2020 Legislative Update by Care Providers of Minnesota

2020

LEGISLATIVE UPDATE A REPORT ON THE SECOND YEAR OF THE 91 ST LEGISLATIVE SESSION & THE 1 ST SPECIAL SESSION

June 26, 2020 Welcome to the 2020 Legislative Update Book! We hope you find the contents useful as a reference to help you understand the laws that passed this year during “regular” and “special” sessions, and to help you prepare for implementation. We encourage you to use the information you find in these pages to talk with your own staff, elected officials, customers, family members, and community leaders about topics of concern for you. The 2020 legislative sessions were like no other—and hopefully like ones we will never experience again. The spread of the COVID-19 pandemic and the killing of George Floyd were two gamechanging events that turned the direction of the entire legislature not once…but twice. While the first weeks of session were business as usual with in-person meetings, and the ability to meet with legislators face-to-face, that all changed in March when it became clear that COVID-19 was not isolated to the east or west coast. So, hearings were converted to virtual events in April and May and the work continued with a muchabbreviated agenda and limited interactions between legislators and their constituencies. The regular session ended on May 18 without major resolution of topics such as a bonding bill, partly because the legislature knew they would be returning to a special session in mid-June to address continued funding and authority to manage COVID-19. Another unanticipated turn happened on May 25 with the murder of George Floyd by Minneapolis police, and the ensuing riots and protests that happened in the aftermath. The special session priorities changed once again with funding a bonding bill taking a back seat to hearings on law enforcement reforms and ongoing COVID-19 funding. There is so much left unfinished from the 2020 sessions but questions remain about whether time will be spent in special session(s) to address the unfinished work or just move on with the 2020 election cycle and getting ready for 2021 when the biennial budget will need to be balanced— knowing the pandemic has turned the economic picture in Minnesota from one of surplus to a significant deficit that will need to be addressed by the next legislature. If you have any questions or need more information about anything you find in this book, do not hesitate to contact me at 952-851-2487. You may also access this book and/or individual pages in an electronic version on our website in the Advocacy section: www.careproviders.org/advocacy. Sincerely,

Patti Cullen, CAE President/CEO

Care Providers of Minnesota 7851 Metro Parkway, Suite 200 • Bloomington, MN 55425 • Phone 952/854-2844 • MN Toll-Free 800/462-0024 • Fax 952/854-6214 • www.careproviders.org Leading Members to Excellence

7851 Metro Parkway, Suite 200 Bloomington, MN 55425 952-854-2844 / 1-800-462-0024 www.careproviders.org

2020 LEGISLATIVE UPDATE A report to the membership on the second year of the 91st Legislative Session & 1st Special Session Patti Cullen, CAE President/CEO

Prepared by: Care Providers of Minnesota Advocacy staff

This report does not constitute legal analyses of the changes in law reported herein. For legal opinions on the application of new statutory language to specific fact situations, contact your organizationâ&#x20AC;&#x2122;s legal counsel. This publication may not be reproduced in whole or in part in any form without the written permission of Care Providers of Minnesota. ÂŠ Care Providers of Minnesota, Inc., 2020

2020 Legislative Update Book Table of Contents I. Session summary .................................................................................................................................... 9 II. COVID-19 policy: Emergency powers granted to Minnesota Department of Health ..... 15 III. COVID-19 related funding ................................................................................................................... 21 a. Public health funding for COVID-19 planning & preparation ..................................... 23 b. Funding for the disaster contingency account ............................................................. 25 c. COVID-19 Health Care Response Fund created ............................................................. 27 d. Patient’s residence added to telemedicine as originating site ................................ 31 e. COVID-19 Minnesota Fund established & many other policy changes .................. 33 f.

Retroactive Medicaid health plan eligibility codified ................................................... 35

IV. Workforce ................................................................................................................................................. 37 a. Occupational disease workers’ compensation .............................................................. 39 b. Health occupations—Occupational therapy .................................................................... 41 c. Health occupations—Social workers .................................................................................. 43 d. Advanced practice registered nurses (APRNs).............................................................. 47 V. Guardianship/Financial exploitation ............................................................................................. 49 a. Guardianship changes ............................................................................................................ 51 b. Financial exploitation of vulnerable adults ..................................................................... 55 VI. Other ........................................................................................................................................................ 57 a. Medical cannabis ...................................................................................................................... 59 b. Medical records change .......................................................................................................... 61 c. Public Employees Retirement Association (PERA) changes ..................................... 63 VII. First Special Session ......................................................................................................................... 67 a. Physician assistant (PA) changes ...................................................................................... 69 b. Extending the expiration of executive order relating to use of telemedicine ...... 71

SESSION SUMMARY

SUMMARY OF 2020 SESSION Termed the “Pandemic Session” by Speaker of the House Melissa Hortman, the 2020 Regular Session adjourned sine die at midnight on Sunday, May 17, 2020. While the Minnesota Constitution requires the legislature to adjourn that day, the Constitution also prohibits the legislature from passing any legislation on the last Monday of the biennial session. This resulted in the usual last weekend of busy negotiations and attempts to resolve their priorities. The 2020 Regular Session, started in mid-February, was initially focused on the passage of a bonding bill in excess of $1 billion, approval of state employee contracts, tax relief, federal tax conformity, investments in early childhood education and a handful of unresolved policy issues left over from the 2019 session. In late February, it was announced the state had a $1.5 billion budget surplus and roughly $2.5 billion saved away in the state’s budget reserves. The legislature started to get down to their normal course of business. Then, COVID-19 changed everything. The governor declared a peacetime emergency and began using executive orders to alter and continue the operations of the state. The Minnesota House initially pushed for remote hearings, an extended recess, and the implementation of many of the CDC’s recommendations for limiting the spread of the Coronavirus. The Senate’s initial response was to try and maintain a working presence at the Capitol. They too, ultimately took an extended recess and began implementing some of the CDC recommendations. As they learned more about the virus, the Senate also began to implement their own policies and procedures to address the virus’s spread. Zoom meetings became commonplace, legislative participation in floor debates by phone and lengthy roll call votes calling each name, one at a time, made the process for considering legislation and passing bills extremely challenging and time consuming. Over the ensuing weeks, the legislative focus changed. Bills were passed allocating funds to address a number of COVID-19 challenges. As a result of the economic and budget uncertainty, the Office of Management & Budget took the unusual step of announcing a new state fiscal projection, the state’s surplus had turned into a $2.4 billion dollar deficit. Money the Legislature had hoped to use to fund new programs and projects disappeared. The state’s financial uncertainty dramatically changed the session’s early goals. While the legislature was able to work in a bi-partisan manner early in the crisis, as the session drew near to an end partisanship returned. Over the final weekend, legislative negotiations were also affected by the COVID-19 need to social distance, when the

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governor and leaders were unable to meet in person making the typical negotiations back and forth process all that more difficult. As a result of process, personality differences, and policy differences, the minority party in both bodies failed to provide votes necessary to reach the 3/5th vote necessary to commit the state to long-term debt and passage of a bonding bill. The bonding bill had been the top priority at the start of the session. Furthermore, negotiations also broke down over a potential tax bill and legislation establishing a process for distributing the state’s $1.8 billion in federal CARES money. On the items of specific interest, the end of session forced the slimming down of the MDH and DHS agendas. The legislature sought to remove items that contained “controversial” topics, in order to pass some needed policy changes without adding controversial issues. For the majority of the topics, the legislature was using the mantra that they needed all four caucuses (majority and minority in both House and Senate) to agree to an item, for it to be included. This meant that a limited number of slimmed down “mini-bus” rather than “omnibus” bills passed as the session wound down. Although the Minnesota Legislature technically will not return until January 5, 2021, the governor’s peacetime executive order, which grants him the authority for all other COVID19 executive orders, expired on June 12. By law, if the governor wishes to extend that order for an additional 30 days, when the legislature is not in session, he must call the legislature back. The legislature does not have to approve the order—but must be given the opportunity to reject the order. In order to reject the order, it would take a majority vote by both the House and Senate to reject the order. Thus, everyone expected he would call a special session on or around June 12, so they weren’t all concerned about deferring some of their regular session action until that time. As part of that special session, the legislature will try once again to complete items they were unable to resolve before adjourning the regular session: the bonding bill, a tax bill, and oversight of federal funds disbursement from the CARES Act were all on the list of potential bills. FIRST SPECIAL SESSION After the regular legislative session adjourned, and prior to the special session, the issue of public safety came to the forefront when there was a video of a Minneapolis police officer suffocating George Floyd to death, while detaining him for allegedly passing a counterfeit $20 dollar bill. This caused multiple days of social unrest, looting, rioting, and burning of sections of Minneapolis and St. Paul—and the spotlight of police brutality shone brightly on Minneapolis police department. The disturbances were mitigated when Governor Walz called out the National Guard and imposed curfews.

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As a result of the local and National attention of George Floyd’s death, both the House and Senate began talking about police reform legislation. There were multiple zoom hearings held by the House leading up to the anticipated special session. It was anticipated that the agenda of the First Special Session would change to highlight legislation seeking to reform police practices. As required by law, when Governor Walz sought to extend his emergency peacetime powers, he called a special session of the legislature. At the start of the special session, the Senate announced that they would be in session for one week. The first order of business was to vote on the continuation of the governor’s emergency powers. In order to terminate the emergency powers, both the House and the Senate would have to vote to terminate the powers. After much debate, the Senate voted to terminate the powers; the House did not. As a result of the votes, the governor’s emergency powers continue for 30 more days. Whereupon, he will have to call another special session if he wants them to continue. The other items on the legislative agendas surrounded the public safety and police brutality issues. Although there were multiple proposals for sweeping changes, the governor, House, and Senate were unable to agree on any items, resulting in no final agreements. Although the three bodies did agree on a few items during the special session, the parties could not agree on big issues such as a bonding bill, a tax bill, and oversight of federal funds disbursement from the federal CARES Act money. As a result of the lack of agreement on the CARES Act money, the governor will work with the Legislative Audit Commission on the disbursement of the 800 million federal dollars.

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COVID-19 POLICY

Emergency powers granted to Minnesota Department of Health 2020 Regular Session SF4462/HF4556 Chapter 74, Article 1, Section 13 COVID-19 policy bill Effective: March 13, 2020 (effective retroactively) Short description The commissioner of health may temporarily delay, waive, modify, or issue variances to state laws, to prepare for and respond to the COVID-19 outbreak, and to preserve access to programs and services provided, licensed, or regulated by the Minnesota Department of Health (MDH). Summary MDH may temporarily delay, waive, or modify the following provisions and applicable rules including the following: •

Provisions governing o

the hospital construction moratorium

healthcare-based use of x-ray technologies

the moratorium on certification of nursing home beds

o •

Provisions related to administrative appeals, reconsiderations, or other reviews; and provisions governing state-funded grants issued by the commissioner

•

Minnesota Statutes, chapters 14, 62D, 62J, 62Q, 144, 144A, 144D, 144G, 144H, 146A, 146B, 148, 149A, 153A, 157, 214, and 327, and in Minnesota Statutes, sections 256.045, 626.556, and 626.557

During the peacetime emergency related to the COVID-19 outbreak, MDH is also granted powers to establish temporary alternative healthcare facilities This includes the suspension of certain compliance and regulatory standards as they apply to nontraditional spaces used for temporary alternative healthcare facilities. Areas of statute that MDH may suspend in creating temporary alternative sites include the following: •

Minnesota Statutes, chapters 14, 144, 144A, 144D, 144G, 144H, 146A, 157, and 327

•

Minnesota Statutes, sections 256.045, 626.556, and 626.557

Implications The temporary powers granted to MDH to waive certain provisions of statute were utilized in several areas of long-term care •

Nursing facilities were allowed exceptions to the moratorium on the certification of new beds o

This allowed beds to be added to existing and sometimes empty wings as well as non-institutional buildings on campuses

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Nursing facilities were able to temporarily certify Medicaid beds for Medicare

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A process for nursing facilities to exceed the maximum charges allowed by supplemental nursing staff agencies (SNSA) was created by MDH and the Minnesota Department of Human Services

Bill language Chapter 74, Article 1, Section 13: https://www.revisor.mn.gov/laws/2020/0/Session+Law/Chapter/74/ Sec. 13. COMMISSIONER OF HEALTH; TEMPORARY EMERGENCY AUTHORITY. Subdivision 1. Peacetime emergency; temporary authority granted. Beginning on the date that the governor declared a peacetime emergency under Minnesota Statutes, section 12.31, subdivision 2, for an outbreak of COVID-19, the commissioner of health is granted temporary authority as described in and limited by this section to protect the health and safety of the public. The temporary authority granted to the commissioner in this section may only be used for purposes related to preparing for, preventing, or responding to an outbreak of COVID-19 and for preserving access to programs and services provided, licensed, or regulated by the Department of Health. Subd. 2. Temporary delay, waiver, or modification. The commissioner may temporarily delay, waive, or modify any of the following provisions and applicable rules: (1) provisions in Minnesota Statutes, sections 144.551, 144A.071, and 144A.073, governing the hospital construction moratorium and the moratorium on certification of nursing home beds; (2) provisions in Minnesota Statutes, section 144.121, and Minnesota Rules, chapter 4732, but only those that govern the health-care-based use of x-ray and related technologies; (3) provisions for which the commissioner is responsible in Minnesota Statutes, chapters 14, 62D, 62J, 62Q, 144, 144A, 144D, 144G, 144H, 146A, 146B, 148, 149A, 153A, 157, 214, and 327, and in Minnesota Statutes, sections 256.045, 626.556, and 626.557; (4) provisions related to administrative appeals, reconsiderations, or other reviews involving or initiated by the commissioner; and (5) provisions governing the scope, timelines, reporting requirements, and activities of state-funded grants issued by the commissioner to allow grant recipients to use such funds to respond to COVID-19 when authorized by the commissioner.

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Subd. 3. Temporary alternative health care facilities. (a) The commissioner may establish temporary alternative health care facilities. (b) During the peacetime emergency specified in subdivision 1, compliance and regulatory standards in the following provisions, as they apply to the use of nontraditional spaces to provide patient care in temporary alternative health care facilities established by the commissioner, are suspended: (1) Minnesota Statutes, chapters 14, 144, 144A, 144D, 144G, 144H, 146A, 157, and 327; (2) Minnesota Statutes, sections 256.045, 626.556, and 626.557; and (3) corresponding chapters of Minnesota Rules. (c) To the extent necessary to establish and regulate the beds at temporary alternative health care facilities described in this subdivision, the commissioner shall consult with the commissioner of labor and industry on state building code issues. Subd. 4. Variances. (a) The commissioner may temporarily grant variances on an individual or blanket basis to rules within the commissioner's jurisdiction that do not affect the health or safety of persons in a licensed program. (b) The commissioner may temporarily grant variances to rules on an individual basis if: (1) the variance is requested by an applicant or license holder in a form and manner prescribed by the commissioner; (2) the request for a variance includes the reasons the applicant or license holder cannot comply with the requirements specified in rule and the alternative, equivalent measures the applicant or license holder will follow to comply with the intent of the rule; and (3) the request for a variance states the time period for which the variance is requested. (c) The commissioner may temporarily grant blanket variances to rules governing licensed programs within the commissioner's jurisdiction if the commissioner: (1) determines that the rule does not affect the health or safety of persons in the licensed program;

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(2) identifies the alternative, equivalent measures the applicant or license holder must follow to comply with the intent of the rule; and (3) establishes a time period for which the variance is granted. (d) The commissioner's decision under this subdivision to grant or deny a variance request is final and not subject to appeal. Subd. 5. Notice. (a) No later than 48 hours after a delay, waiver, blanket variance, or modification under this section goes into effect, the commissioner must provide written notice of the delay, waiver, blanket variance, or modification to the appropriate ombudsman, if any, and to the chairs and ranking minority members of the legislative committees with jurisdiction over the Department of Health. (b) A delay, waiver, blanket variance, or modification issued or granted under this section must be posted on the Department of Health website within 48 hours after being issued or granted and must include a plain-language description of the delay, waiver, blanket variance, or modification. Subd. 6. Report. Within 60 days after the peacetime emergency specified in subdivision 1 is terminated or rescinded by proper authority, the commissioner shall submit a report to the chairs and ranking minority members of the legislative committees with jurisdiction over the Department of Health with specific details about statutes and rules delayed, waived, or modified as authorized in subdivision 2. Subd. 7. Expiration. This section expires 60 days after the peacetime emergency specified in subdivision 1 is terminated or rescinded by proper authority. EFFECTIVE DATE. This section is effective retroactively from March 13, 2020.

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COVID-19 RELATED FUNDING

Patient’s residence added to telemedicine as originating site 2020 Regular Session SF4334/HF3980 Chapter 70, Article 3 COVID-19 funding bill Effective: March 18, 2020 (day following enactment) Short description Telemedicine services coverage is also expanded. Summary In response to the COVID-19 epidemic, the coverage of telemedicine services is expanded to include a patient’s residence. This temporary change to statute expires on February 1, 2021. Implications The language includes the patient’s residence in the originating site definition. Furthermore, a health carrier shall not exclude or reduce coverage for a healthcare service or consultation solely because the service or consultation is provided via telemedicine directly to a patient at the patient's residence. Bill language Chapter 70, Article 3: https://www.revisor.mn.gov/laws/2020/0/Session+Law/Chapter/70/ Section 1. COVERAGE OF TELEMEDICINE SERVICES PROVIDED DIRECTLY TO A PATIENT AT THE PATIENT'S RESIDENCE; RESPONSE TO COVID-19. (a) The definition of "originating site" under Minnesota Statutes, section 62A.671, subdivision 7, includes a patient's residence if the patient is receiving health care services or consultations by means of telemedicine. (b) The definition of "telemedicine" under Minnesota Statutes, section 62A.671, subdivision 9, includes health care services or consultations delivered to a patient at the patient's residence. (c) Under Minnesota Statutes, section 62A.672, subdivision 2, a health carrier shall not exclude or reduce coverage for a health care service or consultation solely because the service or consultation is provided via telemedicine directly to a patient at the patient's residence.

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(d) "Telemedicine" as defined in Minnesota Statutes, section 256B.0625, subdivision 3b, paragraph (d), includes the delivery of health care services or consultations with a patient at the patient's residence and the licensed health care provider at a distant site. (e) This section expires February 1, 2021. EFFECTIVE DATE. This section is effective the day following final enactment.

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Funding for the disaster contingency account 2020 Regular Session SF3564/HF3633 Chapter 68 COVID-19 funding bill Effective: March 18, 2020 (day following enactment) Short description COVID-19 funding appropriated to the disaster contingency account. Summary With the arrival of the COVID-19 pandemic in Minnesota, the legislature authorized a transfer of $30 million in fiscal year 2020 from the general fund to the disaster assistance contingency account. The funding is administered by the commissioner of public safety. Implications Minnesota statutes, section 12.221, subdivision 6 directs the commissioner of public safety to use the fund for the following: •

Cost-share for federal assistance publicly owned capital improvement projects

•

State public disaster assistance to eligible county, city, and other jurisdictions

•

Cost-share for federal assistance from the Federal Highway Administration emergency relief program

•

Cost-share for federal assistance from the United States Department of Agriculture, Natural Resources Conservation Service emergency watershed protection program

Bill language Chapter 68: https://www.revisor.mn.gov/laws/2020/0/Session+Law/Chapter/68/

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COVID-19 Health Care Response Fund created 2020 Regular Session SF4334/HF3980 Chapter 70, Articles 1 & 2 COVID-19 funding bill Effective: March 18, 2020 (day following enactment) Short description COVID-19 funding is transferred to the Public Health Response Contingency Account to create the Health Care Response Fund and Provider Grant Loan program establishment. Summary A total of $200 million was appropriated to the Health Care Response Fund. The $200 million was used to establish the following: •

$50 million was directed to establish the COVID-19 Response Grant for Short-Term Emergency Funding—These grants were to provide cash flow relief to healthcare organizations to cover their highest priority needs and dispersed as quickly as possible

•

$150 million was allocated to the COVID-19 Health Care Response Grant fund, which was constructed to cover costs related to planning for, preparing for, or responding to the COVID-19 outbreak—This appropriation had had several constraints on the use of the funding, included oversight by the Legislative Advisory Commission of grants exceeding $1 million and the use of specific RFP process for the grants

Providers eligible for applying included the following: •

Ambulance services

•

Healthcare clinics

•

Pharmacies

•

Healthcare facilities and long-term care facilities, including but not limited to hospitals, nursing facilities, and assisted living settings

•

Health systems

Allowable uses by the provider of the grant funding included: •

Establishment and operation of temporary sites to provide testing services

•

Conversion of space for another purpose

•

Staff overtime, hiring additional staff, training, and orientation

•

Consumable protective or treatment supplies, equipment to protect or treat staff, visitors, and patients

•

Development and implementation of screening and testing procedures

•

Patient outreach activities

•

Additional emergency transportation of patients

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•

Temporary information technology and systems costs to support patient triage, screening, and telemedicine activities

•

Replacement parts or filters for medical equipment

•

Specialty cleaning supplies for facilities and equipment

•

Expenses related to the isolation or quarantine of staff

•

Other expenses that, in the judgment of the commissioner, cannot reasonably be expected to generate income for the recipient of the funds after the outbreak ends

Implications The first $50 million was distributed by mid-April. The remaining $150 million continued to be dispersed to applicants, and as of June 2, 2020, $97.6 million in emergency healthcare grants was distributed to about 360 provider organizations. Importantly, these grants fund were for several months, the sole source of emergency funding from the State of Minnesota for assisted living and other home and communitybased settings (HCBS). Indeed, a review of the list of grantees displays a high number of assisted living and HCBS settings (https://bit.ly/3epJlQW). As a condition of accepting a grant, providers must agree to several conditions: •

An eligible provider that screens or tests a patient for COVID-19 or provides healthcare services to a patient to treat COVID-19 must agree not to bill uninsured patients for the cost of the screening, testing, or treatment

•

An eligible provider that screens or tests a patient for COVID-19 or provides healthcare services to a patient to treat COVID-19 and does not participate in the network of the patient's health plan must: o o

agree to accept the median network rate as payment in full for the screening, testing, or treatment provided to the patient; and agree not to bill the patient any amount in excess of the cost-sharing that would apply if the provider was in-network, for the screening, testing, or treatment provided to the patient

The above applies to screening, testing, and treatment services related to COVID-19 provided on or before February 1, 2021. Providers receiving funding assistance from other non-state sources must report these to the Minnesota Department of Health (MDH). If MDH determines that the sum of the MDH grants and the non-state funding exceed the costs related to COVID-19, the provider will need return the amount that exceeds the costs, up to the amount of funding provided by MDH.

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Finally, in cases where MDH funding was not used for intended purpose, MDH may terminate and recoup the funding. Bill language Chapter 70, Articles 1 & 2: https://www.revisor.mn.gov/laws/2020/0/Session+Law/Chapter/70/

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COVID-19 Minnesota Fund established & many other policy changes 2020 Regular Session SF4451/HF4531 Chapter 71 COVID-19 funding Effective: March 29, 2020 (day following enactment) Short description This language establishes a temporary $200 million COVID-19 Minnesota fund and appropriates additional money to several programs for COVID-19 response. Summary The bill contains a few funding and policy provisions intended to bolster Minnesota’s COVID-19 response, including the following: •

COVID-19 Minnesota fund o

•

Creates a new $200 million fund in the state treasury for expenditures related to a COVID-19 peacetime emergency declared by Governor Tim Walz

Housing support rates o

Provides a $5.53 million general fund appropriation in fiscal year 2020 to the commissioner of human services to increase certain housing support rates by 15 percent for three consecutive months for purposes of maintaining access to room and board, including activities necessary to comply with federal and state health and safety guidance in response to the COVID-19 pandemic

•

Homeless and emergency shelters o

Provides a $26.537 million general fund appropriation in fiscal year 2020 to the commissioner of human services for emergency services grants to provide homeless persons essential services and emergency shelter in response to COVID-19

•

Specifies activities for which the money may be used

Waives the one-week waiting period for an applicant to start receiving

Temporary suspension of one-week waiting period unemployment insurance benefits for benefit accounts established between March 1, 2020, and December 31, 2020, so payments may start immediately

•

Temporary suspension of five-week business owner benefit limitation o

For unemployment insurance benefit accounts established between March 1, 2020, and December 31, 2020, suspends the five-week limitation on business owners, so business owners may be eligible for more than five weeks of benefits during COVID-19 pandemic

•

Delayed submission of fingerprints authorized

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Authorizes the superintendent of the Bureau of Criminal Apprehension to delay submission of fingerprints as part of background checks for “essential workers” during peacetime emergencies declared by the governor

Provides a gross misdemeanor penalty for “essential workers” who provide false information as part of a background check while the fingerprint requirement is suspended

Requires the superintendent to report to the legislature on the exercise of this emergency power

Additional changes include the following: •

Issue drivers’ license and identification cards

•

Award of childcare grants

•

Financial assistance to military veterans or their surviving spouses

Implications Prior to October 1, 2020, providers receiving additional Housing Supports funding must submit documentation demonstrating increased funding was used for needs related to COVID-19 for the time period from March 1, 2020, through May 31, 2020. Bill language Chapter 71: https://www.revisor.mn.gov/laws/2020/0/Session+Law/Chapter/71/

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Retroactive Medicaid health plan eligibility codified 2020 Regular Session SF13/HF2715 Chapter 115, Article 3, Section 18, Subdivision 7 Health & Human Services omnibus bill Effective: May 28, 2020 (day following enactment) Short description Beneficiaries may request up to three months of retroactive coverage when their eligibility is determined for Medical Assistance. Summary The bill codifies current practice allowing Medicaid beneficiaries to request up to three months of retroactive health plan coverage when eligibility is determined. Implications None. Bill language Chapter 115, Article 3, Section 18, Subdivision 7: https://www.revisor.mn.gov/laws/2020/0/Session+Law/Chapter/115/ Sec. 18. Minnesota Statutes 2018, section 256B.056, subdivision 7, is amended to read: Subd. 7. Period of eligibility. (a) Eligibility is available for the month of application and for three months prior to application if the person was eligible in those prior months. A redetermination of eligibility must occur every 12 months. (b) For a person eligible for an insurance affordability program as defined in section 256B.02, subdivision 19, who reports a change that makes the person eligible for medical assistance, eligibility is available for the month the change was reported and for three months prior to the month the change was reported, if the person was eligible in those prior months. EFFECTIVE DATE. This section is effective the day following final enactment.

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WORKFORCE

Occupational disease workers’ compensation 2020 Regular Session HF4537/SF4458 Chapter 72, Section 1, Subd 15 Effective: April 7, 2020 Short description Includes COVID-19 as an occupational disease for certain groups of employees. Summary Addresses workers’ compensation claims for employees who contract COVID-19 during their duties as healthcare workers—including nurses, healthcare providers, paramedics, emergency medical technicians, police officers, and firefighters, or assistive employees employed in healthcare, home care or long-term care setting with direct COVID-19 patient care or ancillary work in COVID-19 patient units. Such workers will be eligible for workers’ compensation benefits without having to provide proof that they contracted COVID-19 from a particular patient on a particular day. But, to receive compensation, the employee’s condition would have to be confirmed by a positive laboratory test or the diagnosis of a physician, physician’s assistant or nurse, based upon the employee’s symptoms. The legislation sunsets on May 1, 2021. Provides commissioner of labor and industry authority to extend the target date for implementation of a new workers’ compensation data management system for 60 days beyond the original August 31, 2020, target date. Visit the Minnesota Department of Labor FAQ webpage for additional information: http://www.dli.mn.gov/updates. Implications Employees in long-term care settings, including home care, are affected by this bill. Employers should review language and adjust their workers’ compensation tracking processes as needed to reflect presumptive coverage for COVID-19. Bill language Chapter 72: https://www.revisor.mn.gov/laws/2020/0/Session+Law/Chapter/72/

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Health occupations—Occupational therapy 2020 Regular Session SF2939/HF3028 Chapter 79, Article 2 Effective: August 1, 2020 Short description Technical and housekeeping changes to simplify and reorganize sections and modernize language pertaining to occupational therapy. Summary Changes and improvements were made to language; scope of practice; licensure renewal and temporary licensure; delegation of duties; and continuing education requirements. Expanded scope of practice for occupational therapy to include the current list, plus the following: 1)

Functional performance and work participation skills

2) Community mobility 3) Health and wellness 4) Further expansion by using the terms “including but not limited to” and 5) Adding the requirement that occupational therapy services must be based on nationally established standards of practice Implications Employers should look at the expansions in the scope of practice (section 6) and potentially licensure, for credentialing purposes, if applicable. Bill language Chapter 79, Article 2: https://www.revisor.mn.gov/laws/2020/0/Session+Law/Chapter/79/

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Health occupationsâ&#x20AC;&#x201D;Social workers 2020 Regular Session SF2939/HF3028 Chapter 79, Article 3 Effective: August 1, 2020 Short description Technical and housekeeping changes to simplify and reorganize language and sections pertaining to social workers. Changes and improvements were made to applications and licensing; continuing education; board member qualifications; comprehensive housekeeping; and technical changes. Summary Some of the key changes for social workers include the following: 1)

Current: If applicant fails exam three times, they must submit two letters of recommendation and a letter explaining efforts to improve score, BOSW must approve that the applicant is able to re-take a. Change: Eliminate these requirements and allow applicant to take exam again without additional documentation

2) Current: There is no language about when students applying for licensure may take the ASWB exam (in conflict with ASWBâ&#x20AC;&#x2122;s requirement that students be approved for the exam no earlier than 6 months before graduation) a. Change: Specify that students may take the exam no more than six months prior to graduation to comply with ASWB exam policy 3) Current: Applicants required up to 90 hours of the 360 academic clinical clock hours required may be completed through CE a. Change: Up to 120 hours of the 360 academic clinical clock hours required may be completed through CE 4) Current: 20 of 90 hours of CE for 360 academic clinical clock hour requirement may be completed through independent study a. Change: All 120 hours of CE for 360 academic clinical clock hour requirement may be completed through independent learning 5) Current: Post-test required for clinical clock hours completed through CE a. Change: Eliminate post-test requirement for clinical clock hours completed through CE 6) Current: Applicants for licensure by endorsement must: 1) hold current social work license in another jurisdiction; 2) hold an accredited social work degree; 3) have passed the ASWB exam; and 4) document supervised practice for LISW and LICSW license a. Change: Applicants for licensure by endorsement must: 1) hold a current social work license in good standing in another jurisdiction; based on substantially equivalent education and examination requirements across

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jurisdictions; no documentation of supervised practice required for LISW and LICSW applicants 7) Current: Applicants for licensure by endorsement for LSW or LGSW in nonclinical practice must either document past supervised practice which meets Minnesota requirements or complete supervised practice once Minnesota license issued a. Change: Applicants for licensure by endorsement for LSW or LGSW in nonclinical practice not required to complete supervised practice if they have practiced for at least 4,000 hours while licensed in another jurisdiction within the last four years For temporary licenses 1)

Current: CE completed under temporary license not required or applicable to permanent license CE requirements a. Change: CE completed under temporary license (not required) may be applied to permanent license CE requirements

2) Current: Temporary license holders must verify supervised practice before permanent license issued a. Change: Temporary license holders must comply with supervised practice requirements for permanent license 3) Current: Temporary license for persons licensed in another jurisdiction includes “emergency situation” language and limits temporary licensure to a one-time, six-month period a. Change: Eliminate “emergency situation” language and allow temporary license for a six-month period up to once per year 4) Current: Temporary license for visiting teachers whose permanent residence is outside the US and teach in an academic institution for 12 months or less a. Change: Repeal visiting teacher temporary license to eliminate unnecessary residency-based restriction and different licensing standards for educators Continuing education 1)

Current: LICSWs must complete at least 24 CE clock hours in clinical content per 2-year renewal term a. Change: LICSWs must complete at least 12 clock hours in clinical content per two-year renewal term

2) Current: Up to 15 hours of required CE hours may be completed via independent study per twp-year renewal term a. Change: Up to 50% of required CE hours may be completed via independent study per two-year renewal term

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3) Current: No definition of continuing education, clock hour, continuing education independent learning, or continuing education social work ethics included in Minnesota Statutes section 148E.010 a. Change: Add definitions of continuing education, clock hour, continuing education independent learning, and continuing education social work ethics to Minnesota Statutes section 148E.010; include cultural awareness and social diversity in definition of continuing education social work ethics. Implications Prospective social workers should look at various changes to licensure pathways. Current licensees and employers should review the license renewal and expiration language changes. Bill language Chapter 79, Article 3: https://www.revisor.mn.gov/laws/2020/0/Session+Law/Chapter/79/ The Board of Social Work has issued preliminary guidance (https://bit.ly/2YNLnEA). Expect updates to the guidance in the months to come.

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2020 LEGISLATIVE UPDATE

Advanced practice registered nurses (APRNs) 2020 Regular Session Chapter 115, Article 4, multiple sections SF13/HF2715 Health & Human Services omnibus bill Effective: Various Short description Changes to expand APRNs scope of practice. In Minnesota statutes, physicians are specifically given certain rights, duties, and protections and the authority to perform certain acts. This bill adds advanced practice registered nurses (APRNs) to many of those statutes, or gives the rights, duties, and authority in statutes to health care providers which includes APRNs. Summary There were various statutory sections and subjects of the statutes amended in this bill. In each section, the bill adds APRN, APRN clinic, a specific type of APRN, or a healthcare provider that includes an APRN, to existing language that gives physicians certain rights, duties, and protections, or authority to perform certain acts. In a few instances, the term APRN replaces the term nurse practitioner. Advanced practice nurses are now allowed to do the following: •

Refer resident of a healthcare facility to that facility’s skilled nursing unit or an appropriate care setting

•

Nursing facility admission contract; consent to treatment clause

•

Authorize use of restraints

•

Provide documentation for the need for hospitalization, should it occur prior to resolution of a discharge appeal

•

Long-term care insurance; additional standards for benefit triggers

•

Commissioner of health authorized to take action against facility license for certain conduct by facility employees

•

Healthcare bill of rights for patients and residents of certain facilities; provider identity, relationship with other health services, information about treatment, participation in planning treatment, right to refuse care, freedom from maltreatment, isolation and restraints, exception to compliance with healthcare bill of rights in emergencies

•

Appeal of transfer or discharge of a resident of a nursing facility or boarding care home

•

Nursing facility or boarding care home resident relocation requirements

•

Hospice provider licensing

•

Living wills; decision to administer, withdraw, or withhold medical treatment

•

Healthcare directives

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•

Occupational therapy; prior authorization

•

DHS background study requirements; definition of serious maltreatment, background studies for licensed programs

•

Home and community-based services requirements; definition of incident, health and welfare policies, telephone and posted numbers, special dietary needs

•

Board on aging: preadmission screening to Medicare-certified nursing facility, regional and local dementia grants

•

Level of need determination for nonemergency medical transportation

•

MA coverage of home care nursing services; definition of home care nursing, requirements for use of home care nursing, shared home care nursing option, hardship criteria

•

Nursing facility rate adjustment for private room for medical necessity

•

Payment for and use of therapy services in a nursing facility, certification of appropriateness of treatment

Implications Facilities should review APRNs scope of practice with their medical director and clinical teams. Bill language Chapter 115, Article 4: https://www.revisor.mn.gov/laws/2020/0/Session+Law/Chapter/115/

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GUARDIANSHIP/ FINANCIAL EXPLOITATION

Guardianship changes 2020 Regular Session SF3357/HF3517 Chapter 86 Effective: August 1, 2020 Short description This bill made policy, technical, and conforming changes to law related to guardianships, minor trusts, common interest ownerships, and garnishment. The bill makes changes to guardianship and conservatorship laws, including the following: •

Modifies the right to communication and related duties under the Bill of Rights

•

Creates a new form, bill of particulars, that contains confidential information related to a personal health and finances

•

Requires the court to consider and make specific findings related to less restrictive means of assisting a person subject to guardianship or conservatorship, like supported decision making, before appointing a guardian or conservator

•

Requires notice to interested persons when the person subject to guardianship experiences a significant medical or public safety event, or dies

•

Authorizes the establishment and administration of an ABLE account

•

Authorizes a conservator to institute cases for civil court actions

•

Authorizes a person subject to conservatorship to control their own wages

•

Authorizes a guardian or conservator to seek a restraining order on behalf of a victim who is a person subject to guardianship or conservatorship

•

Requires durational limits on guardianships when the person subject to guardianship is under the age of 30, but authorizes a petition for an unlimited guardianship if the person is 29 and currently under a limited guardianship

•

Places durational limits on emergency guardianships and conservatorships

•

Authorizes interested persons to waive notice requirements

Summary The modernization of Minnesota’s guardianship and conservatorship statutes did a number of technical and some substantive changes to the statutes controlling guardianship and conservatorship: •

The changes begin by allowing a court to order parties in a guardianship or conservatorship case to mediate; previously, mediation and alternative dispute resolution was not allowed

•

Makes various federal conforming changes related to ABLE accounts and federal tax gifting allowances

•

The law made several changes to definitions: o

Adds adult step children and tribal chairman/agent to definition of

Codifies a definition of interested party consistent with Minnesota case law

“interested person”

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Adds a definition of supported decision making—Supported decision making means “assistance from one or more persons of an individual's choosing in understanding the nature and consequences of potential personal and financial decisions which enables the individual to make the decisions and, when consistent with the individual's wishes, in communicating a decision once made”

o •

•

Incorporates person-first language by changing the terms ward and protected person to “person subject to guardianship or conservatorship”

Changes to notice provisions: o

Ensures that a bond company involved in the case receives notice of actions

Allows interested persons or the court to waive right of interested persons

that relate to potential claims on the bond to receive notices so as to reduce administrative costs

Modernizes and updates several areas of the protected persons’ bill of rights o

Modifies right to communication and visitation to include the right to interact with others, make telephone calls, use email and social media, and participate in social activities unless the guardian has good cause to believe restriction is necessary because interaction with the person poses a risk of significant harm and there is no other means to avoid the significant harm

Requires guardian to provide written notice of any restriction on communication and interaction to the court, to the person subject to guardianship, and to the person subject to restrictions

o •

Authorizes the person subject to the guardianship or the person subject to the restriction to petition the court to remove or modify the restrictions

Enhanced privacy protections: o

Creates bill of particulars so that parties can file private financial and medical information confidentially 

Directs parties to file certain documents with private financial and medical information with the bill of particulars

Clarifies that a respondent to any guardianship petition and any person subject to guardianship in any other guardianship proceeding has not placed his or her health, physical, or mental condition in controversy 

Any denials, allegations or affirmative assertions by the respondent or person subject to guardianship regarding capacity do not place these matters in controversy



This means a petitioner or other party must put forward evidence related to the respondent’s capacity in order for the issue to be under consideration/controversy

•

For cases filed on or after August 1, 2020: o

Requires the petitioner to explain what less restrictive alternatives have been attempted, for how long, and why they are not sufficient to meet the needs

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

Requires the court to make specific findings about what less restrictive alternatives were attempted and why they were not sufficient

•

For cases filed before August 1, 2020: o

•

Current standards and requirements regarding the petition, proceedings, and any guardianship or conservatorship order remain in effect

Creates limited guardianships (of up to 6 years) for persons under the age of 30 o

If a person is under the age of 30 when a guardianship established, the

A new petition can be filed at that time if it is still believed the person is

guardianship will end after 6 years (or sooner if ordered by the court) incapacitated and no less restrictive alternatives will work

Clarifies that any guardianship or conservatorship order can be of time-limited duration

•

Clarifies that emergency guardianships are temporary, can only last for 60 days, and can only be renewed once

•

Clarifies that a guardian has the right to petition for discharge from the guardianship

•

Clarifies that bonds are required for estates larger than 1,000,000 and that trust companies cannot only rely on their other legal insurance requirements to cover the assets of the estate

•

Clarifies that guardians have standing to bring various civil claims on behalf of the person under guardianship

•

Clarifies that conservators are included in the definition of “victim” for purposes of receiving restitution from criminal cases

•

Changes to all guardians’ responsibilities: o

Heightens the standard under which a guardian can restrict a person under guardianship’s access to visitors. A guardian can only restrict access (including face to face, phone, electronic, or other forms of communication) only when there is a risk of significant harm and no other alternatives to preventing the risk exist 

The guardian must give notice of the restriction to the person under guardianship and the person who is being restricted



The person under guardianship can petition the court to remove or modify the restrictions

Clarifies that guardian can delegate authority to another party for 30 days Requires guardians to inform certain interested persons (including relatives) if the person under guardianship: has an unexpected change in health or medical condition requiring physician treatment or hospitalization; a significant situation that requires action by ambulance, law enforcement, or fire department; or has a permanent change in his or her primary dwelling

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Implications Although many of the changes were intended to modernize and included technical changes to the statutes, if you have persons under guardianship or conservatorship, you should be aware of the changes. Bill language Chapter 86: https://www.revisor.mn.gov/laws/2020/0/Session+Law/Chapter/86/

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Financial exploitation of vulnerable adults 2020 Regular Session SF2466/HF2475 Chapter 85 Effective: August 1, 2020 Short description This modifies provisions governing financial exploitation of vulnerable adults. Summary The bill introduced a definition of financial services provider that applies to: 1.

a bank, bank and trust, trust company with banking powers, savings bank, savings association, or credit union organized under the laws of Minnesota, any other state, or the United States;

2. an industrial loan and thrift under chapter 53; or 3. a regulated lender under chapter 56. The change further allows that if a financial services provider reasonably believes that financial exploitation of an eligible adult may have occurred, may have been attempted, or is being attempted, the financial services provider may promptly notify the common entry point. The bill provided immunity to financial services providers or an employee of a financial services provider who, in good faith, makes a disclosure of information regarding a report of potential financial exploitation, cooperates with a civil or criminal investigation of financial exploitation of an eligible adult, or testifies about alleged financial exploitation of an eligible adult in a judicial or administrative proceeding is immune from administrative, civil, or criminal liability that might otherwise arise from the disclosure or testimony or for failure to notify the customer of the disclosure or testimony. The bill further allows a financial services provider to inform third parties of potential financial exploitation and provides immunity for such a good faith disclosure. The law allows a financial services provider to delay disbursements or place holds on transactions subject to some time constraints and provides appeal rights and process for the subject of the holds if the individual desires to appeal the hold. The law also provides immunity for delaying the disbursement, provided the delay was in good faith. Implications With the variety of ways that individuals attempt financial exploitation of vulnerable adults, this change adds a few more ways in which financial services providers may take steps to help prevent financial exploitation of vulnerable adults.

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Bill language Chapter 85: https://www.revisor.mn.gov/laws/2020/0/Session+Law/Chapter/85/

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OTHER

Medical cannabis 2020 Regular Session SF13/HF2715 Chapter 115, Article 1, Section 16 Health & Human Services omnibus bill Effective: Day following final enactment Short description The legislature acted to override the intention of the commissioner of health to add agerelated macular degeneration as a qualifying condition under Minnesota medical cannabis laws. Summary The commissioner of health notified the legislature that the commissioner intended to add age-related macular degeneration as a qualifying medical condition to the medical cannabis program under Minnesota statutes, section 152.22, subdivision 14. The statute allows the legislature to provide otherwise during a legislative session. In this case, the legislature acted to specifically state that age-related macular degeneration will not be a qualifying condition under the Minnesota medical cannabis statutes. Implications Age-related macular degeneration will not be added as a qualifying medical condition under the Minnesota medical cannabis laws. Bill language Chapter 115, Article 1, Section 16: https://www.revisor.mn.gov/laws/2020/0/Session+Law/Chapter/115/ Sec. 16. AGE-RELATED MACULAR DEGENERATION; QUALIFYING MEDICAL CONDITION. (a) In accordance with Minnesota Statutes, section 152.27, subdivision 2, paragraph (b), the commissioner of health notified the legislature that the commissioner intends to add age-related macular degeneration as a qualifying medical condition to the medical cannabis program under Minnesota Statutes, section 152.22, subdivision 14. (b) Minnesota Statutes, section 152. 27, subdivision 2, paragraph (b), specifies that the proposed qualifying medical condition is added effective August 1 unless the legislature by law provides otherwise.

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(c) The legislature hereby states that age-related macular degeneration shall not be added as a qualifying medical condition under Minnesota Statutes, section 152.22, subdivision 14. EFFECTIVE DATE. This section is effective the day following final enactment.

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Medical records change 2020 Regular Session SF13/HF2715 Chapter 115, Article 1, Section 10, Subdivision 2; and Section 11, Subdivision 5 Health & Human Services omnibus bill Effective: Day following final enactment Short description As part of a larger policy bill, with various provisions applicable to healthcare in general, the legislature amended the requirements of providing copies of health records to patients. The change specifies that records must be furnished within thirty calendar days of receiving the written request, rather than â&#x20AC;&#x153;promptly.â&#x20AC;? Implications When you receive written requests for health records of your patients, you must furnish the records within 30 calendar day of receiving the request. Bill language Chapter 115, Article 1, Section 10, Subdivision 2; and Section 11, Subdivision 5: https://www.revisor.mn.gov/laws/2020/0/Session+Law/Chapter/115/. Sec. 10. Minnesota Statutes 2018, section 144.292, subdivision 2, is amended to read: Subd. 2. Patient access. Upon request, a provider shall supply to a patient within 30 calendar days of receiving a written request for medical records complete and current information possessed by that provider concerning any diagnosis, treatment, and prognosis of the patient in terms and language the patient can reasonably be expected to understand. Sec. 11. Minnesota Statutes 2018, section 144.292, subdivision 5, is amended to read: Subd. 5. Copies of health records to patients. Except as provided in section 144.296, upon a patient's written request, a provider, at a reasonable cost to the patient, shall promptly furnish to the patient within 30 calendar days of receiving a written request for medical records: (1) copies of the patient's health record, including but not limited to laboratory reports, x-rays, prescriptions, and other technical information used in assessing the patient's health conditions; or (2) the pertinent portion of the record relating to a condition specified by the patient.

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With the consent of the patient, the provider may instead furnish only a summary of the record. The provider may exclude from the health record written speculations about the patient's health condition, except that all information necessary for the patient's informed consent must be provided.

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Public Employees Retirement Association (PERA) changes 2020 Regular Session SF3808/HF3903 Chapter 108, Article 3 Effective: July 1, 2020 Short description The legislature periodically updates the PERA statutes to changes taking place. This year, there were a number of proposed changes that ultimately boiled down to clarifying definitions and creating a new augmentation rate. Summary The law changed the definitions of executive director, medical facility, and privatization. Further changes amended the augmentation rate of 2% compounded annually after December 31, 2023. Finally, the change clarified the exceptions for privatized former public employees. Implications If your privatized “medical facility” is covered by PERA laws, you will need to adjust your new augmentation rate of 2% compounded annually, after December 31, 2023. Bill language Chapter 108, Article 3: https://www.revisor.mn.gov/laws/2020/0/Session+Law/Chapter/108/. ARTICLE 3: MODIFICATIONS TO PERA PROVISIONS RELATING TO PRIVATIZATION OF MEDICAL FACILITIES Section 1. Minnesota Statutes 2018, section 353F.02, is amended by adding a subdivision to read: Subd. 3a. Executive director. "Executive director" means the executive director of the Public Employees Retirement Association. EFFECTIVE DATE. This section is effective July 1, 2020. Sec. 2. Minnesota Statutes 2018, section 353F.02, is amended by adding a subdivision to read: Subd. 4a. Medical facility. "Medical facility" means a facility that has the primary purpose of providing medical care and that satisfies the definition of governmental subdivision under section 353.01, subdivision 6.

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EFFECTIVE DATE. This section is effective July 1, 2020. Sec. 3. Minnesota Statutes 2018, section 353F.02, is amended by adding a subdivision to read: Subd. 4b. Privatization. "Privatization" means a medical facility that privatizes when the facility ceases to be a governmental subdivision for any reason other than that the medical facility closes or permanently ceases to operate. EFFECTIVE DATE. This section is effective July 1, 2020. Sec. 4. Minnesota Statutes 2018, section 353F.04, is amended to read: 353F.04 AUGMENTATION INTEREST RATES FOR PRIVATIZED FORMER PUBLIC EMPLOYEES. Subdivision 1. Enhanced augmentation rates. (a) The deferred annuity of a privatized former public employee is subject to augmentation under section 353.71, subdivision 2, of the edition of Minnesota Statutes published in the year in which the privatization occurred 353.34, subdivision 3, except that the rate of augmentation is as specified in this subdivision section. (b) This paragraph applies if the effective date of privatization was on or before January 1, 2007, and also applies to Hutchinson Area Health Care with a privatization effective date of January 1, 2008. For a privatized former public employee, the augmentation rate is 5.5 percent compounded annually until January 1 following the year in which the person attains age 55. From After that date to the effective date of retirement, the augmentation rate is 7.5 percent compounded annually. (c) If paragraph (b) is not applicable, and if the effective date of the privatization is after January 1, 2007, and before January 1, 2011, then the augmentation rate is four percent compounded annually until January 1, following the year in which the person attains age 55. From After that date to the effective date of retirement, the augmentation rate is six percent compounded annually. (d) If the effective date of the privatization is after December 31, 2010, the applicable augmentation rate depends on the result of computations specified in section 353F.025, subdivision 1. If those computations indicate no loss or a net gain to the fund of the general employees retirement plan of the Public Employees Retirement Association, the augmentation rate is two

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percent compounded annually until the effective date of retirement. If the computations under that subdivision indicate a net loss to the fund if a two percent augmentation rate is used, but a net gain or no loss if a one percent rate is used, then the augmentation rate is one percent compounded annually until the effective date of retirement. (e) Notwithstanding paragraphs (b) to (d), after June 30, 2020, and before January 1, 2024, the augmentation rate for all privatized former public employees under paragraphs (b) to (d) is two percent compounded annually. After December 31, 2023, no additional augmentation is applied to the privatized former public employee's deferred annuity. Subd. 2. Exceptions. The increased augmentation rates specified in subdivision 1 do not apply to a privatized former public employee: (1) beginning the first of the month in which the privatized former public employee becomes covered again by a retirement plan enumerated in section 356.30, subdivision 3, if the employee accrues at least six months of credited service in any single plan enumerated in section 356.30, subdivision 3, except clause (6); (2) beginning the first of the month in which the privatized former public employee becomes covered again by the general employees retirement plan of the Public Employees Retirement Association; (3) beginning the first of the month after a privatized former public employee terminates service with the privatized former public employer; or (4) if the person privatized former public employee begins receipt of a retirement annuity while employed by the employer which assumed operations of or purchased the privatized former public employer.; or (5) if the effective date of privatization occurs after June 30, 2020. EFFECTIVE DATE. This section is effective July 1, 2020.

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FIRST SPECIAL SESSION

Physician assistant changes 2020 First Special Session HF11/SF9 Chapter 2, multiple sections Effective: Day following final enactment Short description Changes to expand the physician assistantâ&#x20AC;&#x2122;s scope. Summary Definition of home care nursing now includes physician assistants (PAs). Physician assistants are now allowed to order home care nursing services. Implications Facilities should review PA scope of practice with their medical director and clinical teams. Bill language Chapter 2: https://www.revisor.mn.gov/laws/2020/1/Session+Law/Chapter/2/

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Extending the expiration of the executive order relating to use of telemedicine 2020 First Special Session HF105/SF99 Chapter 7 Effective: Day following final enactment Short description The legislature acted to extend many of the governorâ&#x20AC;&#x2122;s executive orders. The legislation related to the expiration of the executive order relating to use of telemedicine in the state medical cannabis program; extending the expiration of certain human services program waivers and modifications issued by the commissioner of human services pursuant to executive orders during the peacetime emergency declared in response to the COVID-19 pandemic; establishing a 60-day period for the commissioner of human services to transition affected programs off of COVID-19 waivers and modifications following expiration of the peacetime emergency. Summary The legislature agreed with the executive orders and wanted to enact them to allow them to continue beyond the peacetime emergency declaration. Therefore, they took action to extend the following: (1)

CV15: allowing phone or video visits for waiver programs;

(2)

CV16: expanding access to telemedicine services for Children's Health Insurance Program, Medical Assistance, and MinnesotaCare enrollees;

(3)

CV21: allowing telemedicine alternative for school-linked mental health services and intermediate school district mental health services;

(4)

CV24: allowing phone or video use for targeted case management visits;

(5)

CV30: expanding telemedicine in health care, mental health, and substance use disorder settings;

(6)

CV31: allowing partial waiver of county cost when COVID-19 delays discharges from DHS-operated psychiatric hospitals;

(7)

CV38: allowing flexibility in housing licensing requirements;

(8)

CV43: expanding remote home and community-based services waiver services;

(9)

CV44: allowing remote delivery of adult day services;

(10)

CV45: modifying certain licensing requirements for substance use disorder treatment, except that the extension shall be limited to the portions of this modification requiring programs to become and remain familiar with Minnesota Department of Health and Centers for Disease Control and Prevention guidance on COVID-19; requiring programs to follow Minnesota Department of Health and Centers for Disease Control and Prevention guidance specific to the situation and program capabilities if a person receiving services or a staff person tests positive for COVID-19; permitting programs to temporarily suspend group counseling or limit attendance at sessions when unable to accommodate requirements for social

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distancing and community mitigation; permitting comprehensive assessments to be completed by telephone or video communication; permitting a counselor, recovery peer, or treatment coordinator to provide treatment services from their home by telephone or video communication to a client in their home; permitting programs to follow the Substance Abuse and Mental Health Services Administration guidelines as directed by the State Opioid Treatment Authority within the Department of Human Services Behavioral Health division to allow for an increased number of take-home doses in accordance with an assessment conducted under Minnesota Statutes, section 245G.22, subdivision 6; removing the requirement for opioid treatment programs to conduct outreach activities in the community; and permitting programs to document a client's verbal approval of a treatment plan instead of requiring the client's signature; (11)

CV49: modifying certain license requirements for adult day services;

(12)

CV50: modifying certain requirements for early intensive developmental and behavioral intervention (EIDBI) services;

(13)

CV53: allowing flexibility for personal care assistance service oversight, except that the portion of this modification permitting personal care assistance workers to bill 310 hours per month shall expire upon the expiration of the peacetime emergency; and

(14)

CV64: modifying certain certification requirements for mental health centers, except that the extension shall be limited to the portions of this modification requiring programs to become and remain familiar with Minnesota Department of Health and Centers for Disease Control and Prevention guidance on COVID-19; requiring programs to follow Minnesota Department of Health and Centers for Disease Control and Prevention guidance specific to the situation and program capabilities if a person receiving services or a staff person tests positive for COVID19; permitting alternative mental health professional supervision of clinical services at satellite locations; permitting an alternative process for case consultation meetings; and permitting mental health professionals to provide required clientspecific supervisory contact by telephone or video communication instead of faceto-face supervision.

Implications The telemedicine and other waivers outlined that were enacted by executive order will continue. Bill language Chapter 7: https://www.revisor.mn.gov/laws/2020/1/Session+Law/Chapter/7/ Section 1. COMMISSIONER OF HUMAN SERVICES; EXTENSION OF COVID-19 HUMAN SERVICES PROGRAM WAIVERS AND MODIFICATIONS.

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Subdivision 1. Waivers and modifications; federal funding extension. When the peacetime emergency declared by the governor in response to the COVID-19 outbreak expires, is terminated, or is rescinded by the proper authority, the following waivers and modifications to human services programs issued by the commissioner of human services pursuant to Executive Orders 20-11 and 20-12 that are required to comply with federal law may remain in effect for the time period set out in applicable federal law or for the time period set out in any applicable federally approved waiver or state plan amendment, whichever is later: (1) CV17: preserving health care coverage for Medical Assistance and MinnesotaCare; (2) CV18: implementation of federal changes to the Supplemental Nutrition Assistance Program; (3) CV20: eliminating cost-sharing for COVID-19 diagnosis and treatment; (4) CV37: implementation of federal changes to the Supplemental Nutrition Assistance Program; (5) CV39: implementation of federal changes to the Supplemental Nutrition Assistance Program; (6) CV59: modifying eligibility period for the federally funded Refugee Cash Assistance Program; and (7) CV60: modifying eligibility period for the federally funded Refugee Social Services Program. Subd. 2. Waivers and modifications; extension to June 30, 2021. When the peacetime emergency declared by the governor in response to the COVID-19 outbreak expires, is terminated, or is rescinded by the proper authority, the following waivers and modifications to human services programs issued by the commissioner of human services pursuant to Executive Orders 20-11 and 20-12, including any amendments to the waivers or modifications issued before the peacetime emergency expires, shall remain in effect until June 30, 2021, unless necessary federal approval is not received at any time for a waiver or modification: (1) CV15: allowing phone or video visits for waiver programs; (2) CV16: expanding access to telemedicine services for Children's Health Insurance Program, Medical Assistance, and MinnesotaCare enrollees;

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(3) CV21: allowing telemedicine alternative for school-linked mental health services and intermediate school district mental health services; (4) CV24: allowing phone or video use for targeted case management visits; (5) CV30: expanding telemedicine in health care, mental health, and substance use disorder settings; (6) CV31: allowing partial waiver of county cost when COVID-19 delays discharges from DHS-operated psychiatric hospitals; (7) CV38: allowing flexibility in housing licensing requirements; (8) CV43: expanding remote home and community-based services waiver services; (9) CV44: allowing remote delivery of adult day services; (10) CV45: modifying certain licensing requirements for substance use disorder treatment, except that the extension shall be limited to the portions of this modification requiring programs to become and remain familiar with Minnesota Department of Health and Centers for Disease Control and Prevention guidance on COVID-19; requiring programs to follow Minnesota Department of Health and Centers for Disease Control and Prevention guidance specific to the situation and program capabilities if a person receiving services or a staff person tests positive for COVID-19; permitting programs to temporarily suspend group counseling or limit attendance at sessions when unable to accommodate requirements for social distancing and community mitigation; permitting comprehensive assessments to be completed by telephone or video communication; permitting a counselor, recovery peer, or treatment coordinator to provide treatment services from their home by telephone or video communication to a client in their home; permitting programs to follow the Substance Abuse and Mental Health Services Administration guidelines as directed by the State Opioid Treatment Authority within the Department of Human Services Behavioral Health division to allow for an increased number of take-home doses in accordance with an assessment conducted under Minnesota Statutes, section 245G.22, subdivision 6; removing the requirement for opioid treatment programs to conduct outreach activities in the community; and permitting programs to document a client's verbal approval of a treatment plan instead of requiring the client's signature;

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(11) CV49: modifying certain license requirements for adult day services; (12) CV50: modifying certain requirements for early intensive developmental and behavioral intervention (EIDBI) services; (13) CV53: allowing flexibility for personal care assistance service oversight, except that the portion of this modification permitting personal care assistance workers to bill 310 hours per month shall expire upon the expiration of the peacetime emergency; and (14) CV64: modifying certain certification requirements for mental health centers, except that the extension shall be limited to the portions of this modification requiring programs to become and remain familiar with Minnesota Department of Health and Centers for Disease Control and Prevention guidance on COVID-19; requiring programs to follow Minnesota Department of Health and Centers for Disease Control and Prevention guidance specific to the situation and program capabilities if a person receiving services or a staff person tests positive for COVID-19; permitting alternative mental health professional supervision of clinical services at satellite locations; permitting an alternative process for case consultation meetings; and permitting mental health professionals to provide required client-specific supervisory contact by telephone or video communication instead of face-to-face supervision. Subd. 3. Waivers and modifications; 60-day transition period. When the peacetime emergency declared by the governor in response to the COVID-19 outbreak expires, is terminated, or is rescinded by the proper authority, all waivers or modifications issued by the commissioner of human services in response to the COVID-19 outbreak that have not been extended as provided in subdivisions 1, 2, and 4 of this section may remain in effect for no more than 60 days, only for purposes of transitioning affected programs back to operating without the waivers or modifications in place. Subd. 4. Modification; extension to December 30, 2020. When the peacetime emergency declared by the governor in response to the COVID-19 outbreak expires, is terminated, or is rescinded by the proper authority, the modification in CV27: allowing exemption for temporary absence policy in housing support, issued by the commissioner of human services pursuant to Executive Orders 20-11 and 2012, and including any amendments to the modification issued before the peacetime emergency expires, shall remain in effect until December 30, 2020. EFFECTIVE DATE. This section is effective the day following final enactment.

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Sec. 2. EXTENSION OF MEDICAL CANNABIS PROGRAM TELEMEDICINE FLEXIBILITIES. When the peacetime emergency declared by the governor in response to the COVID-19 outbreak expires, is terminated, or is rescinded by the proper authority, the provisions in Executive Order 20-26 authorizing the use of telemedicine in the medical cannabis program to conduct patient assessments to certify patient qualifying medical conditions, and to perform consultations between patients or caregivers and manufacturer employees licensed as pharmacists before the distribution of medical cannabis, shall remain in effect until June 30, 2021. EFFECTIVE DATE. This section is effective the day following final enactment. Sec. 3. APPROPRIATION; HOUSING SUPPORT TEMPORARY ABSENCE POLICY MODIFICATION EXTENSION. $1,135,000 in fiscal year 2021 is appropriated from the coronavirus relief federal fund to the commissioner of human services for extending the modification to the housing support temporary absence policy in section 1, subdivision 4, until December 30, 2020. This is a onetime appropriation. EFFECTIVE DATE. This section is effective the day following final enactment.

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