Minnesota State Register - Accessible_tcm36-376146.pdf · Notice of Request for Proposal (RFP) for...

Proposed, Adopted, Emergency, Expedited, Withdrawn, Vetoed Rules;Executive Orders; Appointments; Commissioners’ Orders; Revenue Notices;

Official Notices; State Grants & Loans; State Contracts; Non-State Public Bids, Contracts and Grants

Monday 18 March 2019Volume 43, Number 38

Pages 1079 - 1114

Minnesota

State RegisterPublished every Monday (Tuesday when Monday is a holiday)

Minnesota Legislative Information

Minnesota State Register Judicial Notice Shall Be Taken of Material Published in the Minnesota State Register

The Minnesota State Register is the official publication of the State of Minnesota’s Executive Branch of government, published weekly to fulfill the legislative mandate set forth in Minnesota Statutes, Chapter 14, and Minnesota Rules, Chapter 1400. It contains:• Proposed Rules • Executive Orders of the • Commissioners’ • Contracts for • Adopted Rules Governor Orders Professional, Technical • Exempt Rules • Appointments • Revenue Notices and Consulting Services• Expedited Rules • Proclamations • Official Notices • Non-State Public Bids, • Withdrawn Rules • Vetoed Rules • State Grants Contracts and Grants

and Loans

Printing Schedule and Submission DeadlinesPUBLISH Deadline for: all Short Rules, Executive and

Vol. 43 DATE Commissioner’s Orders, Revenue and Official Issue (BOLDFACE Notices, State Grants, Professional-Technical- Deadline for LONG, Complicated

shows altered Rules (contact the editor to Number Consulting Contracts, Non-State Bids and

publish date) Public Contracts negotiate a deadline)

# 39 Monday 25 March Noon Tuesday 19 March Noon Thursday 14 March# 40 Monday 1 April Noon Tuesday 26 March Noon Thursday 21 March# 41 Monday 8 April Noon Tuesday 2 April Noon Thursday 28 March# 42 Monday 15 April Noon Tuesday 9 April Noon Thursday 4 April

Governor: Tim Walz (651) 201-3400

Lieutenant Governor: Peggy Flanagan (651) 201-3400Commissioner:

Alice Roberts-Davis (651) 201-2601

Facilities Management Division: Christopher A. Guevin

(651) 201-2350

Attorney General: Keith Ellison (651) 296-3353

Auditor: Julie Blaha (651) 296-2551

Secretary of State: Steve Simon (651) 296-2803

Minnesota’s Bookstore: Justin Patrick (651) 201-3203

Editor: Sean Plemmons (651) 201-3204

[email protected]

Subscriptions Manager: Loretta J. Diaz (651) 201-3202

[email protected]

Copyright © 2019 Facilities Management Division, Department of Administration, State of Minnesota.USPS Publication Number: 326-630 (ISSN: 0146-7751)

THE MINNESOTA STATE REGISTER IS PUBLISHED by Facilities Management Division, Department of Administration, State of Minnesota, pursuant to Minnesota Statutes § 14.46 and is available on-line at: http://www.mn.gov/admin/bookstore

Senate Public Information Office (651) 296-0504 State Capitol, Room 231, St. Paul, MN 55155https://www.senate.mn/

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PUBLISHING NOTICES: We need to receive your submission ELECTRONICALLY in Microsoft WORD format. Submit ONE COPY of your notice via e-mail to: [email protected]. State agency submissions must include a “State Register Printing Order” form, and, with contracts, a “Contract Certification” form. Non-State Agencies should submit ELECTRONICALLY in Microsoft WORD, with a letter on your letterhead stationery requesting publication and date to be published. Costs are $13.50 per tenth of a page (columns are seven inches wide). One typewritten, double-spaced page = 6/10s of a page in the State Register, or $81. About 1.5 pages typed, double-spaced, on 8-1/2"x11" paper = one typeset page in the State Register. Contact editor with questions (651) 201-3204, or e-mail: [email protected].

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1081PageMinnesota State Register, Monday 18 March 2019(Cite 43 SR 1081)

ContentsMinnesota Rules: Amendments and Additions...1082 Department of Human Services

Child Safety and Permanency Division

Adopted RulesNotice of Request for Proposals to Design and Implement Community Integration for a Plan of Safe Care for Prenatal Substance Exposure .....................................................1105

Office of Administrative Hearings Notice of Request for Proposals to Innovate, Develop, Implement and/or Expand Pro-Adopted Permanent Rules Governing Workers' Compensation Litigation Procedures: grams and Initiatives that Will Reduce out of Home Placement of Children, and/or Ad-Resolution of Claims with Intervenors ..........................................................................1083 dress the Disproportional Representation of Marginalized Communities in the Minnesota

Child Welfare System ....................................................................................................1106

Executive Orders Disability Services DivisionAddendum to Request for Proposals for a Qualified Grantee to provide State Quality

Office of the Governor Council Management Support .......................................................................................1106Emergency Executive Order 19-06: Providing for Relief from Regulations to Certain Motor Carriers and Drivers Operating in Minnesota ....................................................1084

State ContractsOfficial Notices Department of Agriculture

Notice of Contract Opportunity for Agricultural Research and Evaluation of the Clean Minnesota Department of Agriculture Water Fund .....................................................................................................................1107Division of Pesticide and Fertilizer ManagementRequest for Comments on Draft Voluntary “Stewardship Guidelines and Best Minnesota State Colleges and Universities (Minnesota State)Management Practices (BMPs) for Home and Residential Use of Neonicotinoid System Office – Marketing and CommunicationsInsecticides” ...................................................................................................................1085 Request for Proposals for a Media Buyer to Support Marketing and Communication

Efforts for Minnesota State Transfer Pathways .............................................................1108Minnesota State Agricultural Society (Minnesota State Fair)Board of Managers Meeting Notice ...............................................................................1086 Bemidji State University and Northwest Technical College

Notice of Request for Proposal (RFP) for Vending Services .........................................1109Department of HealthPublic Hearing Regarding the Minnesota Department of Health Application to the Federal Minnesota State University MankatoDepartment of Health and Human Services for Federal Fiscal Year 2019 Preventive Notice of Availability of Request for Qualifications (RFQ) for Minnesota State Universi-Health and Health Services Block Grant Funding .........................................................1086 ty, Mankato - Sports Dome Project ................................................................................1109Public Notice for Reportable Data Items to Minnesota Cancer Reporting System .......1086Division of Health PolicyNotice of Proposed Revised Rule: Minnesota Uniform Companion Guide (MUCG) for Department of Military Affairsthe Implementation of the ASC X12N/005010X221A1 Health Care Claim Payment/Ad- Facilities Management Office, Camp Ripley, Little Falls, MNvice (835), version 13.0 .................................................................................................1098 Request for Proposals for Consultant Services to Conduct and Prepare a Planning & Health Policy Division – Managed Care Systems Section Programming Document Charrette for the Proposed Joint Emergency Response Training

Center (JERTC) at Camp Ripley, Little Falls, MN (Project No. 19127) ....................... 1110Notice of Application for Essential Community Provider Status .................................1100

Minnesota Department of Transportation (MnDOT)Department of Natural ResourcesEngineering Services DivisionLands and Minerals DivisionNotices Regarding Professional/Technical (P/T) Contracting ....................................... 1110Notice of Proposed Boundary Line Agreement .............................................................1100

Notice of Proposed Deed for Boundary Resolution .....................................................1101Notice of Proposed Deed for Boundary Resolution .....................................................1101 Minnesota Zoo

Request for Information for Venue Programing ............................................................ 1111Minnesota Pollution Control Agency (MPCA) Notice of Contract Opportunity for Chinchilla Sculptures and Field Work Displays at

Llama Trek Exhibit ........................................................................................................ 1111Request for Comments on a Planned Rule Amendment to Change Use Classifications Notice of Contract Opportunity for Market Segmentation and Direct Mail Data Analysis for a Portion of Dark River in St. Louis County, Minn. R. pt. 7050.0470; Revisor’s ID Services .......................................................................................................................... 1112Number 4572 .................................................................................................................1101

Non-State Public Bids, Contracts & GrantsState Grants & Loans Metropolitan Airports Commission (MAC)Department of Employment and Economic Development (DEED) Notice of Call for Bids for 2019 Miscellaneous Construction ...................................... 1113Notice of Grant Opportunity ..........................................................................................1104 Notice of Call for Bids for 2019 South Building Area Development-Phase 1 & Plane

Wash Pad ........................................................................................................................ 1114Department of Human Services Behavioral Health DivisionNotice of Request for Proposals to Provide an Array of Wrap Around Services Necessary to Promote Community Presence and Stability for Individuals Discharged from Anoka Metro Regional Treatment Center (AMRTC) or Minnesota Security Hospital (MSH)-St. Peter ..............................................................................................................................1104

Get the Earliest Delivery of the State RegisterA subscription to the STATE REGISTER gets you the EARLIEST DELIVERY. Instead of waiting until Monday at 8:00 a.m. when the magazine is posted on our website, we’ll SEND you the magazine on Friday at close of business with the State, 4:30 pm: 2-1/2 days early. Yes, that’s right -- 2-1/2 days ahead of normal publication schedule -- to get to know what’s coming in the next week; to prepare your plans for your submissions to grant and loan programs and RFPs, RFIs and other contracts and bids.

Subscriptions for an entire year cost $180. The magazine is SENT TO YOU, as well as ONE OTHER PERSON YOU DESIGNATE, in case of vacations, or illnesses, or other absences in your office.

Subscriptions include the most up-to-date information, including a growing index to issues in each volume, issue by issue, including the current vol-ume, which others do not have access to until the end of the volume year. And a subscription gets you our Current Listing of All OPEN bids, contracts, grants, loans, and RFPs that are still open for bid, so you don’t have to hunt through each back issue to find something.


Minnesota Rules: Amendments and AdditionsNOTICE: How to Follow State Agency Rulemaking in the State RegisterThe State Register is the official source, and only complete listing, for all state agency rulemaking in its various stages. State agencies are

required to publish notice of their rulemaking action in the State Register. Published every Monday, the State Register makes it easy to follow and participate in the important rulemaking process. Approximately 80 state agencies have the authority to issue rules. Each agency is assigned specific Minnesota Rule chapter numbers. Every odd-numbered year the Minnesota Rules are published. Supplements are published to update this set of rules. Generally speaking, proposed and adopted exempt rules do not appear in this set because of their short-term nature, but are published in the State Register.

An agency must first solicit Comments on Planned Rules or Comments on Planned Rule Amendments from the public on the subject matter of a possible rulemaking proposal under active consideration within the agency (Minnesota Statutes §§ 14.101). It does this by publishing a notice in the State Register at least 60 days before publication of a notice to adopt or a notice of hearing, or within 60 days of the effective date of any new statutory grant of required rulemaking.

When rules are first drafted, state agencies publish them as Proposed Rules, along with a notice of hearing, or a notice of intent to adopt rules without a hearing in the case of noncontroversial rules. This notice asks for comment on the rules as proposed. Proposed emergency rules, and with-drawn proposed rules, are also published in the State Register. After proposed rules have gone through the comment period, and have been rewritten into their final form, they again appear in the State Register as Adopted Rules. These final adopted rules are not printed in their entirety, but only the changes made since their publication as Proposed Rules. To see the full rule, as adopted and in effect, a person simply needs two issues of the State Register, the issue the rule appeared in as proposed, and later as adopted.

The State Register features partial and cumulative listings of rules in this section on the following schedule: issues #1-26 inclusive (issue #26 cumulative for issues #1-26); issues #27-52 inclusive (issue #52, cumulative for issues #27-52 or #53 in some years). An annual subject matter index for rules was separately printed usually in August, but starting with Volume 19 now appears in the final issue of each volume. For copies or subscrip-tions to the State Register, contact Minnesota’s Bookstore, 660 Olive Street (one block east of I-35E and one block north of University Ave), St. Paul, MN 55155, phone: (612) 297-3000, or toll-free 1-800-657-3757. TTY relay service phone number: (800) 627-3529.

Volume 43 - Minnesota Rules Pollution Control Agency(Rules Appearing in Vol. 43 Issues #1-26 are 7005.0100; 7007.1250; .1300; 7008.0100; .2300; .2400; .2500; .4100;

in Vol. 43, #26 - Monday 24 December 2018) .4110 (adopted)........................................................................................ 797

Volume 43, #38 7048.1000 (proposed)...................................................................... 825

Department of RevenueMonday 31 December - Monday 18 March 8019.0405 (adopted exempt)........................................................... 886

Office of Administrative Hearings1420.1850 (adopted)....................................................................... 1083

Department of Agriculture1562.0100 (proposed exempt)......................................................... 8281525 (adopted)................................................................................. 917

Department of Employment and Economic Development (DEED)3300.6000; .6005; .6010; .6015; .6020; .6035; .6045;

.6060 (adopted)........................................................................................ 993

Environmental Quality Board4410.0200; .0500; .4300; .4400; .5200; .7904; .7906; .7926;

.4600 (proposed) ..................................................................................... 775

Gambling Control Board7861; 7863; 7864 (proposed).......................................................... 931

Office of Higher Education4830.0150; 4850.0013; .0017 (adopted)......................................... 831

Departmental Natural Resources6106.0050 (adopted exempt)........................................................... 7786232.0400; .1600; .1980 (expedited emergency)............................ 8776230.0200; .0400; 6236.0300; .0600; .1000; .1060;

6240.2300 (expedited emergency).......................................................... 8796232.4900 (expedited emergency).................................................. 9876266.0400 (adopted expedited)....................................................... 9886264.0300; .0400 (adopted exempt)............................................... 989


Adopted RulesA rule becomes effective after the requirements of Minnesota Statutes §§ 14.05-14.28 have been met and five

working days after the rule is published in the State Register, unless a later date is required by statutes or specified in the rule. If an adopted rule is identical to its proposed form as previously published, a notice of adoption and a citation to its previous State Register publication will be printed. If an adopted rule differs from its proposed form, language which has been deleted will be printed with strikeouts and new language will be underlined. The rule's previous State Register publication will be cited.

KEY: Proposed Rules - Underlining indicates additions to existing rule language. Strikeouts indicate dele-tions from existing rule language. If a proposed rule is totally new, it is designated “all new material.” Adopted Rules - Underlining indicates additions to proposed rule language. Strikeout indicates deletions from proposed rule language.

Office of Administrative HearingsAdopted Permanent Rules Governing Workers' Compensation Litigation Procedures: Resolution of Claims with Intervenors

The rules proposed and published at State Register, Volume 43, Number 8, pages 177-179, August 20, 2018 (43 SR 177), are adopted with the following modifications: 1420.1850 RESOLUTION OF CLAIMS WITH INTERVENORS; HEARINGS. Subpart 1. Stipulations without agreement of all intervenors or potential intervenors. A stipulation for settlement that does not include the agreement of all intervenors or that seeks to preclude rights of potential intervenors must meet the requirements of this subpart. B. Where other parties have reached an agreement to settle a claim but have been unable to reach agreement with an intervenor, or obtain the intervenor’s signature on the stipulation, the requirements of subitem (1) or (2) must be met. (2) If the stipulation, or a letter of agreement attached to the stipulation, is not signed by the intervenor, the parties must may file a partial stipulation for settlement that complies with Minnesota Statutes, section 176.521, subdivi-sion 2b. Subp. 3. Intervenor hearing on the merits. A. If the parties have not fully resolved the intervenor claim following the procedure in subpart 1 and there is no action pending at the office, a party must file a written petition under Minnesota Statutes, section 176.291, for a hearing on the merits of the intervening party’s claim. The petition must be filed within 30 days after an award on stipulation is served and filed. If a petition for a hearing on the merits of an intervenor’s claim is pending at the time an award on stipulation is served and filed, the office shall schedule the intervenor claims for a hearing on the merits.

1084Page Minnesota State Register, Monday 18 March 2019 (Cite 43 SR 1084)

Executive OrdersThe governor has the authority to issue written statements or orders, called Executive Orders. as well as Emer-

gency Executive Orders. The governor's authority is specified in the Constitution of the State of Minnesota, Article V, and in Minnesota Statutes § 4.035. Emergency Executive Orders, for protection from an imminent threat to health and safety, become effective immediately, are filed with the secretary of state, and published in the State Reg-ister as soon as possible after they are issued. Other Executive Orders become effective 15 days after publication in the State Register and filing with the secretary of state. Unless otherwise specified, an executive order expires 90 days after the date the governor who issued the order vacates office.

Office of the GovernorEmergency Executive Order 19-06: Providing for Relief from Regulations to Certain Motor Carriers and Drivers Operating in Minnesota

I, Tim Walz, Governor of the State of Minnesota, by the authority vested in me by the Constitution and applicable statutes, issue the following Executive Order:

Extreme winter weather conditions, specifically sub-zero temperatures for prolonged periods of time, have caused freezing of septic systems over much of Minnesota.

It is vital that action be taken to prevent the risk of endangerment to the health of septic system users and homeown-ers and to help avoid further damage to frozen septic systems.

The seasonal load restrictions, as described in Minnesota Statutes 2018, section 169.87, subdivisions 1 and 2 will go into effect on March 15, 2019 in the south, southeast and metro zones and will go into effect in the other portions of the state in the near future. These seasonal weight restrictions on roads in Minnesota will hamper the removal of sewage from septic systems and increase the harm caused by leakage and rupture of septic systems.

For these reasons, I order that:

A state of emergency exists in Minnesota, and vehicles used to pump or transport sewage from septic systems are ex-empted from the seasonal load restrictions on local and state highways and streets imposed by Minnesota Statutes 2018, section 169.87, subdivisions 1 and 2, while providing emergency septic system pumping services.

This Executive Order is effective immediately under Minnesota Statutes 2018, section 4.035, subdivision 2. It will remain in effect until June 1, 2019.

Signed on March 14, 2019.

Tim WalzGovernor

Filed According to Law:

Steve SimonSecretary of State


Official NoticesPursuant to Minnesota Statutes §§ 14.101, an agency must first solicit comments from the public on the subject

matter of a possible rulemaking proposal under active consideration within the agency by publishing a notice in the State Register at least 60 days before publication of a notice to adopt or a notice of hearing, and within 60 days of the effective date of any new statutory grant of required rulemaking.

The State Register also publishes other official notices of state agencies and non-state agencies, including notic-es of meetings and matters of public interest.

Minnesota Department of AgricultureDivision of Pesticide and Fertilizer Management

Request for Comments on Draft Voluntary “Stewardship Guidelines and Best Management Practices (BMPs) for Home and Residential Use of Neonicotinoid Insecticides”

The Minnesota Department of Agriculture (MDA), in cooperation with University of Minnesota Extension and others, has developed voluntary “Stewardship Guidelines and Best Management Practices (BMPs) for home and residential use of neonicotinoid insecticides” to protect pollinators and their habitat. The MDA requests comments on the following document:

“Draft Stewardship Guidelines and Best Management Practices for home and residential use of neonicotinoid insecti-cides”.

Comments are being sought on 1) content and format, and, 2) ways the BMPs can be made available and communi-cated. The comments will assist the MDA in finalizing this draft voluntary BMPs.

Copies of this document are available at www.mda.state.mn.us/best-management-practices-pollinators-and-their-habitat or by contacting Gurinderbir (G) Cha-hal, Minnesota Department of Agriculture, [email protected], 651 201 6237. The comments will be received for 60 days, ending on May 16, 2019. Directions for submitting comments are given at the end of this notice.

These BMPs were developed in response to special registration review on neonicotinoid insecticides. The purpose of the BMPs in this document is to address the potential risk to pollinators from the use of neonicotinoid insecticides in home and residential areas.

Following the 60-day comment period, the MDA will consider further revisions to the BMPs based on comments re-ceived. Once finalized, the revised voluntary “Stewardship Guidelines and Best Management Practices (BMPs) for Home and Residential Use of Neonicotinoid Insecticides” will be made available on the MDA’s website www.mda.state.mn.us/best-management-practices-pollinators-and-their-habitat

Agency Contact Person. Written comments, questions, and requests for more information on the BMPs revisions can be submitted on or before May 16, 2019. Comments should be submitted by letter or e-mail to G Chahal. Contact infor-mation is provided below. “G” can also be contacted with inquiries or comments in regards to this notice.

Gurinderbir Chahal, Pesticide and Fertilizer Management Division

Minnesota Department of Agriculture625 Robert Street North, Saint Paul, MN, 55155

[email protected]


Official NoticesMinnesota State Agricultural Society (Minnesota State Fair)Board of Managers Meeting Notice

The Minnesota State Agricultural Society board of managers will meet at 10 a.m. Thursday, March 21 at the Libby Conference Center on the State Fairgrounds. The session will be a general business meeting. The Society is the govern-ing body of the Minnesota State Fair. Agendas are available upon request by calling the Minnesota State Fair at (651) 288-4400.

The 2019 Minnesota State Fair runs Aug. 22 - Labor Day, Sept. 2.

Department of HealthPublic Hearing Regarding the Minnesota Department of Health Application to the Federal Department of Health and Human Services for Federal Fiscal Year 2019 Preventive Health and Health Services Block Grant Funding

The Minnesota Department of Health will sponsor a public hearing to obtain comments on the proposed uses of the Preventive Health and Health Services Block Grant funds during federal fiscal year 2019. Further information on the use of those funds is available upon request.

The public hearing will be conducted as part of a meeting of the State Preventive Health Advisory Committee to

be held Friday, March 29, 2019, at the Minnesota Department of Health, Orville Freeman Building, 625 Robert Street North, St. Paul, MN in Meeting Room B-149. The meeting and public hearing will begin at 9:30 a.m. and end at 11:30 a.m. Any person or group may submit either written or oral comments at the meeting.

Written comments must be submitted by noon Thursday, March 28, to the address below.

For further information about participating in the public hearing or the PHHS Block Grant, please contact:

Becky BuhlerCenter for Public Health Practice Minnesota Department of Health

P.O. Box 64975St. Paul, Minnesota 55164-0975

(651) [email protected]

Department of HealthPublic Notice for Reportable Data Items to Minnesota Cancer Reporting System

NOTICE IS HEREBY GIVEN to cancer registries, medical laboratories, hospitals, medical clinics, physicians and dentists of the list of data items reported to Minnesota Cancer Reporting System (MCRS).

Minnesota Statute, chapter 144, section 144.672, subdivision 1 gives the Commissioner of Health authority to collect cancer incidence information, analyze the information, and conduct special studies designed to determine the potential public health significance of an increase in cancer incidence.

MCRS Required Data ItemsR= required, R* = if available, RH = required to be reported for historic records within date range given, RH* = if

available, RS = Required, Site Specific, RS* = if available, D = derived, DH = historically derived. Unless otherwise not-ed, staging and treatments data items are required on all cancers diagnosed in or after 1995.


Official NoticesNAACCR Record Layout Version 18 (in layout order)

MCRS NAACCRItem #

NAACCR Item Name Note

R 10 Record Type BlankR 50 NAACCR Record Version BlankR* 21 Patient System ID-Hosp BlankR 70 Addr at DX-- City BlankR 80 Addr at DX--State BlankR 100 Addr at DX--Postal Code BlankR 90 County at DX BlankR 160 Race 1 BlankR 161 Race 2 BlankR 162 Race 3 BlankR 163 Race 4 BlankR 164 Race 5 BlankR* 170 Race Coding Sys--Current BlankR* 180 Race Coding Sys--Original BlankR 190 Spanish/Hispanic Origin BlankR 220 Sex BlankR 230 Age at Diagnosis BlankR 240 Date of Birth BlankR 241 Date of Birth Flag BlankR* 310 Text--Usual Occupation BlankR* 320 Text--Usual Industry BlankR 102 Addr at Dx--Country BlankR 1832 Addr Current--Country BlankR* 252 Birthplace--State BlankR* 254 Birthplace Country BlankR 390 Date of diagnosis BlankR 391 Date of Diagnosis Flag BlankR 400 Primary site BlankR 410 Laterality BlankRH 420 Histology (92-00) ICD-O-2 Dx 1992 – 2000RH 430 Behavior (92-00) ICD-O-2 Dx 1992 – 2000R 522 Histologic Type ICD-O-3 Dx 2001 & laterR 523 Behavior Code ICD-O-3 Dx 2001 & laterRH 440 Grade Dx 1988 – 2017RH* 441 Grade Path Value Dx 2010 – 2013RH* 449 Grade Path System Dx 2010 – 2013R 450 Site Coding Sys – Current BlankR* 460 Site Coding Sys – Original BlankR 470 Morph Coding Sys – Current BlankR* 480 Morph Coding Sys – Original Blank


Official NoticesMCRS NAACCR

Item #NAACCR Item Name Note

R 490 Diagnostic Confirmation BlankR 500 Type of Reporting Source BlankR* 501 Casefinding Source BlankRH 442 Ambiguous Term DX Dx 2007 – 2012 RH 443 Date Conclusive DX Dx 2007 – 2012 RH 448 Date Conclusive DX Flag Dx 2007 – 2012 RH 444 Mult Tumor Rpt as One Prim Dx 2007 – 2012 RH 445 Date of Mult Tumor Dx 2007 – 2012 RH 439 Date of Mult Tumors Flag Dx 2007 – 2012 RH 446 Multiplicity Counter Dx 2007 – 2012 R* 545 NPI – Reporting Facility Dx 2007 & laterR 540 Reporting Facility BlankR 550 Accession Number--Hosp If no software specific ID

#, accession # also goes in state specific field, columns 3101-3115

R 560 Sequence Number--Hosp BlankR 570 Abstracted By BlankR 580 Date of 1st Contact BlankR 581 Date of 1st Contact Flag BlankR 610 Class of Case BlankR* 630 Primary Payer at Dx Dx 2006 & laterR 670 RX Hosp – Surg Prim Site BlankR 672 RX Hosp – Scope Reg LN Surg BlankR 674 RX Hosp – Surg Oth Reg/Dis BlankRH 676 RX Hosp – Reg LN Removed Dx 1998 – 2002 RH 690 RX Hosp – Radiation Dx 1998 – 2002 R 700 RX Hosp – Chemo BlankR 710 RX Hosp – Hormone BlankR 720 RX Hosp – BRM BlankR 730 RX Hosp – Other BlankRH 746 RX Hosp – Surg Site 98-02 Dx 1998 – 2002 RH 747 RX Hosp – Scope Reg 98-02 Dx 1998 – 2002 RH 748 RX Hosp – Surg Other 98-02 Dx 1998 – 2002 RH 930 TNM Path Staged By Dx 1995 - 2003RH 990 TNM Clin Staged By Dx 1995 - 2003R 1112 Mets at Dx – Bone Dx 2016 & later R 1113 Mets at Dx – Brain Dx 2016 & later R 1114 Mets at Dx – Distant LN Dx 2016 & later R 1115 Mets at Dx – Liver Dx 2016 & later R 1116 Mets at Dx – Lung Dx 2016 & later R 1117 Mets at Dx – Other Dx 2016 & later




R* 752 Tumor Size Clinical Dx 2016 & later R* 754 Tumor Size Pathologic Dx 2016 & later R 756 Tumor Size Summary Dx 2016 & later R 764 Summary Stage 2018 Dx 2018 & laterRH 759 SEER Summary Stage 2000 Dx 2001 – 2017 RH 760 SEER Summary Stage 1977 Dx 1995 – 2000RH 780 EOD--Tumor Size Dx 1995 – 2003 R 820 Regional Nodes Positive BlankR 830 Regional Nodes Examined BlankR 682 Date Regional Lymph Node Dissection Dx 2018 & laterR 683 Date Regional Lymph Node Dissection Flag Dx 2018 & laterRS 835 Sentinel Lymph Nodes Positive Dx 2018 & laterRS 834 Sentinel Lymph Nodes Examined Dx 2018 & laterRS 832 Date of Sentinel Lymph Node Biopsy Dx 2018 & laterRS 833 Date of Sentinel Lymph Node Biopsy Flag Dx 2018 & laterR 1060 TNM Edition Number BlankRH 880 TNM path T Dx 1995 – 2003RH 890 TNM path N Dx 1995 – 2003RH 900 TNM path M Dx 1995 – 2003RH 910 TNM Path Stage Group Dx 1995 – 2003RH 920 TNM Path Descriptor Dx 1995 – 2003RH 940 TNM Clin T Dx 1995 – 2003RH 950 TNM Clin N Dx 1995 – 2003RH 960 TNM Clin M Dx 1995 – 2003RH 970 TNM Clin Stage Group Dx 1995 – 2003RH 980 TNM Clin Descriptor Dx 1995 – 2003R 1001 AJCC TNM Clin T Dx 2016 & later R 1031 AJCC TNM Clin T Suffix Dx 2016 & laterR 1002 AJCC TNM Clin N Dx 2016 & laterR 1034 AJCC TNM Clin N Suffix Dx 2016 & laterR 1003 AJCC TNM Clin M Dx 2016 & laterR 1004 AJCC TNM Clin Stage Group Dx 2016 & laterR 1011 AJCC TNM Path T Dx 2016 & laterR 1032 AJCC TNM Path T Suffix Dx 2016 & laterR 1012 AJCC TNM Path N Dx 2016 & laterR 1035 AJCC TNM Path N Suffix Dx 2016 & laterR 1013 AJCC TNM Path M Dx 2016 & laterR 1014 AJCC TNM Path Stage Group Dx 2016 & laterR 1021 AJCC TNM Post Therapy T Dx 2018 & laterR 1033 AJCC TNM Post Therapy T Suffix Dx 2018 & laterR 1022 AJCC TNM Post Therapy N Dx 2018 & later




R 1036 AJCC TNM Post Therapy N Suffix Dx 2018 & laterR 1023 AJCC TNM Post Therapy M Dx 2018 & laterR 1024 AJCC TNM Post Therapy Stage Group Dx 2018 & laterR 3843 Grade Clinical Dx 2018 & laterR* 3844 Grade Pathological Dx 2018 & laterR* 3845 Grade Post Therapy Dx 2018 & laterRH 1150 Tumor Marker 1 Dx 1995 – 2002 RH 1160 Tumor Marker 2 Dx 1995 – 2002 RH 1170 Tumor Marker 3 Dx 1995 – 2002 R* 1182 Lymphovascular Invasion Dx 2010 & laterRH* 2800 CS Tumor Size Dx 2004 – 2015RH* 2810 CS Extension Dx 2004 – 2015RH* 2820 CS Tumor Size/Ext Eval Dx 2004 – 2015RH* 2830 CS Lymph Nodes Dx 2004 – 2015RH* 2840 CS Lymph Nodes Eval Dx 2004 – 2015RH* 2850 CS Mets at DX Dx 2004 – 2015RH* 2860 CS Mets Eval Dx 2004 – 2015RH 2851 CS Mets at Dx – Bone Dx 2010 – 2015 RH 2852 CS Mets at Dx – Brain Dx 2010 – 2015 RH 2853 CS Mets at Dx – Liver Dx 2010 – 2015 RH 2854 CS Mets at Dx – Lung Dx 2010 – 2015 RH* 2880 CS Site-Specific Factor 1 Dx 2004 – 2017RH* 2890 CS Site-Specific Factor 2 Dx 2004 – 2017RH* 2900 CS Site-Specific Factor 3 Dx 2004 – 2017RH* 2910 CS Site-Specific Factor 4 Dx 2004 – 2017RH* 2920 CS Site-Specific Factor 5 Dx 2004 – 2017RH* 2930 CS Site-Specific Factor 6 Dx 2004 – 2017RH* 2861 CS Site-Specific Factor 7 Dx 2010 – 2017RH* 2862 CS Site-Specific Factor 8 Dx 2010 – 2017RH* 2863 CS Site-Specific Factor 9 Dx 2010 – 2017RH* 2864 CS Site-Specific Factor 10 Dx 2010 – 2017RH* 2865 CS Site-Specific Factor 11 Dx 2010 – 2017RH* 2866 CS Site-Specific Factor 12 Dx 2010 – 2017RH* 2867 CS Site-Specific Factor 13 Dx 2010 – 2017RH* 2868 CS Site-Specific Factor 14 Dx 2010 – 2017RH* 2869 CS Site-Specific Factor 15 Dx 2010 – 2017RH* 2870 CS Site-Specific Factor 16 Dx 2010 – 2017RH* 2871 CS Site-Specific Factor 17 Dx 2010 – 2017RH 2872 CS Site-Specific Factor 18 Dx 2010 – 2017 RH 2873 CS Site-Specific Factor 19 Dx 2010 – 2017 RH 2874 CS Site-Specific Factor 20 Dx 2010 – 2017




RH 2875 CS Site-Specific Factor 21 Dx 2010 – 2017 RH 2876 CS Site-Specific Factor 22 Dx 2010 – 2017 RH 2877 CS Site-Specific Factor 23 Dx 2010 – 2017 RH 2878 CS Site-Specific Factor 24 Dx 2010 – 2017 RH* 2879 CS Site-Specific Factor 25 Dx 2010 – 2017 DH 2940 Derived AJCC-6 T Dx 2004 – 2015 DH 2950 Derived AJCC-6 T Descript Dx 2004 – 2015 DH 2960 Derived AJCC-6 N Dx 2004 – 2015 DH 2970 Derived AJCC-6 N Descript Dx 2004 – 2015 DH 2980 Derived AJCC-6 M Dx 2004 – 2015 DH 2990 Derived AJCC-6 M Descript Dx 2004 – 2015 DH 3000 Derived AJCC-6 Stage Grp Dx 2004 – 2015 RH* 3400 Derived AJCC-7 T Dx 2010 – 2015 RH* 3402 Derived AJCC-7 T Descript Dx 2010 – 2015RH* 3410 Derived AJCC-7 N Dx 2010 – 2015RH* 3412 Derived AJCC-7 N Descript Dx 2010 – 2015RH* 3420 Derived AJCC-7 M Dx 2010 – 2015RH* 3422 Derived AJCC-7 M Descript Dx 2010 – 2015RH* 3430 Derived AJCC-7 Stage Grp Dx 2010 – 2015RH* 3020 Derived SS2000 Dx 2004 – 2015 RH* 3050 Derived SS2000--Flag Dx 2004 – 2015 R* 2937 CS Version Input Current Dx 2004 – 2017R* 2935 CS Version Input Original Dx 2004 – 2017RH* 2936 CS Version Derived Dx 2004 – 2015D 995 AJCC ID Dx 2018 & laterD 3800 Schema ID Dx 2018 & laterR 3926 Schema Discriminator 1 Dx 2018 & laterR 3927 Schema Discriminator 2 Dx 2018 & laterRS 3928 Schema Discriminator 3 Dx 2018 & laterRS 3908 Percent Necrosis Post Neoadjuvant Dx 2018 & laterRS 3801 Chromosome 1p Loss of Heterozygosity Dx 2018 & laterRS 3802 Chromosome 19q Loss of Heterozygosity Dx 2018 & laterRS 3889 Methylation of 06-Methylguanine-Methyltransferase Dx 2018 & laterRS 3827 Estrogen Receptor Summary Dx 2018 & laterRS 3855 HER2 Overall Summary Dx 2018 & laterRS 3882 LN Positive Axillary Level I-II Dx 2018 & laterRS 3894 Multigene Signature Method Dx 2018 & laterRS 3895 Multigene Signature Results Dx 2018 & laterRS 3915 Progesterone Receptor Summary Dx 2018 & laterRS 3922 Response to Neoadjuvant Therapy Dx 2018 & laterRS 3826 Estrogen Receptor Percent Positive or Range Dx 2018 & later




RS 3828 Estrogen Receptor Total Allred Score Dx 2018 & laterRS 3850 HER2 IHC Summary Dx 2018 & laterRS 3851 HER2 ISH Dual Probe Copy Number Dx 2018 & laterRS 3852 HER2 ISH Dual Probe Ratio Dx 2018 & laterRS 3853 HER2 ISH Single Probe Ratio Dx 2018 & laterRS 3854 HER2 ISH Summary Dx 2018 & laterRS 3863 Ki-67 Dx 2018 & laterRS 3903 Oncotype Dx Recurrence Score—DCIS Dx 2018 & laterRS 3904 Oncotype Dx Recurrence Score – Invasive Dx 2018 & laterRS 3905 Oncotype Dx Risk Level—DCIS Dx 2018 & laterRS 3906 Oncotype Dx Risk Level – Invasive Dx 2018 & laterRS 3914 Progesterone Receptor Percent Positive or Range Dx 2018 & laterRS 3916 Progesterone Receptor Total Allred Score Dx 2018 & laterRS 3819 CEA Pretreatment Interpretation Dx 2018 & laterRS 3820 CEA Pretreatment Lab Value Dx 2018 & laterRS 3823 Circumferential Resection Margin (CRM) Dx 2018 & laterRS 3866 KRAS Dx 2018 & laterRS* 3890 Microsatellite Instability (MSI) Dx 2018 & laterRS 3909 Perineural Invasion Dx 2018 & laterRS 3934 Tumor Deposits Dx 2018 & laterRS 3901 Number of Positive Para-Aortic Nodes Dx 2018 & laterRS 3899 Number of Examined Para-Aortic Nodes Dx 2018 & laterRS 3902 Number of Positive Pelvic Nodes Dx 2018 & laterRS 3900 Number of Examined Pelvic Nodes Dx 2018 & laterRS 3911 Peritoneal Cytology Dx 2018 & laterRS 3829 Esophagus and EGJ Tumor Epicenter Dx 2018 & laterRS 3865 KIT Gene Immunohistochemistry Dx 2018 & laterRS 3836 FIGO Stage Dx 2018 & laterRS 3831 Extranodal Extension Head and Neck Clinical Dx 2018 & laterRS 3832 Extranodal Extension Head and Neck Pathological Dx 2018 & laterRS 3876 LN Head and Neck Levels I-III Dx 2018 & laterRS 3877 LN Head and Neck Levels IV-V Dx 2018 & laterRS 3878 LN Head and Neck Levels VI-VIII Dx 2018 & laterRS 3879 LN Head and Neck Other Dx 2018 & laterRS 3883 LN Size Dx 2018 & laterRS 3862 JAK2 Dx 2018 & laterRS 3917 Primary Sclerosing Cholangitis Dx 2018 & laterRS 3935 Tumor Growth Pattern Dx 2018 & laterRS 3861 Ipsilateral Adrenal Gland Involvement Dx 2018 & laterRS 3864 Invasion Beyond Capsule Dx 2018 & laterRS 3886 Major Vein Involvement Dx 2018 & later




RS 3925 Sarcomatoid Features Dx 2018 & laterRS 3803 Adenoid Cystic Basaloid Pattern Dx 2018 & laterRS 3809 AFP Pretreatment Interpretation Dx 2018 & laterRS 3810 AFP Pretreatment Lab Value Dx 2018 & laterRS 3813 Bilirubin Pretreatment Total Lab Value Dx 2018 & laterRS 3814 Bilirubin Pretreatment Unit of Measure Dx 2018 & laterRS 3824 Creatinine Pretreatment Lab Value Dx 2018 & laterRS 3825 Creatinine Pretreatment Unit of Measure Dx 2018 & laterRS 3835 Fibrosis Score Dx 2018 & laterRS 3860 International Normalized Ratio Prothrombin Time Dx 2018 & laterRS 3929 Separate Tumor Nodules Dx 2018 & laterRS 3937 Visceral and Parietal Pleural Invasion Dx 2018 & laterRS 3812 B Symptoms Dx 2018 & laterRS 3859 HIV Status Dx 2018 & laterRS 3896 NCCN International Prognostic Index (IPI) Dx 2018 & laterRS 3893 Mitotic Rate Melanoma Dx 2018 & laterRS 3821 Chromosome 3 Status Dx 2018 & laterRS 3822 Chromosome 8q Status Dx 2018 & laterRS 3834 Extravascular Matrix Patterns Dx 2018 & laterRS 3887 Measured Basal Diameter Dx 2018 & laterRS 3888 Measured Thickness Dx 2018 & laterRS 3891 Microvascular Density Dx 2018 & laterRS 3892 Mitotic Count Uveal Melanoma Dx 2018 & laterRS 3817 Breslow Tumor Thickness Dx 2018 & laterRS 3870 LDH Upper Limits of Normal Dx 2018 & laterRS 3932 LDH Pretreatment Lab Value Dx 2018 & laterRS 3936 Ulceration Dx 2018 & laterRS 3880 LN Isolated Tumor Cells (ITC) Dx 2018 & laterRS 3918 Profound Immune Suppression Dx 2018 & laterRS 3910 Peripheral Blood Involvement Dx 2018 & laterRS 3856 Heritable Trait Dx 2018 & laterRS 3804 Adenopathy Dx 2018 & laterRS 3811 Anemia Dx 2018 & laterRS 3885 Lymphocytosis Dx 2018 & laterRS 3907 Organomegaly Dx 2018 & laterRS 3933 Thrombocytopenia Dx 2018 & laterRS 3857 High Risk Cytogenetics Dx 2018 & laterRS 3869 LDH Pretreatment Level Dx 2018 & laterRS 3930 Serum Albumin Pretreatment Level Dx 2018 & laterRS 3931 Serum Beta-2 Microglobulin Pretreatment Level Dx 2018 & laterRS 3818 CA-125 Pretreatment Interpretation Dx 2018 & later




RS 3921 Residual Tumor Volume Post Cytoreduction Dx 2018 & laterRS 3830 Extranodal Extension Clin (non-Head and Neck) Dx 2018 & laterRS 3833 Extranodal Extension Path (non-Head and Neck) Dx 2018 & laterRS 3837 Gestational Trophoblastic Prognostic Scoring Index Dx 2018 & laterRS 3913 Pleural Effusion Dx 2018 & laterRS 3838 Gleason Patterns Clinical Dx 2018 & laterRS 3839 Gleason Patterns Pathological Dx 2018 & laterRS 3840 Gleason Score Clinical Dx 2018 & laterRS 3841 Gleason Score Pathological Dx 2018 & laterRS 3842 Gleason Tertiary Pattern Dx 2018 & laterRS 3897 Number of Cores Examined Dx 2018 & laterRS 3898 Number of Cores Positive Dx 2018 & laterRS 3919 Prostate Pathological Extension Dx 2018 & laterRS 3920 PSA (Prostatic Specific Antigen) Lab Value Dx 2018 & laterRS 3858 High Risk Histologic Features Dx 2018 & laterRS 3815 Bone Invasion Dx 2018 & laterRS 3807 AFP Pre-Orchiectomy Lab Value Dx 2018 & laterRS 3808 AFP Pre-Orchiectomy Range Dx 2018 & laterRS 3805 AFP Post-Orchiectomy Lab Value Dx 2018 & laterRS 3806 AFP Post-Orchiectomy Range Dx 2018 & laterRS 3848 hCG Pre-Orchiectomy Lab Value Dx 2018 & laterRS 3849 hCG Pre-Orchiectomy Range Dx 2018 & laterRS 3846 hCG Post-Orchiectomy Lab Value Dx 2018 & laterRS 3847 hCG Post-Orchiectomy Range Dx 2018 & laterRS 3868 LDH Pre-Orchiectomy Range Dx 2018 & laterRS 3867 LDH Post-Orchiectomy Range Dx 2018 & laterRS 3923 S Category Clinical Dx 2018 & later RS 3924 S Category Pathological Dx 2018 & later RS 3872 LN Assessment Method Para-Aortic Dx 2018 & laterRS 3873 LN Assessment Method Pelvic Dx 2018 & laterRS 3874 LN Distant Assessment Method Dx 2018 & laterRS 3875 LN Distant: Mediastinal, Scalene Dx 2018 & laterRS 3884 LN Status Femoral-Inguinal, Para-Aortic, Pelvic Dx 2018 & laterRS 3871 LN Assessment Method Femoral-Inguinal Dx 2018 & laterRS 3881 LN Laterality Dx 2018 & laterR 3816 Brain Molecular Markers Dx 2018 & laterR 1270 Date 1st Crs RX Coc BlankR 1271 Date 1st Crs RX CoC Flag BlankR 1200 RX Date Surgery BlankR 1201 RX Date Surgery Flag BlankR 3170 RX Date Mst Defn Srg Dx 2003 & later




R 3171 RX Date Mst Defn Srg Flag Dx 2010 & laterR 1210 RX Date Radiation BlankR 1211 RX Date Radiation Flag BlankR 3230 RX Date Systemic Dx 2003 & later R 3231 RX Date Systemic Flag Dx 2003 & later R 1220 RX Date Chemo BlankR 1221 RX Date Chemo Flag BlankR 1230 RX Date Hormone BlankR 1231 RX Date Hormone Flag BlankR 1240 RX Date BRM BlankR 1241 RX Date BRM Flag BlankR 1250 RX Date Other BlankR 1251 RX Date Other Flag BlankR 1285 RX Summ--Treatment Status Dx 2010 & laterR 1290 RX Summ--Surg Prim Site Dx 2003 & laterR 1292 RX Summ--Scope Reg LN Sur Dx 2003 & laterR 1294 RX Summ--Surg Oth Reg/Dis Dx 2003 & laterRH* 1296 RX Summ--Reg LN Examined Dx 1998 – 2002 R 1340 Reason for No Surgery BlankRH 1360 RX Summ--Radiation Dx 2003 – 2017R 1380 RX Summ--Surg/Rad Seq Dx 2003 & laterR 3250 RX Summ--Transplnt/Endocr Dx 2003 & laterR 1390 RX Summ--Chemo BlankR 1400 RX Summ--Hormone BlankR 1410 RX Summ--BRM BlankR 1420 RX Summ--Other BlankR 1430 Reason for No Radiation BlankR 1460 RX Coding Sys--Current Dx 2003 & laterRH 1570 Rad--Regional RX Modality Dx 2003 – 2017 RH 3200 Rad--Boost RX Modality Dx 2003 – 2017 R 1639 RX Summ--Systemic/Sur Seq Dx 2003 & laterRH* 1640 RX Summ--Surgery Type Dx 1998 – 2002 RH 1646 RX Summ--Surg Site 98-02 Dx 1998 – 2002 RH 1647 RX Summ--Scope Reg 98-02 Dx 1998 – 2002 RH 1648 RX Summ--Surg Oth 98-02 Dx 1998 – 2002R 1506 Phase I Radiation Treatment Modality Dx 2018 & laterR 1502 Phase I Radiation External Beam Planning Tech Dx 2018 & laterR 1516 Phase II Radiation Treatment Modality Dx 2018 & laterR 1512 Phase II Radiation External Beam Planning Tech Dx 2018 & laterR 1526 Phase III Radiation Treatment Modality Dx 2018 & laterR 1522 Phase III Radiation External Beam Planning Tech Dx 2018 & later




RH 1960 Site (73-91) ICD-O-1 Dx 1998 – 1991 RH 1971 Histology (73-91) ICD-O-1 Dx 1988 – 1991 RH 1972 Behavior (73-91) ICD-O-1 Dx 1988 – 1991 RH 1980 ICD-O-2 Conversion Flag Dx 1988 – 1991 R 2140 CoC Coding Sys--Current BlankR 2150 CoC Coding Sys--Original BlankR 2152 CoC Accredited Flag BlankR 2170 Vendor Name BlankR 2116 ICD-O-3 Conversion Flag BlankR 1750 Date of Last Contact BlankR 1751 Date of Last Contact Flag BlankR 1760 Vital Status BlankR 1810 Addr Current--City BlankR 1820 Addr Current--State BlankR 1830 Addr Current--Postal Code BlankR 1840 County – Current BlankR 2220 State/Requestor Items BlankBlank Blank “Managing MD Last Name” Col 3049 – 3063Blank Blank “Managing MD 1st Name” Col 3064 – 3073Blank Blank “Managing MD M I” Col 3074 – 3074Blank Blank “Followup MD Last Name” Col 3075 – 3089Blank Blank “Followup MD 1st Name” Col 3090 – 3099Blank Blank “Followup MD M I” Col 3100 – 3100Blank Blank “Patient Identification Number” Software specific pt ID #,

otherwise insert accession #, col 3101 – 3115

R 2230 Name--Last BlankR 2240 Name--First BlankR 2250 Name--Middle BlankR 2280 Name--Alias BlankR* 2390 Name--Maiden BlankR 2300 Medical Record Number BlankR 2320 Social Security Number BlankR 2330 Addr at DX--No & Street BlankR 2335 Addr at DX--Supplementl BlankR 2350 Addr Current--No & Street BlankR* 2355 Addr Current--Supplementl BlankR* 2360 Telephone BlankR 2415 NPI--Inst Referred From Dx 2007 & later R 2425 NPI--Inst Referred To Dx 2007 & laterR* 2465 NPI—Physician--Managing Dx 2007 & later




R 2460 Physician--Managing BlankR* 2475 NPI--Physician--Follow-Up Dx 2007 & later R 2470 Physician--Follow-Up BlankR 2520 Text--DX Proc--PE BlankR 2530 Text--Dx Proc--X-ray/Scan BlankR 2540 Text--DX Proc--Scopes BlankR 2550 Text--DX Proc--Lab Tests BlankR 2560 Text--DX Proc--Op BlankR 2570 Text--DX Proc--Path BlankR 2580 Text--Primary Site Title BlankR 2590 Text--Histology Title BlankR 2600 Text--Staging BlankR 2610 RX Text--Surgery BlankR 2620 RX Text--Radiation (Beam) BlankR 2630 RX Text--Radiation Other BlankR 2640 RX Text--Chemo BlankR 2650 RX Text--Hormone BlankR 2660 RX Text--BRM BlankR 2670 RX Text--Other BlankR* 2680 Text--Remarks BlankR 2690 Text--Place of Diagnosis Blank

This notice is published pursuant to Minnesota Rules, chapter 4606, part 4606.3304, subpart 1a, which requires pub-lication of a list of the required data items to be reported under chapter 4606, part 4606.3303, subpart 1.

Written comments and requests for more information may be sent to: Minnesota Cancer Reporting System, Minneso-ta Department of Health, 85 East 7th Place, P.O. Box 64882, Saint Paul, Minnesota 55164-0882.

E-mail: [email protected], Telephone: 651-201-5900, Fax 651-201-5926.

Minnesota Department of HealthMinnesota Cancer Reporting System

PO Box 64882St. Paul, MN 55164-0822

[email protected]

March 2019

To obtain this information in a different format, call 651-201-5900.

mailto:[email protected]

https://www.health.state.mn.us/


Official NoticesDepartment of Health

Division of Health PolicyNotice of Proposed Revised Rule: Minnesota Uniform Companion Guide (MUCG) for the Implementation of the ASC X12N/005010X221A1 Health Care Claim Payment/Advice (835), version 13.0

Introduction. Pursuant to Minnesota Statutes, section 62J.61, notice is hereby given that the Minnesota Department of Health (MDH) is seeking information or opinions from outside sources regarding a proposed revised version (version 13.0) of the Minnesota Uniform Companion Guide (MUCG) for the X12N/005010X221A1 Health Care Claim Payment/Advice (835). The revised version is proposed by the Commissioner of Health and was developed in consultation with the Minnesota Administrative Uniformity Committee (AUC) and its EOB/Remit Technical Advisory Group (TAG). Interested parties may submit comments to MDH concerning the above-referenced v13.0 MUCG during a 30-day public comment period, March 18, 2019 through April 16, 2019, as described below.

Note: For brevity, the name of the transaction standard referenced above, “X12N/005010X221A1 Health Care Claim Payment/Advice (835),” will hereinafter be referred to in this document as “835.”

Description of the Rules. Minnesota Statutes, section 62J.536, requires the Minnesota Commissioner of Health, in consultation with the Minnesota Administrative Uniformity Committee (AUC), to promulgate rules pursuant to section 62J.61 establishing and requiring group purchasers, clearinghouses, and health care providers to exchange specified health care administrative transactions electronically, using the applicable single, uniform companion guide adopted by the Commissioner of Health. Under Minnesota Statutes, section 62J.61, the Commissioner of Health is exempt from chapter 14, including section 14.386, in implementing sections 62J.50 to 62J.54, subdivision 3, and 62J.56 to 62J.59.

Changes and Updates to Previously Adopted Rule. The Commissioner of Health, in consultation with the AUC and its Technical Advisory Groups (TAGs), has determined that it is necessary to make revisions to the version 835 MUCG rule most recently adopted and now in force, known as “version 12.0.” The v12.0 835 MUCG is available at: http://www.health.state.mn.us/asa/rules.html.

The proposed new version of the rule is “version 13.0 (v13.0)” and will be available at http://www.health.state.mn.us/asa/index.html starting March 18, 2019. The proposed version 13.0 rule describes the data content and other transaction specific characteristics of the 835 transaction, for use by entities subject to Minnesota Statutes, section 62J.536. A more detailed summary of the differences between v12.0 and the proposed v13.0 follow below in the “Modifications” section.

How to Obtain the Proposed Changes to Minnesota Uniform Companion Guides. Free copies of the proposed version 13.0 rule as described above are available for viewing or downloading on the World Wide Web starting March 18, 2019 at: http://www.health.state.mn.us/asa/. Persons who wish to obtain paper copies should contact Susie Blake at MDH, via email at [email protected], by calling (651) 201-5508, or by fax at (651) 201-3830. She may also be reached via US mail at Minnesota Department of Health, P.O. Box 64882, St. Paul, MN 55164-0822. E-mail is preferred. Please clearly identify the document(s) being requested.

Public review process. MDH requests information and opinions concerning the applicability and functionality of the proposed v13.0 rule revisions above. Interested persons or groups may submit data or views in writing to MDH during a 30-day public comment period, to be received no later than 4:00 p.m. April 16, 2019. Electronic submissions should be sent in Word format. All submissions should be addressed to Susie Blake at the contact information above. E-mail is preferred.

Modifications. Modifications of the v12.0 835 MUCG are proposed in v13.0 as described below to improve the clarity, accuracy, usefulness, and accessibility of the MUCG. A copy of v13.0 will be posted at http://www.health.state.mn.us/asa/ for approximately 30 days following the publication of this announcement.

http://www.health.state.mn.us/asa/rules.html

http://www.health.state.mn.us/asa/





Official NoticesThe revisions proposed in v13.0 include changes in format and content throughout to delete and/or update outdated,

extraneous material, for brevity, accuracy, ease of use, and for assuring that the document meets accessibility standards and requirements. In particular, the changes from v12.0 to the proposed v13.0 include:

• Deletion of the cover page of v12.0 and incorporation of much of the cover page information in the body of v13.0, in section “1. Overview”:

• Revisions to the table of contents;• Deletions, consolidation, and reorganization of material in v12.0, sections “1 Overview” and “2 Purpose of this doc-

ument and its relationship with other applicable regulations,” into a new consolidated, shorter section “1 Overview” in v13.0. In particular, several lengthy quotations of statutes in v12.0 that had been published unchanged for several years have become extraneous now that the statutes are available on easily accessed websites, and are deleted from v13.0. Similarly, a lengthy “document revision history” in v12.0 (section 1.6.2) will be posted for reference on an easily accessible website and no longer needs to be incorporated in the rule. Other similar changes were made to reduce information and/or instructions that have become outdated and/or unnecessary, especially when such infor-mation can be made readily available through more accessible, easily maintained websites.

• Similarly, sections 3 (“How to use this document) and 4 (“ASC X12/005010X221A1 Health Care Claim Payment Advice (835) Transaction: Transaction Specific Information”) in v12.0 were consolidated in a single section 2 (“Transaction specific instructions and information to be used with the 005010X221A1”) in v13.0. The consolida-tion resulted in deletions and reorganization of information and instructions that had become redundant or superflu-ous.

• V12.0 included five appendices that are also included in v13.0, and these appendices have also been shortened, reor-ganized, and renumbered for clarity, brevity, and ease of use. In particular:

o Appendix A in v12.0 (“Minnesota Crosswalk for the Claim Adjustment Reason Codes (CARC), Claim Adjustment Group Codes, and Remittance Advice Remark Codes (RARC)” has been retitled more simply in v13.0 as “Requirements and instructions for CARC, RARC, and CAGC use.” In addition, section 5.1.5 of the v12.0 Appendix A included a lengthy, multi-page table listing “RARC and CAGC to use with CARC 227 for the business scenario ‘Additional Information Required – Missing/Invalid/Incomplete Information from the Patient.’” The list has been deleted from v13.0 for brevity and will instead be available at an easily accessible website.

o Appendix C, “Coordination of Benefits (COB) Examples” in v13.0 includes a new “Example 4 – Tertiary Billing” for COB associated with tertiary billing.

o Additional brief explanatory material, including a new subsection E.2.3 (“Interpretation of APR-DRG”), and some slightly new formatting have been added to v13.0 Appendix E, “Reporting All Patients Refined Diagnosis Related Groups (APR- DRG).” These changes are proposed to better convey the information shown in the examples and to assure that the document meets accessibility standards and requirements.

• Other minor grammatical and formatting changes or corrections have been made throughout for clarification, accura-cy, ease of use, and accessibility.

Rule Adoption. After the Commissioner of Health has considered all comments received during the 30-day public comment period, the Commissioner will publish a notice of adoption of the rule in the State Register, including any re-visions to the above referenced proposed version 13.0 rule. The adopted version will be known as version 14.0 and will supersede any previous versions. The version 14.0 rule will take effect 30 days subsequent to the notice of adoption.

When the proposed rule is adopted, it:

• Is to be used in conjunction with all applicable Minnesota and federal regulations, including 45 CFR Parts 160, 162, and 164 (HIPAA Administrative Simplification, including adopted federal operating rules) and related X12N and retail pharmacy specifications (X12N and NCPDP implementation specifications).

• Will supplement, but will not otherwise modify, the ASC X12N and NCPDP implementation specifications in a manner that will make their implementation by users to be out of compliance.


Official Notices• Must be appropriately incorporated by reference and/or the relevant transaction information must be displayed in

any companion guides provided by entities subject to Minnesota Statutes, section 62J.536.

Jan K. MalcolmCommissionerP.O. Box 64975St. Paul, MN 55164-0975

Department of HealthHealth Policy Division – Managed Care Systems Section

Notice of Application for Essential Community Provider Status

NOTICE IS HEREBY GIVEN that an application for designation as an Essential Community Provider (ECP) has been submitted to the Commissioner of Health by St. Cloud Hospital Behavioral Health Services in St. Cloud. Clini-cal services are offered at St. Cloud Hospital Behavioral Health Services and the Central Minnesota Heart Center, both at 1406 6th Avenue North, St. Cloud, Minnesota 56303; CentraCare Family Health Center, 1555 Northway Drive, St. Cloud 56303; and Internal Medicine, Pediatrics, and Northway Family Medicine, all at 1900 CentraCare Circle, St. Cloud, Minnesota 56303.

An ECP is a health care provider that serves high-risk, special needs, and underserved individuals. To be designat-ed as an ECP, a provider must demonstrate that it meets the requirements of Minnesota Statutes Section 62Q.19 and Minnesota Rules Chapter 4688. The public is allowed 30 days from the publication date of this notice to submit written comments on the application. The commissioner will approve or deny the application once the comment period and compliance review are complete.

For more information contact:Anne Kukowski

Managed Care Systems SectionHealth Regulation Division

Department of HealthP.O. Box 64882

St. Paul, MN 55164-0882651-201-5173

Department of Natural ResourcesLands and Minerals Division

Notice of Proposed Boundary Line Agreement

NOTICE IS HEREBY GIVEN, that the Minnesota Department of Natural Resources, Division of Lands and Min-erals, pursuant to Minnesota Statutes, section 84.0273, proposes to issue a boundary line agreement to correct a boundary line discrepancy affecting the ownership interests of the State and adjacent landowners, Walter J. Bonfe and Susanne Rosen Bonfe, married to each other. The boundary line agreement involves land located in the Southeast Quarter of the Southwest Quarter of Section 24, Township 102, Range 9, Fillmore County, Minnesota. The reason for the boundary line agreement is to create a definite boundary between the parcels owned by the State and the adjacent landowners, consistent with a 2012 survey. The State and the adjacent landowners wish to make their mutual boundaries definite and certain.

For more information about this conveyance or a copy of the proposed boundary line agreement, contact Derek Hilding, Department of Natural Resources, Division of Lands and Minerals, 500 Lafayette Road, St. Paul, MN 55155; telephone (651) 259-5388; TTY: 1-800-657-3929; fax: (651) 896-5939; email: [email protected].

Signed February 19, 2019, by Susan E. Damon, Acting Director, Division of Lands and Minerals.


Official NoticesDepartment of Natural Resources

Lands and Minerals DivisionNotice of Proposed Deed for Boundary Resolution

NOTICE IS HEREBY GIVEN, that the Minnesota Department of Natural Resources, Division of Lands and Minerals, pursuant to Minnesota Statutes, section 84.0273, proposes to issue a quit claim deed to correct boundary line discrepancies affecting the ownership interests of the State and adjacent landowners, Cherice Bearden and John Bearden, married to each other, and Deri Nordsving and Karen Nordsving, married to each other. The quit claim deed involves land located in the S1/2 of SE1/4 of SW1/4 of SE1/4 of Section 24 and N1/2 of NW1/4 of NE1/4 of Section 25, all in Township 102, Range 9, Fillmore County, Minnesota. The reason for the deed is to create definite boundaries between the parcels owned by the State and the adjacent landowners. The State and the adjacent landowners wish to make their mutual boundaries definite and certain.

For more information about this conveyance or a copy of the proposed quit claim deed, contact Derek Hilding, Department of Natural Resources, Division of Lands and Minerals, 500 Lafayette Road, St. Paul, MN 55155; telephone (651) 259-5388; TTY: 1-800-657-3929; fax: (651) 896-5939; email: [email protected].


Department of Natural ResourcesLands and Minerals Division

Notice of Proposed Deed for Boundary Resolution

NOTICE IS HEREBY GIVEN, that the Minnesota Department of Natural Resources, Division of Lands and Minerals, pursuant to Minnesota Statutes, section 84.0273, proposes to issue a quit claim deed to correct a boundary line discrepancy affecting the ownership interests of the State and adjacent landowners, Kevin Nelson and Sandy Nelson, married to each other, Ben Stelpflug and Alissa Stelpflug, married to each other, Sam Nelson and Amy Nelson, married to each other, Ryan Nelson, a single person, and Trent Nelson, a single person. The quit claim deed involves the east 24 rods of the Southwest Quarter of the Southeast Quarter of Section 24, Township 102, Range 9, Fillmore County, Minne-sota, lying north of the north line of the South Half of the Southeast Quarter of the Southwest Quarter of the Southeast Quarter of said Section 24, Fillmore County, Minnesota. The reason for the deed is to create a definite boundary between the parcels owned by the State and the adjacent landowners. The State and the adjacent landowners wish to make their mutual boundaries definite and certain.

For more information about this conveyance or a copy of the proposed quit claim deed, contact Derek Hilding, Department of Natural Resources, Division of Lands and Minerals, 500 Lafayette Road, St. Paul, MN 55155; telephone (651) 259-5388; TTY: 1-800-657-3929; fax: (651) 896-5939; email: [email protected].


Minnesota Pollution Control Agency (MPCA)Request for Comments on a Planned Rule Amendment to Change Use Classifications for a Portion of Dark River in St. Louis County, Minn. R. pt. 7050.0470; Revisor’s ID Number 4572

NOTICE IS HEREBY GIVEN that the Minnesota Pollution Control Agency (MPCA) is requesting comments from affected or interested parties on a planned amendment to rules establishing the beneficial use classifications of the trout stream portion of Dark River in St. Louis County (identified as AUID 09030005-525). The planned amendments will only affect the use classifications of this portion of the Dark River as identified in Minn. R. pt. 7050.0470.


Official NoticesPlain-Language Summary of the Request for Comments. This is the MPCA’s legal notice of its intent to begin

the rulemaking process to amend the rule establishing the use classification of the trout stream portion of the Dark River. This is the first opportunity for public comment and input on this rule project. We want your feedback to inform us about the ideas described under the Subject of Rules section below. If you have comments or ideas about the amendment being considered, please submit them in writing according to the Public Comment section below. Submitting your ideas and information at this early stage in rulemaking allows us more time to address issues, and helps to ensure informed decision-making.

Subject of Rules. Minnesota’s surface waters are currently assigned, or designated, multiple beneficial uses (e.g., drinking water, aquatic life, industrial consumption) based on which beneficial uses are or should be attained in those waters. Different physical and chemical criteria apply depending on the beneficial uses that need to be protected in each water. Unless specifically reclassified in rule, all waters are by default assigned the uses for aquatic life, industrial and agricultural use, wildlife, and aesthetic enjoyment. This Request for Comments (Request) provides notice that the MPCA is considering conducting rulemaking to change certain of the existing use classifications that apply to a trout stream portion of the Dark River in St. Louis County.

Minn R. 7050.0405 establishes that any person may petition the MPCA to consider the reclassification of a water body by submitting evidence that a beneficial use does not exist or is not attainable. The MPCA has received such a petition from U.S. Steel Corporation requesting specific changes to the use classification of the portion of Dark River currently classified as a trout stream. The portion of the Dark River classified as a trout stream originates 1.59 miles downstream of Dark Lake and continues for 7.91 miles (identified as AUID 09030005-525). The portions of the Dark River upstream and downstream of this section are not being considered for reclassification.

The petition requests to remove the Class 1B (drinking water), Class 3 (industrial consumption), and Class 4A (agricultural irrigation) beneficial use designations from the portion of the Dark River designated as a trout stream on the basis that they are not existing or attainable uses. The MPCA has reviewed the petition request and tentatively supports the requested changes. With this notice, the MPCA is seeking public comment on its intent to enter into the state’s administrative rulemaking process to make the changes necessary to remove the Class 1B, 3, and 4A uses from the trout stream portion of the Dark River.

The MPCA’s decision to propose these changes is based on the determination that the specific beneficial uses of drinking water, industrial consumption, and agricultural irrigation do not currently exist for the trout stream portion of the Dark River and are not reasonably expected to exist in the future. All other use classes, and the standards that protect those uses, including the protection of aquatic life and the identification of this water as a trout water, will not be affected by the use classification changes being considered. The U.S. Steel petition, which provides the technical basis for the change in use classifications, is available for review at https://www.pca.state.mn.us/water/wqs-dark-river .

The planned changes in this rulemaking will update the document incorporated by reference in Minn. R. 7050.0470 that lists the specific use designations for the trout stream portion of the Dark River to remove the Classes 1B, 3, and 4A designated uses. The Classes 2Ag, 4B, 5, and 6 designated uses will remain unchanged.

Persons Affected. The persons affected by this rule change will be the petitioner and any persons who have a cur-rent or future interest in the use of this portion of the Dark River for drinking water, agricultural irrigation or industrial consumption. Persons who may be interested, though unaffected, may be environmental groups, trout fishers, wild rice harvesters and any persons interested in the protection of Minnesota’s waters.

Statutory Authority. Minnesota Statutes § 115.03, subd. 1(b) and 1(c) authorizes the MPCA to “…make such classi-fication of the waters of the state as it may deem advisable…,” and to “…alter such reasonable pollution standards for any waters of the state in relation to the public use to which they are or may be put as it shall deem necessary….”

https://www.pca.state.mn.us/water/wqs-dark-river


Official Notices115.03, subd. 1. Generally.

The agency is hereby given and charged with the following powers and duties:

(a) to administer and enforce all laws relating to the pollution of any of the waters of the state;

(b) to investigate the extent, character, and effect of the pollution of the waters of this state and to gather data and information necessary or desirable in the administration or enforcement of pollution laws, and to make such classification of the waters of the state as it may deem advisable;

(c) to establish and alter such reasonable pollution standards for any waters of the state in relation to the public use to which they are or may be put as it shall deem necessary for the purposes of this chapter and, with respect to the pollution of waters of the state, chapter 116;

Minnesota Statutes § 115.44, subd.2 also authorizes the MPCA to “…group the designated waters of the state into class-es, and adopt classifications and standards of purity and quality therefor. Such classification shall be made in accor-dance with considerations of best usage in the interest of the public and with regard to the considerations mentioned in subdivision 3 hereof.”

Public Comment. Interested persons or groups may submit comments or information on these possible rules in writing until 4:30 p.m. on April 29, 2019. The MPCA will not publish a notice of intent to adopt the rules until at least 60 days have elapsed from the date of this Request.

In addition to seeking general information and opinions about the changes being considered, the state rulemaking process requires agencies to seek and consider information on specific topics relating to the changes being considered. The MPCA requests that interested persons submit:

• Information regarding the possible economic effect of the possible rule amendments. • Information pertaining to the cumulative effect of the possible rule amendments. Cumulative effect means the

impact that results from incremental effects of the proposed rule in addition to other rules, regardless of what state or federal agency has adopted the other rules.

• Information on the potential effect on local government ordinances or regulations as described in Minnesota Statutes § 14.128. The MPCA does not anticipate that the rule amendments will require a local government to adopt or amend an ordinance or other regulation. Local governments may submit written information to the contrary.

Rule Drafts. Information about the proposed amendment and rulemaking activities will be posted on https://www.pca.state.mn.us/water/wqs-dark-river and you are encouraged to register at GovDelivery to receive notice and information about this rulemaking.

MPCA Contact Person. Written comments, questions, and requests for more information on this possible amend-ment should be directed to:

Carol Nankivel Minnesota Pollution Control Agency

520 Lafayette Road North, St. Paul, Minnesota, 55155-4194Telephone: 651-757-2597; Toll-free: 1-800-657-3864; Fax 651-297-1456

Email: [email protected]

Alternative Format. Upon request, the MPCA can make this information available in an alternative format, such as large print, braille, or audio. To make such a request, please contact the MPCA contact person at the address or telephone number listed above.

https://www.pca.state.mn.us/water/wqs-dark-river

https://public.govdelivery.com/accounts/MNPCA/subscriber/new?topic_id=MNPCA_359



Official NoticesNOTE: Comments received in response to this notice will be considered by the MPCA in the development of pro-

posed rules but will not necessarily be included in the formal rulemaking record submitted to the Administrative Law Judge (ALJ). The MPCA is required to submit to the ALJ only those written comments received in response to the rules after they are proposed. If you want the ALJ to review your comments, you must resubmit them when the MPCA pub-lishes proposed rules for public comment.

Laura Bishop, Commissioner Minnesota Pollution Control Agency

State Grants & LoansIn addition to requests by state agencies for technical/professional services (published in the State Contracts

Section), the State Register also publishes notices about grants and loans available through any agency or branch of state government. Although some grant and loan programs specifically require printing in a statewide pub-lication such as the State Register, there is no requirement for publication in the State Register itself. Agencies are encouraged to publish grant and loan notices, and to provide financial estimates as well as sufficient time for interested parties to respond.

SEE ALSO: Office of Grants Management (OGM) at: http://www.grants.state.mn.us/public/

Department of Employment and Economic Development (DEED)Notice of Grant Opportunity

NOTICE IS HEREBY GIVEN that the Minnesota Department of Employment and Economic Development (DEED) places notice of any available grant opportunities online at https://mn.gov/deed/about/contracts/

Department of Human Services Behavioral Health Division

Notice of Request for Proposals to Provide an Array of Wrap Around Services Necessary to Promote Community Presence and Stability for Individuals Discharged from Anoka Metro Regional Treatment Center (AMRTC) or Minnesota Security Hospital (MSH)-St. Peter

NOTICE IS HEREBY GIVEN that the Minnesota Department of Human Services is requesting proposals through its Behavioral Health Division (State), is seeking proposals from qualified Responders to provide an array of wrap around services that will promote community reintegration and stabilization for individuals who are discharging from Anoka Metro Regional Treatment Center (AMRTC) OR Minnesota Security Hospital (MSH) - St. Peter. These services have been referred to as the “Whatever It Takes (WIT)” program that is overseen by the DHS Behavioral Health Divi-sion’s Transition to Community Initiative team lead.

Work is proposed to start June 15, 2019. For more information, or to obtain a copy of the Request for Proposal, contact:

Maria Krynicki, MSW, LICSWDepartment of Human Services

Behavioral Health DivisionP.O. Box 64981

444 Lafayette Road North, St. Paul, MN 55155Phone: (651) 431-6413, Fax: (651) 431-7566

[email protected]

This is the only person designated to answer questions by potential responders regarding this request.


State Grants & Loans Proposals submitted in response to this Request for Proposals must be received at the address above no later than

4:00 p.m., Central Time, April 19, 2019. Late proposals will not be considered. Faxed or e-mailed proposals will not be considered.

The RFP can be viewed by visiting the Minnesota Department of Human Services RFP web site: http://www.dhs.state.mn.us/id_000102

This request does not obligate the State to complete the work contemplated in this notice. The State reserves the right to cancel this solicitation. All expenses incurred in responding to this notice are solely the responsibility of the responder.

Department of Human ServicesChild Safety and Permanency Division

Notice of Request for Proposals to Design and Implement Community Integration for a Plan of Safe Care for Prenatal Substance Exposure

NOTICE IS HEREBY GIVEN that the Minnesota Department of Human Services (State) is requesting proposals to design community integration of a plan of safe care for prenatal substance exposure.

Work is proposed to start July 1, 2019. For more information, or a copy of the Request for Proposal, contact:

Susan KrinkieMinnesota Department of Human Services

Child Safety and Permanency DivisionP.O. Box 64943

444 Lafayette Road North, St. Paul, MN 55155 0943Phone: 651-431-4697, Fax: 651-431-7522

[email protected] This is the only person designated to answer questions by potential responders regarding this request. Proposals submitted in response to this Request for Proposals must be received at the address above no later than

4:00 p.m., Central Time, April 5, 2019. Late proposals will not be considered. Faxed or emailed proposals will not be considered.

The RFP is online and accessed on the Minnesota Department of Human Services’ RFP website:

http://www.dhs.state.mn.us/id_000102. This request does not obligate the State to complete the work contemplated in this notice. The State reserves the

right to cancel this solicitation. All expenses incurred in responding to this notice are solely the responsibility of respond-ers.


State Grants & LoansDepartment of Human Services

Child Safety and Permanency Division Notice of Request for Proposals to Innovate, Develop, Implement and/or Expand Programs and Initiatives that Will Reduce out of Home Placement of Children, and/or Address the Disproportional Representation of Marginalized Communities in the Minnesota Child Welfare System

NOTICE IS HEREBY GIVEN that the Minnesota Department of Human Services is requesting proposals to innovate, develop, implement and/or expand programs and initiatives that will reduce out of home placement of children, and/or address the disproportional representation of marginalized communities in the Minnesota child welfare system.

Work is proposed to start no earlier than March 30, 2019. For more information, or to obtain a copy of the Request for Proposal, contact:

Joanne MooneyDepartment of Human Services

Child Safety and Permanency DivisionP.O. Box 64943

444 Lafayette Road North, St. Paul, MN 55155 0943Phone: (651) 431-4660, Fax: (651) 431-7522

[email protected]

This is the only person designated to answer questions by potential responders regarding this request.

Proposals submitted in response to this Request for Proposals must be received at the address above no later than 4:00 p.m., Central Time, January 21, 2022. Late proposals will not be considered. Faxed or e-mailed proposals will not be considered.

The RFP can be viewed by visiting the Minnesota Department of Human Services RFP web site: http://www.dhs.state.mn.us/id_000102


Department of Human Services Disability Services Division

Addendum to Request for Proposals for a Qualified Grantee to provide State Quality Council Management Support

NOTICE IS HEREBY GIVEN that the Minnesota Department of Human Services through its Disability Services

Division has published an Addendum to its Request for Proposal for a Qualified Grantee to provide State Quality Council management support that was published in the March 4, 2019 State Register. In the Addendum, the State is (a) extending the deadline for responders to submit questions regarding this RFP to 4:00 p.m. Central Time on April 15, 2019, and (b) extending the deadline for submitting proposals to 4:00 p.m. Central Time on April 29, 2019.


State Grants & LoansTo request a full text of the RFP Addendum please contact:

Jason FlintDepartment of Human Services

Disability Services DivisionP.O. Box 64967

St. Paul, MN 55164 0967Phone: (651) 431-2386

This is the only person designated to answer questions by potential responders regarding this RFP.

The text of the RFP Addendum can also be viewed by visiting the Minnesota Department of Human Services RFP web site: http://www.dhs.state.mn.us/main/id_000102


State Contracts Informal Solicitations: Informal solicitations for professional/technical (consultant) contracts valued at over

$5,000 through $50,000, may either be published in the State Register or posted on the Department of Administra-tion, Materials Management Division’s (MMD) Web site. Interested vendors are encouraged to monitor the P/T Contract Section of the MMD Website at www.mmd.admin.state.mn.us for informal solicitation announcements.

Formal Solicitations: Department of Administration procedures require that formal solicitations (announce-ments for contracts with an estimated value over $50,000) for professional/technical contracts must be published in the State Register. Certain quasi-state agency and Minnesota State College and University institutions are exempt from these requirements.

Requirements: There are no statutes or rules requiring contracts to be advertised for any specific length of time, but the Materials Management Division strongly recommends meeting the following requirements: $0 - $5000 does not need to be advertised. Contact the Materials Management Division: (651) 296-2600 $5,000 - $25,000 should be advertised in the State Register for a period of at least seven calendar days; $25,000 - $50,000 should be advertised in the State Register for a period of at least 14 calendar days; and anything above $50,000 should be advertised in the State Register for a minimum of at least 21 calendar days.

Department of AgricultureNotice of Contract Opportunity for Agricultural Research and Evaluation of the Clean Water Fund

PROJECT NAME: Agricultural Research and Evaluation of the Clean Water Fund

DETAILS: The Minnesota Department of Agriculture, Pesticide and Fertilizer Management Division (MDA) is requesting proposals from scientists and researchers to conduct research related to clean water in agricultural areas of the State. The goal of this RFP is to fund research that improves water quality in Minnesota by evaluating and promot-ing agricultural practices and technologies. Research outcome are applicable and informative to many state programs including the Minnesota Nitrogen Fertilizer Management Plan (NFMP), the Water Restoration and Protection Strate-gies (WRAPS) and the comprehensive watershed framework One Watershed One Plan (1W1P). A number of research priorities have been identified based on input from multiple stakeholders including state agencies and research entities. Proposals must include a cost effectiveness component, as well as an education and outreach plan to benefit the people of Minnesota. See the Request for Proposals (RFP) for information on the research priorities for this cycle. MDA may


State Contractsaward multiple projects from this RFP. Approximately $700,000 in funds can be awarded across all projects.

COPY REQUEST: To get a copy of the RFP, please send a written request, by email, to:

Aicam LaacouriClean Water Research Coordinator

Email: [email protected]

PROPOSAL DEADLINE: Proposals submitted in response to the RFP in this advertisement must be received no later than 3:00 p.m. Central Time, on Friday, April 12, 2019 (hard copy or email submission). Late or faxed propos-als will not be considered.


Completed and Current Funded ProjectsFor a list of Clean Water research projects supported by MDA, please visit:

www.mda.state.mn.us/clean-water-research-projects.

Minnesota State Colleges and Universities (Minnesota State)System Office – Marketing and Communications

Request for Proposals for a Media Buyer to Support Marketing and Communication Efforts for Minnesota State Transfer Pathways

Minnesota State Colleges and Universities (Minnesota State) is requesting proposals for a media buying agency to assist with making media purchases to promote Minnesota State Transfer Pathways available at state colleges and univer-sities. The timeframe for media purchases is spring and summer of 2019, but may be extended if funds are available.

Minnesota State must receive all responses to this RFP no later than 5:00 P.M. Central Time on Monday, April 1, 2019 and should be delivered to:

Minnesota State Colleges and Universities, System OfficeMargie Takash, Administrative Project Support

Marketing and Communications Division30 7th Street East, Suite 350

St. Paul, MN 55101

Inquiries about this RFP must be directed to:

Barbara Hein, Director of MarketingTelephone: 651-201-1429

E-mail: [email protected]

For a complete copy of the RFP and required submission materials, please visit the RFP website at http://www.mnscu.edu/vendors/index.html (following media buying link).


State ContractsMinnesota State Colleges and Universities (Minnesota State)

Bemidji State University and Northwest Technical College Notice of Request for Proposal (RFP) for Vending Services

Bemidji State University and Northwest Technical College are soliciting proposals for Vending Services – Beverage and/or Snack Services. The full Request for Bid/Bid Form can be downloaded at: https://www.bemidjistate.edu/rfps-and-bids/

Questions regarding this RFP need to be submitted in writing through the university’s website https://www.bemidjistate.edu/rfps-and-bids/ under Submit Questions by the end of the day on Monday, April 1, 2019. Responses to the questions will be posted to the BSU RFP website on Wednesday, April 3, 2019.

Please submit your original, signed, sealed proposal to:

Bemidji State University and Northwest Technical College Ron Beckstrom

Director of Business ServicesBusiness Services #5

1500 Birchmont DriveBemidji, MN 56601

Sealed proposals must be received NO later than 2:00 PM, Tuesday, April 9, 2019; late responses will not be con-sidered. Faxed and e-mails proposals will be rejected.

Bemidji State University reserves the right to reject any or all bids, to waive any irregularities or informalities, and to cancel the solicitation if it is considered to be in its own best interest. This Request for Bid does not obligate Bemidji State University to award a purchase order or contract.

Minnesota State Colleges and Universities (Minnesota State)Minnesota State University Mankato

Notice of Availability of Request for Qualifications (RFQ) for Minnesota State University, Mankato - Sports Dome Project

Kraus-Anderson Construction Company, acting on behalf of the Board of Trustees of the Minnesota State Colleges & Universities, on behalf of Minnesota State University Mankato, is soliciting qualification proposals from interested, qualified firms for the Construction Trade Packages of the Minnesota State University, Mankato - Sports Dome project.

A full Request for Qualifications is available at the offices of Kraus-Anderson Construction Company, or at the following websites: www.franzrepro.com, www.bexroch.com, www.mbex.org, www.mankatobx.org or on the Minnesota State Register website.

Project questions shall be referred to the appropriate person listed in the Request for Qualifications. Qualifications from interested firms must be delivered to John Pristash, Senior Project Manager, Kraus-Anderson Construction Com-pany, 502 2nd Avenue SW, Rochester, MN 55902, not later than 4:00 PM, April 12th, 2019. Late responses will not be considered.

Kraus-Anderson Construction Company and Minnesota State Colleges and Universities are not obligated to complete the proposed project and reserve the right to cancel the solicitation if it is considered to be in its best interest.


State ContractsDepartment of Military Affairs

Facilities Management Office, Camp Ripley, Little Falls, MNRequest for Proposals for Consultant Services to Conduct and Prepare a Planning & Programming Document Charrette for the Proposed Joint Emergency Response Training Center (JERTC) at Camp Ripley, Little Falls, MN (Project No. 19127)

The State of Minnesota, Department of Military Affairs, is soliciting proposals from interested, qualified consultants for architectural and engineering design services for the above referenced project.

COPY REQUEST: To request a copy of the Request for Proposals (RFP), please send a written request, by email, to:

Ms. Jill SchultzContract Specialist

Facilities Management OfficeCamp Ripley

15000 Highway 115Little Falls, MN [email protected]

RFP responses must be received by the Department of Military Affairs, Attn: Ms. Jill Schultz, Facilities Management Office, Camp Ripley, 15000 Highway 115, Little Falls, Minnesota 56345-4173 no later than 3:00 p.m. Central Time on April 9, 2018. Late responses will not be considered. Fax and email responses to this RFP will not be accepted or considered.

A project site tour may be scheduled by contacting Mr. Mike Ramsdell at 320.616.2635 or [email protected].

The Department of Military Affairs is not obligated to complete the work contemplated in this notice and reserves the right to cancel the solicitation if it is considered to be in its best interest. All expenses incurred in responding to this notice are solely the responsibility of the responder.

Minnesota Department of Transportation (MnDOT)Engineering Services Division

Notices Regarding Professional/Technical (P/T) Contracting

P/T Contracting Opportunities: MnDOT is now placing additional public notices for P/T contract opportunities on the MnDOT’s Consultant Services website. New public notices may be added to the website on a daily basis and be available for the time period as indicated within the public notice.

Taxpayers’ Transportation Accountability Act (TTAA) Notices: MnDOT is posting notices as required by the TTAA on the MnDOT Consultant Services website.

MnDOT’s Prequalification Program: MnDOT maintains a Pre-Qualification Program in order to streamline the process of contracting for highway related P/T services. Program information, application requirements, application forms and contact information can be found on MnDOT’s Consultant Services website. Applications may be submitted at any time for this Program.

MnDOT Consultant Services website: www.dot.state.mn.us/consult

If you have any questions regarding this notice, or are having problems viewing the information on the Consultant Services website, please all the Consultant Services Help Line at 651-366-4611, Monday – Friday, 9:00am – 4:00pm.


State ContractsMinnesota ZooRequest for Information for Venue Programing

PROJECT NAME: Venue Programing

DETAILS: The Minnesota Zoological Garden (Minnesota Zoo or Zoo) is requesting information relative to pro-gramming in two venues on its campus: the 1,450-seat outdoor Weesner Family Amphitheater and a soon-to-be-vacated 514-seat large-format screen theater. The Zoo is evaluating potential uses and business models that best leverage the venues to raise revenue and advance the mission of the Zoo. No contract will result from any response to this RFI.

COPY REQUEST: To get a copy of the Request for Information, please send a written request, by email, to: [email protected]

RFI responses are due on or before April 4, 2019. Late submissions may not be addressed.

Minnesota ZooNotice of Contract Opportunity for Chinchilla Sculptures and Field Work Displays at Llama Trek Exhibit

PROJECT NAME: Chinchilla Sculptures and Field Work Displays at Llama Trek Exhibit

DETAILS: The Minnesota Zoo requests proposals for the design, fabrication, and installation of two realistic, life-size chinchilla sculptures (a short-tailed chinchilla and a long-tailed chinchilla). Secondly, the Minnesota Zoo requests proposals for fabrication and installation of two “smoke card” replicas. Additionally, the Minnesota Zoo requests propos-als for the fabrication, or modification, and installation of a camera trap and a quadcopter drone. The Zoo will provide a decommissioned camera trap and decommissioned quadcopter drone that can either be modified for mounting in the Llama Trek exhibit, or a mold could be made from which a sturdy, realistic replica can be produced. These interpretive elements will be featured in the chinchilla conservation area of the seasonal Llama Trek exhibit, located along the North-ern Trail. The storyline of the Llama Trek exhibit is that a team of Minnesota Zoo researchers is going to a chinchilla field research station in the Andes Mountains. Guests will learn about chinchilla conservation, and will have the opportu-nity to donate to the Zoo’s chinchilla conservation efforts.

Work is anticipated to start after April 9, 2019.

COPY REQUEST: To get a copy of the Request for Proposals, please send a written request, by email, to:

Nicole MattsonInterpretive Program Developer

Minnesota Zoo, 13000 Zoo Blvd, Apple Valley, MN [email protected]

PROPOSAL DEADLINE: Proposals submitted in response to the Request for Proposals in this advertisement must be received by mail and email no later than April 2, 2019, 3:00 pm. Late proposals will not be considered. Faxed proposals will not be considered.



State ContractsMinnesota ZooNotice of Contract Opportunity for Market Segmentation and Direct Mail Data Analysis Services

PROJECT NAME: Market Segmentation and Direct Mail Data Analysis Services

DETAILS: The Minnesota Zoo is requesting proposals from qualified vendors to develop market segmentation mod-els and provide database marketing services.

Work is anticipated to start after July 1, 2019

COPY REQUEST: To get a copy of the Request for Proposals, please send a written request, by email, to:

Caren Berry, Director of Sales, Events and MembershipMinnesota Zoo13000 Zoo Blvd

Apple Valley MN [email protected]

PROPOSAL DEADLINE: Proposals submitted in response to the Request for Proposals in this advertisement must be received, via mail, by 5PM on Friday, April 26, 2019. Late proposals will not be considered.



Non-State Public Bids, Contracts & GrantsThe State Register also serves as a central marketplace for contracts let out on bid by the public sector. The

State Register meets state and federal guidelines for statewide circulation of public notices. Any tax-supported institution or government jurisdiction may advertise contracts and requests for proposals from the private sector. It is recommended that contracts and RFPs include the following: 1) name of contact person; 2) institution name, address, and telephone number; 3) brief description of commodity, project or tasks; 4) cost estimate; and 5) final submission date of completed contract proposal. Allow at least three weeks from publication date (four weeks from the date article is submitted for publication). Surveys show that subscribers are interested in hearing about contracts for estimates as low as $1,000. Contact editor for further details.

Besides the following listing, readers are advised to check: http://www.mmd.admin.state.mn.us/solicitations.htm as well as the Office of Grants Management (OGM) at: http://www.grants.state.mn.us/public/.

Metropolitan Airports Commission (MAC)Notice of Call for Bids for 2019 Miscellaneous Construction

Project Location: Minneapolis-St. Paul International AirportProject Name: 2019 Miscellaneous ConstructionMAC Contract No. 106-1-293 Bids Close At: 2:00 PM on April 16, 2019

Notice to Contractors: Sealed bid proposals for the project listed above will be received by the MAC, a public cor-poration, at the office thereof located at 6040 28th Avenue South, Minneapolis, Minnesota 55450, until the date and hour indicated. This project provides for grading and drainage improvements for a portion of Runway 04-22 and the removal and installation of airfield pavement markings. Site work includes traffic control and airport security; grading and drain-age improvements; erosion control and turf establishment; and pavement marking.

Note: You can sign up on our Web site (www.metroairports.org) to receive email notifications of new business op-portunities, or go directly to https://public.govdelivery.com/accounts/MNORGMAC/subscriber/topics?gsp-CODE_RED and choose this and other topics about which you are interested.

Disadvantaged Business Enterprises (DBE): The goal of the MAC for the utilization of Disadvantaged Business Enterprises (DBE) on this project is 7%.

Bid Security: Each bid shall be accompanied by a "Bid-Security" in the form of a certified check made payable to the MAC in the amount of not less than five percent (5%) of the total bid, or a surety bond in the same amount, running to the MAC, with the surety company thereon duly authorized to do business in the State of Minnesota.

Availability of Bidding Documents: Bidding documents are on file for inspection at the office of TKDA, the Minne-sota Builders Exchange, Dodge Data and Analytics, and NAMC-UM Plan Room. Digital copies of the bidding documents will also be available at www.questcdn.com. Documents may be downloaded for a non-refundable fee of $50.00 by enter-ing Quest Project No. 6203754 on the Project Search page. Please contact QuestCDN at (952) 233-1632 or [email protected] for assistance and free membership registration. Hard copy drawings and specifications will not be made available to Bidders.

MAC Internet Access of Additional Information: A comprehensive Notice of Call for Bids for this project will be available on March 18, 2019, at MAC’s web address of http://www.metroairports.org/Airport-Authority/Business-Opportunities/Solicitations.aspx (construction bids).


Non-State Public Bids, Contracts & GrantsMetropolitan Airports Commission (MAC)Notice of Call for Bids for 2019 South Building Area Development-Phase 1 & Plane Wash Pad

Airport Location: Airlake AirportProject Name: 2019 South Building Area Development-Phase 1 & Plane Wash PadMAC Contract No.: 113-1-023 & 113-1-024Bids Close At: 2:00 p.m. on Tuesday, April 16, 2019

Notice to Contractors: Sealed Bid Proposals for the project listed above will be received by the MAC, a public cor-poration, at the office thereof located at 6040-28th Avenue South, Minneapolis, Minnesota 55450, until the date and hour indicated. Major work items include: 8” PVC Sanitary Sewer, 8” C900 Water Main, Excavation & Grading, Geotextile Fabric, P-154 Granular Borrow, P-208 Aggregate Base, P-401 Bituminous Pavement, P-501 Concrete Pavement, Pave-ment Marking, and Turf Restoration.

Note: You can sign up on our Web site (www.metroairports.org) to receive email notifications of new business op-portunities, or go directly to https://public.govdelivery.com/accounts/MNORGMAC/subscriber/topics?gsp-CODE_RED and choose this and other topics about which you are interested.

Disadvantaged Business Enterprises (DBE): The goal of the MAC for the utilization of Disadvantaged Business Enterprises (DBE) on this project is 11%.

Bid Security: Each bid shall be accompanied by a "Bid Security" in the form of a certified check made payable to the MAC in the amount of not less than five percent (5%) of the total bid, or a surety bond in the same amount, running to the MAC, with the surety company thereon duly authorized to do business in the State of Minnesota.

Availability of Bidding Documents: Bidding documents are on file for inspection at the office of Short Elliott Hen-drickson Inc., 3535 Vadnais Center Drive, Saint Paul, MN 55110; at the Minnesota Builders Exchange; Dodge Data and Analytics; and NAMC-UM Plan Room. Bidders desiring bidding documents may secure a complete set from: Northstar Imaging Services, Inc.; 1325 Eagandale Court - Suite 130; Eagan, MN 55121; 651.686.0477. Make checks payable to: Northstar Imaging Services, Inc. Deposit per set (nonrefundable): $65 (includes shipping).

MAC Internet Access of Additional Information: A comprehensive Notice of Call for Bids for this project will be available on March 18, 2019, at MAC’s web address of http://www.metroairports.org/Airport-Authority/Business-Opportunities/Solicitations.aspx (construction bids).

Minnesota State Register - Accessible_tcm36-376146.pdf · Notice of Request for Proposal (RFP) for...

Documents

Transcript of Minnesota State Register - Accessible_tcm36-376146.pdf · Notice of Request for Proposal (RFP) for...