports submitted 15 months prior to the current rate year.

Section 12 (256B.441, subdivision 5 – “Administrative costs”) includes property insurance as an administrative cost. (Section 15 removes property insurance from external fixed costs).

Section 13 (256B.441, subdivision 6 – “Allowed costs”) adds language specifying the conditions under which the wages and associated compensation-related costs for nursing facility employees represented by collective bargaining agents are allowed costs for the purposes of a nursing facility’s payment rate under Medical Assistance.

Section 14 (256B.441, subdivision 11a – “Employer health insurance costs”) adds a new subdivision defining “employer health insurance costs.” (In section 15, these costs are included in the definition of external fixed costs.)

Section 15 (256B.441, subdivision 13 – “External fixed costs”) removes long-term consultation fees and property insurance from the definition of external fixed costs but includes property assessments, payments in lieu of taxes, employer health insurance costs, quality improvement incentive payment rate adjustments, performance-based incentive payments, and special dietary needs.

Section 16 (256B.441, subdivision 14 – “RUG”) replaces the previously defined RUG’s weights with the RUG’s weights prescribed in section 256B.438.

Section 17 (256B.441, subdivision 17 – “Fringe benefit costs”) removes health insurance costs from fringe benefit costs, and clarifies that health insurance costs are excluded from the costs of other employee insurance and that the costs of PERA are excluded from pension costs.

Section 18 (256B.441, subdivision 30 – Median costs) removes language related to peer groups and requires the commissioner to use only the cost reports from nursing facilities in the seven-county metro area when determining the median total care-related cost and other operating cost per diems that will be used to set the statewide operating cost payment limits.

Section 19 (256B.441, subdivision 31 – Hold harmless) updates the date of the prior system operating cost payment rate to be the rate in effect on December 31, 2015, including employer health insurance costs and property insurance, but excluding the alternative rate for publically owned facilities.

Section 20 (256B.441, subdivision 33 – “Rate year”) modifies the definition of “rate year” to conform to the change of the first day of the rate year from October 1 to January 1.

Section 21 (256B.441, subdivision 35 – “Reporting year”) modifies the definition of “reporting period” to include parameters for interim and settle-up periods.

Section 22 (256B.441, subdivision 40 – “Standardized days”) modifies the definition of “standardized days” to specify how resident days at a penalty classification are treated.

Section 23 (256B.441, subdivision 44 – Quality scores) removes obsolete language and makes technical and conforming changes to the statute governing the calculation of nursing facility quality scores.

Section 24 (256B.441, subdivision 46c – Quality improvement incentives) makes conforming changes to the quality improvement incentive system to reflect the new rate year timeline and specifies that quality improvement incentive rate adjustments must be included in the external fixed payment rate.

Section 25 (256B.441, subdivision 46d – Performance-based incentives) inserts the performance-based incentive payment language removed from 256B.434, subdivision 4, paragraph (d), and specifies that performance-based incentive rate adjustments must be included in the external fixed payment rate.

Section 26 (256B.441, subdivision 48 – Care-related per diem) changes the name “operating per diem” to “care-related per diem” and removes the costs associated with the other operating per diem, moving them to 256B.441, subdivision 30, which includes a definition of “other operating per diem.”

Section 27 (256B.441, subdivision 50 – Total care-related limit) modifies the total care-related per diem limits. The calculation of a facility’s total care-related per diem limit begins with two calculations: (1) the calculation of the reporting year median total care-related per diem for only those facilities in the seven-county metro area, and (2) a facility's individual quality score for the reporting year as determined under section 256B.441, subdivision 44.  A facility’s total care-related per diem limit for each rate year is a function of its individual quality score and the median total care-related per diem of only the facilities in the seven-county metro area. Facilities with higher quality scores are subject to higher limits. Any facility with total care-related costs during the reporting year in excess of its total care-related limit for the rate year will have its total care-related per diem reduced to its limit. The table below shows example limits for a number of different facility quality scores.

 

Facility Quality Score

Care-related Limit
(percent of metro median care-related per diem for the reporting year)

0

                        89.375%

10

                        90%

25

                        103.4375%

50

                        117.5%

75

                        131.5625%

90

                        140%

100

                        145.625%

Section 28 (256B.441, subdivision 51 – Other operating price) sets the other operating price for any facility equal to 105 percent of the median other operating per diem of only those facilities operating in the seven-county metro area.

Section 29 (256B.441, subdivision 51a – Specialized care) removes the commissioner’s authority to negotiate certain increases for nursing facilities that provide specialized care, and instead, beginning January 1, 2016, increases by 50 percent the total care-related limit for specialized care facilities, which are defined only as “Rule 80” facilities and a certain facility in Robbinsdale.

Section 30 (256B.441, subdivision 51b – Special dietary needs) inserts a provision relating to special dietary needs that was removed from section 256B.431, subdivision 2b, paragraph (h), and removes costs related to special dietary needs from allowable raw food per diem costs, including them instead in the external fixed per diem rate.

Section 31 (256B.441, subdivision 53 – External fixed costs) eliminates obsolete language, reorders paragraphs, and modifies the calculations for the external fixed costs payment rate by: eliminating the exclusion of planned closure rate adjustments; eliminating the exclusion of single bedroom incentives; removing property insurance costs; and providing instructions for calculating employer health insurance costs, quality improvement incentive payment rate adjustments, performance-based incentive payments, and reimbursement for special dietary needs.

Section 32 (256B.441, subdivision 54 – Total payment rates) removes obsolete language, makes conforming changes, and eliminates reference to the repealed efficiency incentives.

Section 33 (256B.441, subdivision 55a – Publicly owned facilities) makes conforming changes to the alternative operating payment rate for publicly owned nursing facilities by removing references to the repealed phase-in of the rebased operating payment rates and by correcting rate year dates.

Section 34 (256B.441, subdivision 56 – Hold harmless) removes obsolete language related to the repealed phase-in of the rebased operating payment rates and updates hold harmless language, effective for the rate year beginning January 1, 2016, to specify that no nursing facility will receive an operating payment rate less than its operating payment rate as of December 31, 2015. Paragraph (b) prohibits facilities from being subject to a care-related payment rate limit reduction greater than five percent of the median total care-related per diem for rate years beginning on or after January 1, 2016.

Section 35 (256B.441, subdivision 63 – Suspension of critical access nursing facilities program) suspends the critical access nursing facility program from January 1, 2016, to December 31, 2017.

Section 36 (256B.441, subdivision 65 – Rate increases for a specialized care facility in Golden Valley) requires the operating payment rate for a specified facility located in Golden Valley to be calculated without the application of the total care-related limit and the determination of the other operating price, effective for the rate year beginning on January 1, 2016.

Section 37 (256B.441, subdivision 66 – Rate increases for nursing facilities in Breckenridge) increases the operating payment rate for nonprofit nursing facilities in the city of Breckenridge.  Nonprofit facilities in Breckenridge will receive an operating payment rate that the commissioner will calculate based upon the operating rates received in nonprofit facilities in adjacent cities located in another state. Exempts facilities from certain nursing facility payment rate limits if the adjustments under this subdivision result in a rate that exceeds those limits. The new operating rate will only apply if a facility receives a rate increase as a result of the new calculation.

Section 38 (256B.441, subdivision 67 – Employer health insurance costs) allows facilities that did not provide employee health insurance coverage as of May 1, 2015, to be reimbursed for employer health insurance costs beginning January 1, 2016, if the facility has a signed contract with a health insurance provider to provide coverage beginning January 1, 2016.

Section 39 (256B.50, subdivision 1 – Medical Assistance Appeals) modifies the scope of MA appeals to include allowable costs under the nursing facility payment system.  Makes this section effective January 1, 2015, and it applies to appeals filed on or after that date.

Section 40 (256I.05, subdivision 2 – Alternative payment rate for a group residential housing facility) adds to existing cross-references so as to allow a certain group residential housing facility to continue to be eligible for reimbursement under the nursing facility payment system.

Section 41 (Direction to commissioner; nursing facility payment reform report) requires by January 1, 2017, that the commissioner of human services evaluate and report to the legislature on several items related to nursing facility payment reform, including the impact of the quality adjusted care limits and the ability of nursing facilities to attract and retain employees under the new payment system.

Section 42 (Property rate setting) requires the commissioner, in consultation with stakeholders and experts, to conduct a study of property rate setting for Minnesota nursing facilities and to report to the legislature by March 1, 2016, for a system implementation date of January 1, 2017.  Lists actions the commissioner must take, including contracting with at least two firms to conduct appraisals of all nursing facilities in the MA program and using the information from the appraisals to complete the design of a rate setting system and calculate a replacement value and an effective age for each nursing facility.

Section 43 (Revisor’s instruction) instructs the Revisor of Statutes, in consultation with the House Research Department; Office of Senate Counsel, Research, and Fiscal Analysis; Department of Human Services; and stakeholders, to prepare legislation for the 2016 legislative session to recodify laws governing nursing home payments and rates.  Makes this section effective the day following final enactment.

Section 44 (Repealer) repeals Minnesota Statutes, 256B.434, subd. 19b (nursing facility rate adjustments beginning October 1, 2015); and § 256B.441, subds. 14a (facility group types), 19 (hospital-attached nursing facility status), 50a (determination of proximity adjustments), 52 (determination of efficiency incentive), 55 (phase-in of rebased operating payment rates), 58 (implementation delay), and 62 (repeal of rebased operating payment rates).


Article 7 - Continuing Care

Section 1 (13.461, subdivision 32 – ABLE Act) places notice in Minnesota Statutes, chapter 13, Minnesota Government Data Practices Act, that the Minnesota ABLE Act, section 256Q.05, subdivision 7, classifies data as other than public, places restrictions on access to government data, or involves data sharing.

Section 2 (144.057, subdivision. 1 – Background Studies for Special Circumstances) requires DHS, when conducting background studies of non-Minnesota residents who provide direct-care services in nursing homes, home care agencies, or boarding care homes, to (1) check for substantiated findings of maltreatment in the individual’s state of residence whenever the study subject’s state of residence makes that information available, and (2) check the national Crime Information Center database.

Section 3 (245A.06, subdivision 1a – DHS Licensing Actions) requires that, when a license holder operates more than one service site under a single HCBS license or has more than one HCBS license for different program sites, a correction order or a conditional license for a violation must specify the service site at which the violations occurred, or the specific HCBS program license that is at issue, and must not apply to other service sites or licensed programs that are not violating law or rule. 

Section 4 (245A.081 – DHS Licensing Actions) allows settlement discussions under certain circumstances between the license holder and the commissioner in order to reach a settlement agreement with regard to a licensing sanction. Neither party is required to initiate a settlement discussion, and the commissioner may decide at any time to discontinue settlement discussions with the license holder. 

Sections 5 and 6 [245A.155, subdivision 1; 245A.155, subdivision 2; – Adult Foster Care Licensing] clarifies that for foster care agencies that care for individuals who rely on medical monitoring equipment, the requirements of this section apply only if the monitored medical condition could become life-threatening without proper use of the medical equipment.

Section 7 [245A.65, subdivision 2 – Adult Foster Care Licensing] amends the foster care provider’s abuse prevention plan to allow the governing body or “governing body’s delegated representative” to review the plan annually and revise the plan if necessary, to reflect review results.

Section 8 (245C.08, subdivision 1 – Background Studies for Special Circumstances) provides a cross-reference to section144.057, subdivision 1, thereby requiring DHS to review information from the national Crime Information System when conducting background studies of any non-Minnesota resident who performs direct-care services in a nursing home, home care agency, or boarding care home.  This section also permits DHS to inform any entity that initiated a background study of the status of processing the study subject’s fingerprints.

Section 9 (245C.12 – Background Studies for Special Circumstances) requires DHS, when it contracts with Tribes to conduct background studies for staff working in Tribal nursing homes, to obtain criminal history data from the National Criminal Records Repository.

Section 10 [245D.02, subdivision 37 – HCBS Licensing Standards] defines the term “working day.”

Section 11 [245D.05, subdivision 1– HCBS Licensing Standards] requires the license holder to notify the person’s legal representative of changes in the person’s physical or mental needs that affect the services in the coordinated service plan when the changes are discovered by the license holder, unless directed otherwise in the person’s coordinated service plan.

Section 12 [245D.05, subdivision 2– HCBS Licensing Standards] strikes the requirement that the license holder obtain reauthorization annually for medication administration. The existing requirement that the license holder obtain written authorization to administer medication and treatment is not modified, and the authorization remains in effect unless withdrawn in writing.

Section 13 [245D.06, subdivision 1– HCBS Licensing Standards] amends the license holder incident response and reporting requirements to clarify that, in addition to death, the license holder must also report serious injury to DHS and the Ombudsman for Mental Health and Developmental Disabilities.

Section 14 [245D.06, subdivision 2 – HCBS Licensing Standards] amend provisions related to first aid training.  This section removes the requirement that CPR instruction be done “in person.”

Section 15 [245D.06, subdivision 7– HCBS Licensing Standards] modifies requirements related to restraint of a person. This section strikes the language that limited restraints to certain circumstances.

Section 16 [245D.07, subdivision 2 – HCBS Licensing Standards] specifies that service planning requirements are required within a certain number of “calendar” days. 

Section 17 [245D.071, subdivision 5 – HCBS Licensing Standards] amends the provision that requires the license holder to summarize the person’s status and progress. It removes the requirement that the report be written, and that the report, prior to the progress review meeting, be sent to the person or the person’s legal representative and case manager. New language requires that the report be sent at least five days prior to the progress meeting if requested by the team in the service plan, and requires the license holder, under paragraph (c), to send the plan addendum to the person, the person's legal representative, and the case manager, by mail within ten working days of the review meeting. New paragraph (d) states that if within ten working days the revised coordinated service plan is not signed by the person, the person’s legal representative, or case manager, the plan is deemed approved, and becomes effective until the legal representative or case manager submits a written request to review the plan.

Section 18 [245D.09, subdivision 3 – HCBS Licensing Standards] amends staff qualifications and competency to provide services as required under this chapter, to allow the competency determination "to be conducted by an individual who has been previously deemed competent by the trainer or instructor in the area being assessed."  Current law requires a trainer or instructor to conduct the competency determination.

Section 19 [245D.09, subdivision 5 – HCBS Licensing Standards] provides that if a staff person is currently certified in first aid, that person is not required to participate in annual training.

Section 20 [245D.22, subdivision 4 – HCBS Licensing Standards] amend provisions related to first aid training.  This section removes the requirement that CPR instruction be done “in person.”

Section 21 [245D.31, subdivision 3 – HCBS Licensing Standards] strikes the requirement that the documentation reflecting the appropriate staff ratio for each person receiving services be recorded on a standard assessment form required by the commissioner.

Section 22 [245D.31, subdivision 4 – HCBS Licensing Standards] amends the requirements for a person to be assigned a one-to-four staff ratio.  Language is stricken regarding a person who is not capable of taking appropriate action for self-preservation under emergency conditions.

Section 23 [245D.31, subdivision 5 – HCBS Licensing Standards] amends the requirements for a person to be assigned a one-to-eight staff ratio.  Changes in this section require three activities of daily living instead of four, and also strike the same language as in section 17, related to taking appropriate action for self-preservation under emergency conditions.

Section 24 (252.27, subdivision 2a – MA TEFRA Payments) reduces TEFRA parental fees by ten percent.

Section 25 (256.478 – HCBS Transition Grants) repeals the authority of the Commissioner of Human Services to transfer funds between the Medical Assistance account and the home and community-based services transitions grant account. 

Section 26 [256.975, subdivision 11 – Dementia Grants] establishes a regional and local competitive grant program administered by the Minnesota Board on Aging to fund regional and local projects and initiatives targeted to specific communities to promote awareness of Alzheimer’s disease and other dementias, increase the rate of cognitive testing in populations at risk of dementias, promote the benefits of early diagnosis of dementias, or connect caregivers of persons with dementia to education and resources.  This section also specifies eligible grant applicants, provides guidance on the criteria to be used to award grants, requires reporting, and specifies dates of application for and awarding of the grants.

Section 27 (256B.056, subdivision 5c – MA Spenddown) modifies medical assistance eligibility requirements for persons who are over age 64, who are blind, or who have a disability by increasing on July 1, 2016, the excess income standard (aka the spenddown limit) from 75 percent to 80 percent of the federal poverty guidelines.

Section 28 (256B.057, subdivision 9 – MA-EPD Premiums) reverses a premium increase that was implemented October 1, 2015, by (1) reducing from $65 to $35 the amount of the minimum premium that enrollees in the Medical Assistance for Employed Persons with Disabilities (MA-EPD) program must pay, and (2) reduces the additional premium amount that enrollees who receive unearned income must pay from five percent to one-half of one percent of their unearned income.  This section is effective September 1, 2015.

Section 29 (256B.059, subdivision 5 – Treatment of Assets for MA Long-Term Care Eligibility) removes language that prohibits under any circumstances a married couple from converting assets to income in order to avoid being subject to the asset limit for the purposes of determining an institutionalized spouse’s eligibility for long-term care under medical assistance.  This change is required to bring Minnesota into compliance with the 2013 federal Geston decision, in which the Eighth Circuit Court held that federal Medicaid law does not permit treating certain income streams as an asset for the purposes of determining Medicaid eligibility for long-term care.

Section 30 (256B.0916, subdivision 2 – Disability Waivers Rate Setting Changes) adds language clarifying that the commissioner must manage developmental disability (DD) waiver allocations in a manner that will maximize the use of all available DD waiver funding.

Section 31 (256B.0916, subdivision 11 – Disability Waivers Rate Setting Changes) modifies the existing provisions governing the consequences for lead agencies if they overspend their DD waiver allocation.  Under the proposed language, if a lead agency over spends its allocation for DD waiver services, it must submit a corrective action plan for approval.  The lead agency will have 2 years to successfully implement the plan.  The commissioner must recoup spending in excess of the allocation made to the agency, but only if the statewide appropriation dedicated to home and community-based services (HCBS) waivers is overspent.

Section 32 (256B.0916, subdivision 12 – Disability Waivers Rate Setting Changes) introduces new language to control underspending of DD waiver funds. A lead agency that underspends its allocation while maintaining a waiting list for waiver services must submit a corrective action plan for approval.  If a lead agency fails to submit a corrective action plan or fails to implement the approved changes, the commissioner is required to make sure that the lead agency’s allocation is used to provide appropriate services to all waiver participants in the county or tribe.

Section 33 (256B.49, subdivision 26 – Disability Waivers Rate Setting Changes) applies to over-authorizations under the community alternatives for disabled individuals (CADI), community alternative care (CAC), and brain injury (BI) waivers provisions similar to the overspending provisions for the DD waiver under section 256B.0916, subdivision 11.

Section 34 (256B.49, subdivision 27 – Disability Waivers Rate Setting Changes) applies to underauthorizations under the CADI, CAC and BI waivers provisions similar to the underspending provisions for the DD waiver under section 256B.0916, subdivision 12.

Section 35 (256B.4913, subdivision 4a – Disability Waivers Rate Setting Changes) modifies the banding period for CADI, CAC, and BI waivers by prohibiting the commissioner for one year from enforcing any rate decrease or increase that would otherwise result from the end of the banding period.

Section 36 (256B.4913, subdivision 5 – Disability Waivers Rate Setting Changes) increases the training of and resources available to county personnel responsible for administering the CADI, CAC, and BI waiver rate-setting framework so that the framework is properly implemented; prohibits the commissioner from deferring to the county or tribal agency on matters of technical application of the rate-setting framework;  and prohibits county and tribal agencies from setting rates in a manner that conflicts with the rate-setting framework.

Section 37 (256B.4914, subdivision 2 – Disability Waivers Rate Setting Changes) modifies the definition of individual staffing for the purposes of setting rates under CADI, CAC, and BI waivers.

Section 38 [256B.4914, subdivision 6 – HCBS Waiver Payment Rate Changes] strikes language that required the commissioner to establish a monitoring technology review panel to annually review and approve plans that include care provided remotely, and strikes the requirement that lead agencies submit services plans to the panel. 

Section 39 (256B.4914, subdivision 8 – Disability Waivers Rate Setting Changes) makes a technical change to a program name under the HCBS waivers.

Section 40 (256B.4914, subdivision 10 – Disability Waivers Rate Setting Changes) expands the range of providers the costs of whom the commissioner must research and analyze when refining the HCBS waiver rate-setting methodology.  This section also requires the commissioner to develop and implement a methodology to determine appropriate shared staffing levels for HCBS waiver participants living in shared residential settings.  Also, this section requires that individual staffing be used when shared staffing is insufficient to meet the needs of individuals living in shared residential settings.

Section 41 (256B.4914, subdivision 14 – Disability Waivers Rate Setting Changes) makes extensive revisions to the procedures and policies governing the approval of alternative payment plans for HCBS waiver participants with exceptional needs.

Section 42 (256B.4914, subdivision 15 – Disability Waivers Rate Setting Changes) strikes language that provided for an alternative policy with respect to overspending during the first two years of implementation of the new HCBS rate-setting framework.  The new language inserts cross-references to the overspending provisions in sections 256B.0916 and 246B.49.

Section 43 (256B.492 – Home and Community-Based Settings for People with Disabilities) updates Minnesota Statutes to come into compliance with new federal requirements governing settings in which people with disabilities may receive home and community-based waiver services.  This section simplifies language by stating that the only settings in which a person with a disability may receive DD, CADI, BI, and CAC waiver services are those settings that comply with the requirements of either (1) the new federal requirements, the federally approved plan for Minnesota to come into compliance with those requirements, and the waiver, or (2) the Housing Opportunities for Persons with AIDS program; retains old language that specifies some of the qualities of a setting that are inconsistent with the new setting requirements; eliminates, effective July 1, 2016, exceptions to the setting requirements; and strikes obsolete language.

Section 44 (256Q.01 – ABLE Act) establishes the Minnesota ABLE plan and states its purpose.

Section 45 (256Q.02 – ABLE Act) provides a citation for chapter 256Q.

Section 46 (256A.03 – ABLE Act) provides definitions, many of which are defined by cross-reference to federal law.

Section 47 (256Q.04 – ABLE Act) requires the Minnesota ABLE plan to meet the federally mandated requirements for a qualifying ABLE program.  These requirements are that the plan only be available to state residents, that no participant in the plan be the beneficiary of more than one account, that the plan maintain a separate account for each beneficiary, that the state limit the number of opportunities for an account owner to direct investments, and that the state prohibit the use of account balances as security for a loan.

Section 48 (256Q.05 – ABLE Act) directs the Commissioner of Human Services in the administration of the ABLE plan by requiring the commissioner to ensure the plan conforms with federal law; requiring the commissioner to consult with the State Board of Investment and the Commissioner of the Office of Higher Education while establishing plan administration and entering into contracts; permitting the commissioner to enter into contracts with third parties to carry out some or all of the administrative duties and investment management; authorizing the commissioner to impose fees on account owners to cover administrative costs; requiring the commissioner to perform federally mandated reporting; and specifying the conditions under which the commissioner may share private and nonpublic data.

Section 49 (256Q.06 – ABLE Act) Subdivision 1 allows anyone to make a cash contribution to any account, but that contribution becomes the property to the account beneficiary, and the contributor acquires no interest in the account.

Subdivision 2 states that the annual contribution limit for each account from all sources is equal to the gift tax limit for that taxable year.  This section also states that the total account balance cannot exceed the maximum account balance limit under the Minnesota college savings plan. Subdivision 3 specifies that only the account owner may request distributions or change the designated beneficiary of an account.

Subdivision 4 states that amendments to this statute automatically amend the participation agreement and any amendments to the operating procedures and policies of the plan automatically amend the participation agreement after adoption by the commissioner or the board.

Subdivision 5 specifies that each beneficiary of an ABLE account is to have a separate account, and that plan assets are not subject to claims by creditors of the state, are not part of the general fund, and are not subject to appropriation by the state.

Section 50 (256Q.07 – ABLE Act) requires the State Board of Investment to invest the money in the accounts in the plan in approved ways or to contract with a third party to do so. Allows the board to contract with one or more third parties for investment management, record-keeping, or other services in connection with investing the accounts. 

Section 51 (256Q.08 – ABLE Act) specifies to whom and how distributions for qualifying disability expenses can be made. This section also permits nonqualified distributions, but the earnings portions of such distributions are subject to applicable taxes and a ten percent penalty. Finally, this section permits the state, upon the death of an account’s designated beneficiary, to make a claim against the account to recover costs for medical care provided to the account’s beneficiary.

Section 52 (Individual Providers of Direct Support Services) ratifies the personal care attendants’ contract between SEIU Healthcare Minnesota and the state of Minnesota.

Section 53 (Rate Increase for Self-Directed Workforce Negotiations) increases the reimbursement rate by 1.53 percent on July 1, 2015, and by an additional 0.2 percent on July 1, 2016, for direct support services provided through a covered program if the legislature ratifies the contract negotiated between the state and SEIU Healthcare Minnesota.  Covered programs include PCA Choice, Consumer-Directed Community Supports, home and community-based waivered services, alternative care, consumer support grant, and Community First Services and Supports.

Section 54 (Commissioner to seek amendment exception to consumer-directed community supports budget methodology) replaces a previously enacted exception to the CDCS budget methodology, by allowing recent graduates to receive up to 20 percent more funding for CDCS if the CDCS  funding would be less than the funding under HCBS for the same services.

Section 55 (Home and Community-Based Services Incentive Pool) requires the commissioner to (1) develop an initiative to provide incentives for innovation in achieving integrated competitive employment, living in the most integrated setting, and other outcomes determined by the commissioner; and (2) seek requests for proposals and contract with one or more entities to provide incentive payments for meeting identified outcomes.  Requires the initial requests for proposals to be issued by October 1, 2015.

Section 56 (Direction to Commissioner; Disability Waiver Spending Report) requires the commissioner to submit two annual reports on the implementation of the reforms to the over and underspending provisions under the disability waivers.

Section 57 (Instructions to the Commissioner – CFSS Eligibility Report)  requires the commissioner to determine the number of people who were determined ineligible for CFSS because they did not require constant supervision and cuing in order to accomplish activities of daily living.  Instructs the commissioner to issue a report with the findings to the legislature.

Section 58 (Repealer) repeals a previously enacted consumer-directed community supports budget methodology exception that is replace by section 54 of this article.

Article 8 -Health Department and Public Health

Section 1 (16A.724, subd. 2) strikes the $1,000,000 contingent transfer from the health care access fund to the medical education and research costs fund that currently occurs if resources in the health care access fund exceed expenditures.

Section 2 (62J.498) updates definitions and specifies that portions of the application for certification classified as public data shall be made available to the public for at least ten days while an application is under consideration and upon the request of the commissioner.  At the request of the commissioner, the applicant must participate in a public hearing by presenting an overview of the application and responding to questions from the public.

Section 3 (62J.4981) modifies the certificate of authority requirements for health data intermediaries and health information organizations.

Section 4 (62J.4982, subd. 4) strikes obsolete language.

Section 5 (62J.4982, subd. 5) modifies the fee structure for health information exchange service providers.

Section 6 (62J.692, subd. 4) strikes the $1,000,000 from the health care access fund for grants to family medicine residency programs.

Section 7 (62Q.37, subd. 2) adds the Accreditation Association for Ambulatory Health Care (AAAHC) to the definition of “nationally recognized independent organization” for purposes of organizations that are recognized to conduct independent audits of health plan companies.

Section 8 (62U.04, subd. 11) permits the Commissioner of Health to compile public use files of summary data or tables from the all-payer claims data submitted under section 62U.04 (encounter data and pricing data) that (1) are available to the public by March 1, 2016, at no or at a minimal cost and available by web-based electronic data download by June 30, 2019; (2) do not identify individual patients, providers, or payers; (3) are updated by the commissioner at least annually with the most current data available; (4) contain clear and conspicuous explanations of the characteristics of the data; and (5) not lead to the collection of additional data elements beyond what is authorized as of June 30, 2015.  This section also requires the commissioner to consult with the all-payer claims database work group when creating these public use summary files.

Section 9 (62U.10, subd. 6) requires the commissioner to report the projected impact on spending from specified health indicators related to various preventable illnesses and death, beginning February 1, 2016, and each February thereafter.  The impacts shall be reported over a ten-year time frame using a baseline forecast of private and public health care and long-term care spending for Minnesota residents beginning with calendar year 2009 projected estimates of costs and updated annually.

Section 10 (62U.10, subd. 7) requires the commissioner to determine the actual total private and public health care and long-term care spending for Minnesota residents related to each health indicator projected for the most recent calendar year available beginning November 1, 2016, and each November 1 thereafter.  If the actual spending is less than the projected spending, the commissioner shall use the proportion of spending for public health care programs to total private and public health care spending for each indicator for the calendar years two years before the current calendar year to determine the percentage of the calculated aggregate savings amount accruing to state public health care programs.

Section 11 (62U.10, subd. 8) specifies that if the accumulated annual savings accruing in state public health care programs as calculated under section 10 meets or exceeds $50,000,000 for all health indicators in aggregate statewide, the commissioner shall certify that to the commissioner of management and budget, no later than December 15 of each year, and the commissioner of management and budget shall transfer $50,000,000 from the general fund to the health care access fund.  This transfer shall occur each fiscal year following subsequent certifications of additional cumulative savings up to $50,000,000 per year.  The amount necessary to transfer is appropriated from the general fund to the Commissioner of Management and Budget.

Sections 12 to 15 (144.1501) expands the health professional education loan forgiveness program to include advanced dental therapists, dental therapists, mental health professionals, pharmacists, and public health nurses.  Permits a nurse who agrees to practice in a hospital, if the hospital owns and operates a Minnesota nursing home and a minimum of 50 percent of the hours worked by the nurse in the nursing home for a minimum of two years, to be eligible for the loan forgiveness program.  Requires the commissioner to consider applications submitted by graduates in the eligible professions who are licensed and in practice and requires the commissioner to give preference to applicants who document diverse cultural competencies.

Section 16 (144.1506) creates the primary care residency expansion grant program.

Subd. 1 defines terms.

Subd. 2 (a) requires the commissioner to award primary care residency expansion grants to eligible programs to plan and implement new residency slots. Caps grant amount for certain activities.

(b) lists what the grant funds may be used for, including, but not limited to, planning related to establishing an accredited primary care residency program, recruitment, and training site improvements.

Subd. 3 states requirements for the grant applications for eligible applicants.

Subd. 4 requires the commissioner to review each application and requires specific awards for certain practices.

Subd. 5 allows the commissioner to require grantees to submit information during the grant period for evaluation of the program.

Section 17 (144.1911) establishes the international medical graduates assistance program.

Subd. 1 establishes the international medical graduate assistance program.

Subd. 2 defines the following terms:  board; commissioner; immigrant international medical graduate; international medical graduate; Minnesota immigrant international medical graduate; rural community; and underserved community.

Subd. 3 requires the Commissioner of Health to administer the program.  In administering the program, the commissioner shall (1) provide overall coordination for the planning, development, and implementation of a system for integrating qualified immigrant international medical graduates into the Minnesota health care delivery system; (2) develop and maintain a voluntary roster of immigrant  international medical graduates interested in entering the Minnesota health work force; (3) work with graduate clinical medical training programs to address barriers faced by immigrant international medical graduates in securing residency positions in Minnesota; (4) develop a standardized assessment of the clinical readiness of eligible immigrant international medical graduates to serve in a residency program; (5) explore and facilitate more streamlined pathways for immigrant international medical graduates to serve in nonphysician professions; and (6) study changes necessary in health professional licensure and regulation to ensure full utilization of immigrant international medical graduates in the Minnesota health care delivery system and report recommendations to the legislature by January 15, 2017.

Subd. 4 requires the commissioner to award grants to eligible nonprofit organizations to provide career guidance and support services to immigrant international medical graduates seeking to enter Minnesota’s work force.

Subd. 5 requires the commissioner to award grants to support clinical preparation for Minnesota international medical graduates needing additional clinical preparation or experience to qualify for residency.

Subd. 6 requires the commissioner to award grants to support primary care residency positions designated for Minnesota immigrant physicians who are willing to serve in rural or underserved areas of the state.  The commissioner shall also establish a revolving international medical graduate residency account and require a participating resident to enter into an agreement to provide primary care for at least five years in a rural or underserved area after graduating from the residency program and to make payments to the revolving account.

Subd. 7 specifies that a hospital may establish residency programs for foreign trained physicians to become candidates for licensure to practice medicine.

Subd. 8 specifies that this section does not alter the authority of the Board of Medical Practice to regulate the practice or the licensing of the practice of medicine.

Subd. 9 requires the commissioner to administer the program in consultation with a number of stakeholders.

Subd. 10 requires the commissioner to submit an annual report to the legislature on integration of international medical graduates into the Minnesota health care delivery system beginning January 15, 2016.

Section 18 (144.291, subd. 2) adds a definition and references to a patient information service within the Health Records Act.

Section 19 (144.293, subd. 5) permits a health care provider to release a deceased patient’s health care records to another provider for the purposes of diagnosing or treating the deceased patient’s surviving adult child.  This section is effect the day following final enactment.

Section 20 (144.293, subd. 8) adds a definition and references to a patient information service within the Health Records Act.

Section 21 (144.298, subd. 2) adds a definition and references to a patient information service within the Health Records Act.

Section 22 (144.298, subd. 3) adds a definition and references to a patient information service within the Health Records Act.

Section 23 (144.3875) requires the commissioner to implement a statewide initiative to increase awareness among communities of color and recent immigrants on the importance of early preventive dental intervention for infants and toddlers before and after primary teeth appear.  Requires the commissioner to develop educational materials and information for expectant and new parents within targeted communities on the importance of early dental care to prevent early cavities and to develop a distribution plan for these materials.

Section 24 (144.4961) establishes the Minnesota Radon Licensing Act.

Subd. 1 permits this section to be cited as the Minnesota Radon Licensing Act.

Subd. 2 defines terms.

Subd. 3 authorizes the Commissioner of Health to adopt rules relating to licensure and enforcement of laws and rules relating to indoor radon in dwellings and other buildings, with the exception of newly constructed homes.

Subd. 4 requires all radon mitigation systems installed in Minnesota on or after October 1, 2017, to have a radon mitigation system tag provided by the commissioner.  The tag must be attached by a radon mitigation professional and must be in a visible location.

Subd. 5 requires that every person, firm, or corporation that sells or performs a service for compensation to detect the presence of radon in the indoor atmosphere, performs laboratory analysis, or performs a service to mitigate radon in the indoor atmosphere be licensed on an annual basis.  Specifies that this does not apply to retail stores that only sell or distribute radon sampling and are not engaged in the manufacture of radon sampling devices.

Subd. 6 specifies that radon systems installed in newly constructed homes prior to the issuance of a certificate of occupancy are exempt from this section.

Subd. 7 requires that applications for licensure, system tags, and other reporting requirements be submitted on forms prescribed by the commissioner.

Subd. 8 establishes radon license fees.

Subd. 9 states that the commissioner shall enforce this section under Minnesota Statutes, sections 144.989 to 144.993.

Section 25 (144.566) provides definitions; requires hospitals to design, implement, and review annually preparedness and incident response action plans designed to prevent violence against health care workers; specifies elements of required staff training; requires hospitals to share information with local law enforcement; and permits the commissioner to impose a fine of $250 on hospitals that fail to comply with the requirements of this subdivision.

Section 26 (144.586) allows hospitals 24 hours to provide notice to patients they place on observation status that Medicare may not cover (1) hospital services, nor (2) upon discharge, home and community-based care or care provided at a skilled nursing facility. This section also requires hospitals to provide discharge planning that complies with federal hospital requirements.

Section 27 to 31 (144.9501) make changes to the definitions for lead sampling technician and renovation, and adds definitions for “certified renovation firm,” and “lead renovator.”

Section 32 (144.9505) modifies the credentialing requirements for lead firms and professionals.  Requires renovation firms to be licensed by the commissioner.  Requires a person that employs an individual to perform regulated lead work outside the person’s property to obtain certification as a certified lead firm or a certified renovation firm. Clarifies that an individual who performs lead hazard reduction, lead hazard screens, lead inspections, lead risk assessment, lead project designer services, lead sampling technician services, swab team services, and activities performed to comply with lead orders must be employed by a certified lead firm.  Specifies that the fees are annual fees.  Specifies that a person who employs individuals to perform renovation activities outside the person’s property must obtain certification as a renovation firm.  Requires a person who provides training to lead workers, supervisors, inspectors, assessors, project designers, technicians, and lead renovators to obtain a permit from the commissioner.

Section 33 (144.9508) specifies that the commissioner’s authority to adopt rules consistent with the Toxic Substance Control Act do not expire.

Section 34 (144.999) establishes the parameters in which epinephrine auto-injectors may be obtained and used by authorized entities.

Subdivision 1 defines the following terms: administer; authorized entity; commissioner; epinephrine auto-injector; provider.

Subdivision 2 permits the commissioner to identify additional categories of entities or organizations to be authorized entities.

Subdivision 3 permits an authorized entity to obtain and possess epinephrine auto-injectors to provide or administer to individuals if an owner, manager, employee, or agent of the authorized entity believes in good faith that the individual is experiencing anaphylaxis, regardless of whether the individual has a prescription for an epinephrine auto-injector.  Permits an authorized entity to obtain epinephrine auto-injectors from pharmacy wholesalers if the authorized entity presents the pharmacy or manufacturer with a valid certificate of training.  Requires an authorized entity to store the epinephrine auto-injectors in a location readily accessible in an emergency and in accordance with the manufacturer’s instructions and any additional requirements established by the commissioner.

Subdivision 4 permits any owner, manager, employee, or agent of an authorized entity who has completed the training program to either provide an epinephrine auto-injector to an individual, or the individual’s parent, legal guardian or caretaker, or administer an epinephrine auto-injector to the individual  if the employee or agent believes in good faith the individual is experiencing anaphylaxis, regardless of whether the individual has a prescription for an epinephrine auto-injector or has previously been diagnosed with an allergy.  Specifies that an authorized entity is not required to maintain a stock of epinephrine auto-injectors.

Subdivision 5 requires an individual to successfully complete every two years a anaphylaxis training program before the individual can provide or administer an epinephrine auto-injector as permitted under subdivision 4.  Requires the individual or entity conducting the training to issue a certificate to each person who completes the training program.  Specifies that the certificate is valid for two years.

Subdivision 6 specifies that an act or omission taken by an authorized entity that obtains, an employee or agent who provides or uses, a pharmacy or manufacturer that dispenses, or an individual or entity that conducts trainings for epinephrine auto- injectors pursuant to this section, is considered “emergency care, advice, or assistance" under the Good Samaritan law.

Section 35 (144A.70, subdivision 6) expands the list of temporary employees placed by supplemental nursing services agencies to include any licensed health professional.

Section 36 (144A.70, subdivision 7) requires annual unannounced inspections of supplemental nursing services agencies to ensure compliance with the sections of statute regulating them.

Section 37 (144A.71, subdivision 1) requires supplemental nursing agencies to register annually with MDH and requires MDH to deposit registration fees in the special revenue fund.

Subdivision 2 requires registration applications to include a policy for making a supplemental nursing services agency’s records immediately available at all times to MDH and increases an annual registration fee from $891 to $2,035.  If the agency fails to provide all the required parts of the registration application, MDH must refuse to issue the registration, subject to an appeals process.

Section 38 (144A.72, subdivision 1)  adds a requirement that supplemental nursing services agencies retain for five years all records pertaining to their registration, including those records related to an agency’s insurance and bonding and its employees’ education, training, and licensing. Agencies must make these documents immediately available to MDH. Subdivision 1 also adds a requirement that in order to retain their registration, agencies provide services to a health care facility during the year prior to the date of their registration renewal.

Subdivision 2 removes the requirement that an agency must engage in a pattern of failure to comply with the provision of the section before it is subject to revocation or nonrenewal of its registration; a single instance of failure to comply is sufficient.

Subdivision 4 requires a hearing involving an administrative law judge prior to the revocation or rejection of an agency’s registration or nonrenewal of registration.

Section 39 (144A.73) requires the Office of Health Facility Complaints to investigate complaints against supplemental nursing services agencies.

Section 40 (144A.75, subdivision 13) modifies the definition of residential hospice facility to also include a facility that directly provides 24-hour residential and support services for hospital patients; houses no more than 21 hospice patients; meets federal hospice certification regulations; and is located on St. Anthony Avenue in St. Paul, Minnesota, and was licensed as a 40-bed non-Medicare certified nursing home as of January 1, 2015.

Section 41 (144D.01) adds the definition of “direct-care staff” to the housing with services chapter.

Section 42 (144D.066, sub. 1) requires MDH to enforce dementia care training among the staff of housing with services establishments, including direct-care staff, supervisors of direct-care staff, maintenance staff, housekeeping staff, food service staff, and housing managers.

Subdivision 2 permits MDH to impose fines for failure to comply with required dementia care training, but the fines are subject to an appeals process; requires that employees be permitted to complete the training as part of their duties; does not allow payment of a fine to substitute for completion of the required training; permits the revocation or nonrenewal of registration for continued noncompliance with the requirement to receive the required training; and requires MDH to make public a list of all housing with services establishments that have complied with the training requirements.

Subdivision 3 requires MDH, in lieu of imposing fines between January 1, 2016, and December 31, 2016, to offer technical assistance to help providers come into compliance with the dementia care training requirements.

Section 43 (145.4131, subdivision 1) adds to the list of required information on the form provided to the commissioner by an abortion provider, whether the abortion resulted in a born alive infant, medical actions taken to preserve the life of the born alive infant, whether the born alive infant survived, and the status, if known, of the born alive infant if the infant did survive.

Section 44 (145.423) makes changes to the live birth statute.

Subdivision 1 makes conforming changes to refer to “born alive infant” instead of a “live child born.” 

Subdivision 2 makes a conforming change to refer to “born alive infant” instead of a “live birth.”

Subdivision 3 makes conforming changes to refer to a born alive infant instead of “child.”

Subdivision 4 (a) states that any infant human who is born alive at any stage of development must be included in the determination of any Minnesota law or ruling with the words “person,” “human being,” “child,” and “individual.”

(b) states that “born alive” means, regardless of how the human was extracted or whether the umbilical cord has been cut, any human who (1) breathes, (2) has a beating heart, (3) has pulsation of the umbilical cord, or (4) has definite movement of voluntary muscles.

(c) prohibits anything in this section from being construed to affirm, deny, expand, or contract any legal status or legal right to a human prior to being born alive.

Subd. 5 (a) creates a cause of action against the abortion provider by the person upon whom an abortion was performed, or the parent or guardian of the mother if the mother is a minor, for death of or injury to a born alive infant if the death or injury was caused by simple negligence, gross negligence, wantonness, willfulness, intentional conduct, or another violation of the legal standard of care.

(b) allows suspension or revocation of a medical personnel’s professional license if that person does not take all reasonable measures to preserve the life and health of a born alive infant as required by subdivision 1. Requires an automatic suspension of a person’s medical license for one year if the person performed an abortion and had judgment rendered against them under paragraph (a) and states reinstatement requirements.

(c) prohibits this section from being construed to create a cause of action against the mother of a born alive infant, civilly or criminally, for the actions of medical personnel in violation of this section for which she did not give her consent.

Subdivision 6 requires a court to rule if the anonymity of any female upon whom an abortion was performed or attempted should be preserved from the public if the female does not consent to disclosure. Provides requirements for the court if the court determines anonymity should be preserved. Requires any person who is not a public official to use a pseudonym if bringing an action under subdivision 5 if there is no written consent from the female upon whom the abortion was performed or attempted.

Subdivision 7 states that a born alive infant will be an abandoned ward of the state and the parents will have no parental rights unless the abortion was performed to save the life of the woman or fetus or unless one or both parents agree within 30 days of birth to accept the parental rights and responsibilities for the child.

Subdivision 8 allows for severability of any one or more provisions of this section if any part is found to be unconstitutional.

Section 45 (145.928, subdivision 13) requires the commissioner to submit an annual report to the legislature on grants made to decrease racial and ethnic disparities in infant mortality rates. States specifications for the report and requires the first report to be issued by January 15, 2016.

Section 46 (145.928, subdivision 15) requires the commissioner to consider applicants who present evidence of a promising strategy to accomplish the applicant’s objective as part of the application, and requires the commissioner when considering grant applications for health disparities grants to give equal weight to a promising strategy as given to a research or evidence-based strategy.

Section 47 (145.986, subdivision 1a) permits the commissioner to consider grants to implement health improvement strategies that improve the health status, delay the expression of dementia, or slow the progression of dementia for a targeted population at risk for dementia through the state health improvement program (SHIP), and that at least two of the grants awarded on November 1, 2015, must be for these purposes.

Section 48 (145.986, subdivision 2) requires the commissioner for the state health improvement program (SHIP) grants awarded on or after July 1, 2016, to identify:

  1. the geographic area or population to be targeted;
  2. the policy systems or environmental strategy to be used to address one or more health indicators listed in section 62U.10, subdivision 6; and
  3. the selected outcomes and evaluation measures for the grant related to one or more of the health indicators within the geographic area or population targeted.

Section 49 (145.986, subdivision. 4) requires SHIP grantees to cooperate with the commissioner in the evaluation and to provide the commissioner with the information necessary to conduct an evaluation, including information on any impact on the health indicators listed in section 62U.10, subdivision 6.

Section 50 (145A.131, subdivision 1) provides an increase in the local public health grant for community health boards that are all or a portion is located outside of the counties of Anoka, Chisago, Carver, Dakota, Hennepin, Isanti, Ramsey, Scott, Sherburne, Washington, and Wright equal to ten percent of the grant award to the community health board.  The amount distributed shall be adjusted each year based on available funding and the number of eligible community health boards.

Sections 51 to 56 make changes to the mortuary science chapter.

Section 51 (149A.20, subdivision 5) specifies that if a passing score is not attained on the state examination, the individual must wait two weeks before retaking the examination.

Section 52 (149A.20, subdivision 6) requires that a mortuary science internship shall at a minimum be 2,080 hours completed within a three-year period, and that the commissioner may waive up to 520 hours upon the satisfactory completion of a clinical or practicum in mortuary science through a program approved by the commissioner.  Requires an intern to complete 25 case reports in the areas of embalming arrangements and services.  Requires case reports be completed by the intern and filed with the commissioner before completion of the internship.

Section 53 (149A.20, subdivision 11) requires 18 continuing education hours for license renewal to practice mortuary science.  Specifies the areas that these hours must cover.

Section 54 (149A.65) increases mortuary science fees.

Section 55 (149A.92, subdivision 1) extends the compliance date for a funeral establishment with other establishment locations that uses one preparation and embalming room for all establishment locations to bring the other establishment locations into compliance with the preparation and embalming room minimum standards to July 1, 2017.

Section 56 (149A.97, subdivision 7) requires funeral providers reporting preneed trust accounts to complete an independent audit by an independent third-party auditing firm every other year, and report the findings to the commissioner by March 31 of that calendar year.  This is in addition to the annual report that is required to be submitted.

Section 57 (157.15, subdivision 8) includes within the definition of a lodging establishment within chapter 157, a building, structure, or enclosure located within ten miles distance minutes travel time from a hospital or medical center and is used or held out to be a place where exclusively patients, their families, and caregivers can sleep while the patient is receiving treatment for periods of one week or more that does not provide health or home care services.  States that this section is effective the day following final enactment.

Section 58 (Working Group on Violence Against Asian Women and Children) requires the commissioner of health, in collaboration with the commissioners of human services and public safety and the Council on Asian-Pacific Minnesotans, to create a working group to address violence against Asian women and children and report back to the legislature with recommendations by February 15, 2017.

Section 59 (Health Equity Grants) requires the Commissioner of Health to consider applicants who present evidence of a promising strategy to accomplish the applicant’s objectives and give a promising strategy the same weight as a research or evidence-based strategy when awarding the competitive health equity grants that were passed last session.

Article 9 - Health Care Delivery

Section 1 (62A.67) permits these sections to be cited as the “Minnesota Telemedicine Act.”

Section 2 (62A.671) defines the following terms:  distant site; health care provider; health carrier; health plan; licensed health care provider; originating site; store-and-forward technology; and telemedicine. The definition of telemedicine specifies that a communication between licensed health care providers that consists solely of a telephone conversation, e-mail, or facsimile transmission or a communication between a licensed health care provider and a patient that consists of a fax or facsimile transaction does not constitute telemedicine consultations or services.

Section 3 (62A.672) requires the coverage of telemedicine services.

Subdivision 1 requires a health plan issued or renewed on or after January 1, 2017, to cover telemedicine benefits in the same manner as any other benefit covered under the health plan.

Subdivision 2 prohibits a health carrier from denying coverage of a service solely because the service was delivered via telemedicine and was not provided through in-person contact between the licensed health care provider and patient.

Subdivision 3 requires the health carrier to reimburse the distant site provider for services delivered via telemedicine on the same basis and at the same rate as would apply to the services, consultation, or contacts if provided in person.  Permits the health carrier to require a deductible, co-payment, or coinsurance for services provided by telemedicine so long as the deductible, co-payment, or coinsurance does not exceed the deductible, co-payment, or coinsurance applicable if the service is provided through in-person contact.

Section 4 (62U.02, subd. 1) requires the commissioner to stratify quality measures the Commissioner of Health is required to develop to assess the quality of health care services offered by health care providers that are to be used for the quality incentive payment system by race, ethnicity, preferred language, and country of origin effective July 1, 2016, and to stratify other measures by other sociodemographic factors on or after January 1, 2018.  Permits the commissioner to require that other socio-demographics that are correlated with health disparities and have an impact on performance, quality, and cost indicators be considered after voluntary pilot projects are completed.  Requires the commissioner to consult with the communities impacted by health disparities through culturally appropriate community engagement principles and methods.  Specifies that the commissioner does not have the authority to collect or analyze patient-level or patient-specific data of the patient's characteristics.

Section 5 (62U.02, subd. 2) requires that the quality incentive payment system developed by the commissioner under this section adjust for variations in patient population to reduce incentives for providers to avoid patients with risk factors related to race, ethnicity, language, country of origin, and socio-demographic factors.

Section 6 (62U.02, subd. 3) requires, effective July 1, 2017, that the risk adjustment system that the commissioner is developing under this section take into account patient characteristics that are correlated with health disparities and have an impact on performance, cost, and quality measures. Permits the risk adjustment method to be based on reporting based on an actual to expected comparison that reflects the characteristics of the patient population served by the clinic or hospital.

Section 7 (62U.02, subd. 4) specifies that if the commissioner contracts with a private entity to complete the requirements of this section that the entity has a governance that includes representatives of providers serving high concentration of patients and communities impacted by health disparities, and consumers who represent groups who experience health disparities.

Section 8 (144E.001, subd. 5h) adds a definition of community medical response emergency medical technician (CEMT) to the Emergency Medical Services Regulatory Board chapter of law.

Section 9 (144E.275, subd.  1) expands the definition of medical response unit to permit medical response units to provide CEMT services.

Section 10 (144E.275, subd.  7) specifies the prerequisites for an individual to be certified by the board as a CEMT; requires a CEMT to practice under the supervision of the medical director of the CEMT’s medical response unit; specifies the services a CEMT is permitted to provide; clarifies that CEMTs are not exempt from any of the regulatory requirements for EMTs or AEMTs; and further limits CEMT services by prohibiting most home care services.

Section 11 (151.58, subd. 2) modifies the definition of a health care facility for purposes of the use of automated drug distribution systems to include a boarding care home that provides centralized storage of medications.

Section 12 (151.58, subd. 5) creates an exemption from the requirement that a pharmacist employed by and working at the managing pharmacy certify that accuracy of the filling of the cassettes, canisters, or other containers that contain drugs that are loaded into an automated drug distribution system if the filled cassette, canister, or other container has been provided by a repackage registered by the FDA and licensed by the Board of Pharmacy as a manufacturer.

Section 13 (256B.0625, subdivision 3b) specifies that medical assistance cover services and consultations delivered via telemedicine (real-time two-way, interactive audio and visual communications and through technologies consisting of telephones, patient monitoring devises or other electronic means) in the same manner as if the service or consultation was delivered in person.  Provides a definition of telemedicine that does not include a communication between licensed health care providers or between a licensed health care provider and a patient if the communication consists solely of a telephone conversation, e-mail, or facsimile transaction.

Section 14 (256B.0625, subd. 13) modifies the reimbursement for over-the-counter medications under medical assistance by specifying that the payment is the lowest of:  (1) the number of dosage units in the manufacturer’s original package; (2) the number of dosage units required to complete the patient’s course of therapy; or (3) if applicable, the number of dosage units dispensed for a system using retrospective billing as permitted under section 256B.0625, subd. 13e, paragraph (b).

Section 15 (256B.0625, subd. 13e) Paragraph (a) clarifies that the pharmacy dispensing fee for over-the-counter drugs shall be $3.65, except that the fee shall be $1.31 for retrospectively billing pharmacies when billing for quantities less than the number of units contained in the manufacturer’s original package.

Paragraph (b) authorizes pharmacies dispensing prescriptions to residents of long-term care facilities using an automated drug distribution system or a packaging system that meet the rules governing the return of unused drugs to the pharmacy for reuse to use retrospective billing for prescription drugs dispensed to long-term care facility residents.  The pharmacy must submit a claim only for the quantity of medication used by the recipient during the defined billing period and the pharmacy must use a billing period not less than one calendar month or 30 days.

Paragraph (c) specifies that a pharmacy that is using a packaging system is required to credit the department for the actual acquisition cost of all unused drugs that are eligible for reuse unless the pharmacy is using a retrospective rebilling.

Section 16  (256B.072) requires that the measures used in the performance reporting system established by the Commissioner of Human Services for health care providers who provide services to public program recipients must be stratified by race, ethnicity, preferred language, and country of origin and risk-adjusted as specified in section 62U.02, subdivision 3, paragraph (b).

Section 17 (Proposal for Child Protection Focused CEMT Model) requires the commissioner to develop a proposal for a pilot program to coordinate services between child protective services and CEMTs.

Section 18 (CEMT Technical Services Covered under Medical Assistance) requires that by January 15, 2016, the Commissioner of Human Services, in consultation with specified stakeholders, recommend to the legislature which CEMT services are to be covered under medical assistance and what the payment rates for those services are to be.

Section 19 (Evaluation of CEMT Services) In the event that legislation is enacted to cover CEMT services under medical assistance, this section requires the Commissioner of Human Services to provide a report to the legislature on the cost, quality, and coordination of CEMT services.

Article 10 - Health Licensing Boards

Sections 1 to 14 make changes to the optometrist licensure statutes.

Section 1 (148.52) clarifies that optometrists who are appointed to the board must be licensed in Minnesota.

Section 2 (148.54) adds the offices of vice president and secretary to the Board of Optometry.

Section 3 (148.57, subd. 1) strikes the $87 application fee and creates a cross-reference to section 148.59, the section in which all fees are listed.  Strikes references obsolete requirements regarding use of legend drugs.

Section 4 (148.57, subd. 2) strikes the $87 application fee and creates a cross-reference to section 148.59, the section in which all fees are listed.  Makes structural changes to section by dividing it into paragraphs.  Strikes a cross reference to an obsolete board certification.

Section 5 (148.57, subd. 5) requires a regulated person to maintain a current name and address with the board and notify the board in writing within 30 days of any change.  Requires a regulated person to request revised credentials from the board when the person has a name change.  Establishes requirements for reissuance of lost, stolen, or destroyed credentials.

Section 6 (148.574) strikes references to sections repealed in this article.

Section 7 (148.575, subd. 2) strikes obsolete language related to board certification for use of legend drugs since the use of legend drugs is now part of the curriculum in optometric training.

Section 8 (148.577) strikes reference to a section repealed in this article.

Section 9 (148.59) provides that fees may not exceed the listed amounts, but may be adjusted lower by the board.

Section 10 (148.603) establishes the conduct that may be the basis for disciplinary action.

Section 11 (148.604) creates a reporting obligations section.

Subd. 1 allows any person to report conduct constituting grounds for discipline to the board.

Subd. 2 requires health care institutions and organizations to notify the board if the entity has taken action to revoke, suspend, restrict, or condition the optometrists practice privileges. Requires the institutions or organizations to notify the board if an optometrist has resigned prior to the conclusion of disciplinary proceedings.

Subd. 3 requires licensed optometrists to report conduct constituting grounds for disciplinary action to the board.

Subd. 4 requires an optometrist to report to the board any personal conduct that constitutes grounds for disciplinary action.

Subd. 5 requires reports to be made to the board within 30 days after occurrence of the reportable event.  Allows the board to provide forms for submission of reports and to adopt rules.

Subd. 6 allows the board to issue subpoenas for production of reports required by subdivisions 2 to 4.

Section 12 (148.605) creates an immunity section.

Subd. 1 provides that any individual or entity making a report under section 148.604 in good faith and in exercise of reasonable care is immune from criminal and civil liability.

 Subd. 2  Paragraph (a) provides that members and employees of the board, and consultants retained by the board, are immune from criminal and civil liability related to their duties in investigating complaints and imposing disciplinary action when acting in good faith and in exercise of reasonable care.Paragraph (b) provides that members and employees of the board engaged in maintaining records and making reports regarding adverse health care events are immune from civil and criminal liability when acting in good faith and in exercise of reasonable care.

Paragraph (c) states that for purposes of this section, a member of the board or a consultant is considered a state employee.

Section 13 (148.606) requires an optometrist who is the subject of an investigation to cooperate fully with the investigation.

Section 14 (148.607) lists the types of disciplinary action that can be taken by the board: revocation or suspension of the license, limitations or conditions placed on the license, civil penalties, and censure or reprimand.

Sections 15 to 19 make changes to the social worker licensure chapter.

Section 15 (148E.075) creates the following alternative licenses:  temporary leave license; emeritus inactive license; and an emeritus active license.

Subd. 1 establishes a temporary leave license and removes reference to inactive status.

Subd. 1a establishes an emeritus inactive license.

Subd. 1b establishes an emeritus active license.

Subd. 2 permits a licensee to apply for temporary leave license, emeritus inactive license, or emeritus active license at any time when currently licensed or as an alternative to applying for a renewal of a license.

Subd. 3 requires applicants for a temporary leave license or an emeritus inactive license to submit the established fee.  Requires an applicant for an emeritus active license to pay one-half of the renewal fee for the applicable license.  Requires the applicants to submit the fees with the application for the new license.

Subds. 4, 5, 6 and 7 are stricken.

Subd. 8 authorizes the board to resolve any pending complaints against a licensee before approving an application for an alternative license.  Permits the board to take disciplinary action against a licensee with an alternative license.

Section 16 (148E.080, subd.1) changes a cross-reference.

Section 17 (148E.080, subd. 2) changes a cross-reference.

Section 18 (148E.180, subd. 2) creates an emeritus inactive license fee and an emeritus active license.

Section 19 (148E.180, subd. 5) establishes a license late fee.

Sections 20 to 25 make changes to the fees for dental providers.

Section 20 (150A.091, subd. 4) allows the Board of Dentistry to increase the annual license fee for a resident dentist or dental provider to no more than $85.

Section 21 (150A.091, subd. 5) establishes an increased cap on fees for dentists, dental therapists, dental hygienists, and licensed dental assistants.

Section 22 (150A.091, subd. 11) establishes increased cap on fees for anesthesia and sedation applications and biennial renewals.

Section 23 (150A.091, subd. 17) provides that the application fee to sit for the examination cannot exceed $250.

Section 24 (150A.091, subd. 18) allows the Board of Dentistry to assess a late fee of not more than $15 if a corporation or professional firm does not timely submit its annual fee.

Section 25 (150A.31) allows the Board of Dentistry to charge dental laboratories a biennial renewal registration fee not to exceed $80.

 Sections 26 to 33 make changes to the Board of Pharmacy chapter.

Section 26 (151.01, subd. 15a) modifies the definition of pharmacy technician.  Provides that a pharmacy technician is a person who has been trained to perform pharmacy tasks that do not require the professional judgment of a licensed pharmacist.  Prohibits pharmacy technicians from performing tasks reserved to a licensed pharmacist.

Section 27 (151.01, subd. 27) allows pharmacists to administer flu vaccines to individuals age six and older and all other vaccines to patients age 13 and older.  (Current law allows administration of flu vaccine to individuals age 10 and older and all other vaccines to patients age 18 and older.) Requires the pharmacist to check the Minnesota Immunization Information Connection prior to administration of vaccines, except when giving a flu shot to individuals age nine and older.  Strikes the requirement to notify the patient’s primary physician.

Section 28 (151.02) increases the membership on the board to three public members (currently there are two) and six pharmacists who actively practice (currently there are five).

Section 29 (151.056, subd. 1) increase application fees for licensure and registration assessed by the Board of Pharmacy.

Section 30 (151.065, subd. 2) increases the pharmacist original license fee.

Section 31 (151.065, subd. 3) increases annual licensure and registration renewal fees assessed by the Board of Pharmacy.

Section 32 (151.065, subd. 4) increases the fees for affidavits, duplicate licenses, and certifications assessed by the Board of Pharmacy.

Section 33 (151.102) makes changes to pharmacy technician scope of practice. Clarifies that a pharmacy technician can perform tasks that are not reserved to, and do not require the professional judgment of, a licensed pharmacist.  Changes the number of pharmacy technicians that can be supervised by a pharmacist from two to three.  Allows the board to adopt rules to set ratios of pharmacists to technicians greater than three to one.  Allows the board to issue waivers to pharmacists who request permission to supervise more than three pharmacy technicians.

Section 34 Repealer.  Repeals §§ 148.57, subds. 3 (revocation, suspension) and 4 (peddling and canvassing prohibited); 148.571 (use of topical ocular drugs); 148.572 (advice to seek diagnosis and treatment); 148.573, subd. 1 (certificate required for use or possession of topical ocular drug); 148.575, subds. 1 (certificate required for use of legend drugs), 3 (display of certificate required), 5 (notice to Board of Pharmacy), and 6 (board certification required); and 148.576, subds. 1 (authority to prescribe or administer legend drugs) and 2 (adverse reaction reports); § 148E.060, subd. 12 (ineligibility for a temporary license); § 148E.075, subds. 4 (time limits for temporary leaves), 5 (time limits for emeritus license), 6 (prohibition on practice), and 7 (representations of professional status).

Article 11 - Health Care

Section 1 (62A.045) Paragraph (f) requires a health insurer to process a clean claim from a state agency for covered expenses paid under state medical programs within 90 days. Requires an insurer to pay all other claims within the timeline set forth in federal regulations.

Paragraph (g) permits an insurer to request a refund of a claim paid in error to DHS within two years of the date the payment was made to DHS. Specifies that a request for a refund made after that time period will not be honored.

Section 2 (150A.06, subd. 1b.) states that a University of Minnesota School of Dentistry dental resident holding a resident dental license is eligible for enrollment in MA under section 250B.0625, subd. 9b.

Section 3 (174.29, subd. 1) effective July 1, 2016, adds certain nonemergency medical transportation services to the definition of special transportation services.

Section 4 (174.30, subd. 3) effective July 1, 2016, requires the Commissioner of Transportation to inspect the safety features required in vehicles designated as protected transport under nonemergency medical transportation services, section 256B.0625, subdivision 17.

Section 5 (174.30, subd. 4) Paragraph (e) requires beginning July 1, 2016, certain nonemergency medical transportation providers and special transportation service providers to pay a $45 annual fee to obtain a decal signifying possession of a certificate of compliance with the operating standards for special transportation services, and exempts ambulance services from this fee. The revenue from the fee is appropriated to the Commissioner of Transportation to pay for the inspection program.

Paragraph (g) permits nonemergency medical transportation providers to use the phrase “nonemergency medical transportation” in their name, advertisements or information describing their service, thereby exempting these providers from a Minnesota Rule that prohibits special transportation service providers from doing so.

Section 6 (174.30, subd. 4b) permits the Commissioner of Transportation to issue a variance from the operating standards for special transportation services to nonemergency medical transportation providers who were not subject to the operating standards prior to July 1, 2014. Providers may apply for a variance if they will not be able to meet the operating standards within six months following the enactment of this subdivision.  No variance may exceed 60 days, unless extended by the commissioner.

Section 7 (174.30, subd. 10) Paragraphs (a) and (b) require a provider of special transportation services (STS) to initiate background studies on its employees using the online NETStudy system operated by the Commissioner of Human Services.

Paragraph (c) prohibits an STS provider from allowing an employee to provide services unless the employee passes a background study.

Paragraph (d) permits a local or contracting agency to initiate background studies of volunteer drivers who provide nonemergency medical transportation services.

Section 8 (245C.03, subd. 10) requires DHS to conduct background studies for providers of special transportation services who initiate the studies of their employees.

Section 9 (245C.10, subd. 11) imposes on special transportation providers a fee of no more than $20 per background study.  Appropriates the fee to the commissioner to conduct the background studies.

Section 10 (256.015, subd. 7) requires an employer or third-party payer to provide DHS, within 60 days of a request, the following information as part of the data file:  name, date of birth, Social Security number, if number is collected and stored in a system routinely used for producing data, employer name, policy identification number, group identification number, and plan or coverage type.

Section 11 (256.969, subd. 1) establishes a new basis for and method of calculating the hospital cost index, and eliminates the requirement that MMB submit budget change requests for annual adjustments to hospital payment rates that are based on the hospital cost index.

Section 12 (256.969, subd 2b) Paragraph (d) extends until the next rebasing the five percent banding for hospital payment rates that was set to expire June 30, 2016, but only for hospitals paid on a diagnosis-related group (DRG) methodology.

Paragraph (e) extends until the next rebasing the additional adjustments to the rebased hospital payment rates that were set to expire on June 30, 2016.

Paragraph (f) extends until June 30, 2015, the payment rates for critical access hospitals that were in effect on October 31, 2014.

Paragraph (i) grants DHS the authority to determine a new cost-neutral tiered payment methodology for determining a cost-based final payment rate for discharges from critical access hospitals between July 1, 2015, and June 30, 2016.  Until the next hospital rate rebasing, which is scheduled for July 1, 2017, no critical access hospital may receive less than 95 percent of its base year payment rate, unless a hospital received in the base year a payment greater than 100 percent of its base year costs, in which case the hospital may receive only 100 percent of its base year costs.  For discharge from critical access hospitals on or after July l, 2016, payment rates will be increased by the hospital cost index.  The payment tiers are specified.

Paragraph (j) authorizes DHS, prior to each rebasing, to refine the critical access hospital payment tiers and the criteria for designation as a critical access hospital.

Section 13 (256.969, subd. 2d) extends the existing interim hospital payment process until March 1, 2016, and includes failure to complete the electronic systems changes as a condition under which the interim payment system may be used.

Section 14 (256.969, subd. 3a)  specifies that beginning July 1, 2015, individual hospital payment rate adjustments to long-term care hospitals and rehabilitation hospitals for fee-for-service inpatient services must be incorporated into the hospital’s payment rate and not applied to each claim.

Section 15 (256.969, subd. 3c)  specifies that beginning July 1, 2015, the ten percent buy-back for fee-for-service inpatient services at long-term care hospitals and rehabilitation hospitals must be incorporated into the hospital’s payment rate and not applied to each claim.

Section 16 (256.969, subd. 9) removes the authority of the commissioner to establish a separate DSH adjustment for critical access hospitals; requires disproportionate share hospital (DSH) payments to be paid according to a new methodology, effective July 1, 2015; requires annual DSH payments under the new methodology to equal the total amount of DSH payments made for 2012; lists factors that the methodology must take into account; and requires payments returned to the commissioner because they exceed the hospital-specific DSH limit for a hospital to be redistributed to other DSH-eligible hospitals in the manner specified.

Section 17 (256B.0561) establishes periodic data matching to evaluate continued eligibility in medical assistance and MinnesotaCare.

Subdivision 1 defines periodic data matching.

Subdivision 2, paragraph (a), requires the commissioner to conduct periodic data matching to identify recipients, who, based on available electronic data, may not meet eligibility criteria for the public health care program in which the recipient is enrolled.  Requires the commissioner to conduct data matching for medical assistance and MinnesotaCare recipients at least once during a recipient’s 12-month period of eligibility.

Paragraph (b) specifies that if the data matching indicates that a recipient no longer qualifies for medical assistance or MinnesotaCare, the commissioner must notify the recipient and allow the recipient 30 days to confirm information or provide a reasonable explanation for the discrepancy to the state or county agency responsible for the recipient’s case.  Requires the commissioner, if the recipient does not respond or provide a reasonable explanation to terminate the recipient’s eligibility in a manner provided for by the laws governing the program for which the recipient has been identified as being ineligible.

Paragraph (c) prohibits the commissioner from terminating eligibility if the recipient is cooperating, but needs additional time to provide the necessary information. 

Paragraph (d) specifies that a termination under this section may be appealed.

Subdivision 3 requires the commissioner to include in all communications with the recipient affected by this data matching with contact information for:  (1) the state or county agency directly responsible for the recipient’s case; and (2) consumer assistance partners who may be able to assist the recipient in the process.

Subdivision 4 requires the commissioner to report to the legislature annually, beginning September 1, 2017, on the number of cases affected by periodic data matching; the number of recipients whose eligibility was terminated as a result of a periodic data match; and how many recipients whose eligibility was terminated due to a failure to cooperate.

Subdivision 5 requires the commissioner to ensure that the implementation of this section complies with the ACA, and shall not permit eligibility terminations that would not conform with federal requirements.

Section 18 (256B.06, subd. 6) requires the commissioner to award grants to nonprofit programs that provide legal services based on indigency to provide legal services to individuals with emergency medical conditions or chronic health conditions who are not currently eligible for medical assistance due to their legal status, but may meet eligibility requirements with legal assistance.

Section 19 (256B.0625, subd. 9b) authorizes a dentist who is not a medical assistance provider, and who is either a faculty or adjunct member at the University of Minnesota Dental School or a dental resident to be enrolled as a medical assistance provider for purposes of providing dental services at the University of Minnesota Dental School clinic if the provider submits an agreement form to the commissioner.

Section 20 (256B.0625, subd. 13h) expands medication therapy services covered by MA to recipients taking prescriptions to treat or prevent one or more chronic medical conditions.  Also permits medication therapy management services to be delivered into patient’s residence via secure interactive video if the services are performed electronically during a covered home visit by an enrolled provider.  States that reimbursement shall be at the same rate and same condition as would otherwise apply and the pharmacist providing the services must be located within an ambulatory setting that meets specified requirements.

Section 21 (256B.0625, subd. 17) creates effective July 1, 2016, a new rate structure for nonemergency medical transportation and thereby implements the new modes of transportation placed in statute in 2014, implementation of which was contingent on a new rate structure.

Paragraph (f) eliminates the rate structure for special transportation services provided to eligible persons who need a wheelchair accessible van; and reorganizes the paragraph.

Old paragraph (g) eliminates redundant language contained in paragraph h.

New paragraph (g) permits acquaintances of a client to receive client reimbursement for providing qualifying transportation to the client and moves language concerning protected transport to clause (6).

Paragraph (i) clarifies that local agencies will assume responsibility for administering the nonemergency medical transportation program only after the commissioner has developed, made available, and funded the single administrative structure and delivery system described under section 256B.0625, subdivision 18e.  Counties' financial obligations are limited.

Paragraph (l) creates a new rate structure for nonemergency medical transportation based on a client’s assessed mode of transportation.

Paragraph (m) provides adjustments to the base rate for services provided in super rural areas and to the mileage rates for services provided in rural and super rural areas.

Paragraph (n) makes technical and conforming changes.

Old paragraph (o) strikes a rate decrease for nonemergency medical transportation.

Section 22 (256B.0625, subd. 17a) strikes a rate decrease for ambulance services effective July 1, 2016.

Section 23 (256B.0625, subd. 18a) strikes language concerning direct mileage reimbursement that is replaced by the client reimbursement language in section 256B.0625, subdivision 17, paragraph (l), effective July 1, 2016.

Section 24 (256B.0625, subd. 18e) requires the Commissioner of Human Services to coordinate with the Commissioner of Transportation in developing the single administrative structure and delivery system for nonemergency medical transportation.

Section 25 (256B.0625, subd. 28a.) allows licensed physician assistants meeting specified criteria, who have completed 2,000 hours of clinical experience in the evaluation and treatment of mental health, to bill for medication management and evaluation and management services provided to MA enrollees in outpatient settings.

Section 26 (256B.0625, subd. 31.)  Strikes language allowing the commissioner to set MA payment rates for specified categories of medical supplies at levels below the Medicare payment rate.

Section 27 (256B.0625, subd. 57) excludes payments to federally qualified health centers and rural health centers from the Medicare cost-sharing payment limitation.

Section 28 (256B.0625, subd. 58) specifies that payment for providing an EPSDT screening shall not include charges for health care services and products that are available to the provider at no cost.

Section 29 (256B.0631) makes changes to the MA co-payments to conform to changes in federal regulations.

Subd. 1 modifies the family deductible amount to keep the deductible at $2.75 per month per family and permits it to be adjusted annually by the percentage in the medical care component of the CPI-U.  Also specifies that family deductible does not apply to premiums charged to individuals enrolled in MA-EPD.

Subd. 2 exempts from co-payments and deductibles: American Indians who are enrolled in a federally recognized tribe; individuals eligible for MA through the breast and cervical cancer control program; and preventive health services recommended by the U.S. Preventive Services Task Force.

Subd. 3 caps cost-sharing for all MA recipients at five percent of the family’s income.

Section 30 (256B.0638) creates the opioid prescribing improvement program.

Subd. 1 requires the Commissioners of Human Services, in conjunction with the Commissioner of Health, to establish a statewide opioid prescribing program to reduce opioid dependency and substance use due to the prescribing of opioid analgesics by health care providers.

Subd. 2 defines terms.

Subd. 3 requires the Commissioner of Human Services, in consultation with the Commissioner of Health, to establish an opioid prescribing work group.

Subd. 4 requires the work group to recommend to the commissioners the components of the statewide opioid prescribing improvement program, including criteria for opioid prescribing protocols; developing sentinel measures; educational resources for opioid prescribers about pain management and the use of opioids to treat pain; opioid quality improvement standard thresholds and opioid disenrollment standards for opioid prescribers and provider groups; and other program issues as determined by the commissioners.

Subd. 5.  Paragraph (a) requires the Commissioner of Human Services to implement the program and to annually collect and report to opioid prescriber’s data showing the sentinel measures of their opioid prescribing patterns compared to their anonymized peers.

Paragraph (b) requires the commissioner to notify the prescriber and all provider groups with which the prescriber is employed or affiliated when the prescriber’s prescribing pattern exceeds the opioid quality improvement standards thresholds.  If notified by the commissioner, the prescriber is required to submit to the commissioner a quality improvement plan for review and approval.

Paragraph (c) specifies that if after one year the prescriber’s prescribing practices are not consistent with community standards, the commissioner may take certain steps.

Paragraph (d) requires the commissioner to disenroll from the Minnesota health care programs all prescribers and provider groups whose prescribing practices fall within the applicable opioid disenrollment standards.

Subd. 6 classifies the reports and data identifying an opioid prescriber as private data on individuals until the prescriber is subject to disenrollment as a MA provider, then permits the commissioner to share with all the provider groups with which the prescriber is employed or affiliated a report identifying the prescriber.  Specifies that data and reports identifying a provider group are nonpublic data until the provider group is subject to disenrollment.  At that time the data and reports are public, except that any identifying information of enrollees must be redacted by the commissioner.

Subd. 7 requires the commissioner to annually report to the legislature on the status of the implementation of the program, including data on utilization of opioids in the Minnesota health care programs.

Section 31 (256B.0757) expands the certification of health homes to include behavioral health homes.

Subd. 1 requires the commissioner to establish behavioral health homes to serve individuals with serious mental illness.  Requires the services provided by these behavioral health homes to focus on both behavioral and physical health.

Subd. 2 expands who is eligible for health home services to include individuals who have been diagnosed with a mental illness.

Subd. 4 specifies that health home services are voluntary and that an eligible individual may choose any designated provider.  Defines a designated provider as a clinical practice or clinical group practice, rural clinic, community health center, community mental health center, or another entity that is determined by the commissioner to be qualified to be a health home.

Subd. 5 clarifies that the commissioner shall make payments to each designated provider for the provision of health home services.

Subd. 6 changes terminology to refer to designated providers.

Subd. 8 requires health homes to meet process, outcome, and quality standards developed and specified by the commissioner.  Requires the commissioner to collect data from health homes to monitor compliance with certification standards. Permits the commissioner to contract with a private entity to evaluate patient and family experiences, health care utilization, and costs.  Requires the commissioners to utilize findings from the utilization of health homes to determine populations to serve under subsequent health home models for individuals with chronic conditions.

Section 32 (256B.0758) permits the commissioner to establish a health care delivery pilot program to test integrated health care delivery networks created by or including North Memorial Health Care.

Section 33 (256B.69, subd. 5a) requires managed care and county-based purchasing plans to maintain current and fully executed agreements for all subcontractors, including bargaining groups for administrative services that are expensed to the state’s public health care programs.  Subcontractor agreements determined to be material, as determined by the commissioner, must be in a form of a written instrument or electronic document and must contain specific elements and must clearly indicate how they relate to state public health care programs. Provides the commissioner, upon request, with access to all subcontractor documentation under this paragraph.  Specifies that nothing in this paragraph allows the release of information that is nonpublic data pursuant to section 13.02.

Section 34 (256B.69, subd. 5i) Paragraph (a) specifies that administrative costs paid to managed care plans or county-based purchasing plans must not exceed 6.6 percent of total payments to all managed care and county-based purchasing plans in aggregate across all state public health care programs based on payments to be made at the beginning of each calendar year.  Authorizes the commissioner to eliminate or reduce administrative requirements to meet the administrative cost limit.  Excludes premium taxes, surcharges, and federal health insurance fees under the ACA.

Paragraph (b) specifies the expenses that are not allowable administrative expenses for rate-setting purposes.

Paragraph (c) specifies that payments to a quality improvement organization and an allowable administrative expense for rate setting purposes to the extent the payments are allocated to state public health care programs and are approved by the commissioner.

Paragraph (d) requires, to the extent possible, expenses for an administrative item to be directly allocated so as to assign costs for an item to an individual state public health care program when the cost can be specifically identified with and benefits the specific state public health care program.  Requires manage care plans and county-based purchasing plans to clearly identify and separately record expense items listed in paragraph (b) in their accounting systems in a manner that allows for independent verification of unallowable expenses for purposes of determining payment rates for state public health care programs.

Paragraph (e) requires the commissioner to reduce administrative expenses paid to managed care plans and county-based purchasing plans by .50 of a percentage point for contracts beginning January 1, 2016, and ending December 31, 2017.

Section 35 (256B.69, subd. 9c) requires managed care plans and county-based purchasing plans to certify to the commissioner, for the purpose of financial reporting for state public health care programs, that costs reported for state public health care program include only: (1) services covered under the state plan and waivers and related allowable expenses; and (2) the dollar value of unallowable and nonstate plan services, including both medical and administrative expenditures that have been excluded.

Section 36 (256B.69, subd. 9d) modifies the current financial audits to require managed care plans and county-based purchasing plans to submit to and cooperate with the independent third- party financial audits by the legislative auditor.  Authorizes the commissioner to conduct ad hoc audits of the state public health care programs administrative and medical expenses of managed care plans and county-based purchasing plans.  Requires the commissioner to report to the legislature by February 1, 2016, and annually thereafter the number of ad hoc audits conducted in the past calendar year and the results of the audits.

Section 37 (256B.69, subd. 9e) requires the legislative auditor to contract with vendors to conduct independent third-party financial audits of the information required to be provided by managed care plans and county-based purchasing plans.  Requires the audits to include a determination of DHS’s compliance with the federal Medicaid rate certification process.  Provides a definition of “independent third-party.”

Section 38 (256B.75) specifies that beginning July 1, 2015, payments to critical access hospitals for outpatient, emergency, and ambulatory surgery hospital facility fee services will be final payments and will not be settled to actual costs.

Section 39 (256B.76, subd. 1.) effective July 1, 2015, increases payment rates by 90 percent for physical therapy, occupational therapy, and speech pathology and related services provided by Gillette Children’s Hospital and provides that payments to managed care and county-based purchasing plans shall not be adjusted to reflect this payment increase.

Section 40 (256B.76, subd. 2.) effective July 1, 2015, increases payments rates for dental services provided by providers located outside the seven-county metropolitan area by a maximum percentage above the rates in effect on June 30, 2015, within the limits of the appropriation for this rate increase.  Effective January 1, 2016, payments to managed care plans and county-based purchasing plans shall reflect this rate increase and the plans are required to pass on the full amount of the increase in the form of higher payment rates to dental providers located outside of the seven-county metropolitan area.

Section 41 (256B.76 subd. 4) modifies the critical access dental provider criteria for private practicing dentists by eliminating the requirement that the dentist does not restrict access or services because of a patient’s financial limitations or public assistance status.

Section 42 (256B.762) effective for services provided on or after July 1, 2015, increases payment for managed care and fee-for-service visits for physical therapy, occupational therapy, and speech therapy by 10 percent, when these services are provided as home health services. Requires the commissioner to adjust managed care and county-based purchasing capitation rates to reflect these payment rates.

Section 43 (256B.766) Paragraph (g), effective July 1, 2015, increases payment rates by 90 percent for outpatient hospital facility fees, certain medical supplies and durable medical equipment, prosthetics and orthotics, and laboratory services provided by Gillette Children’s Hospital. Provides that payments to managed care and county-based purchasing plans shall not be adjusted to reflect this payment increase.

Paragraph (i), effective July 1, 2015, restores payment rates for durable medical equipment, prosthetics, orthotics, or supplies, including individually priced items, to the January 1, 2008 fee schedule rate, updated to include subsequent rate increases.  Exempts certain items from this provision.  Also requires that a July 1, 2015, 3 percent payment increase in current law be calculated using the 2008 fee schedule rate.

Section 44 (256B.767) Paragraph (d), effective July 1, 2015, exempts durable medical equipment, prosthetics, orthotics, or supplies from the requirement that MA payments not exceed the Medicare payment rate. 

Paragraph (e) exempts physical therapy, occupational therapy, speech pathology and related services, and basic care services provided by Gillette Children’s Hospital from the requirement that MA payment rates not exceed the Medicare payment rate for the applicable service.

Section 45 (256B.79) establishes integrated care for high-risk pregnant women.

Subd. 1 defines terms.

Subd. 2 requires the commissioner to implement a pilot program to improve birth outcomes and strengthen early parental resilience for pregnant women who are receiving MA, are at a significantly elevated risk for adverse outcomes of pregnancy, and are in targeted populations.

Subd. 3 requires the commissioner to award grants to qualifying applicants to support interdisciplinary, integrated perinatal care. Requires the grants to be distributed through a request for proposals (RFP) process to a designated lead agency within an entity that has been determined to be a qualified integrated perinatal care collaborative or an entity in the process of meeting the qualifications to become a collaborative.

Subd. 4 specifies that to be eligible for a grant, an entity must show that the entity meets or is in the process of meeting the qualifications established by the commissioner to be a qualified perinatal care collaborative.  Specifies the policies, services, and partnerships that an entity must have in place to meet the qualifications to be a collaborative.

Subd. 5 requires a collaborative receiving a grant to develop means to identify and report gaps in the  communication, administrative support, and direct care that must be remedied for the collaborative to provide integrated care and enhanced services to targeted populations.

Subd. 6 requires the commissioner to report to the legislature on the status and progress of the pilot program by January 31, 2019.

Subd. 7 specifies that this section expires June 30, 2019.

Section 46 (256L.01, subd.3a) defines family in the MinnesotaCare program to comply with federal requirements for the basic health plan (BHP).

Section 47 (256L.01, subd. 5) clarifies the definition of income to mean a household’s projected annual income for the applicable year.

Section 48 (256L.03, subd. 5) Paragraph (a) updates the family deductible cost-sharing requirement by specifying that the family deductible is equal to $2.75 per month per family, and that it will be annually adjusted by the increase in the medical care component of the CPI-U. Paragraph (b) specifies that cost-sharing requirements do not apply to American Indians. Paragraph (f) requires the commissioner to increase copayments for covered services in a manner sufficient to reduce the actuarial value of the benefit to 94 percent.  These cost-sharing changes shall not apply to those individuals and services that are exempt from cost-sharing under state law and must not be implemented before January 1, 2016.

Section 49 (256L.04, subd. 1c) clarifies eligibility requirements for MinnesotaCare.

Section 50 (256L.04, subd. 7b) requires the commissioner to adjust the income limits annually on January 1 as provided in federal regulations.

Section 51 (256L.05, subd. 2a) specifies that the commissioner must determine eligibility for each applicable period of eligibility, and if the individual is required to pay a premium, that coverage is only available in each month for which a premium has been paid.

Section 52 (256L.05, subd. 3) clarifies that coverage for American Indians begins the first day of the month following the month in which eligibility is approved.

Section 53 (256L.05, subd. 3a) clarifies that eligibility must be redetermined on an annual basis and that the period of eligibility is the entire calendar year following the year in which eligibility is redetermined.  Specifies that beginning in calendar year 2015, eligibility redeterminations shall occur during open enrollment periods for qualified health plans.

Section 54 (256L.05, subd. 4) requires the commissioner to determine an applicant’s eligibility for MinnesotaCare no more than 45 days from the date the application was received by the department.

Section 55 (256L.06, subd. 3) specifies that disenrollment for nonpayment of the premium is effective for the calendar month following the months the premium was due, and if disenrolled, an individual may not reenroll prior to the first day of the month following payment of an amount equal to two months’ premiums.

Section 56 (256L.121, subd. 1) clarifies a cross-reference.

Section 57 (256L.15, subd. 1) requires the commissioner to increase MinnesotaCare premiums for recipients based on June 2015 program enrollment after consulting with the legislature.  Requires the premium increases to be sufficient to increase projected revenue to the health care access fund by at least $27,800,000 for the biennium ending June 30, 2017. The revised premiums shall apply on or after August 1, 2015.  The premium changes shall not apply to enrollees who are excluded from paying premiums under state or federal law and must satisfy federal requirements for premiums under the basic health program.

Section 58 (256L.15, subd. 2) modifies the MinnesotaCare premiums to comply with federal regulations.  Specifies that children under the age of 21 and individuals with household incomes below 35 percent of federal poverty guidelines are not required to pay premiums.

Section 59 (Laws 2008, chapter 363, article 18, section 3, subd. 5) strikes the current limits on aggregate administrative costs paid to managed care plans and county-based purchasing plans.  This limit is modified and reinstated in section 256B.69, subdivision 5i.

Section 60 (Laws 2014, chapter 312, article 45, subdivision 2) modifies the expiration date of variances from the operating standards for special transportation service issued by the Commissioner of Human Services to new nonemergency medical transportation providers.

Section 61 (Statewide Opioid Prescribing Improvement Program) requires the Commissioner of Human Services to report to the legislature by December 1, 2015, any recommendations made by the opioid prescribing work group and steps taken to implement the opioid prescribing improvement program.

Section 62 (Task Force on Health Care Financing) requires the Governor to convene a task force on health care financing to advise the Governor and legislature on strategies that will increase access to and improve the quality of health care for Minnesotans and the task force is required to report their recommendations to the governor and the legislature by January 15, 2016.

Section 63 (Health Disparities Payment Enhancement) requires the Commissioner of Human Services to develop a methodology to pay a higher payment rate for providers and services that takes into account the higher cost, complexity, and resources needed to serve patients and populations who experience the greatest health disparities.  The commissioner must submit a report to the legislature by December 15, 2015, that includes recommendations and a proposed methodology for providing a health disparities payment adjustment.

Section 64 Capitation Payment Delay.  Requires the commissioner of human services to delay $135 million in MA capitation payments due in May 2017, and special needs basic care payments due in April 2017, until July 1, 2017.  Requires the payment to be made between July 1 and July 31, 2017.

Section 65 (Repealer) repeals the following:

(a) Minnesota Statutes, sections 256.01, subd. 35, 256.969, subd. 30 (payment for births); and 256B.69, subd. 32 (initiatives to reduce incidence of low birth weight), effective July 1, 2015.

(b) Minnesota Statutes, sections 256L.02, subd. 3 (financial management for MinnesotaCare); and 256L.05, subd. 1b (MinnesotaCare enrollment by counties), 1c (open enrollment and streamlined application), 3c (retroactive coverage), and 5 (availability of private insurance), effective the day following final enactment.

(c) Repeals rules requiring providers of special transportation services to conduct driver and criminal record checks.

Article 12 - MNsure

Section 1 (62A.02, subd. 2) requires health plans offered outside of MNsure and qualified health plans offered through MNsure must receive rate approval from the Commissioner of Commerce no later than 30 days prior to the beginning of the annual open enrollment period for MNsure and final and approved rates must be released to the public at a uniform time no later than 30 days prior to the beginning of the open enrollment period.

Section 2 (62V.03) removes the following current exemptions for MNsure:

  •  certain exemptions to the Open Meeting Law (board must comply with Open Meeting Law in chapter 13D)
  • exemptions from chapters 16B (Department of Administration) and 16C (State Procurement); (board must comply with chapters 16B and 16C)
  • exemptions from certain sections in chapter 16E (board must comply with chapter 16E)

 Section 3 (62V.05, subd. 6) provides details for an appeals process for appellants aggrieved by orders of MNsure.

Section 4 (62V.05, subd. 7) strikes the requirement that MNsure establish and maintain an agreement with the Office of MN.IT Services for information technology (IT) services.

Section 5 (62V.05, subd. 8) strikes the “super” expedited rulemaking authority the MNsure board had until January 1, 2015.  The board will still have the option to use expedited rulemaking process under section 14.389.

Section 6 (62V.05, subd. 11) prohibits MNsure from certifying, selecting, or offering products and policies of coverage other than qualified health plans or dental plans. 

Section 7 requires the Commissioner of Human Services, in consultation with the MNsure Board and the Legislative Oversight Committee, to develop a proposal to allow small employers the ability to receive the small business health care tax credit when the small employer pays the premiums on behalf of employees enrolled in either a qualified health plan or small group health plan offered outside of MNsure.

Section 8 (Expanded access to qualified health plans and subsidies) requires the Commissioner of Commerce, in consultation with the MNsure Board and the MNsure Legislative Oversight Committee, to develop a proposal to allow individuals to purchase qualified health plans directly from health plan companies (rather than through MNsure), and receive advanced premium tax credits and cost-sharing subsidies.  Requires the commissioner to seek all federal waivers and approvals to implement this proposal.  Requires the commissioner to submit a draft proposal to the MNsure board and legislative oversight committee at least 30 days before submitting the final proposal to the federal government, and to notify the board and oversight committee of any federal decision or action related to the proposal.

Section 9 repeals section 62V.11, subd. 3 (obsolete language in the Legislative Oversight Committee section).

 
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