sch4065a-2

1.1Senator Abeler moved to amend H.F. No. 4065, as amended pursuant to Rule 45,
1.2adopted by the Senate April 6, 2022, as follows:
1.3(The text of the amended House File is identical to S.F. No. 3816.)
1.4Delete everything after the enacting clause and insert:

1.5"ARTICLE 1

1.6DEPARTMENT OF HEALTH

1.7    Section 1. Minnesota Statutes 2020, section 144.057, subdivision 1, is amended to read:
1.8    Subdivision 1. Background studies required. (a) Except as specified in paragraph (b),
1.9the commissioner of health shall contract with the commissioner of human services to
1.10conduct background studies of:
1.11(1) individuals providing services that have direct contact, as defined under section
1.12245C.02, subdivision 11, with patients and residents in hospitals, boarding care homes,
1.13outpatient surgical centers licensed under sections 144.50 to 144.58; nursing homes and
1.14home care agencies licensed under chapter 144A; assisted living facilities and assisted living
1.15facilities with dementia care licensed under chapter 144G; and board and lodging
1.16establishments that are registered to provide supportive or health supervision services under
1.17section 157.17;
1.18(2) individuals specified in section 245C.03, subdivision 1, who perform direct contact
1.19services in a nursing home or a home care agency licensed under chapter 144A; an assisted
1.20living facility or assisted living facility with dementia care licensed under chapter 144G;
1.21or a boarding care home licensed under sections 144.50 to 144.58. If the individual under
1.22study resides outside Minnesota, the study must include a check for substantiated findings
1.23of maltreatment of adults and children in the individual's state of residence when the
1.24information is made available by that state, and must include a check of the National Crime
1.25Information Center database;
1.26(3) all other employees in assisted living facilities or assisted living facilities with
1.27dementia care licensed under chapter 144G, nursing homes licensed under chapter 144A,
1.28and boarding care homes licensed under sections 144.50 to 144.58. A disqualification of
1.29an individual in this section shall disqualify the individual from positions allowing direct
1.30contact or access to patients or residents receiving services. "Access" means physical access
1.31to a client or the client's personal property without continuous, direct supervision as defined
1.32in section 245C.02, subdivision 8, when the employee's employment responsibilities do not
1.33include providing direct contact services;
2.1(4) individuals employed by a supplemental nursing services agency, as defined under
2.2section 144A.70, who are providing services in health care facilities; ~~and~~
2.3(5) controlling persons of a supplemental nursing services agency, as defined under
2.4section 144A.70.; and
2.5(6) license applicants, owners, managerial officials, and controlling individuals who are
2.6required under section 144A.476, subdivision 1, or 144G.13, subdivision 1, to undergo a
2.7background study under chapter 245C, regardless of the licensure status of the license
2.8applicant, owner, managerial official, or controlling individual.
2.9(b) The commissioner of human services shall not conduct a background study on any
2.10individual identified in paragraph (a), clauses (1) to (5), if the individual has a valid license
2.11issued by a health-related licensing board as defined in section 214.01, subdivision 2, and
2.12has completed the criminal background check as required in section 214.075. An entity that
2.13is affiliated with individuals who meet the requirements of this paragraph must separate
2.14those individuals from the entity's roster for NETStudy 2.0.
2.15(c) If a facility or program is licensed by the Department of Human Services and subject
2.16to the background study provisions of chapter 245C and is also licensed by the Department
2.17of Health, the Department of Human Services is solely responsible for the background
2.18studies of individuals in the jointly licensed programs.
2.19EFFECTIVE DATE.This section is effective the day following final enactment.

2.20    Sec. 2. Minnesota Statutes 2021 Supplement, section 144.0724, subdivision 4, is amended
2.21to read:
2.22    Subd. 4. Resident assessment schedule. (a) A facility must conduct and electronically
2.23submit to the federal database MDS assessments that conform with the assessment schedule
2.24defined by the Long Term Care Facility Resident Assessment Instrument User's Manual,
2.25version 3.0, or its successor issued by the Centers for Medicare and Medicaid Services. The
2.26commissioner of health may substitute successor manuals or question and answer documents
2.27published by the United States Department of Health and Human Services, Centers for
2.28Medicare and Medicaid Services, to replace or supplement the current version of the manual
2.29or document.
2.30(b) The assessments required under the Omnibus Budget Reconciliation Act of 1987
2.31(OBRA) used to determine a case mix classification for reimbursement include ~~the following~~:
2.32(1) a new admission comprehensive assessment, which must have an assessment reference
2.33date (ARD) within 14 calendar days after admission, excluding readmissions;
3.1(2) an annual comprehensive assessment, which must have an ARD within 92 days of
3.2a previous quarterly review assessment or a previous comprehensive assessment, which
3.3must occur at least once every 366 days;
3.4(3) a significant change in status comprehensive assessment, which must have an ARD
3.5within 14 days after the facility determines, or should have determined, that there has been
3.6a significant change in the resident's physical or mental condition, whether an improvement
3.7or a decline, and regardless of the amount of time since the last comprehensive assessment
3.8or quarterly review assessment;
3.9(4) a quarterly review assessment must have an ARD within 92 days of the ARD of the
3.10previous quarterly review assessment or a previous comprehensive assessment;
3.11(5) any significant correction to a prior comprehensive assessment, if the assessment
3.12being corrected is the current one being used for RUG classification;
3.13(6) any significant correction to a prior quarterly review assessment, if the assessment
3.14being corrected is the current one being used for RUG classification;
3.15(7) a required significant change in status assessment when:
3.16(i) all speech, occupational, and physical therapies have ended. If the most recent OBRA
3.17comprehensive or quarterly assessment completed does not result in a rehabilitation case
3.18mix classification, then the significant change in status assessment is not required. The ARD
3.19of this assessment must be set on day eight after all therapy services have ended; and
3.20(ii) isolation for an infectious disease has ended. If isolation was not coded on the most
3.21recent OBRA comprehensive or quarterly assessment completed, then the significant change
3.22in status assessment is not required. The ARD of this assessment must be set on day 15 after
3.23isolation has ended; and
3.24(8) any modifications to the most recent assessments under clauses (1) to (7).
3.25(c) In addition to the assessments listed in paragraph (b), the assessments used to
3.26determine nursing facility level of care include the following:
3.27(1) preadmission screening completed under section 256.975, subdivisions 7a to 7c, by
3.28the Senior LinkAge Line or other organization under contract with the Minnesota Board on
3.29Aging; and
3.30(2) a nursing facility level of care determination as provided for under section 256B.0911,
3.31subdivision 4e, as part of a face-to-face long-term care consultation assessment completed
4.1under section 256B.0911, by a county, tribe, or managed care organization under contract
4.2with the Department of Human Services.

4.3    Sec. 3. Minnesota Statutes 2020, section 144.1201, subdivision 2, is amended to read:
4.4    Subd. 2. ~~By-product nuclear~~ Byproduct material. "~~By-product nuclear~~ Byproduct
4.5material" means ~~a radioactive material, other than special nuclear material, yielded in or~~
4.6~~made radioactive by exposure to radiation created incident to the process of producing or~~
4.7~~utilizing special nuclear material.~~:
4.8(1) any radioactive material, except special nuclear material, yielded in or made
4.9radioactive by exposure to the radiation incident to the process of producing or using special
4.10nuclear material;
4.11(2) the tailings or wastes produced by the extraction or concentration of uranium or
4.12thorium from ore processed primarily for its source material content, including discrete
4.13surface wastes resulting from uranium solution extraction processes. Underground ore
4.14bodies depleted by these solution extraction operations do not constitute byproduct material
4.15within this definition;
4.16(3) any discrete source of radium-226 that is produced, extracted, or converted after
4.17extraction for commercial, medical, or research activity, or any material that:
4.18(i) has been made radioactive by use of a particle accelerator; and
4.19(ii) is produced, extracted, or converted after extraction for commercial, medical, or
4.20research activity; and
4.21(4) any discrete source of naturally occurring radioactive material, other than source
4.22nuclear material, that:
4.23(i) the United States Nuclear Regulatory Commission, in consultation with the
4.24Administrator of the Environmental Protection Agency, the Secretary of Energy, the Secretary
4.25of Homeland Security, and the head of any other appropriate federal agency determines
4.26would pose a threat similar to the threat posed by a discrete source of radium-226 to the
4.27public health and safety or the common defense and security; and
4.28(ii) is extracted or converted after extraction for use in a commercial, medical, or research
4.29activity.

5.1    Sec. 4. Minnesota Statutes 2020, section 144.1201, subdivision 4, is amended to read:
5.2    Subd. 4. Radioactive material. "Radioactive material" means a matter that emits
5.3radiation. Radioactive material includes special nuclear material, source nuclear material,
5.4and ~~by-product nuclear~~ byproduct material.

5.5    Sec. 5. Minnesota Statutes 2020, section 144.1503, is amended to read:
5.6144.1503 HOME AND COMMUNITY-BASED SERVICES EMPLOYEE
5.7SCHOLARSHIP AND LOAN FORGIVENESS PROGRAM.
5.8    Subdivision 1. Creation. The home and community-based services employee scholarship
5.9grant and loan forgiveness program is established for the ~~purpose~~ purposes of assisting
5.10qualified provider applicants to fund employee scholarships for education in nursing and
5.11other health care fields; funding scholarships to individual home and community-based
5.12services workers for education in nursing and other health care fields; and repaying qualified
5.13educational loans secured by employees for education in nursing or other health care fields.
5.14    Subd. 1a. Definition. For purposes of this section, "qualified educational loan" means
5.15a government, commercial, or foundation loan secured by an employee of a qualified provider
5.16of home and community-based services for older adults for actual costs paid for tuition,
5.17reasonable education expenses, and reasonable living expenses related to the employee's
5.18graduate or undergraduate education.
5.19    Subd. 2. Provision of grants; scholarships; loan forgiveness. (a) The commissioner
5.20shall make grants available to qualified providers of ~~older adult~~ home and community-based
5.21services for older adults. Grants must be used by home and community-based service
5.22providers to recruit and train staff through the establishment of an employee scholarship
5.23fund.
5.24(b) The commissioner may provide scholarships for qualified educational expenses to
5.25individual home and community-based services workers who are employed in the home
5.26and community-based services field.
5.27(c) The commissioner may use up to one-third of the annual funding available for this
5.28section to establish a loan forgiveness program for eligible home and community-based
5.29services workers who provide home and community-based services to older adults and for
5.30whom an eligible provider employer submits their names to the commissioner for
5.31consideration. To the extent possible, the loan forgiveness program must meet the standards
5.32of the loan forgiveness program in section 144.1501.
6.1    Subd. 3. Eligibility. (a) Eligible providers must primarily provide services to individuals
6.2who are 65 years of age and older in home and community-based settings, including ~~housing~~
6.3~~with services establishments as defined in section~~ ~~144D.01, subdivision~~ 4 assisted living
6.4facilities as defined in section 144G.08, subdivision 7; adult day care as defined in section
6.5245A.02, subdivision 2a; and home care services as defined in section 144A.43, subdivision
6.63.
6.7(b) Under the scholarship program, qualifying providers must establish a home and
6.8community-based services employee scholarship program, as specified in subdivision 4.
6.9Providers that receive funding under this section must use the funds to provide educational
6.10programs or award scholarships to employees who: (1) are enrolled in a course of study
6.11that leads to career advancement with the provider or in the field of long-term care, including
6.12home care, care of persons with disabilities, nursing, or as a licensed assisted living director;
6.13and (2) work an average of at least 16 ten hours per week for the provider. Employees who
6.14receive a scholarship under this section must use the scholarship funds for eligible costs of
6.15enrolling in a course of study that leads to career advancement in the facility or in the field
6.16of long-term care, including home care, care of persons with disabilities, nursing, or as a
6.17licensed assisted living director.
6.18(c) Under the loan forgiveness program, qualifying providers that provide employee
6.19names to the commissioner for consideration must be located in Minnesota. If necessary
6.20due to the volume of applications for loan forgiveness, the commissioner, in collaboration
6.21with home and community-based services stakeholders, shall determine priority areas for
6.22loan forgiveness. Employees eligible for loan forgiveness include employees working as a
6.23licensed assisted living director. Employees selected to receive loan forgiveness must agree
6.24to work a minimum average of 32 hours per week for a minimum of two years for a
6.25qualifying provider organization in order to maintain eligibility for loan forgiveness under
6.26this section.
6.27    Subd. 4. ~~Home and community-based services employee scholarship program~~ Duties
6.28of participating qualifying providers. (a) Each qualifying provider under this section must
6.29propose a home and community-based services employee scholarship program, propose to
6.30provide contracted programming from a qualified educational institution, or submit employee
6.31names for consideration for participation in the loan forgiveness program.
6.32(b) For the scholarship program, providers must establish criteria by which funds are to
6.33be distributed among employees. At a minimum, the scholarship program must cover
6.34employee costs related to a course of study that is expected to lead to career advancement
7.1with the provider or in the field of long-term care, including home care, care of persons
7.2with disabilities, or nursing, or as a licensed assisted living director.
7.3    Subd. 5. ~~Participating providers~~ Request for proposals. The commissioner shall
7.4publish a request for proposals in the State Register, specifying qualifying provider eligibility
7.5requirements, criteria for a qualifying employee scholarship program, provider selection
7.6criteria, documentation required for program participation, maximum award amount, and
7.7methods of evaluation. The commissioner must publish additional requests for proposals
7.8each year in which funding is available for this purpose.
7.9    Subd. 6. Application requirements. (a) Eligible providers seeking a grant to provide
7.10scholarships and educational programming and eligible employees seeking a scholarship
7.11shall submit an application to the commissioner. Applications from eligible providers must
7.12contain a complete description of the employee scholarship program being proposed by the
7.13applicant, including the need for the organization to enhance the education of its workforce,
7.14the process for determining which employees will be eligible for scholarships, any other
7.15sources of funding for scholarships, the expected degrees or credentials eligible for
7.16scholarships, the amount of funding sought for the scholarship program, a proposed budget
7.17detailing how funds will be spent, and plans for retaining eligible employees after completion
7.18of their scholarship.
7.19(b) Eligible providers seeking loan forgiveness for employees shall submit to the
7.20commissioner the names of their employees to be considered for loan forgiveness. An
7.21employee whose name has been submitted to the commissioner and who wishes to apply
7.22for loan forgiveness must submit an application to the commissioner. The employee is
7.23responsible for securing the employee's qualified educational loans. The commissioner shall
7.24select employees for participation based on their suitability for practice as indicated by
7.25experience or training. The commissioner shall give preference to employees close to
7.26completing their training. For each year that an employee meets the service obligation
7.27required under subdivision 3, up to a maximum of four years, the commissioner shall make
7.28annual disbursements directly to the employee equivalent to 15 percent of the average
7.29educational debt for indebted graduates in their profession in the year closest to the
7.30employee's selection for which information is available, not to exceed the balance of the
7.31employee's qualified educational loans. Before receiving loan repayment disbursements
7.32and as requested, the employee must complete and return to the commissioner a confirmation
7.33of practice form provided by the commissioner verifying that the employee is practicing as
7.34required under subdivision 3. The employee must provide the commissioner with verification
7.35that the full amount of loan repayment disbursement received by the employee has been
8.1applied toward the designated loans. After each disbursement, verification must be received
8.2by the commissioner and approved before the next loan repayment disbursement is made.
8.3Employees who move to a different eligible provider remain eligible for loan repayment as
8.4long as they practice as required in subdivision 3. If an employee does not fulfill the required
8.5minimum service commitment according to subdivision 3, the commissioner shall collect
8.6from the employee the total amount paid to the employee under the loan forgiveness program,
8.7plus interest at a rate established according to section 270C.40. The commissioner shall
8.8deposit the money collected in an account in the special revenue fund and money in that
8.9account is annually appropriated to the commissioner for purposes of this section. The
8.10commissioner may allow waivers of all or part of the money owed to the commissioner as
8.11a result of a nonfulfillment penalty if emergency circumstances prevented fulfillment of the
8.12minimum service commitment.
8.13    Subd. 7. Selection process. The commissioner shall determine a maximum award for
8.14grants and loan forgiveness, and shall make ~~grant~~ selections based on the information
8.15provided in the grant application, including the demonstrated need for an applicant provider
8.16to enhance the education of its workforce, the proposed employee scholarship or loan
8.17forgiveness selection process, the applicant's proposed budget, and other criteria as
8.18determined by the commissioner. Notwithstanding any law or rule to the contrary, ~~funds~~
8.19~~awarded to grantees in a grant agreement do not lapse until the grant agreement expires~~
8.20amounts appropriated for purposes of this section do not cancel and are available until
8.21expended, except that at the end of each biennium, any remaining amount that is not
8.22committed by contract and not needed to fulfill existing commitments shall cancel to the
8.23general fund.
8.24    Subd. 8. Reporting requirements. (a) Participating providers who receive a grant for
8.25employee scholarships shall submit an invoice for reimbursement and a report to the
8.26commissioner on a schedule determined by the commissioner and on a form supplied by
8.27the commissioner. The report shall include the amount spent on scholarships; the number
8.28of employees who received scholarships; and, for each scholarship recipient, the name of
8.29the recipient, the current position of the recipient, the amount awarded, the educational
8.30institution attended, the nature of the educational program, and the expected or actual
8.31program completion date. During the grant period, the commissioner may require and collect
8.32from grant recipients other information necessary to evaluate the program.
8.33(b) Employees who receive scholarships from the commissioner shall report information
8.34to the commissioner on a schedule determined by the commissioner and on a form supplied
8.35by the commissioner.
9.1(c) Participating providers whose employees receive loan forgiveness shall submit a
9.2report to the commissioner on a schedule determined by the commissioner and on a form
9.3supplied by the commissioner. The report must include the number of employees receiving
9.4loan forgiveness, and for each employee receiving loan forgiveness, the employee's name,
9.5current position, and average number of hours worked per week. During the loan forgiveness
9.6period, the commissioner may require and collect from participating providers and employees
9.7receiving loan forgiveness other information necessary to evaluate the program and ensure
9.8ongoing eligibility.

9.9    Sec. 6. Minnesota Statutes 2020, section 144.1911, subdivision 4, is amended to read:
9.10    Subd. 4. Career guidance and support services. ~~(a)~~ The commissioner shall award
9.11grants to eligible nonprofit organizations and eligible postsecondary educational institutions,
9.12including the University of Minnesota, to provide career guidance and support services to
9.13immigrant international medical graduates seeking to enter the Minnesota health workforce.
9.14Eligible grant activities include the following:
9.15(1) educational and career navigation, including information on training and licensing
9.16requirements for physician and nonphysician health care professions, and guidance in
9.17determining which pathway is best suited for an individual international medical graduate
9.18based on the graduate's skills, experience, resources, and interests;
9.19(2) support in becoming proficient in medical English;
9.20(3) support in becoming proficient in the use of information technology, including
9.21computer skills and use of electronic health record technology;
9.22(4) support for increasing knowledge of and familiarity with the United States health
9.23care system;
9.24(5) support for other foundational skills identified by the commissioner;
9.25(6) support for immigrant international medical graduates in becoming certified by the
9.26Educational Commission on Foreign Medical Graduates, including help with preparation
9.27for required licensing examinations and financial assistance for fees; and
9.28(7) assistance to international medical graduates in registering with the program's
9.29Minnesota international medical graduate roster.
9.30~~(b) The commissioner shall award the initial grants under this subdivision by December~~
9.31~~31, 2015.~~

10.1    Sec. 7. Minnesota Statutes 2020, section 144.292, subdivision 6, is amended to read:
10.2    Subd. 6. Cost. (a) When a patient requests a copy of the patient's record for purposes of
10.3reviewing current medical care, the provider must not charge a fee.
10.4    (b) When a provider or its representative makes copies of patient records upon a patient's
10.5request under this section, the provider or its representative may charge the patient or the
10.6patient's representative no more than 75 cents per page, plus $10 for time spent retrieving
10.7and copying the records, unless other law or a rule or contract provide for a lower maximum
10.8charge. This limitation does not apply to x-rays. The provider may charge a patient no more
10.9than the actual cost of reproducing x-rays, plus no more than $10 for the time spent retrieving
10.10and copying the x-rays.
10.11    (c) The respective maximum charges of 75 cents per page and $10 for time provided in
10.12this subdivision are in effect for calendar year 1992 and may be adjusted annually each
10.13calendar year as provided in this subdivision. The permissible maximum charges shall
10.14change each year by an amount that reflects the change, as compared to the previous year,
10.15in the Consumer Price Index for all Urban Consumers, Minneapolis-St. Paul (CPI-U),
10.16published by the Department of Labor.
10.17    (d) A provider or its representative may charge the $10 retrieval fee, but must not charge
10.18a per page fee to provide copies of records requested by a patient or the patient's authorized
10.19representative if the request for copies of records is for purposes of appealing a denial of
10.20Social Security disability income or Social Security disability benefits under title II or title
10.21XVI of the Social Security Act; except that no fee shall be charged to a ~~person~~ patient who
10.22is receiving public assistance, or to a patient who is represented by an attorney on behalf
10.23of a civil legal services program or a volunteer attorney program based on indigency. For
10.24the purpose of further appeals, a patient may receive no more than two medical record
10.25updates without charge, but only for medical record information previously not provided.
10.26For purposes of this paragraph, a patient's authorized representative does not include units
10.27of state government engaged in the adjudication of Social Security disability claims.

10.28    Sec. 8. Minnesota Statutes 2020, section 144.497, is amended to read:
10.29144.497 ST ELEVATION MYOCARDIAL INFARCTION.
10.30The commissioner of health shall assess and report on the quality of care provided in
10.31the state for ST elevation myocardial infarction response and treatment. The commissioner
10.32shall:
11.1(1) utilize and analyze data provided by ST elevation myocardial infarction receiving
11.2centers to the ACTION Registry-Get with the guidelines or an equivalent data platform that
11.3does not identify individuals or associate specific ST elevation myocardial infarction heart
11.4attack events with an identifiable individual;
11.5(2) ~~quarterly~~ annually post a summary report of the data in aggregate form on the
11.6Department of Health website; and
11.7~~(3) annually inform the legislative committees with jurisdiction over public health of~~
11.8~~progress toward improving the quality of care and patient outcomes for ST elevation~~
11.9~~myocardial infarctions; and~~
11.10~~(4)~~ (3) coordinate to the extent possible with national voluntary health organizations
11.11involved in ST elevation myocardial infarction heart attack quality improvement to encourage
11.12ST elevation myocardial infarction receiving centers to report data consistent with nationally
11.13recognized guidelines on the treatment of individuals with confirmed ST elevation myocardial
11.14infarction heart attacks within the state and encourage sharing of information among health
11.15care providers on ways to improve the quality of care of ST elevation myocardial infarction
11.16patients in Minnesota.

11.17    Sec. 9. Minnesota Statutes 2021 Supplement, section 144.551, subdivision 1, is amended
11.18to read:
11.19    Subdivision 1. Restricted construction or modification. (a) The following construction
11.20or modification may not be commenced:
11.21(1) any erection, building, alteration, reconstruction, modernization, improvement,
11.22extension, lease, or other acquisition by or on behalf of a hospital that increases the bed
11.23capacity of a hospital, relocates hospital beds from one physical facility, complex, or site
11.24to another, or otherwise results in an increase or redistribution of hospital beds within the
11.25state; and
11.26(2) the establishment of a new hospital.
11.27(b) This section does not apply to:
11.28(1) construction or relocation within a county by a hospital, clinic, or other health care
11.29facility that is a national referral center engaged in substantial programs of patient care,
11.30medical research, and medical education meeting state and national needs that receives more
11.31than 40 percent of its patients from outside the state of Minnesota;
12.1(2) a project for construction or modification for which a health care facility held an
12.2approved certificate of need on May 1, 1984, regardless of the date of expiration of the
12.3certificate;
12.4(3) a project for which a certificate of need was denied before July 1, 1990, if a timely
12.5appeal results in an order reversing the denial;
12.6(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200,
12.7section 2;
12.8(5) a project involving consolidation of pediatric specialty hospital services within the
12.9Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number
12.10of pediatric specialty hospital beds among the hospitals being consolidated;
12.11(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds to
12.12an existing licensed hospital that will allow for the reconstruction of a new philanthropic,
12.13pediatric-orthopedic hospital on an existing site and that will not result in a net increase in
12.14the number of hospital beds. Upon completion of the reconstruction, the licenses of both
12.15hospitals must be reinstated at the capacity that existed on each site before the relocation;
12.16(7) the relocation or redistribution of hospital beds within a hospital building or
12.17identifiable complex of buildings provided the relocation or redistribution does not result
12.18in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds from
12.19one physical site or complex to another; or (iii) redistribution of hospital beds within the
12.20state or a region of the state;
12.21(8) relocation or redistribution of hospital beds within a hospital corporate system that
12.22involves the transfer of beds from a closed facility site or complex to an existing site or
12.23complex provided that: (i) no more than 50 percent of the capacity of the closed facility is
12.24transferred; (ii) the capacity of the site or complex to which the beds are transferred does
12.25not increase by more than 50 percent; (iii) the beds are not transferred outside of a federal
12.26health systems agency boundary in place on July 1, 1983; (iv) the relocation or redistribution
12.27does not involve the construction of a new hospital building; and (v) the transferred beds
12.28are used first to replace within the hospital corporate system the total number of beds
12.29previously used in the closed facility site or complex for mental health services and substance
12.30use disorder services. Only after the hospital corporate system has fulfilled the requirements
12.31of this item may the remainder of the available capacity of the closed facility site or complex
12.32be transferred for any other purpose;
13.1(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice
13.2County that primarily serves adolescents and that receives more than 70 percent of its
13.3patients from outside the state of Minnesota;
13.4(10) a project to replace a hospital or hospitals with a combined licensed capacity of
13.5130 beds or less if: (i) the new hospital site is located within five miles of the current site;
13.6and (ii) the total licensed capacity of the replacement hospital, either at the time of
13.7construction of the initial building or as the result of future expansion, will not exceed 70
13.8licensed hospital beds, or the combined licensed capacity of the hospitals, whichever is less;
13.9(11) the relocation of licensed hospital beds from an existing state facility operated by
13.10the commissioner of human services to a new or existing facility, building, or complex
13.11operated by the commissioner of human services; from one regional treatment center site
13.12to another; or from one building or site to a new or existing building or site on the same
13.13campus;
13.14(12) the construction or relocation of hospital beds operated by a hospital having a
13.15statutory obligation to provide hospital and medical services for the indigent that does not
13.16result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27
13.17beds, of which 12 serve mental health needs, may be transferred from Hennepin County
13.18Medical Center to Regions Hospital under this clause;
13.19(13) a construction project involving the addition of up to 31 new beds in an existing
13.20nonfederal hospital in Beltrami County;
13.21(14) a construction project involving the addition of up to eight new beds in an existing
13.22nonfederal hospital in Otter Tail County with 100 licensed acute care beds;
13.23(15) a construction project involving the addition of 20 new hospital beds in an existing
13.24hospital in Carver County serving the southwest suburban metropolitan area;
13.25(16) a project for the construction or relocation of up to 20 hospital beds for the operation
13.26of up to two psychiatric facilities or units for children provided that the operation of the
13.27facilities or units have received the approval of the commissioner of human services;
13.28(17) a project involving the addition of 14 new hospital beds to be used for rehabilitation
13.29services in an existing hospital in Itasca County;
13.30(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin County
13.31that closed 20 rehabilitation beds in 2002, provided that the beds are used only for
13.32rehabilitation in the hospital's current rehabilitation building. If the beds are used for another
13.33purpose or moved to another location, the hospital's licensed capacity is reduced by 20 beds;
14.1(19) a critical access hospital established under section 144.1483, clause (9), and section
14.21820 of the federal Social Security Act, United States Code, title 42, section 1395i-4, that
14.3delicensed beds since enactment of the Balanced Budget Act of 1997, Public Law 105-33,
14.4to the extent that the critical access hospital does not seek to exceed the maximum number
14.5of beds permitted such hospital under federal law;
14.6(20) notwithstanding section 144.552, a project for the construction of a new hospital
14.7in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:
14.8(i) the project, including each hospital or health system that will own or control the entity
14.9that will hold the new hospital license, is approved by a resolution of the Maple Grove City
14.10Council as of March 1, 2006;
14.11(ii) the entity that will hold the new hospital license will be owned or controlled by one
14.12or more not-for-profit hospitals or health systems that have previously submitted a plan or
14.13plans for a project in Maple Grove as required under section 144.552, and the plan or plans
14.14have been found to be in the public interest by the commissioner of health as of April 1,
14.152005;
14.16(iii) the new hospital's initial inpatient services must include, but are not limited to,
14.17medical and surgical services, obstetrical and gynecological services, intensive care services,
14.18orthopedic services, pediatric services, noninvasive cardiac diagnostics, behavioral health
14.19services, and emergency room services;
14.20(iv) the new hospital:
14.21(A) will have the ability to provide and staff sufficient new beds to meet the growing
14.22needs of the Maple Grove service area and the surrounding communities currently being
14.23served by the hospital or health system that will own or control the entity that will hold the
14.24new hospital license;
14.25(B) will provide uncompensated care;
14.26(C) will provide mental health services, including inpatient beds;
14.27(D) will be a site for workforce development for a broad spectrum of health-care-related
14.28occupations and have a commitment to providing clinical training programs for physicians
14.29and other health care providers;
14.30(E) will demonstrate a commitment to quality care and patient safety;
14.31(F) will have an electronic medical records system, including physician order entry;
14.32(G) will provide a broad range of senior services;
15.1(H) will provide emergency medical services that will coordinate care with regional
15.2providers of trauma services and licensed emergency ambulance services in order to enhance
15.3the continuity of care for emergency medical patients; and
15.4(I) will be completed by December 31, 2009, unless delayed by circumstances beyond
15.5the control of the entity holding the new hospital license; and
15.6(v) as of 30 days following submission of a written plan, the commissioner of health
15.7has not determined that the hospitals or health systems that will own or control the entity
15.8that will hold the new hospital license are unable to meet the criteria of this clause;
15.9(21) a project approved under section 144.553;
15.10(22) a project for the construction of a hospital with up to 25 beds in Cass County within
15.11a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's license holder
15.12is approved by the Cass County Board;
15.13(23) a project for an acute care hospital in Fergus Falls that will increase the bed capacity
15.14from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16 and closing
15.15a separately licensed 13-bed skilled nursing facility;
15.16(24) notwithstanding section 144.552, a project for the construction and expansion of a
15.17specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for patients
15.18who are under 21 years of age on the date of admission. The commissioner conducted a
15.19public interest review of the mental health needs of Minnesota and the Twin Cities
15.20metropolitan area in 2008. No further public interest review shall be conducted for the
15.21construction or expansion project under this clause;
15.22(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if the
15.23commissioner finds the project is in the public interest after the public interest review
15.24conducted under section 144.552 is complete;
15.25(26)(i) a project for a 20-bed psychiatric hospital, within an existing facility in the city
15.26of Maple Grove, exclusively for patients who are under 21 years of age on the date of
15.27admission, if the commissioner finds the project is in the public interest after the public
15.28interest review conducted under section 144.552 is complete;
15.29(ii) this project shall serve patients in the continuing care benefit program under section
15.30256.9693. The project may also serve patients not in the continuing care benefit program;
15.31and
15.32(iii) if the project ceases to participate in the continuing care benefit program, the
15.33commissioner must complete a subsequent public interest review under section 144.552. If
16.1the project is found not to be in the public interest, the license must be terminated six months
16.2from the date of that finding. If the commissioner of human services terminates the contract
16.3without cause or reduces per diem payment rates for patients under the continuing care
16.4benefit program below the rates in effect for services provided on December 31, 2015, the
16.5project may cease to participate in the continuing care benefit program and continue to
16.6operate without a subsequent public interest review;
16.7(27) a project involving the addition of 21 new beds in an existing psychiatric hospital
16.8in Hennepin County that is exclusively for patients who are under 21 years of age on the
16.9date of admission;
16.10(28) a project to add 55 licensed beds in an existing safety net, level I trauma center
16.11hospital in Ramsey County as designated under section 383A.91, subdivision 5, of which
16.1215 beds are to be used for inpatient mental health and 40 are to be used for other services.
16.13In addition, five unlicensed observation mental health beds shall be added;
16.14(29) upon submission of a plan to the commissioner for public interest review under
16.15section 144.552 and the addition of the 15 inpatient mental health beds specified in clause
16.16(28), to its bed capacity, a project to add 45 licensed beds in an existing safety net, level I
16.17trauma center hospital in Ramsey County as designated under section 383A.91, subdivision
16.185. Five of the 45 additional beds authorized under this clause must be designated for use
16.19for inpatient mental health and must be added to the hospital's bed capacity before the
16.20remaining 40 beds are added. Notwithstanding section 144.552, the hospital may add licensed
16.21beds under this clause prior to completion of the public interest review, provided the hospital
16.22submits its plan by the 2021 deadline and adheres to the timelines for the public interest
16.23review described in section 144.552; or
16.24(30) upon submission of a plan to the commissioner for public interest review under
16.25section 144.552, a project to add up to 30 licensed beds in an existing psychiatric hospital
16.26in Hennepin County that exclusively provides care to patients who are under 21 years of
16.27age on the date of admission. Notwithstanding section 144.552, the psychiatric hospital
16.28may add licensed beds under this clause prior to completion of the public interest review,
16.29provided the hospital submits its plan by the 2021 deadline and adheres to the timelines for
16.30the public interest review described in section 144.552.;
16.31(31) any project to add licensed beds in a hospital located in Cook County or Mahnomen
16.32County that: (i) is designated as a critical access hospital under section 144.1483, clause
16.33(9), and United States Code, title 42, section 1395i-4; (ii) has a licensed bed capacity of
16.34fewer than 25 beds; and (iii) has an attached nursing home, so long as the total number of
17.1licensed beds in the hospital after the bed addition does not exceed 25 beds. Notwithstanding
17.2section 144.552, a public interest review is not required for a project authorized under this
17.3clause; or
17.4(32) upon submission of a plan to the commissioner for public interest review under
17.5section 144.552, a project to add 22 licensed beds at a Minnesota freestanding children's
17.6hospital in St. Paul that is part of an independent pediatric health system with freestanding
17.7inpatient hospitals located in Minneapolis and St. Paul. The beds shall be utilized for pediatric
17.8inpatient behavioral health services. Notwithstanding section 144.552, the hospital may add
17.9licensed beds under this clause prior to completion of the public interest review, provided
17.10the hospital submits its plan by the 2022 deadline and adheres to the timelines for the public
17.11interest review described in section 144.552.

17.12    Sec. 10. Minnesota Statutes 2020, section 144.565, subdivision 4, is amended to read:
17.13    Subd. 4. Definitions. (a) For purposes of this section, the following terms have the
17.14meanings given:.
17.15    (b) "Diagnostic imaging facility" means a health care facility that is not a hospital or
17.16location licensed as a hospital which offers diagnostic imaging services in Minnesota,
17.17regardless of whether the equipment used to provide the service is owned or leased. For the
17.18purposes of this section, diagnostic imaging facility includes, but is not limited to, facilities
17.19such as a physician's office, clinic, mobile transport vehicle, outpatient imaging center, or
17.20surgical center. A dental clinic or office is not considered a diagnostic imaging facility for
17.21the purpose of this section when the clinic or office performs diagnostic imaging through
17.22dental cone beam computerized tomography.
17.23    (c) "Diagnostic imaging service" means the use of ionizing radiation or other imaging
17.24technique on a human patient including, but not limited to, magnetic resonance imaging
17.25(MRI) or computerized tomography (CT) other than dental cone beam computerized
17.26tomography, positron emission tomography (PET), or single photon emission computerized
17.27tomography (SPECT) scans using fixed, portable, or mobile equipment.
17.28    (d) "Financial or economic interest" means a direct or indirect:
17.29    (1) equity or debt security issued by an entity, including, but not limited to, shares of
17.30stock in a corporation, membership in a limited liability company, beneficial interest in a
17.31trust, units or other interests in a partnership, bonds, debentures, notes or other equity
17.32interests or debt instruments, or any contractual arrangements;
18.1    (2) membership, proprietary interest, or co-ownership with an individual, group, or
18.2organization to which patients, clients, or customers are referred to; or
18.3    (3) employer-employee or independent contractor relationship, including, but not limited
18.4to, those that may occur in a limited partnership, profit-sharing arrangement, or other similar
18.5arrangement with any facility to which patients are referred, including any compensation
18.6between a facility and a health care provider, the group practice of which the provider is a
18.7member or employee or a related party with respect to any of them.
18.8    (e) "Fixed equipment" means a stationary diagnostic imaging machine installed in a
18.9permanent location.
18.10    (f) "Mobile equipment" means a diagnostic imaging machine in a self-contained transport
18.11vehicle designed to be brought to a temporary ~~offsite~~ off-site location to perform diagnostic
18.12imaging services.
18.13    (g) "Portable equipment" means a diagnostic imaging machine designed to be temporarily
18.14transported within a permanent location to perform diagnostic imaging services.
18.15    (h) "Provider of diagnostic imaging services" means a diagnostic imaging facility or an
18.16entity that offers and bills for diagnostic imaging services at a facility owned or leased by
18.17the entity.

18.18    Sec. 11. Minnesota Statutes 2020, section 144.6502, subdivision 1, is amended to read:
18.19    Subdivision 1. Definitions. (a) For the purposes of this section, the terms defined in this
18.20subdivision have the meanings given.
18.21(b) "Commissioner" means the commissioner of health.
18.22(c) "Department" means the Department of Health.
18.23(d) "Electronic monitoring" means the placement and use of an electronic monitoring
18.24device ~~by a resident~~ in the resident's room or private living unit in accordance with this
18.25section.
18.26(e) "Electronic monitoring device" means a camera or other device that captures, records,
18.27or broadcasts audio, video, or both, that is placed in a resident's room or private living unit
18.28and is used to monitor the resident or activities in the room or private living unit.
18.29(f) "Facility" means a facility that is:
18.30(1) licensed as a nursing home under chapter 144A;
18.31(2) licensed as a boarding care home under sections 144.50 to 144.56;
19.1(3) until August 1, 2021, a housing with services establishment registered under chapter
19.2144D that is either subject to chapter 144G or has a disclosed special unit under section
19.3325F.72; or
19.4(4) on or after August 1, 2021, an assisted living facility.
19.5(g) "Resident" means a person 18 years of age or older residing in a facility.
19.6(h) "Resident representative" means one of the following in the order of priority listed,
19.7to the extent the person may reasonably be identified and located:
19.8(1) a court-appointed guardian;
19.9(2) a health care agent as defined in section 145C.01, subdivision 2; or
19.10(3) a person who is not an agent of a facility or of a home care provider designated in
19.11writing by the resident and maintained in the resident's records on file with the facility.

19.12    Sec. 12. Minnesota Statutes 2020, section 144A.01, is amended to read:
19.13144A.01 DEFINITIONS.
19.14    Subdivision 1. Scope. For the purposes of sections 144A.01 to 144A.27, the terms
19.15defined in this section have the meanings given them.
19.16    Subd. 2. Commissioner of health. "Commissioner of health" means the state
19.17commissioner of health established by section 144.011.
19.18    Subd. 3. Board of Executives for Long Term Services and Supports. "Board of
19.19Executives for Long Term Services and Supports" means the Board of Executives for Long
19.20Term Services and Supports established by section 144A.19.
19.21    Subd. 3a. Certified. "Certified" means certified for participation as a provider in the
19.22Medicare or Medicaid programs under title XVIII or XIX of the Social Security Act.
19.23    Subd. 4. Controlling person. (a) "Controlling person" means ~~any public body,~~
19.24~~governmental agency, business entity,~~ an owner and the following individuals and entities,
19.25if applicable:
19.26    (1) each officer of the organization, including the chief executive officer and the chief
19.27financial officer;
19.28    (2) the nursing home administrator~~, or director whose responsibilities include the direction~~
19.29~~of the management or policies of a nursing home~~; and
19.30    (3) any managerial official.
20.1    (b) "Controlling person" also means any entity or natural person who~~, directly or~~
20.2~~indirectly, beneficially owns any~~ has any direct or indirect ownership interest in:
20.3    (1) any corporation, partnership or other business association which is a controlling
20.4person;
20.5    (2) the land on which a nursing home is located;
20.6    (3) the structure in which a nursing home is located;
20.7    (4) any entity with at least a five percent mortgage, contract for deed, deed of trust, or
20.8other ~~obligation secured in whole or part by~~ security interest in the land or structure
20.9comprising a nursing home; or
20.10    (5) any lease or sublease of the land, structure, or facilities comprising a nursing home.
20.11    ~~(b)~~ (c) "Controlling person" does not include:
20.12    (1) a bank, savings bank, trust company, savings association, credit union, industrial
20.13loan and thrift company, investment banking firm, or insurance company unless the entity
20.14directly or through a subsidiary operates a nursing home;
20.15(2) government and government-sponsored entities such as the United States Department
20.16of Housing and Urban Development, Ginnie Mae, Fannie Mae, Freddie Mac, and the
20.17Minnesota Housing Finance Agency which provide loans, financing, and insurance products
20.18for housing sites;
20.19    ~~(2)~~ (3) an individual who is a state or federal official or, a state or federal employee, or
20.20a member or employee of the governing body of a political subdivision of the state ~~which~~
20.21or federal government that operates one or more nursing homes, unless the individual is
20.22also an officer ~~or director of a~~, owner, or managerial official of the nursing home, receives
20.23any remuneration from a nursing home, or ~~owns any of the beneficial interests~~ who is a
20.24controlling person not otherwise excluded in this subdivision;
20.25    ~~(3)~~ (4) a natural person who is a member of a tax-exempt organization under section
20.26290.05, subdivision 2, unless the individual is also ~~an officer or director of a nursing home,~~
20.27~~or owns any of the beneficial interests~~ a controlling person not otherwise excluded in this
20.28subdivision; and
20.29    ~~(4)~~ (5) a natural person who owns less than five percent of the outstanding common
20.30shares of a corporation:
20.31    (i) whose securities are exempt by virtue of section 80A.45, clause (6); or
20.32    (ii) whose transactions are exempt by virtue of section 80A.46, clause (7).
21.1    Subd. 4a. Emergency. "Emergency" means a situation or physical condition that creates
21.2or probably will create an immediate and serious threat to a resident's health or safety.
21.3    Subd. 5. Nursing home. "Nursing home" means a facility or that part of a facility which
21.4provides nursing care to five or more persons. "Nursing home" does not include a facility
21.5or that part of a facility which is a hospital, a hospital with approved swing beds as defined
21.6in section 144.562, clinic, doctor's office, diagnostic or treatment center, or a residential
21.7program licensed pursuant to sections 245A.01 to 245A.16 or 252.28.
21.8    Subd. 6. Nursing care. "Nursing care" means health evaluation and treatment of patients
21.9and residents who are not in need of an acute care facility but who require nursing supervision
21.10on an inpatient basis. The commissioner of health may by rule establish levels of nursing
21.11care.
21.12    Subd. 7. Uncorrected violation. "Uncorrected violation" means a violation of a statute
21.13or rule or any other deficiency for which a notice of noncompliance has been issued and
21.14fine assessed and allowed to be recovered pursuant to section 144A.10, subdivision 8.
21.15    Subd. 8. Managerial ~~employee~~ official. "Managerial ~~employee~~ official" means an
21.16~~employee of a~~ individual who has the decision-making authority related to the operation of
21.17the nursing home ~~whose duties include~~ and the responsibility for either: (1) the ongoing
21.18management of the nursing home; or (2) the direction of ~~some or all of the management or~~
21.19policies, services, or employees of the nursing home.
21.20    Subd. 9. Nursing home administrator. "Nursing home administrator" means a person
21.21who administers, manages, supervises, or is in general administrative charge of a nursing
21.22home, whether or not the individual has an ownership interest in the home, and whether or
21.23not the person's functions and duties are shared with one or more individuals, and who is
21.24licensed pursuant to section 144A.21.
21.25    Subd. 10. Repeated violation. "Repeated violation" means the issuance of two or more
21.26correction orders, within a 12-month period, for a violation of the same provision of a statute
21.27or rule.
21.28    Subd. 11. Change of ownership. "Change of ownership" means a change in the licensee.
21.29    Subd. 12. Direct ownership interest. "Direct ownership interest" means an individual
21.30or legal entity with the possession of at least five percent equity in capital, stock, or profits
21.31of the licensee or who is a member of a limited liability company of the licensee.
22.1    Subd. 13. Indirect ownership interest. "Indirect ownership interest" means an individual
22.2or legal entity with a direct ownership interest in an entity that has a direct or indirect
22.3ownership interest of at least five percent in an entity that is a licensee.
22.4    Subd. 14. Licensee. "Licensee" means a person or legal entity to whom the commissioner
22.5issues a license for a nursing home and who is responsible for the management, control,
22.6and operation of the nursing home.
22.7    Subd. 15. Management agreement. "Management agreement" means a written, executed
22.8agreement between a licensee and manager regarding the provision of certain services on
22.9behalf of the licensee.
22.10    Subd. 16. Manager. "Manager" means an individual or legal entity designated by the
22.11licensee through a management agreement to act on behalf of the licensee in the on-site
22.12management of the nursing home.
22.13    Subd. 17. Owner. "Owner" means: (1) an individual or legal entity that has a direct or
22.14indirect ownership interest of five percent or more in a licensee; and (2) for purposes of this
22.15chapter, owner of a nonprofit corporation means the president and treasurer of the board of
22.16directors; and (3) for an entity owned by an employee stock ownership plan, owner means
22.17the president and treasurer of the entity. A government entity that is issued a license under
22.18this chapter shall be designated the owner.
22.19EFFECTIVE DATE.This section is effective August 1, 2022.

22.20    Sec. 13. Minnesota Statutes 2020, section 144A.03, subdivision 1, is amended to read:
22.21    Subdivision 1. Form; requirements. (a) The commissioner of health by rule shall
22.22establish forms and procedures for the processing of nursing home license applications.
22.23(b) An application for a nursing home license shall include ~~the following information~~:
22.24(1) the ~~names~~ business name and ~~addresses of all controlling persons and managerial~~
22.25~~employees of the facility to be licensed~~ legal entity name of the licensee;
22.26(2) the street address, mailing address, and legal property description of the facility;
22.27(3) the names, e-mail addresses, telephone numbers, and mailing addresses of all owners,
22.28controlling persons, managerial officials, and the nursing home administrator;
22.29(4) the name and e-mail address of the managing agent and manager, if applicable;
22.30(5) the licensed bed capacity;
22.31(6) the license fee in the amount specified in section 144.122;
23.1(7) documentation of compliance with the background study requirements in section
23.2144.057 for the owner, controlling persons, and managerial officials. Each application for
23.3a new license must include documentation for the applicant and for each individual with
23.4five percent or more direct or indirect ownership in the applicant;
23.5~~(3)~~ (8) a copy of the architectural and engineering plans and specifications of the facility
23.6as prepared and certified by an architect or engineer registered to practice in this state; ~~and~~
23.7(9) a representative copy of the executed lease agreement between the landlord and the
23.8licensee, if applicable;
23.9(10) a representative copy of the management agreement, if applicable;
23.10(11) a representative copy of the operations transfer agreement or similar agreement, if
23.11applicable;
23.12(12) an organizational chart that identifies all organizations and individuals with an
23.13ownership interest in the licensee of five percent or greater and that specifies their relationship
23.14with the licensee and with each other;
23.15(13) whether the applicant, owner, controlling person, managerial official, or nursing
23.16home administrator of the facility has ever been convicted of:
23.17(i) a crime or found civilly liable for a federal or state felony-level offense that was
23.18detrimental to the best interests of the facility and its residents within the last ten years
23.19preceding submission of the license application. Offenses include: (A) felony crimes against
23.20persons and other similar crimes for which the individual was convicted, including guilty
23.21pleas and adjudicated pretrial diversions; (B) financial crimes such as extortion,
23.22embezzlement, income tax evasion, insurance fraud, and other similar crimes for which the
23.23individual was convicted, including guilty pleas and adjudicated pretrial diversions; (C)
23.24any felonies involving malpractice that resulted in a conviction of criminal neglect or
23.25misconduct; and (D) any felonies that would result in a mandatory exclusion under section
23.261128(a) of the Social Security Act;
23.27(ii) any misdemeanor under federal or state law related to the delivery of an item or
23.28service under Medicaid or a state health care program or the abuse or neglect of a patient
23.29in connection with the delivery of a health care item or service;
23.30(iii) any misdemeanor under federal or state law related to theft, fraud, embezzlement,
23.31breach of fiduciary duty, or other financial misconduct in connection with the delivery of
23.32a health care item or service;
24.1(iv) any felony or misdemeanor under federal or state law relating to the interference
24.2with or obstruction of any investigation into any criminal offense described in Code of
24.3Federal Regulations, title 42, section 1001.101 or 1001.201; or
24.4(v) any felony or misdemeanor under federal or state law relating to the unlawful
24.5manufacture, distribution, prescription, or dispensing of a controlled substance;
24.6(14) whether the applicant, owner, controlling person, managerial official, or nursing
24.7home administrator of the facility has had:
24.8(i) any revocation or suspension of a license to provide health care by any state licensing
24.9authority. This includes the surrender of the license while a formal disciplinary proceeding
24.10was pending before a state licensing authority;
24.11(ii) any revocation or suspension of accreditation; or
24.12(iii) any suspension or exclusion from participation in, or any sanction imposed by, a
24.13federal or state health care program or any debarment from participation in any federal
24.14executive branch procurement or nonprocurement program;
24.15(15) whether in the preceding three years the applicant or any owner, controlling person,
24.16managerial official, or nursing home administrator of the facility has a record of defaulting
24.17in the payment of money collected for others, including the discharge of debts through
24.18bankruptcy proceedings;
24.19(16) the signature of the owner of the licensee or an authorized agent of the licensee;
24.20(17) identification of all states where the applicant or individual having a five percent
24.21or more ownership currently or previously has been licensed as an owner or operator of a
24.22long-term care, community-based, or health care facility or agency where the applicant's or
24.23individual's license or federal certification has been denied, suspended, restricted, conditioned,
24.24refused, not renewed, or revoked under a private or state-controlled receivership or where
24.25these same actions are pending under the laws of any state or federal authority; and
24.26~~(4)~~ (18) any other relevant information which the commissioner of health by rule or
24.27otherwise may determine is necessary to properly evaluate an application for license.
24.28(c) A controlling person which is a corporation shall submit copies of its articles of
24.29incorporation and bylaws and any amendments thereto as they occur, together with the
24.30names and addresses of its officers and directors. A controlling person which is a foreign
24.31corporation shall furnish the commissioner of health with a copy of its certificate of authority
24.32to do business in this state. ~~An application on behalf of a controlling person which is a~~
25.1~~corporation, association or a governmental unit or instrumentality shall be signed by at least~~
25.2~~two officers or managing agents of that entity.~~
25.3EFFECTIVE DATE.This section is effective August 1, 2022.

25.4    Sec. 14. Minnesota Statutes 2020, section 144A.04, subdivision 4, is amended to read:
25.5    Subd. 4. Controlling person restrictions. (a) The commissioner has discretion to bar
25.6any controlling persons of a nursing home ~~may not include any~~ if the person ~~who~~ was a
25.7controlling person of ~~another~~ any other nursing home ~~during any period of time~~, assisted
25.8living facility, long-term care or health care facility, or agency in the previous two-year
25.9period and:
25.10(1) during ~~which~~ that period of time ~~of control that other nursing home~~ the facility or
25.11agency incurred ~~the following number of uncorrected or repeated violations:~~
25.12~~(i)~~ two or more uncorrected violations or one or more repeated violations which created
25.13an imminent risk to direct resident or client care or safety; or
25.14~~(ii) four or more uncorrected violations or two or more repeated violations of any nature~~
25.15~~for which the fines are in the four highest daily fine categories prescribed in rule; or~~
25.16(2) ~~who~~ during that period of time, was convicted of a felony or gross misdemeanor that
25.17~~relates~~ related to operation of the ~~nursing home~~ facility or agency or directly ~~affects~~ affected
25.18resident safety or care~~, during that period~~.
25.19(b) The provisions of this subdivision shall not apply to any controlling person who had
25.20no legal authority to affect or change decisions related to the operation of the nursing home
25.21which incurred the uncorrected violations.
25.22(c) When the commissioner bars a controlling person under this subdivision, the
25.23controlling person has the right to appeal under chapter 14.

25.24    Sec. 15. Minnesota Statutes 2020, section 144A.04, subdivision 6, is amended to read:
25.25    Subd. 6. Managerial ~~employee~~ official or licensed administrator; employment
25.26prohibitions. A nursing home may not employ as a managerial ~~employee~~ official or as its
25.27licensed administrator any person who was a managerial ~~employee~~ official or the licensed
25.28administrator of another facility during any period of time in the previous two-year period:
25.29(1) during which time of employment that other nursing home incurred the following
25.30number of uncorrected violations which were in the jurisdiction and control of the managerial
25.31~~employee~~ official or the administrator:
26.1(i) two or more uncorrected violations ~~or one or more repeated violations which created~~
26.2~~an imminent risk to direct resident care or safety~~; or
26.3(ii) four or more uncorrected violations or two or more repeated violations of any nature
26.4for which the fines are in the four highest daily fine categories prescribed in rule; or
26.5(2) who was convicted of a felony or gross misdemeanor that relates to operation of the
26.6nursing home or directly affects resident safety or care, during that period.
26.7EFFECTIVE DATE.This section is effective August 1, 2022.

26.8    Sec. 16. Minnesota Statutes 2020, section 144A.06, is amended to read:
26.9144A.06 TRANSFER OF ~~INTERESTS~~ LICENSE PROHIBITED.
26.10    Subdivision 1. ~~Notice; expiration of license~~ Transfers prohibited. ~~Any controlling~~
26.11~~person who makes any transfer of a beneficial interest in a nursing home shall notify the~~
26.12~~commissioner of health of the transfer within 14 days of its occurrence. The notification~~
26.13~~shall identify by name and address the transferor and transferee and shall specify the nature~~
26.14~~and amount of the transferred interest. On determining that the transferred beneficial interest~~
26.15~~exceeds ten percent of the total beneficial interest in the nursing home facility, the structure~~
26.16~~in which the facility is located, or the land upon which the structure is located, the~~
26.17~~commissioner may, and on determining that the transferred beneficial interest exceeds 50~~
26.18~~percent of the total beneficial interest in the facility, the structure in which the facility is~~
26.19~~located, or the land upon which the structure is located, the commissioner shall require that~~
26.20~~the license of the nursing home expire 90 days after the date of transfer. The commissioner~~
26.21~~of health shall notify the nursing home by certified mail of the expiration of the license at~~
26.22~~least 60 days prior to the date of expiration.~~ A nursing home license may not be transferred.
26.23    Subd. 2. ~~Relicensure~~ New license required; change of ownership. (a) The
26.24commissioner of health by rule shall prescribe procedures for ~~relicensure~~ licensure under
26.25this section. ~~The commissioner of health shall relicense a nursing home if the facility satisfies~~
26.26~~the requirements for license renewal established by section~~ ~~144A.05. A facility shall not be~~
26.27~~relicensed by the commissioner if at the time of transfer there are any uncorrected violations.~~
26.28~~The commissioner of health may temporarily waive correction of one or more violations if~~
26.29~~the commissioner determines that:~~
26.30~~(1) temporary noncorrection of the violation will not create an imminent risk of harm~~
26.31~~to a nursing home resident; and~~
26.32~~(2) a controlling person on behalf of all other controlling persons:~~
27.1~~(i) has entered into a contract to obtain the materials or labor necessary to correct the~~
27.2~~violation, but the supplier or other contractor has failed to perform the terms of the contract~~
27.3~~and the inability of the nursing home to correct the violation is due solely to that failure; or~~
27.4~~(ii) is otherwise making a diligent good faith effort to correct the violation.~~
27.5(b) A new license is required and the prospective licensee must apply for a license prior
27.6to operating a currently licensed nursing home. The licensee must change whenever one of
27.7the following events occur:
27.8(1) the form of the licensee's legal entity structure is converted or changed to a different
27.9type of legal entity structure;
27.10(2) the licensee dissolves, consolidates, or merges with another legal organization and
27.11the licensee's legal organization does not survive;
27.12(3) within the previous 24 months, 50 percent or more of the licensee's ownership interest
27.13is transferred, whether by a single transaction or multiple transactions to:
27.14(i) a different person; or
27.15(ii) a person who had less than a five percent ownership interest in the facility at the
27.16time of the first transaction; or
27.17(4) any other event or combination of events that results in a substitution, elimination,
27.18or withdrawal of the licensee's responsibility for the facility.
27.19    Subd. 3. Compliance. The commissioner must consult with the commissioner of human
27.20services regarding the history of financial and cost reporting compliance of the prospective
27.21licensee and prospective licensee's financial operations in any nursing home that the
27.22prospective licensee or any controlling person listed in the license application has had an
27.23interest in.
27.24    Subd. 4. Facility operation. The current licensee remains responsible for the operation
27.25of the nursing home until the nursing home is licensed to the prospective licensee.
27.26EFFECTIVE DATE.This section is effective August 1, 2022.

27.27    Sec. 17. [144A.32] CONSIDERATION OF APPLICATIONS.
27.28(a) Before issuing a license or renewing an existing license, the commissioner shall
27.29consider an applicant's compliance history in providing care in a facility that provides care
27.30to children, the elderly, ill individuals, or individuals with disabilities.
28.1(b) The applicant's compliance history shall include repeat violations, rule violations,
28.2and any license or certification involuntarily suspended or terminated during an enforcement
28.3process.
28.4(c) The commissioner may deny, revoke, suspend, restrict, or refuse to renew the license
28.5or impose conditions if:
28.6(1) the applicant fails to provide complete and accurate information on the application
28.7and the commissioner concludes that the missing or corrected information is needed to
28.8determine if a license is granted;
28.9(2) the applicant, knowingly or with reason to know, made a false statement of a material
28.10fact in an application for the license or any data attached to the application or in any matter
28.11under investigation by the department;
28.12(3) the applicant refused to allow agents of the commissioner to inspect the applicant's
28.13books, records, files related to the license application, or any portion of the premises;
28.14(4) the applicant willfully prevented, interfered with, or attempted to impede in any way:
28.15(i) the work of any authorized representative of the commissioner, the ombudsman for
28.16long-term care, or the ombudsman for mental health and developmental disabilities; or
28.17(ii) the duties of the commissioner, local law enforcement, city or county attorneys, adult
28.18protection, county case managers, or other local government personnel;
28.19(5) the applicant has a history of noncompliance with federal or state regulations that
28.20were detrimental to the health, welfare, or safety of a resident or a client; or
28.21(6) the applicant violates any requirement in this chapter or chapter 256R.
28.22(d) If a license is denied, the applicant has the reconsideration rights available under
28.23chapter 14.
28.24EFFECTIVE DATE.This section is effective August 1, 2022.

28.25    Sec. 18. Minnesota Statutes 2020, section 144A.4799, subdivision 1, is amended to read:
28.26    Subdivision 1. Membership. The commissioner of health shall appoint ~~eight~~ 13 persons
28.27to a home care and assisted living program advisory council consisting of the following:
28.28(1) ~~three~~ two public members as defined in section 214.02 who shall be persons who
28.29are currently receiving home care services, persons who have received home care services
28.30within five years of the application date, persons who have family members receiving home
29.1care services, or persons who have family members who have received home care services
29.2within five years of the application date;
29.3(2) ~~three~~ two Minnesota home care licensees representing basic and comprehensive
29.4levels of licensure who may be a managerial official, an administrator, a supervising
29.5registered nurse, or an unlicensed personnel performing home care tasks;
29.6(3) one member representing the Minnesota Board of Nursing;
29.7(4) one member representing the Office of Ombudsman for Long-Term Care; ~~and~~
29.8(5) one member representing the Office of Ombudsman for Mental Health and
29.9Developmental Disabilities;
29.10~~(5)~~ (6) beginning July 1, 2021, one member of a county health and human services or
29.11county adult protection office.;
29.12(7) two Minnesota assisted living facility licensees representing assisted living facilities
29.13and assisted living facilities with dementia care levels of licensure who may be the facility's
29.14assisted living director, managerial official, or clinical nurse supervisor;
29.15(8) one organization representing long-term care providers, home care providers, and
29.16assisted living providers in Minnesota; and
29.17(9) two public members as defined in section 214.02. One public member shall be a
29.18person who either is or has been a resident in an assisted living facility and one public
29.19member shall be a person who has or had a family member living in an assisted living
29.20facility setting.

29.21    Sec. 19. Minnesota Statutes 2020, section 144A.4799, subdivision 3, is amended to read:
29.22    Subd. 3. Duties. (a) At the commissioner's request, the advisory council shall provide
29.23advice regarding regulations of Department of Health licensed assisted living and home
29.24care providers in this chapter, including advice on the following:
29.25(1) community standards for home care practices;
29.26(2) enforcement of licensing standards and whether certain disciplinary actions are
29.27appropriate;
29.28(3) ways of distributing information to licensees and consumers of home care and assisted
29.29living services defined under chapter 144G;
29.30(4) training standards;
30.1(5) identifying emerging issues and opportunities in home care and assisted living services
30.2defined under chapter 144G;
30.3(6) identifying the use of technology in home and telehealth capabilities;
30.4(7) allowable home care licensing modifications and exemptions, including a method
30.5for an integrated license with an existing license for rural licensed nursing homes to provide
30.6limited home care services in an adjacent independent living apartment building owned by
30.7the licensed nursing home; and
30.8(8) recommendations for studies using the data in section 62U.04, subdivision 4, including
30.9but not limited to studies concerning costs related to dementia and chronic disease among
30.10an elderly population over 60 and additional long-term care costs, as described in section
30.1162U.10, subdivision 6.
30.12(b) The advisory council shall perform other duties as directed by the commissioner.
30.13(c) The advisory council shall annually make recommendations to the commissioner for
30.14the purposes in section 144A.474, subdivision 11, paragraph (i). The recommendations shall
30.15address ways the commissioner may improve protection of the public under existing statutes
30.16and laws and include but are not limited to projects that create and administer training of
30.17licensees and their employees to improve residents' lives, supporting ways that licensees
30.18can improve and enhance quality care and ways to provide technical assistance to licensees
30.19to improve compliance; information technology and data projects that analyze and
30.20communicate information about trends of violations or lead to ways of improving client
30.21care; communications strategies to licensees and the public; and other projects or pilots that
30.22benefit clients, families, and the public.

30.23    Sec. 20. Minnesota Statutes 2020, section 144A.75, subdivision 12, is amended to read:
30.24    Subd. 12. Palliative care. "Palliative care" means ~~the total active care of patients whose~~
30.25~~disease is not responsive to curative treatment. Control of pain, of other symptoms, and of~~
30.26~~psychological, social, and spiritual problems is paramount~~ specialized medical care for
30.27individuals living with a serious illness or life-limiting condition. This type of care is focused
30.28on reducing the pain, symptoms, and stress of a serious illness or condition. Palliative care
30.29is a team-based approach to care, providing essential support at any age or stage of a serious
30.30illness or condition, and is often provided together with curative treatment. The goal of
30.31palliative care is ~~the achievement of the best quality of life for patients and their families~~
30.32to improve quality of life for both the patient and the patient's family or care partner.

31.1    Sec. 21. Minnesota Statutes 2020, section 144G.08, is amended by adding a subdivision
31.2to read:
31.3    Subd. 62a. Serious injury. "Serious injury" has the meaning given in section 245.91,
31.4subdivision 6.
31.5EFFECTIVE DATE.This section is effective August 1, 2022.

31.6    Sec. 22. Minnesota Statutes 2020, section 144G.15, is amended to read:
31.7144G.15 CONSIDERATION OF APPLICATIONS.
31.8(a) Before issuing a provisional license or license or renewing a license, the commissioner
31.9shall consider an applicant's compliance history in providing care in this state or any other
31.10state in a facility that provides care to children, the elderly, ill individuals, or individuals
31.11with disabilities.
31.12(b) The applicant's compliance history shall include repeat violation, rule violations, and
31.13any license or certification involuntarily suspended or terminated during an enforcement
31.14process.
31.15(c) The commissioner may deny, revoke, suspend, restrict, or refuse to renew the license
31.16or impose conditions if:
31.17(1) the applicant fails to provide complete and accurate information on the application
31.18and the commissioner concludes that the missing or corrected information is needed to
31.19determine if a license shall be granted;
31.20(2) the applicant, knowingly or with reason to know, made a false statement of a material
31.21fact in an application for the license or any data attached to the application or in any matter
31.22under investigation by the department;
31.23(3) the applicant refused to allow agents of the commissioner to inspect its books, records,
31.24and files related to the license application, or any portion of the premises;
31.25(4) the applicant willfully prevented, interfered with, or attempted to impede in any way:
31.26(i) the work of any authorized representative of the commissioner, the ombudsman for
31.27long-term care, or the ombudsman for mental health and developmental disabilities; or (ii)
31.28the duties of the commissioner, local law enforcement, city or county attorneys, adult
31.29protection, county case managers, or other local government personnel;
31.30(5) the applicant, owner, controlling individual, managerial official, or assisted living
31.31director for the facility has a history of noncompliance with federal or state regulations that
31.32were detrimental to the health, welfare, or safety of a resident or a client; or
32.1(6) the applicant violates any requirement in this chapter.
32.2(d) If a license is denied, the applicant has the reconsideration rights available under
32.3section 144G.16, subdivision 4.
32.4EFFECTIVE DATE.This section is effective August 1, 2022.

32.5    Sec. 23. Minnesota Statutes 2020, section 144G.17, is amended to read:
32.6144G.17 LICENSE RENEWAL.
32.7A license that is not a provisional license may be renewed for a period of up to one year
32.8if the licensee:
32.9(1) submits an application for renewal in the format provided by the commissioner at
32.10least 60 calendar days before expiration of the license;
32.11(2) submits the renewal fee under section 144G.12, subdivision 3;
32.12(3) submits the late fee under section 144G.12, subdivision 4, if the renewal application
32.13is received less than 30 days before the expiration date of the license or after the expiration
32.14of the license;
32.15(4) provides information sufficient to show that the applicant meets the requirements of
32.16licensure, including items required under section 144G.12, subdivision 1; ~~and~~
32.17(5) provides information sufficient to show the licensee provided assisted living services
32.18to at least one resident during the immediately preceding license year and at the assisted
32.19living facility listed on the license; and
32.20~~(5)~~ (6) provides any other information deemed necessary by the commissioner.
32.21EFFECTIVE DATE.This section is effective August 1, 2022.

32.22    Sec. 24. Minnesota Statutes 2020, section 144G.19, is amended by adding a subdivision
32.23to read:
32.24    Subd. 4. Change of licensee. Notwithstanding any other provision of law, a change of
32.25licensee under subdivision 2 does not require the facility to meet the design requirements
32.26of section 144G.45, subdivisions 4 to 6, or 144G.81, subdivision 3.
32.27EFFECTIVE DATE.This section is effective August 1, 2022.

33.1    Sec. 25. Minnesota Statutes 2020, section 144G.20, subdivision 1, is amended to read:
33.2    Subdivision 1. Conditions. (a) The commissioner may refuse to grant a provisional
33.3license, refuse to grant a license as a result of a change in ownership, refuse to renew a
33.4license, suspend or revoke a license, or impose a conditional license if the owner, controlling
33.5individual, or employee of an assisted living facility:
33.6(1) is in violation of, or during the term of the license has violated, any of the requirements
33.7in this chapter or adopted rules;
33.8(2) permits, aids, or abets the commission of any illegal act in the provision of assisted
33.9living services;
33.10(3) performs any act detrimental to the health, safety, and welfare of a resident;
33.11(4) obtains the license by fraud or misrepresentation;
33.12(5) knowingly makes a false statement of a material fact in the application for a license
33.13or in any other record or report required by this chapter;
33.14(6) denies representatives of the department access to any part of the facility's books,
33.15records, files, or employees;
33.16(7) interferes with or impedes a representative of the department in contacting the facility's
33.17residents;
33.18(8) interferes with or impedes ombudsman access according to section 256.9742,
33.19subdivision 4, or interferes with or impedes access by the Office of Ombudsman for Mental
33.20Health and Developmental Disabilities according to section 245.94, subdivision 1;
33.21(9) interferes with or impedes a representative of the department in the enforcement of
33.22this chapter or fails to fully cooperate with an inspection, survey, or investigation by the
33.23department;
33.24(10) destroys or makes unavailable any records or other evidence relating to the assisted
33.25living facility's compliance with this chapter;
33.26(11) refuses to initiate a background study under section 144.057 or 245A.04;
33.27(12) fails to timely pay any fines assessed by the commissioner;
33.28(13) violates any local, city, or township ordinance relating to housing or assisted living
33.29services;
33.30(14) has repeated incidents of personnel performing services beyond their competency
33.31level; or
34.1(15) has operated beyond the scope of the assisted living facility's license category.
34.2(b) A violation by a contractor providing the assisted living services of the facility is a
34.3violation by the facility.
34.4EFFECTIVE DATE.This section is effective August 1, 2022.

34.5    Sec. 26. Minnesota Statutes 2020, section 144G.20, subdivision 4, is amended to read:
34.6    Subd. 4. Mandatory revocation. Notwithstanding the provisions of subdivision 13,
34.7paragraph (a), the commissioner must revoke a license if a controlling individual of the
34.8facility is convicted of a felony or gross misdemeanor that relates to operation of the facility
34.9or directly affects resident safety or care. The commissioner shall notify the facility and the
34.10Office of Ombudsman for Long-Term Care and the Office of Ombudsman for Mental Health
34.11and Developmental Disabilities 30 calendar days in advance of the date of revocation.
34.12EFFECTIVE DATE.This section is effective August 1, 2022.

34.13    Sec. 27. Minnesota Statutes 2020, section 144G.20, subdivision 5, is amended to read:
34.14    Subd. 5. Owners and managerial officials; refusal to grant license. (a) The owners
34.15and managerial officials of a facility whose Minnesota license has not been renewed or
34.16whose ~~Minnesota~~ license in this state or any other state has been revoked because of
34.17noncompliance with applicable laws or rules shall not be eligible to apply for nor will be
34.18granted an assisted living facility license under this chapter or a home care provider license
34.19under chapter 144A, or be given status as an enrolled personal care assistance provider
34.20agency or personal care assistant by the Department of Human Services under section
34.21256B.0659, for five years following the effective date of the nonrenewal or revocation. If
34.22the owners or managerial officials already have enrollment status, the Department of Human
34.23Services shall terminate that enrollment.
34.24(b) The commissioner shall not issue a license to a facility for five years following the
34.25effective date of license nonrenewal or revocation if the owners or managerial officials,
34.26including any individual who was an owner or managerial official of another licensed
34.27provider, had a ~~Minnesota~~ license in this state or any other state that was not renewed or
34.28was revoked as described in paragraph (a).
34.29(c) Notwithstanding subdivision 1, the commissioner shall not renew, or shall suspend
34.30or revoke, the license of a facility that includes any individual as an owner or managerial
34.31official who was an owner or managerial official of a facility whose ~~Minnesota~~ license in
35.1this state or any other state was not renewed or was revoked as described in paragraph (a)
35.2for five years following the effective date of the nonrenewal or revocation.
35.3(d) The commissioner shall notify the facility 30 calendar days in advance of the date
35.4of nonrenewal, suspension, or revocation of the license.
35.5EFFECTIVE DATE.This section is effective August 1, 2022.

35.6    Sec. 28. Minnesota Statutes 2020, section 144G.20, subdivision 8, is amended to read:
35.7    Subd. 8. Controlling individual restrictions. (a) The commissioner has discretion to
35.8bar any controlling individual of a facility if the person was a controlling individual of any
35.9other nursing home, home care provider licensed under chapter 144A, or given status as an
35.10enrolled personal care assistance provider agency or personal care assistant by the Department
35.11of Human Services under section 256B.0659, or assisted living facility in the previous
35.12two-year period and:
35.13(1) during that period of time the nursing home, home care provider licensed under
35.14chapter 144A, or given status as an enrolled personal care assistance provider agency or
35.15personal care assistant by the Department of Human Services under section 256B.0659, or
35.16assisted living facility incurred the following number of uncorrected or repeated violations:
35.17(i) two or more repeated violations that created an imminent risk to direct resident care
35.18or safety; or
35.19(ii) four or more uncorrected violations that created an imminent risk to direct resident
35.20care or safety; or
35.21(2) during that period of time, was convicted of a felony or gross misdemeanor that
35.22related to the operation of the nursing home, home care provider licensed under chapter
35.23144A, or given status as an enrolled personal care assistance provider agency or personal
35.24care assistant by the Department of Human Services under section 256B.0659, or assisted
35.25living facility, or directly affected resident safety or care.
35.26(b) When the commissioner bars a controlling individual under this subdivision, the
35.27controlling individual may appeal the commissioner's decision under chapter 14.
35.28EFFECTIVE DATE.This section is effective August 1, 2022.

35.29    Sec. 29. Minnesota Statutes 2020, section 144G.20, subdivision 9, is amended to read:
35.30    Subd. 9. Exception to controlling individual restrictions. Subdivision 8 does not apply
35.31to any controlling individual of the facility who had no legal authority to affect or change
36.1decisions related to the operation of the nursing home or, assisted living facility, or home
36.2care that incurred the uncorrected or repeated violations.
36.3EFFECTIVE DATE.This section is effective August 1, 2022.

36.4    Sec. 30. Minnesota Statutes 2020, section 144G.20, subdivision 12, is amended to read:
36.5    Subd. 12. Notice to residents. (a) Within five business days after proceedings are initiated
36.6by the commissioner to revoke or suspend a facility's license, or a decision by the
36.7commissioner not to renew a living facility's license, the controlling individual of the facility
36.8or a designee must provide to the commissioner ~~and~~, the ombudsman for long-term care,
36.9and the Office of Ombudsman for Mental Health and Developmental Disabilities the names
36.10of residents and the names and addresses of the residents' designated representatives and
36.11legal representatives, and family or other contacts listed in the assisted living contract.
36.12(b) The controlling individual or designees of the facility must provide updated
36.13information each month until the proceeding is concluded. If the controlling individual or
36.14designee of the facility fails to provide the information within this time, the facility is subject
36.15to the issuance of:
36.16(1) a correction order; and
36.17(2) a penalty assessment by the commissioner in rule.
36.18(c) Notwithstanding subdivisions 21 and 22, any correction order issued under this
36.19subdivision must require that the facility immediately comply with the request for information
36.20and that, as of the date of the issuance of the correction order, the facility shall forfeit to the
36.21state a $500 fine the first day of noncompliance and an increase in the $500 fine by $100
36.22increments for each day the noncompliance continues.
36.23(d) Information provided under this subdivision may be used by the commissioner or,
36.24the ombudsman for long-term care, or the Office of Ombudsman for Mental Health and
36.25Developmental Disabilities only for the purpose of providing affected consumers information
36.26about the status of the proceedings.
36.27(e) Within ten business days after the commissioner initiates proceedings to revoke,
36.28suspend, or not renew a facility license, the commissioner must send a written notice of the
36.29action and the process involved to each resident of the facility, legal representatives and
36.30designated representatives, and at the commissioner's discretion, additional resident contacts.
37.1(f) The commissioner shall provide the ombudsman for long-term care and the Office
37.2of Ombudsman for Mental Health and Developmental Disabilities with monthly information
37.3on the department's actions and the status of the proceedings.
37.4EFFECTIVE DATE.This section is effective August 1, 2022.

37.5    Sec. 31. Minnesota Statutes 2020, section 144G.20, subdivision 15, is amended to read:
37.6    Subd. 15. Plan required. (a) The process of suspending, revoking, or refusing to renew
37.7a license must include a plan for transferring affected residents' cares to other providers by
37.8the facility. The commissioner shall monitor the transfer plan. Within three calendar days
37.9of being notified of the final revocation, refusal to renew, or suspension, the licensee shall
37.10provide the commissioner, the lead agencies as defined in section 256B.0911, county adult
37.11protection and case managers, ~~and~~ the ombudsman for long-term care, and the Office of
37.12Ombudsman for Mental Health and Developmental Disabilities with the following
37.13information:
37.14(1) a list of all residents, including full names and all contact information on file;
37.15(2) a list of the resident's legal representatives and designated representatives and family
37.16or other contacts listed in the assisted living contract, including full names and all contact
37.17information on file;
37.18(3) the location or current residence of each resident;
37.19(4) the ~~payor~~ payer sources for each resident, including ~~payor~~ payer source identification
37.20numbers; and
37.21(5) for each resident, a copy of the resident's service plan and a list of the types of services
37.22being provided.
37.23(b) The revocation, refusal to renew, or suspension notification requirement is satisfied
37.24by mailing the notice to the address in the license record. The licensee shall cooperate with
37.25the commissioner and the lead agencies, county adult protection and case managers, ~~and~~
37.26the ombudsman for long-term care, and the Office of Ombudsman for Mental Health and
37.27Developmental Disabilities during the process of transferring care of residents to qualified
37.28providers. Within three calendar days of being notified of the final revocation, refusal to
37.29renew, or suspension action, the facility must notify and disclose to each of the residents,
37.30or the resident's legal and designated representatives or emergency contact persons, that the
37.31commissioner is taking action against the facility's license by providing a copy of the
37.32revocation, refusal to renew, or suspension notice issued by the commissioner. If the facility
37.33does not comply with the disclosure requirements in this section, the commissioner shall
38.1notify the residents, legal and designated representatives, or emergency contact persons
38.2about the actions being taken. Lead agencies, county adult protection and case managers,
38.3and the Office of Ombudsman for Long-Term Care may also provide this information. The
38.4revocation, refusal to renew, or suspension notice is public data except for any private data
38.5contained therein.
38.6(c) A facility subject to this subdivision may continue operating while residents are being
38.7transferred to other service providers.
38.8EFFECTIVE DATE.This section is effective August 1, 2022.

38.9    Sec. 32. Minnesota Statutes 2020, section 144G.30, subdivision 5, is amended to read:
38.10    Subd. 5. Correction orders. (a) A correction order may be issued whenever the
38.11commissioner finds upon survey or during a complaint investigation that a facility, a
38.12managerial official, an agent of the facility, or an employee of the facility is not in compliance
38.13with this chapter. The correction order shall cite the specific statute and document areas of
38.14noncompliance and the time allowed for correction.
38.15(b) The commissioner shall mail or e-mail copies of any correction order to the facility
38.16within 30 calendar days after the survey exit date. A copy of each correction order and
38.17copies of any documentation supplied to the commissioner shall be kept on file by the
38.18facility and public documents shall be made available for viewing by any person upon
38.19request. Copies may be kept electronically.
38.20(c) By the correction order date, the facility must document in the facility's records any
38.21action taken to comply with the correction order. The commissioner may request a copy of
38.22this documentation and the facility's action to respond to the correction order in future
38.23surveys, upon a complaint investigation, and as otherwise needed.
38.24EFFECTIVE DATE.This section is effective August 1, 2022.

38.25    Sec. 33. Minnesota Statutes 2020, section 144G.31, subdivision 4, is amended to read:
38.26    Subd. 4. Fine amounts. (a) Fines and enforcement actions under this subdivision may
38.27be assessed based on the level and scope of the violations described in subdivisions 2 and
38.283 as follows and may be imposed immediately with no opportunity to correct the violation
38.29prior to imposition:
38.30(1) Level 1, no fines or enforcement;
39.1(2) Level 2, a fine of $500 per violation, in addition to any enforcement mechanism
39.2authorized in section 144G.20 for widespread violations;
39.3(3) Level 3, a fine of $3,000 per violation ~~per incident~~, in addition to any enforcement
39.4mechanism authorized in section 144G.20;
39.5(4) Level 4, a fine of $5,000 per ~~incident~~ violation, in addition to any enforcement
39.6mechanism authorized in section 144G.20; and
39.7(5) for maltreatment violations for which the licensee was determined to be responsible
39.8for the maltreatment under section 626.557, subdivision 9c, paragraph (c), a fine of $1,000
39.9per incident. A fine of $5,000 per incident may be imposed if the commissioner determines
39.10the licensee is responsible for maltreatment consisting of sexual assault, death, or abuse
39.11resulting in serious injury.
39.12(b) When a fine is assessed against a facility for substantiated maltreatment, the
39.13commissioner shall not also impose an immediate fine under this chapter for the same
39.14circumstance.
39.15EFFECTIVE DATE.This section is effective August 1, 2022.

39.16    Sec. 34. Minnesota Statutes 2020, section 144G.31, subdivision 8, is amended to read:
39.17    Subd. 8. Deposit of fines. Fines collected under this section shall be deposited in a
39.18dedicated special revenue account. On an annual basis, the balance in the special revenue
39.19account shall be appropriated to the commissioner for special projects to improve ~~home~~
39.20~~care~~ resident quality of care and outcomes in assisted living facilities licensed under this
39.21chapter in Minnesota as recommended by the advisory council established in section
39.22144A.4799.
39.23EFFECTIVE DATE.This section is effective retroactively for fines collected on or
39.24after August 1, 2021.

39.25    Sec. 35. Minnesota Statutes 2020, section 144G.41, subdivision 7, is amended to read:
39.26    Subd. 7. Resident grievances; reporting maltreatment. All facilities must post in a
39.27conspicuous place information about the facilities' grievance procedure, and the name,
39.28telephone number, and e-mail contact information for the individuals who are responsible
39.29for handling resident grievances. The notice must also have the contact information for the
39.30~~state and applicable regional~~ Office of Ombudsman for Long-Term Care and the Office of
39.31Ombudsman for Mental Health and Developmental Disabilities, and must have information
39.32for reporting suspected maltreatment to the Minnesota Adult Abuse Reporting Center. The
40.1notice must also state that if an individual has a complaint about the facility or person
40.2providing services, the individual may contact the Office of Health Facility Complaints at
40.3the Minnesota Department of Health.
40.4EFFECTIVE DATE.This section is effective August 1, 2022.

40.5    Sec. 36. Minnesota Statutes 2020, section 144G.41, subdivision 8, is amended to read:
40.6    Subd. 8. Protecting resident rights. All facilities shall ensure that every resident has
40.7access to consumer advocacy or legal services by:
40.8(1) providing names and contact information, including telephone numbers and e-mail
40.9addresses of at least three organizations that provide advocacy or legal services to residents,
40.10one of which must include the designated protection and advocacy organization in Minnesota
40.11that provides advice and representation to individuals with disabilities;
40.12(2) providing the name and contact information for the Minnesota Office of Ombudsman
40.13for Long-Term Care and the Office of Ombudsman for Mental Health and Developmental
40.14Disabilities~~, including both the state and regional contact information~~;
40.15(3) assisting residents in obtaining information on whether Medicare or medical assistance
40.16under chapter 256B will pay for services;
40.17(4) making reasonable accommodations for people who have communication disabilities
40.18and those who speak a language other than English; and
40.19(5) providing all information and notices in plain language and in terms the residents
40.20can understand.
40.21EFFECTIVE DATE.This section is effective August 1, 2022.

40.22    Sec. 37. Minnesota Statutes 2020, section 144G.42, subdivision 10, is amended to read:
40.23    Subd. 10. Disaster planning and emergency preparedness plan. (a) The facility must
40.24meet the following requirements:
40.25(1) have a written emergency disaster plan that contains a plan for evacuation, addresses
40.26elements of sheltering in place, identifies temporary relocation sites, and details staff
40.27assignments in the event of a disaster or an emergency;
40.28(2) post an emergency disaster plan prominently;
40.29(3) provide building emergency exit diagrams to all residents;
40.30(4) post emergency exit diagrams on each floor; and
41.1(5) have a written policy and procedure regarding missing ~~tenant~~ residents.
41.2(b) The facility must provide emergency and disaster training to all staff during the initial
41.3staff orientation and annually thereafter and must make emergency and disaster training
41.4annually available to all residents. Staff who have not received emergency and disaster
41.5training are allowed to work only when trained staff are also working on site.
41.6(c) The facility must meet any additional requirements adopted in rule.
41.7EFFECTIVE DATE.This section is effective August 1, 2022.

41.8    Sec. 38. Minnesota Statutes 2020, section 144G.45, subdivision 7, is amended to read:
41.9    Subd. 7. Variance or waiver. (a) A facility may request that the commissioner grant a
41.10variance or waiver from the provisions of this section or section 144G.81, subdivision 5. A
41.11request for a waiver must be submitted to the commissioner in writing. Each request must
41.12contain:
41.13(1) the specific requirement for which the variance or waiver is requested;
41.14(2) the reasons for the request;
41.15(3) the alternative measures that will be taken if a variance or waiver is granted;
41.16(4) the length of time for which the variance or waiver is requested; and
41.17(5) other relevant information deemed necessary by the commissioner to properly evaluate
41.18the request for the waiver.
41.19(b) The decision to grant or deny a variance or waiver must be based on the
41.20commissioner's evaluation of the following criteria:
41.21(1) whether the waiver will adversely affect the health, treatment, comfort, safety, or
41.22well-being of a resident;
41.23(2) whether the alternative measures to be taken, if any, are equivalent to or superior to
41.24those permitted under section 144G.81, subdivision 5; ~~and~~
41.25(3) whether compliance with the requirements would impose an undue burden on the
41.26facility; and
41.27(4) notwithstanding clause (1), for construction existing as of August 1, 2021, the
41.28commissioner's evaluation of a variance from the requirement to provide an option for a
41.29bath under subdivision 4, paragraph (a), must be based on clauses (2) and (3) and whether
41.30the variance will adversely affect the health, treatment, or safety of a resident.
42.1(c) The commissioner must notify the facility in writing of the decision. If a variance or
42.2waiver is granted, the notification must specify the period of time for which the variance
42.3or waiver is effective and the alternative measures or conditions, if any, to be met by the
42.4facility.
42.5(d) Alternative measures or conditions attached to a variance or waiver have the force
42.6and effect of this chapter and are subject to the issuance of correction orders and fines in
42.7accordance with sections 144G.30, subdivision 7, and 144G.31. The amount of fines for a
42.8violation of this subdivision is that specified for the specific requirement for which the
42.9variance or waiver was requested.
42.10(e) A request for renewal of a variance or waiver must be submitted in writing at least
42.1145 days before its expiration date. Renewal requests must contain the information specified
42.12in paragraph (b). A variance or waiver must be renewed by the commissioner if the facility
42.13continues to satisfy the criteria in paragraph (a) and demonstrates compliance with the
42.14alternative measures or conditions imposed at the time the original variance or waiver was
42.15granted.
42.16(f) The commissioner must deny, revoke, or refuse to renew a variance or waiver if it
42.17is determined that the criteria in paragraph (a) are not met. The facility must be notified in
42.18writing of the reasons for the decision and informed of the right to appeal the decision.
42.19(g) A facility may contest the denial, revocation, or refusal to renew a variance or waiver
42.20by requesting a contested case hearing under chapter 14. The facility must submit, within
42.2115 days of the receipt of the commissioner's decision, a written request for a hearing. The
42.22request for hearing must set forth in detail the reasons why the facility contends the decision
42.23of the commissioner should be reversed or modified. At the hearing, the facility has the
42.24burden of proving by a preponderance of the evidence that the facility satisfied the criteria
42.25specified in paragraph (b), except in a proceeding challenging the revocation of a variance
42.26or waiver.
42.27EFFECTIVE DATE.This section is effective August 1, 2022.

42.28    Sec. 39. Minnesota Statutes 2020, section 144G.50, subdivision 2, is amended to read:
42.29    Subd. 2. Contract information. (a) The contract must include in a conspicuous place
42.30and manner on the contract the legal name and the ~~license number~~ health facility identification
42.31of the facility.
42.32(b) The contract must include the name, telephone number, and physical mailing address,
42.33which may not be a public or private post office box, of:
43.1(1) the facility and contracted service provider when applicable;
43.2(2) the licensee of the facility;
43.3(3) the managing agent of the facility, if applicable; and
43.4(4) the authorized agent for the facility.
43.5(c) The contract must include:
43.6(1) a disclosure of the category of assisted living facility license held by the facility and,
43.7if the facility is not an assisted living facility with dementia care, a disclosure that it does
43.8not hold an assisted living facility with dementia care license;
43.9(2) a description of all the terms and conditions of the contract, including a description
43.10of and any limitations to the housing or assisted living services to be provided for the
43.11contracted amount;
43.12(3) a delineation of the cost and nature of any other services to be provided for an
43.13additional fee;
43.14(4) a delineation and description of any additional fees the resident may be required to
43.15pay if the resident's condition changes during the term of the contract;
43.16(5) a delineation of the grounds under which the resident may be ~~discharged, evicted,~~
43.17or transferred or have housing or services terminated or be subject to an emergency
43.18relocation;
43.19(6) billing and payment procedures and requirements; and
43.20(7) disclosure of the facility's ability to provide specialized diets.
43.21(d) The contract must include a description of the facility's complaint resolution process
43.22available to residents, including the name and contact information of the person representing
43.23the facility who is designated to handle and resolve complaints.
43.24(e) The contract must include a clear and conspicuous notice of:
43.25(1) the right under section 144G.54 to appeal the termination of an assisted living contract;
43.26(2) the facility's policy regarding transfer of residents within the facility, under what
43.27circumstances a transfer may occur, and the circumstances under which resident consent is
43.28required for a transfer;
43.29(3) contact information for the Office of Ombudsman for Long-Term Care, the
43.30Ombudsman for Mental Health and Developmental Disabilities, and the Office of Health
43.31Facility Complaints;
44.1(4) the resident's right to obtain services from an unaffiliated service provider;
44.2(5) a description of the facility's policies related to medical assistance waivers under
44.3chapter 256S and section 256B.49 and the housing support program under chapter 256I,
44.4including:
44.5(i) whether the facility is enrolled with the commissioner of human services to provide
44.6customized living services under medical assistance waivers;
44.7(ii) whether the facility has an agreement to provide housing support under section
44.8256I.04, subdivision 2, paragraph (b);
44.9(iii) whether there is a limit on the number of people residing at the facility who can
44.10receive customized living services or participate in the housing support program at any
44.11point in time. If so, the limit must be provided;
44.12(iv) whether the facility requires a resident to pay privately for a period of time prior to
44.13accepting payment under medical assistance waivers or the housing support program, and
44.14if so, the length of time that private payment is required;
44.15(v) a statement that medical assistance waivers provide payment for services, but do not
44.16cover the cost of rent;
44.17(vi) a statement that residents may be eligible for assistance with rent through the housing
44.18support program; and
44.19(vii) a description of the rent requirements for people who are eligible for medical
44.20assistance waivers but who are not eligible for assistance through the housing support
44.21program;
44.22(6) the contact information to obtain long-term care consulting services under section
44.23256B.0911; and
44.24(7) the toll-free phone number for the Minnesota Adult Abuse Reporting Center.
44.25EFFECTIVE DATE.This section is effective August 1, 2022, and applies to assisted
44.26living contracts executed on or after that date.

44.27    Sec. 40. Minnesota Statutes 2020, section 144G.52, subdivision 2, is amended to read:
44.28    Subd. 2. Prerequisite to termination of a contract. (a) Before issuing a notice of
44.29termination of an assisted living contract, a facility must schedule and participate in a meeting
44.30with the resident and the resident's legal representative and designated representative. The
44.31purposes of the meeting are to:
45.1(1) explain in detail the reasons for the proposed termination; and
45.2(2) identify and offer reasonable accommodations or modifications, interventions, or
45.3alternatives to avoid the termination or enable the resident to remain in the facility, including
45.4but not limited to securing services from another provider of the resident's choosing that
45.5may allow the resident to avoid the termination. A facility is not required to offer
45.6accommodations, modifications, interventions, or alternatives that fundamentally alter the
45.7nature of the operation of the facility.
45.8(b) The meeting must be scheduled to take place at least seven days before a notice of
45.9termination is issued. The facility must make reasonable efforts to ensure that the resident,
45.10legal representative, and designated representative are able to attend the meeting.
45.11(c) The facility must notify the resident that the resident may invite family members,
45.12relevant health professionals, a representative of the Office of Ombudsman for Long-Term
45.13Care, a representative of the Office of Ombudsman for Mental Health and Developmental
45.14Disabilities, or other persons of the resident's choosing to participate in the meeting. For
45.15residents who receive home and community-based waiver services under chapter 256S and
45.16section 256B.49, the facility must notify the resident's case manager of the meeting.
45.17(d) In the event of an emergency relocation under subdivision 9, where the facility intends
45.18to issue a notice of termination and an in-person meeting is impractical or impossible, the
45.19facility ~~may attempt to schedule and participate in a meeting under this subdivision via~~ must
45.20use telephone, video, or other electronic means to conduct and participate in the meeting
45.21required under this subdivision and rules within Minnesota Rules, chapter 4659.
45.22EFFECTIVE DATE.This section is effective August 1, 2022.

45.23    Sec. 41. Minnesota Statutes 2020, section 144G.52, subdivision 8, is amended to read:
45.24    Subd. 8. Content of notice of termination. The notice required under subdivision 7
45.25must contain, at a minimum:
45.26(1) the effective date of the termination of the assisted living contract;
45.27(2) a detailed explanation of the basis for the termination, including the clinical or other
45.28supporting rationale;
45.29(3) a detailed explanation of the conditions under which a new or amended contract may
45.30be executed;
46.1(4) a statement that the resident has the right to appeal the termination by requesting a
46.2hearing, and information concerning the time frame within which the request must be
46.3submitted and the contact information for the agency to which the request must be submitted;
46.4(5) a statement that the facility must participate in a coordinated move to another provider
46.5or caregiver, as required under section 144G.55;
46.6(6) the name and contact information of the person employed by the facility with whom
46.7the resident may discuss the notice of termination;
46.8(7) information on how to contact the Office of Ombudsman for Long-Term Care and
46.9the Office of Ombudsman for Mental Health and Developmental Disabilities to request an
46.10advocate to assist regarding the termination;
46.11(8) information on how to contact the Senior LinkAge Line under section 256.975,
46.12subdivision 7, and an explanation that the Senior LinkAge Line may provide information
46.13about other available housing or service options; and
46.14(9) if the termination is only for services, a statement that the resident may remain in
46.15the facility and may secure any necessary services from another provider of the resident's
46.16choosing.
46.17EFFECTIVE DATE.This section is effective August 1, 2022.

46.18    Sec. 42. Minnesota Statutes 2020, section 144G.52, subdivision 9, is amended to read:
46.19    Subd. 9. Emergency relocation. (a) A facility may remove a resident from the facility
46.20in an emergency if necessary due to a resident's urgent medical needs or an imminent risk
46.21the resident poses to the health or safety of another facility resident or facility staff member.
46.22An emergency relocation is not a termination.
46.23(b) In the event of an emergency relocation, the facility must provide a written notice
46.24that contains, at a minimum:
46.25(1) the reason for the relocation;
46.26(2) the name and contact information for the location to which the resident has been
46.27relocated and any new service provider;
46.28(3) contact information for the Office of Ombudsman for Long-Term Care and the Office
46.29of Ombudsman for Mental Health and Developmental Disabilities;
47.1(4) if known and applicable, the approximate date or range of dates within which the
47.2resident is expected to return to the facility, or a statement that a return date is not currently
47.3known; and
47.4(5) a statement that, if the facility refuses to provide housing or services after a relocation,
47.5the resident has the right to appeal under section 144G.54. The facility must provide contact
47.6information for the agency to which the resident may submit an appeal.
47.7(c) The notice required under paragraph (b) must be delivered as soon as practicable to:
47.8(1) the resident, legal representative, and designated representative;
47.9(2) for residents who receive home and community-based waiver services under chapter
47.10256S and section 256B.49, the resident's case manager; and
47.11(3) the Office of Ombudsman for Long-Term Care if the resident has been relocated
47.12and has not returned to the facility within four days.
47.13(d) Following an emergency relocation, a facility's refusal to provide housing or services
47.14constitutes a termination and triggers the termination process in this section.
47.15EFFECTIVE DATE.This section is effective August 1, 2022.

47.16    Sec. 43. Minnesota Statutes 2020, section 144G.53, is amended to read:
47.17144G.53 NONRENEWAL OF HOUSING.
47.18(a) If a facility decides to not renew a resident's housing under a contract, the facility
47.19must either (1) provide the resident with 60 calendar days' notice of the nonrenewal and
47.20assistance with relocation planning, or (2) follow the termination procedure under section
47.21144G.52.
47.22(b) The notice must include the reason for the nonrenewal and contact information of
47.23the Office of Ombudsman for Long-Term Care and the Office of Ombudsman for Mental
47.24Health and Developmental Disabilities.
47.25(c) A facility must:
47.26(1) provide notice of the nonrenewal to the Office of Ombudsman for Long-Term Care;
47.27(2) for residents who receive home and community-based waiver services under chapter
47.28256S and section 256B.49, provide notice to the resident's case manager;
47.29(3) ensure a coordinated move to a safe location, as defined in section 144G.55,
47.30subdivision 2, that is appropriate for the resident;
48.1(4) ensure a coordinated move to an appropriate service provider identified by the facility,
48.2if services are still needed and desired by the resident;
48.3(5) consult and cooperate with the resident, legal representative, designated representative,
48.4case manager for a resident who receives home and community-based waiver services under
48.5chapter 256S and section 256B.49, relevant health professionals, and any other persons of
48.6the resident's choosing to make arrangements to move the resident, including consideration
48.7of the resident's goals; and
48.8(6) prepare a written plan to prepare for the move.
48.9(d) A resident may decline to move to the location the facility identifies or to accept
48.10services from a service provider the facility identifies, and may instead choose to move to
48.11a location of the resident's choosing or receive services from a service provider of the
48.12resident's choosing within the timeline prescribed in the nonrenewal notice.
48.13EFFECTIVE DATE.This section is effective August 1, 2022.

48.14    Sec. 44. Minnesota Statutes 2020, section 144G.55, subdivision 1, is amended to read:
48.15    Subdivision 1. Duties of facility. (a) If a facility terminates an assisted living contract,
48.16reduces services to the extent that a resident needs to move or obtain a new service provider
48.17or the facility has its license restricted under section 144G.20, or the facility conducts a
48.18planned closure under section 144G.57, the facility:
48.19(1) must ensure, subject to paragraph (c), a coordinated move to a safe location that is
48.20appropriate for the resident and that is identified by the facility prior to any hearing under
48.21section 144G.54;
48.22(2) must ensure a coordinated move of the resident to an appropriate service provider
48.23identified by the facility prior to any hearing under section 144G.54, provided services are
48.24still needed and desired by the resident; and
48.25(3) must consult and cooperate with the resident, legal representative, designated
48.26representative, case manager for a resident who receives home and community-based waiver
48.27services under chapter 256S and section 256B.49, relevant health professionals, and any
48.28other persons of the resident's choosing to make arrangements to move the resident, including
48.29consideration of the resident's goals.
48.30(b) A facility may satisfy the requirements of paragraph (a), clauses (1) and (2), by
48.31moving the resident to a different location within the same facility, if appropriate for the
48.32resident.
49.1(c) A resident may decline to move to the location the facility identifies or to accept
49.2services from a service provider the facility identifies, and may choose instead to move to
49.3a location of the resident's choosing or receive services from a service provider of the
49.4resident's choosing within the timeline prescribed in the termination notice.
49.5(d) Sixty days before the facility plans to reduce or eliminate one or more services for
49.6a particular resident, the facility must provide written notice of the reduction that includes:
49.7(1) a detailed explanation of the reasons for the reduction and the date of the reduction;
49.8(2) the contact information for the Office of Ombudsman for Long-Term Care, the Office
49.9of Ombudsman for Mental Health and Developmental Disabilities, and the name and contact
49.10information of the person employed by the facility with whom the resident may discuss the
49.11reduction of services;
49.12(3) a statement that if the services being reduced are still needed by the resident, the
49.13resident may remain in the facility and seek services from another provider; and
49.14(4) a statement that if the reduction makes the resident need to move, the facility must
49.15participate in a coordinated move of the resident to another provider or caregiver, as required
49.16under this section.
49.17(e) In the event of an unanticipated reduction in services caused by extraordinary
49.18circumstances, the facility must provide the notice required under paragraph (d) as soon as
49.19possible.
49.20(f) If the facility, a resident, a legal representative, or a designated representative
49.21determines that a reduction in services will make a resident need to move to a new location,
49.22the facility must ensure a coordinated move in accordance with this section, and must provide
49.23notice to the Office of Ombudsman for Long-Term Care.
49.24(g) Nothing in this section affects a resident's right to remain in the facility and seek
49.25services from another provider.
49.26EFFECTIVE DATE.This section is effective August 1, 2022.

49.27    Sec. 45. Minnesota Statutes 2020, section 144G.55, subdivision 3, is amended to read:
49.28    Subd. 3. Relocation plan required. The facility must prepare a relocation plan to prepare
49.29for the move to ~~the~~ a new safe location or appropriate service provider, as required by this
49.30section.
49.31EFFECTIVE DATE.This section is effective August 1, 2022.

50.1    Sec. 46. Minnesota Statutes 2020, section 144G.56, subdivision 3, is amended to read:
50.2    Subd. 3. Notice required. (a) A facility must provide at least 30 calendar days' advance
50.3written notice to the resident and the resident's legal and designated representative of a
50.4facility-initiated transfer. The notice must include:
50.5(1) the effective date of the proposed transfer;
50.6(2) the proposed transfer location;
50.7(3) a statement that the resident may refuse the proposed transfer, and may discuss any
50.8consequences of a refusal with staff of the facility;
50.9(4) the name and contact information of a person employed by the facility with whom
50.10the resident may discuss the notice of transfer; and
50.11(5) contact information for the Office of Ombudsman for Long-Term Care and the Office
50.12of Ombudsman for Mental Health and Developmental Disabilities.
50.13(b) Notwithstanding paragraph (a), a facility may conduct a facility-initiated transfer of
50.14a resident with less than 30 days' written notice if the transfer is necessary due to:
50.15(1) conditions that render the resident's room or private living unit uninhabitable;
50.16(2) the resident's urgent medical needs; or
50.17(3) a risk to the health or safety of another resident of the facility.
50.18EFFECTIVE DATE.This section is effective August 1, 2022.

50.19    Sec. 47. Minnesota Statutes 2020, section 144G.56, subdivision 5, is amended to read:
50.20    Subd. 5. Changes in facility operations. (a) In situations where there is a curtailment,
50.21reduction, or capital improvement within a facility necessitating transfers, the facility must:
50.22(1) minimize the number of transfers it initiates to complete the project or change in
50.23operations;
50.24(2) consider individual resident needs and preferences;
50.25(3) provide reasonable accommodations for individual resident requests regarding the
50.26transfers; and
50.27(4) in advance of any notice to any residents, legal representatives, or designated
50.28representatives, provide notice to the Office of Ombudsman for Long-Term Care and~~, when~~
50.29~~appropriate,~~ the Office of Ombudsman for Mental Health and Developmental Disabilities
50.30of the curtailment, reduction, or capital improvement and the corresponding needed transfers.
51.1EFFECTIVE DATE.This section is effective August 1, 2022.

51.2    Sec. 48. Minnesota Statutes 2020, section 144G.57, subdivision 1, is amended to read:
51.3    Subdivision 1. Closure plan required. In the event that an assisted living facility elects
51.4to voluntarily close the facility, the facility must notify the commissioner ~~and~~, the Office
51.5of Ombudsman for Long-Term Care, and the Office of Ombudsman for Mental Health and
51.6Developmental Disabilities in writing by submitting a proposed closure plan.
51.7EFFECTIVE DATE.This section is effective August 1, 2022.

51.8    Sec. 49. Minnesota Statutes 2020, section 144G.57, subdivision 3, is amended to read:
51.9    Subd. 3. Commissioner's approval required prior to implementation. (a) The plan
51.10shall be subject to the commissioner's approval and subdivision 6. The facility shall take
51.11no action to close the residence prior to the commissioner's approval of the plan. The
51.12commissioner shall approve or otherwise respond to the plan as soon as practicable.
51.13(b) The commissioner may require the facility to work with a transitional team comprised
51.14of department staff, staff of the Office of Ombudsman for Long-Term Care, the Office of
51.15Ombudsman for Mental Health and Developmental Disabilities, and other professionals the
51.16commissioner deems necessary to assist in the proper relocation of residents.
51.17EFFECTIVE DATE.This section is effective August 1, 2022.

51.18    Sec. 50. Minnesota Statutes 2020, section 144G.57, subdivision 5, is amended to read:
51.19    Subd. 5. Notice to residents. After the commissioner has approved the relocation plan
51.20and at least 60 calendar days before closing, except as provided under subdivision 6, the
51.21facility must notify residents, designated representatives, and legal representatives of the
51.22closure, the proposed date of closure, the contact information of the ombudsman for long-term
51.23care and the ombudsman for mental health and developmental disabilities, and that the
51.24facility will follow the termination planning requirements under section 144G.55, and final
51.25accounting and return requirements under section 144G.42, subdivision 5. For residents
51.26who receive home and community-based waiver services under chapter 256S and section
51.27256B.49, the facility must also provide this information to the resident's case manager.
51.28EFFECTIVE DATE.This section is effective August 1, 2022.

52.1    Sec. 51. Minnesota Statutes 2020, section 144G.70, subdivision 2, is amended to read:
52.2    Subd. 2. Initial reviews, assessments, and monitoring. (a) Residents who are not
52.3receiving any assisted living services shall not be required to undergo an initial nursing
52.4assessment.
52.5(b) An assisted living facility shall conduct a nursing assessment by a registered nurse
52.6of the physical and cognitive needs of the prospective resident and propose a temporary
52.7service plan prior to the date on which a prospective resident executes a contract with a
52.8facility or the date on which a prospective resident moves in, whichever is earlier. If
52.9necessitated by either the geographic distance between the prospective resident and the
52.10facility, or urgent or unexpected circumstances, the assessment may be conducted using
52.11telecommunication methods based on practice standards that meet the resident's needs and
52.12reflect person-centered planning and care delivery.
52.13(c) Resident reassessment and monitoring must be conducted no more than 14 calendar
52.14days after initiation of services. Ongoing resident reassessment and monitoring must be
52.15conducted as needed based on changes in the needs of the resident and cannot exceed 90
52.16calendar days from the last date of the assessment.
52.17(d) For residents only receiving assisted living services specified in section 144G.08,
52.18subdivision 9, clauses (1) to (5), the facility shall complete an individualized initial review
52.19of the resident's needs and preferences. The initial review must be completed within 30
52.20calendar days of the start of services. Resident monitoring and review must be conducted
52.21as needed based on changes in the needs of the resident and cannot exceed 90 calendar days
52.22from the date of the last review.
52.23(e) A facility must inform the prospective resident of the availability of and contact
52.24information for long-term care consultation services under section 256B.0911, prior to the
52.25date on which a prospective resident executes a contract with a facility or the date on which
52.26a prospective resident moves in, whichever is earlier.
52.27EFFECTIVE DATE.This section is effective August 1, 2022.

52.28    Sec. 52. Minnesota Statutes 2020, section 144G.70, subdivision 4, is amended to read:
52.29    Subd. 4. Service plan, implementation, and revisions to service plan. (a) No later
52.30than 14 calendar days after the date that services are first provided, an assisted living facility
52.31shall finalize a current written service plan.
52.32(b) The service plan and any revisions must include a signature or other authentication
52.33by the facility and by the resident documenting agreement on the services to be provided.
53.1The service plan must be revised, if needed, based on resident reassessment under subdivision
53.22. The facility must provide information to the resident about changes to the facility's fee
53.3for services and how to contact the Office of Ombudsman for Long-Term Care and the
53.4Office of Ombudsman for Mental Health and Developmental Disabilities.
53.5(c) The facility must implement and provide all services required by the current service
53.6plan.
53.7(d) The service plan and the revised service plan must be entered into the resident record,
53.8including notice of a change in a resident's fees when applicable.
53.9(e) Staff providing services must be informed of the current written service plan.
53.10(f) The service plan must include:
53.11(1) a description of the services to be provided, the fees for services, and the frequency
53.12of each service, according to the resident's current assessment and resident preferences;
53.13(2) the identification of staff or categories of staff who will provide the services;
53.14(3) the schedule and methods of monitoring assessments of the resident;
53.15(4) the schedule and methods of monitoring staff providing services; and
53.16(5) a contingency plan that includes:
53.17(i) the action to be taken if the scheduled service cannot be provided;
53.18(ii) information and a method to contact the facility;
53.19(iii) the names and contact information of persons the resident wishes to have notified
53.20in an emergency or if there is a significant adverse change in the resident's condition,
53.21including identification of and information as to who has authority to sign for the resident
53.22in an emergency; and
53.23(iv) the circumstances in which emergency medical services are not to be summoned
53.24consistent with chapters 145B and 145C, and declarations made by the resident under those
53.25chapters.
53.26EFFECTIVE DATE.This section is effective August 1, 2022.

53.27    Sec. 53. Minnesota Statutes 2020, section 144G.80, subdivision 2, is amended to read:
53.28    Subd. 2. Demonstrated capacity. (a) An applicant for licensure as an assisted living
53.29facility with dementia care must have the ability to provide services in a manner that is
54.1consistent with the requirements in this section. The commissioner shall consider the
54.2following criteria, including, but not limited to:
54.3(1) the experience of the ~~applicant in~~ applicant's assisted living director, managerial
54.4official, and clinical nurse supervisor managing residents with dementia or previous long-term
54.5care experience; and
54.6(2) the compliance history of the applicant in the operation of any care facility licensed,
54.7certified, or registered under federal or state law.
54.8(b) If the ~~applicant does~~ applicant's assisted living director and clinical nurse supervisor
54.9do not have experience in managing residents with dementia, the applicant must employ a
54.10consultant for at least the first six months of operation. The consultant must meet the
54.11requirements in paragraph (a), clause (1), and make recommendations on providing dementia
54.12care services consistent with the requirements of this chapter. The consultant must (1) have
54.13two years of work experience related to dementia, health care, gerontology, or a related
54.14field, and (2) have completed at least the minimum core training requirements in section
54.15144G.64. The applicant must document an acceptable plan to address the consultant's
54.16identified concerns and must either implement the recommendations or document in the
54.17plan any consultant recommendations that the applicant chooses not to implement. The
54.18commissioner must review the applicant's plan upon request.
54.19(c) The commissioner shall conduct an on-site inspection prior to the issuance of an
54.20assisted living facility with dementia care license to ensure compliance with the physical
54.21environment requirements.
54.22(d) The label "Assisted Living Facility with Dementia Care" must be identified on the
54.23license.
54.24EFFECTIVE DATE.This section is effective August 1, 2022.

54.25    Sec. 54. Minnesota Statutes 2020, section 144G.90, subdivision 1, is amended to read:
54.26    Subdivision 1. Assisted living bill of rights; notification to resident. (a) An assisted
54.27living facility must provide the resident a written notice of the rights under section 144G.91
54.28before the initiation of services to that resident. The facility shall make all reasonable efforts
54.29to provide notice of the rights to the resident in a language the resident can understand.
54.30(b) In addition to the text of the assisted living bill of rights in section 144G.91, the
54.31notice shall also contain the following statement describing how to file a complaint or report
54.32suspected abuse:
55.1"If you want to report suspected abuse, neglect, or financial exploitation, you may contact
55.2the Minnesota Adult Abuse Reporting Center (MAARC). If you have a complaint about
55.3the facility or person providing your services, you may contact the Office of Health Facility
55.4Complaints, Minnesota Department of Health. If you would like to request advocacy services,
55.5you may ~~also~~ contact the Office of Ombudsman for Long-Term Care or the Office of
55.6Ombudsman for Mental Health and Developmental Disabilities."
55.7    (c) The statement must include contact information for the Minnesota Adult Abuse
55.8Reporting Center and the telephone number, website address, e-mail address, mailing
55.9address, and street address of the Office of Health Facility Complaints at the Minnesota
55.10Department of Health, the Office of Ombudsman for Long-Term Care, and the Office of
55.11Ombudsman for Mental Health and Developmental Disabilities. The statement must include
55.12the facility's name, address, e-mail, telephone number, and name or title of the person at
55.13the facility to whom problems or complaints may be directed. It must also include a statement
55.14that the facility will not retaliate because of a complaint.
55.15    (d) A facility must obtain written acknowledgment from the resident of the resident's
55.16receipt of the assisted living bill of rights or shall document why an acknowledgment cannot
55.17be obtained. Acknowledgment of receipt shall be retained in the resident's record.
55.18EFFECTIVE DATE.This section is effective August 1, 2022.

55.19    Sec. 55. Minnesota Statutes 2020, section 144G.90, is amended by adding a subdivision
55.20to read:
55.21    Subd. 6. Notice to residents. For any notice to a resident, legal representative, or
55.22designated representative provided under this chapter or under Minnesota Rules, chapter
55.234659, that is required to include information regarding the Office of Ombudsman for
55.24Long-Term Care and the Office of Ombudsman for Mental Health and Developmental
55.25Disabilities, the notice must contain the following language: "You may contact the
55.26Ombudsman for Long-Term Care for questions about your rights as an assisted living facility
55.27resident and to request advocacy services. As an assisted living facility resident, you may
55.28contact the Ombudsman for Mental Health and Developmental Disabilities to request
55.29advocacy regarding your rights, concerns, or questions on issues relating to services for
55.30mental health, developmental disabilities, or chemical dependency."
55.31EFFECTIVE DATE.This section is effective August 1, 2022.

56.1    Sec. 56. Minnesota Statutes 2020, section 144G.91, subdivision 13, is amended to read:
56.2    Subd. 13. Personal and treatment privacy. (a) Residents have the right to consideration
56.3of their privacy, individuality, and cultural identity as related to their social, religious, and
56.4psychological well-being. Staff must respect the privacy of a resident's space by knocking
56.5on the door and seeking consent before entering, except in an emergency or ~~where clearly~~
56.6~~inadvisable or~~ unless otherwise documented in the resident's service plan.
56.7(b) Residents have the right to have and use a lockable door to the resident's unit. The
56.8facility shall provide locks on the resident's unit. Only a staff member with a specific need
56.9to enter the unit shall have keys. This right may be restricted in certain circumstances if
56.10necessary for a resident's health and safety and documented in the resident's service plan.
56.11(c) Residents have the right to respect and privacy regarding the resident's service plan.
56.12Case discussion, consultation, examination, and treatment are confidential and must be
56.13conducted discreetly. Privacy must be respected during toileting, bathing, and other activities
56.14of personal hygiene, except as needed for resident safety or assistance.
56.15EFFECTIVE DATE.This section is effective August 1, 2022.

56.16    Sec. 57. Minnesota Statutes 2020, section 144G.91, subdivision 21, is amended to read:
56.17    Subd. 21. Access to counsel and advocacy services. Residents have the right to the
56.18immediate access by:
56.19(1) the resident's legal counsel;
56.20(2) any representative of the protection and advocacy system designated by the state
56.21under Code of Federal Regulations, title 45, section 1326.21; or
56.22(3) any representative of the Office of Ombudsman for Long-Term Care or the Office
56.23of Ombudsman for Mental Health and Developmental Disabilities.
56.24EFFECTIVE DATE.This section is effective August 1, 2022.

56.25    Sec. 58. Minnesota Statutes 2020, section 144G.92, subdivision 1, is amended to read:
56.26    Subdivision 1. Retaliation prohibited. A facility or agent of a facility may not retaliate
56.27against a resident or employee if the resident, employee, or any person acting on behalf of
56.28the resident:
56.29(1) files a good faith complaint or grievance, makes a good faith inquiry, or asserts any
56.30right;
57.1(2) indicates a good faith intention to file a complaint or grievance, make an inquiry, or
57.2assert any right;
57.3(3) files, in good faith, or indicates an intention to file a maltreatment report, whether
57.4mandatory or voluntary, under section 626.557;
57.5(4) seeks assistance from or reports a reasonable suspicion of a crime or systemic
57.6problems or concerns to the director or manager of the facility, the Office of Ombudsman
57.7for Long-Term Care, the Office of Ombudsman for Mental Health and Developmental
57.8Disabilities, a regulatory or other government agency, or a legal or advocacy organization;
57.9(5) advocates or seeks advocacy assistance for necessary or improved care or services
57.10or enforcement of rights under this section or other law;
57.11(6) takes or indicates an intention to take civil action;
57.12(7) participates or indicates an intention to participate in any investigation or
57.13administrative or judicial proceeding;
57.14(8) contracts or indicates an intention to contract to receive services from a service
57.15provider of the resident's choice other than the facility; or
57.16(9) places or indicates an intention to place a camera or electronic monitoring device in
57.17the resident's private space as provided under section 144.6502.
57.18EFFECTIVE DATE.This section is effective August 1, 2022.

57.19    Sec. 59. Minnesota Statutes 2020, section 144G.93, is amended to read:
57.20144G.93 CONSUMER ADVOCACY AND LEGAL SERVICES.
57.21Upon execution of an assisted living contract, every facility must provide the resident
57.22with the names and contact information, including telephone numbers and e-mail addresses,
57.23of:
57.24(1) nonprofit organizations that provide advocacy or legal services to residents including
57.25but not limited to the designated protection and advocacy organization in Minnesota that
57.26provides advice and representation to individuals with disabilities; and
57.27(2) the Office of Ombudsman for Long-Term Care~~, including both the state and regional~~
57.28~~contact information~~ and the Office of Ombudsman for Mental Health and Developmental
57.29Disabilities.
57.30EFFECTIVE DATE.This section is effective August 1, 2022.

58.1    Sec. 60. Minnesota Statutes 2020, section 144G.95, is amended to read:
58.2144G.95 OFFICE OF OMBUDSMAN FOR LONG-TERM CARE AND OFFICE
58.3OF OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL
58.4DISABILITIES.
58.5    Subdivision 1. Immunity from liability. (a) The Office of Ombudsman for Long-Term
58.6Care and representatives of the office are immune from liability for conduct described in
58.7section 256.9742, subdivision 2.
58.8(b) The Office of Ombudsman for Mental Health and Developmental Disabilities and
58.9representatives of the office are immune from liability for conduct described in section
58.10245.96.
58.11    Subd. 2. Data classification. (a) All forms and notices received by the Office of
58.12Ombudsman for Long-Term Care under this chapter are classified under section 256.9744.
58.13(b) All data collected or received by the Office of Ombudsman for Mental Health and
58.14Developmental Disabilities are classified under section 245.94.
58.15EFFECTIVE DATE.This section is effective August 1, 2022.

58.16    Sec. 61. [145.267] FETAL ALCOHOL SPECTRUM DISORDERS PREVENTION
58.17GRANTS.
58.18(a) The commissioner of health shall award a grant to a statewide organization that
58.19focuses solely on prevention of and intervention with fetal alcohol spectrum disorders. The
58.20grant recipient must make subgrants to eligible regional collaboratives in rural and urban
58.21areas of the state for the purposes specified in paragraph (c).
58.22(b) "Eligible regional collaboratives" means a partnership between at least one local
58.23government or Tribal government and at least one community-based organization and,
58.24where available, a family home visiting program. For purposes of this paragraph, a local
58.25government includes a county or a multicounty organization, a county-based purchasing
58.26entity, or a community health board.
58.27(c) Eligible regional collaboratives must use subgrant funds to reduce the incidence of
58.28fetal alcohol spectrum disorders and other prenatal drug-related effects in children in
58.29Minnesota by identifying and serving pregnant women suspected of or known to use or
58.30abuse alcohol or other drugs. Eligible regional collaboratives must provide intensive services
58.31to chemically dependent women to increase positive birth outcomes.
59.1(d) An eligible regional collaborative that receives a subgrant under this section must
59.2report to the grant recipient by January 15 of each year on the services and programs funded
59.3by the subgrant. The report must include measurable outcomes for the previous year,
59.4including the number of pregnant women served and the number of toxin-free babies born.
59.5The grant recipient must compile the information in the subgrant reports and submit a
59.6summary report to the commissioner of health by February 15 of each year.
59.7EFFECTIVE DATE.This section is effective July 1, 2023.

59.8    Sec. 62. Minnesota Statutes 2021 Supplement, section 245C.03, subdivision 5a, is amended
59.9to read:
59.10    Subd. 5a. Facilities serving children or adults licensed or regulated by the
59.11Department of Health. (a) Except as specified in paragraph (b), the commissioner shall
59.12conduct background studies of:
59.13(1) individuals providing services who have direct contact, as defined under section
59.14245C.02, subdivision 11, with patients and residents in hospitals, boarding care homes,
59.15outpatient surgical centers licensed under sections 144.50 to 144.58; nursing homes and
59.16home care agencies licensed under chapter 144A; assisted living facilities and assisted living
59.17facilities with dementia care licensed under chapter 144G; and board and lodging
59.18establishments that are registered to provide supportive or health supervision services under
59.19section 157.17;
59.20(2) individuals specified in subdivision 2 who provide direct contact services in a nursing
59.21home or a home care agency licensed under chapter 144A; an assisted living facility or
59.22assisted living facility with dementia care licensed under chapter 144G; or a boarding care
59.23home licensed under sections 144.50 to 144.58. If the individual undergoing a study resides
59.24outside of Minnesota, the study must include a check for substantiated findings of
59.25maltreatment of adults and children in the individual's state of residence when the state
59.26makes the information available;
59.27(3) all other employees in assisted living facilities or assisted living facilities with
59.28dementia care licensed under chapter 144G, nursing homes licensed under chapter 144A,
59.29and boarding care homes licensed under sections 144.50 to 144.58. A disqualification of
59.30an individual in this section shall disqualify the individual from positions allowing direct
59.31contact with or access to patients or residents receiving services. "Access" means physical
59.32access to a client or the client's personal property without continuous, direct supervision as
59.33defined in section 245C.02, subdivision 8, when the employee's employment responsibilities
59.34do not include providing direct contact services;
60.1(4) individuals employed by a supplemental nursing services agency, as defined under
60.2section 144A.70, who are providing services in health care facilities; ~~and~~
60.3(5) controlling persons of a supplemental nursing services agency, as defined by section
60.4144A.70.; and
60.5(6) license applicants, owners, managerial officials, and controlling individuals who are
60.6required under section 144A.476, subdivision 1, or 144G.13, subdivision 1, to undergo a
60.7background study under this chapter, regardless of the licensure status of the license applicant,
60.8owner, managerial official, or controlling individual.
60.9(b) The commissioner of human services shall not conduct a background study on any
60.10individual identified in paragraph (a), clauses (1) to (5), if the individual has a valid license
60.11issued by a health-related licensing board as defined in section 214.01, subdivision 2, and
60.12has completed the criminal background check as required in section 214.075. An entity that
60.13is affiliated with individuals who meet the requirements of this paragraph must separate
60.14those individuals from the entity's roster for NETStudy 2.0.
60.15(c) If a facility or program is licensed by the Department of Human Services and the
60.16Department of Health and is subject to the background study provisions of this chapter, the
60.17Department of Human Services is solely responsible for the background studies of individuals
60.18in the jointly licensed program.
60.19~~(c)~~ (d) The commissioner of health shall review and make decisions regarding
60.20reconsideration requests, including whether to grant variances, according to the procedures
60.21and criteria in this chapter. The commissioner of health shall inform the requesting individual
60.22and the Department of Human Services of the commissioner of health's decision regarding
60.23the reconsideration. The commissioner of health's decision to grant or deny a reconsideration
60.24of a disqualification is a final administrative agency action.
60.25EFFECTIVE DATE.This section is effective the day following final enactment.

60.26    Sec. 63. Minnesota Statutes 2020, section 245C.31, subdivision 1, is amended to read:
60.27    Subdivision 1. Board determines disciplinary or corrective action. (a) ~~When the~~
60.28~~subject of a background study is regulated by a health-related licensing board as defined in~~
60.29~~chapter~~ ~~214, and the commissioner determines that the regulated individual is responsible~~
60.30~~for substantiated maltreatment under section~~ ~~626.557~~ ~~or chapter~~ ~~260E, instead of the~~
60.31~~commissioner making a decision regarding disqualification, the board shall make a~~
60.32~~determination whether to impose disciplinary or corrective action under chapter~~ ~~214~~ The
60.33commissioner shall notify a health-related licensing board as defined in section 214.01,
61.1subdivision 2, if the commissioner determines that an individual who is licensed by the
61.2health-related licensing board and who is included on the board's roster list provided in
61.3accordance with subdivision 3a is responsible for substantiated maltreatment under section
61.4626.557 or chapter 260E, in accordance with subdivision 2. Upon receiving notification,
61.5the health-related licensing board shall make a determination as to whether to impose
61.6disciplinary or corrective action under chapter 214.
61.7(b) This section does not apply to a background study of an individual regulated by a
61.8health-related licensing board if the individual's study is related to child foster care, adult
61.9foster care, or family child care licensure.
61.10EFFECTIVE DATE.This section is effective February 1, 2023.

61.11    Sec. 64. Minnesota Statutes 2020, section 245C.31, subdivision 2, is amended to read:
61.12    Subd. 2. Commissioner's notice to board. ~~(a)~~ The commissioner shall notify ~~the~~ a
61.13health-related licensing board:
61.14(1) ~~upon completion of a background study that produces~~ of a record showing that the
61.15individual licensed by the board was determined to have been responsible for substantiated
61.16maltreatment;
61.17(2) upon the commissioner's completion of an investigation that determined ~~the~~ an
61.18individual licensed by the board was responsible for substantiated maltreatment; or
61.19(3) upon receipt from another agency of a finding of substantiated maltreatment for
61.20which ~~the~~ an individual licensed by the board was responsible.
61.21~~(b) The commissioner's notice to the health-related licensing board shall indicate whether~~
61.22~~the commissioner would have disqualified the individual for the substantiated maltreatment~~
61.23~~if the individual were not regulated by the board.~~
61.24~~(c) The commissioner shall concurrently send the notice under this subdivision to the~~
61.25~~individual who is the subject of the~~ ~~background study~~.
61.26EFFECTIVE DATE.This section is effective February 1, 2023.

61.27    Sec. 65. Minnesota Statutes 2020, section 245C.31, is amended by adding a subdivision
61.28to read:
61.29    Subd. 3a. Agreements with health-related licensing boards. The commissioner and
61.30each health-related licensing board shall enter into an agreement in order for each board to
61.31provide the commissioner with a daily roster list of individuals who have a license issued
62.1by the board in active status. The list must include for each licensed individual the individual's
62.2name, aliases, date of birth, and license number; the date the license was issued; status of
62.3the license; and the last four digits of the individual's Social Security number.
62.4EFFECTIVE DATE.This section is effective August 1, 2022.

62.5    Sec. 66. Minnesota Statutes 2020, section 245C.31, is amended by adding a subdivision
62.6to read:
62.7    Subd. 3b. Maltreatment study; fees. (a) The administrative service unit for the
62.8health-related licensing boards shall apportion between the health-related licensing boards
62.9that are required to submit a daily roster list in accordance with subdivision 3a an amount
62.10to be paid through an additional fee collected by each board in accordance with paragraph
62.11(b). The amount apportioned to each health-related licensing board must equal the board's
62.12share of the annual appropriation from the state government special revenue fund to the
62.13commissioner of human services to conduct the maltreatment studies on licensees who are
62.14listed on the daily roster lists and to comply with the notification requirement under
62.15subdivision 2. Each board's apportioned share must be based on the number of licensees
62.16that each health-related licensing board licenses as a percentage of the total number of
62.17licensees licensed collectively by all health-related licensing boards.
62.18(b) Each health-related licensing board may collect an additional fee from a licensee at
62.19the time the initial license fee is collected to compensate for the amount apportioned to each
62.20board by the administrative services unit. If an additional fee is collected by the health-related
62.21licensing board under this paragraph, the fee must be deposited in the state government
62.22special revenue fund.
62.23EFFECTIVE DATE.This section is effective August 1, 2022.

62.24    Sec. 67. Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 33,
62.25is amended to read:

62.26
62.27

Subd. 33.Grant Programs; Chemical
Dependency Treatment Support Grants

`62.28`	Appropriations by Fund
`62.29`	General	4,273,000	4,274,000
`62.30`	Lottery Prize	1,733,000	1,733,000
`62.31` `62.32`	Opiate Epidemic Response	500,000	500,000

63.1(a) Problem Gambling. $225,000 in fiscal
63.2year 2022 and $225,000 in fiscal year 2023
63.3are from the lottery prize fund for a grant to
63.4the state affiliate recognized by the National
63.5Council on Problem Gambling. The affiliate
63.6must provide services to increase public
63.7awareness of problem gambling, education,
63.8training for individuals and organizations
63.9providing effective treatment services to
63.10problem gamblers and their families, and
63.11research related to problem gambling.
63.12(b) Recovery Community Organization
63.13Grants. $2,000,000 in fiscal year 2022 and
63.14$2,000,000 in fiscal year 2023 are from the
63.15general fund for grants to recovery community
63.16organizations, as defined in Minnesota
63.17Statutes, section 254B.01, subdivision 8, to
63.18provide for costs and community-based peer
63.19recovery support services that are not
63.20otherwise eligible for reimbursement under
63.21Minnesota Statutes, section 254B.05, as part
63.22of the continuum of care for substance use
63.23disorders. The general fund base for this
63.24appropriation is $2,000,000 in fiscal year 2024
63.25and $0 in fiscal year 2025
63.26(c) Base Level Adjustment. The general fund
63.27base is ~~$4,636,000~~ $3,886,000 in fiscal year
63.282024 and ~~$2,636,000~~ $1,886,000 in fiscal year
63.292025. The opiate epidemic response fund base
63.30is $500,000 in fiscal year 2024 and $0 in fiscal
63.31year 2025.

63.32 Sec. 68. Laws 2021, First Special Session chapter 7, article 16, section 3, subdivision 2,
63.33is amended to read:

63.34

Subd. 2.Health Improvement

`64.1`	Appropriations by Fund
`64.2`	General	123,714,000	124,000,000
`64.3` `64.4`	State Government Special Revenue	11,967,000	11,290,000
`64.5`	Health Care Access	37,512,000	36,832,000
`64.6`	Federal TANF	11,713,000	11,713,000

64.7(a) TANF Appropriations. (1) $3,579,000 in
64.8fiscal year 2022 and $3,579,000 in fiscal year
64.92023 are from the TANF fund for home
64.10visiting and nutritional services listed under
64.11Minnesota Statutes, section 145.882,
64.12subdivision 7, clauses (6) and (7). Funds must
64.13be distributed to community health boards
64.14according to Minnesota Statutes, section
64.15145A.131, subdivision 1;
64.16(2) $2,000,000 in fiscal year 2022 and
64.17$2,000,000 in fiscal year 2023 are from the
64.18TANF fund for decreasing racial and ethnic
64.19disparities in infant mortality rates under
64.20Minnesota Statutes, section 145.928,
64.21subdivision 7;
64.22(3) $4,978,000 in fiscal year 2022 and
64.23$4,978,000 in fiscal year 2023 are from the
64.24TANF fund for the family home visiting grant
64.25program according to Minnesota Statutes,
64.26section 145A.17. $4,000,000 of the funding
64.27in each fiscal year must be distributed to
64.28community health boards according to
64.29Minnesota Statutes, section 145A.131,
64.30subdivision 1. $978,000 of the funding in each
64.31fiscal year must be distributed to tribal
64.32governments according to Minnesota Statutes,
64.33section 145A.14, subdivision 2a;
64.34(4) $1,156,000 in fiscal year 2022 and
64.35$1,156,000 in fiscal year 2023 are from the
65.1TANF fund for family planning grants under
65.2Minnesota Statutes, section 145.925; and
65.3(5) the commissioner may use up to 6.23
65.4percent of the funds appropriated from the
65.5TANF fund each fiscal year to conduct the
65.6ongoing evaluations required under Minnesota
65.7Statutes, section 145A.17, subdivision 7, and
65.8training and technical assistance as required
65.9under Minnesota Statutes, section 145A.17,
65.10subdivisions 4 and 5.
65.11(b) TANF Carryforward. Any unexpended
65.12balance of the TANF appropriation in the first
65.13year of the biennium does not cancel but is
65.14available for the second year.
65.15(c) Tribal Public Health Grants. $500,000
65.16in fiscal year 2022 and $500,000 in fiscal year
65.172023 are from the general fund for Tribal
65.18public health grants under Minnesota Statutes,
65.19section 145A.14, for public health
65.20infrastructure projects as defined by the Tribal
65.21government.
65.22(d) Public Health Infrastructure Funds.
65.23$6,000,000 in fiscal year 2022 and $6,000,000
65.24in fiscal year 2023 are from the general fund
65.25for public health infrastructure funds to
65.26distribute to community health boards and
65.27Tribal governments to support their ability to
65.28meet national public health standards.
65.29(e) Public Health System Assessment and
65.30Oversight. $1,500,000 in fiscal year 2022 and
65.31$1,500,000 in fiscal year 2023 are from the
65.32general fund for the commissioner to assess
65.33the capacity of the public health system to
65.34meet national public health standards and
66.1oversee public health system improvement
66.2efforts.
66.3(f) Health Professional Education Loan
66.4Forgiveness. Notwithstanding the priorities
66.5and distribution requirements under Minnesota
66.6Statutes, section 144.1501, $3,000,000 in
66.7fiscal year 2022 and $3,000,000 in fiscal year
66.82023 are from the general fund for loan
66.9forgiveness under article 3, section 43, for
66.10individuals who are eligible alcohol and drug
66.11counselors, eligible medical residents, or
66.12eligible mental health professionals, as defined
66.13in article 3, section 43. The general fund base
66.14for this appropriation is $2,625,000 in fiscal
66.15year 2024 and $0 in fiscal year 2025. The
66.16health care access fund base for this
66.17appropriation is $875,000 in fiscal year 2024,
66.18$3,500,000 in fiscal year 2025, and $0 in fiscal
66.19year 2026. The general fund amounts in this
66.20paragraph are available until March 31, 2024.
66.21This paragraph expires on April 1, 2024.
66.22(g) Mental Health Cultural Community
66.23Continuing Education Grant Program.
66.24$500,000 in fiscal year 2022 and $500,000 in
66.25fiscal year 2023 are from the general fund for
66.26the mental health cultural community
66.27continuing education grant program. This is
66.28a onetime appropriation
66.29(h) Birth Records; Homeless Youth. $72,000
66.30in fiscal year 2022 and $32,000 in fiscal year
66.312023 are from the state government special
66.32revenue fund for administration and issuance
66.33of certified birth records and statements of no
66.34vital record found to homeless youth under
66.35Minnesota Statutes, section 144.2255.
67.1(i) Supporting Healthy Development of
67.2Babies During Pregnancy and Postpartum.
67.3$260,000 in fiscal year 2022 and $260,000 in
67.4fiscal year 2023 are from the general fund for
67.5a grant to the Amherst H. Wilder Foundation
67.6for the African American Babies Coalition
67.7initiative for community-driven training and
67.8education on best practices to support healthy
67.9development of babies during pregnancy and
67.10postpartum. Grant funds must be used to build
67.11capacity in, train, educate, or improve
67.12practices among individuals, from youth to
67.13elders, serving families with members who
67.14are Black, indigenous, or people of color,
67.15during pregnancy and postpartum. This is a
67.16onetime appropriation and is available until
67.17June 30, 2023.
67.18(j) Dignity in Pregnancy and Childbirth.
67.19$494,000 in fiscal year 2022 and $200,000 in
67.20fiscal year 2023 are from the general fund for
67.21purposes of Minnesota Statutes, section
67.22144.1461. Of this appropriation: (1) $294,000
67.23in fiscal year 2022 is for a grant to the
67.24University of Minnesota School of Public
67.25Health's Center for Antiracism Research for
67.26Health Equity, to develop a model curriculum
67.27on anti-racism and implicit bias for use by
67.28hospitals with obstetric care and birth centers
67.29to provide continuing education to staff caring
67.30for pregnant or postpartum women. The model
67.31curriculum must be evidence-based and must
67.32meet the criteria in Minnesota Statutes, section
67.33144.1461, subdivision 2, paragraph (a); and
67.34(2) $200,000 in fiscal year 2022 and $200,000
67.35in fiscal year 2023 are for purposes of
68.1Minnesota Statutes, section 144.1461,
68.2subdivision 3.
68.3(k) Congenital Cytomegalovirus (CMV). (1)
68.4$196,000 in fiscal year 2022 and $196,000 in
68.5fiscal year 2023 are from the general fund for
68.6outreach and education on congenital
68.7cytomegalovirus (CMV) under Minnesota
68.8Statutes, section 144.064.
68.9(2) Contingent on the Advisory Committee on
68.10Heritable and Congenital Disorders
68.11recommending and the commissioner of health
68.12approving inclusion of CMV in the newborn
68.13screening panel in accordance with Minnesota
68.14Statutes, section 144.065, subdivision 3,
68.15paragraph (d), $656,000 in fiscal year 2023 is
68.16from the state government special revenue
68.17fund for follow-up services.
68.18(l) Nonnarcotic Pain Management and
68.19Wellness. $649,000 in fiscal year 2022 is from
68.20the general fund for nonnarcotic pain
68.21management and wellness in accordance with
68.22Laws 2019, chapter 63, article 3, section 1,
68.23paragraph (n).
68.24(m) Base Level Adjustments. The general
68.25fund base is ~~$120,451,000~~ $121,201,000 in
68.26fiscal year 2024 and ~~$115,594,000~~
68.27$116,344,000 in fiscal year 2025, of which
68.28$750,000 in fiscal year 2024 and $750,000 in
68.29fiscal year 2025 are for fetal alcohol spectrum
68.30disorders prevention grants under Minnesota
68.31Statutes, section 145.267. The health care
68.32access fund base is $38,385,000 in fiscal year
68.332024 and $40,644,000 in fiscal year 2025.

69.1    Sec. 69. DIRECTION TO COMMISSIONER OF HEALTH; J-1 VISA WAIVER
69.2PROGRAM RECOMMENDATION.
69.3(a) For purposes of this section:
69.4(1) "Department of Health recommendation" means a recommendation from the state
69.5Department of Health that a foreign medical graduate should be considered for a J-1 visa
69.6waiver under the J-1 visa waiver program; and
69.7(2) "J-1 visa waiver program" means a program administered by the United States
69.8Department of State under United States Code, title 8, section 1184(l), in which a waiver
69.9is sought for the requirement that a foreign medical graduate with a J-1 visa must return to
69.10the graduate's home country for two years at the conclusion of the graduate's medical study
69.11before applying for employment authorization in the United States.
69.12(b) In administering the program to issue Department of Health recommendations for
69.13purposes of the J-1 visa waiver program, the commissioner of health shall allow an applicant
69.14to submit to the commissioner evidence that the foreign medical graduate for whom the
69.15waiver is sought is licensed to practice medicine in Minnesota in place of evidence that the
69.16foreign medical graduate has passed steps 1, 2, and 3 of the United States Medical Licensing
69.17Examination.

69.18    Sec. 70. APPROPRIATION; ELIMINATION OF DUPLICATIVE BACKGROUND
69.19STUDIES.
69.20$522,000 in fiscal year 2023 is appropriated from the state government special revenue
69.21fund to the commissioner of human services to implement provisions to eliminate duplicative
69.22background studies. The state government special revenue fund base for this appropriation
69.23is $334,000 in fiscal year 2024, $574,000 in fiscal year 2025, $170,000 in fiscal year 2026,
69.24and $170,000 in fiscal year 2027.

69.25    Sec. 71. REVISOR INSTRUCTION.
69.26The revisor of statutes shall make any necessary cross-reference changes required as a
69.27result of the amendments in this article to Minnesota Statutes, sections 144A.01; 144A.03,
69.28subdivision 1; 144A.04, subdivisions 4 and 6; and 144A.06.

69.29    Sec. 72. REPEALER.
69.30(a) Minnesota Statutes 2020, section 254A.21, is repealed effective July 1, 2023.
69.31(b) Minnesota Statutes 2021 Supplement, section 144G.07, subdivision 6, is repealed.

70.1ARTICLE 2

70.2HEALTH CARE

70.3    Section 1. Minnesota Statutes 2020, section 62J.2930, subdivision 3, is amended to read:
70.4    Subd. 3. Consumer information. (a) The information clearinghouse or another entity
70.5designated by the commissioner shall provide consumer information to health plan company
70.6enrollees to:
70.7(1) assist enrollees in understanding their rights;
70.8(2) explain and assist in the use of all available complaint systems, including internal
70.9complaint systems within health carriers, community integrated service networks, and the
70.10Departments of Health and Commerce;
70.11(3) provide information on coverage options in each region of the state;
70.12(4) provide information on the availability of purchasing pools and enrollee subsidies;
70.13and
70.14(5) help consumers use the health care system to obtain coverage.
70.15(b) The information clearinghouse or other entity designated by the commissioner for
70.16the purposes of this subdivision shall not:
70.17(1) provide legal services to consumers;
70.18(2) represent a consumer or enrollee; or
70.19(3) serve as an advocate for consumers in disputes with health plan companies.
70.20(c) Nothing in this subdivision shall interfere with the ombudsman program established
70.21under section ~~256B.69, subdivision 20~~ 256B.6903, or other existing ombudsman programs.
70.22EFFECTIVE DATE.This section is effective the day following final enactment.

70.23    Sec. 2. Minnesota Statutes 2020, section 152.125, is amended to read:
70.24152.125 INTRACTABLE PAIN.
70.25    Subdivision 1. ~~Definition~~ Definitions. (a) For purposes of this section, the terms in this
70.26subdivision have the meanings given.
70.27(b) "Drug diversion" means the unlawful transfer of prescription drugs from their licit
70.28medical purpose to the illicit marketplace.
70.29(c) "Intractable pain" means a pain state in which the cause of the pain cannot be removed
70.30or otherwise treated with the consent of the patient and in which, in the generally accepted
71.1course of medical practice, no relief or cure of the cause of the pain is possible, or none has
71.2been found after reasonable efforts. Conditions associated with intractable pain may include
71.3cancer and the recovery period, sickle cell disease, noncancer pain, rare diseases, orphan
71.4diseases, severe injuries, and health conditions requiring the provision of palliative care or
71.5hospice care. Reasonable efforts for relieving or curing the cause of the pain may be
71.6determined on the basis of, but are not limited to, the following:
71.7(1) when treating a nonterminally ill patient for intractable pain, an evaluation conducted
71.8by the attending physician, advanced practice registered nurse, or physician assistant and
71.9one or more physicians, advanced practice registered nurses, or physician assistants
71.10specializing in pain medicine or the treatment of the area, system, or organ of the body
71.11confirmed or perceived as the source of the intractable pain; or
71.12(2) when treating a terminally ill patient, an evaluation conducted by the attending
71.13physician, advanced practice registered nurse, or physician assistant who does so in
71.14accordance with the standard of care and the level of care, skill, and treatment that would
71.15be recognized by a reasonably prudent physician, advanced practice registered nurse, or
71.16physician assistant under similar conditions and circumstances.
71.17(d) "Palliative care" has the meaning given in section 144A.75, subdivision 12.
71.18(e) "Rare disease" means a disease, disorder, or condition that affects fewer than 200,000
71.19individuals in the United States and is chronic, serious, life altering, or life threatening.
71.20    Subd. 1a. Criteria for the evaluation and treatment of intractable pain. The evaluation
71.21and treatment of intractable pain when treating a nonterminally ill patient is governed by
71.22the following criteria:
71.23(1) a diagnosis of intractable pain by the treating physician, advanced practice registered
71.24nurse, or physician assistant and either by a physician, advanced practice registered nurse,
71.25or physician assistant specializing in pain medicine or a physician, advanced practice
71.26registered nurse, or physician assistant treating the area, system, or organ of the body that
71.27is the source of the pain is sufficient to meet the definition of intractable pain; and
71.28(2) the cause of the diagnosis of intractable pain must not interfere with medically
71.29necessary treatment, including but not limited to prescribing or administering a controlled
71.30substance in Schedules II to V of section 152.02.
71.31    Subd. 2. Prescription and administration of controlled substances for intractable
71.32pain. (a) Notwithstanding any other provision of this chapter, a physician, advanced practice
71.33registered nurse, or physician assistant may prescribe or administer a controlled substance
72.1in Schedules II to V of section 152.02 to ~~an individual~~ a patient in the course of the
72.2physician's, advanced practice registered nurse's, or physician assistant's treatment of the
72.3~~individual~~ patient for a diagnosed condition causing intractable pain. No physician, advanced
72.4practice registered nurse, or physician assistant shall be subject to disciplinary action by
72.5the Board of Medical Practice or Board of Nursing for appropriately prescribing or
72.6administering a controlled substance in Schedules II to V of section 152.02 in the course
72.7of treatment of ~~an individual~~ a patient for intractable pain, provided the physician, advanced
72.8practice registered nurse, or physician assistant:
72.9(1) keeps accurate records of the purpose, use, prescription, and disposal of controlled
72.10substances, writes accurate prescriptions, and prescribes medications in conformance with
72.11chapter 147. or 148 or in accordance with the current standard of care; and
72.12(2) enters into a patient-provider agreement that meets the criteria in subdivision 5.
72.13(b) No physician, advanced practice registered nurse, or physician assistant, acting in
72.14good faith and based on the needs of the patient, shall be subject to disenrollment or
72.15termination by the commissioner of health solely for prescribing a dosage that equates to
72.16an upward deviation from morphine milligram equivalent dosage recommendations or
72.17thresholds specified in state or federal opioid prescribing guidelines or policies, including
72.18but not limited to the Guideline for Prescribing Opioids for Chronic Pain issued by the
72.19Centers for Disease Control and Prevention and Minnesota opioid prescribing guidelines.
72.20(c) A physician, advanced practice registered nurse, or physician assistant treating
72.21intractable pain by prescribing, dispensing, or administering a controlled substance in
72.22Schedules II to V of section 152.02 that includes but is not limited to opioid analgesics must
72.23not taper a patient's medication dosage solely to meet a predetermined morphine milligram
72.24equivalent dosage recommendation or threshold if the patient is stable and compliant with
72.25the treatment plan, is experiencing no serious harm from the level of medication currently
72.26being prescribed or previously prescribed, and is in compliance with the patient-provider
72.27agreement as described in subdivision 5.
72.28(d) A physician's, advanced practice registered nurse's, or physician assistant's decision
72.29to taper a patient's medication dosage must be based on factors other than a morphine
72.30milligram equivalent recommendation or threshold.
72.31(e) No pharmacist, health plan company, or pharmacy benefit manager shall refuse to
72.32fill a prescription for an opiate issued by a licensed practitioner with the authority to prescribe
72.33opiates solely based on the prescription exceeding a predetermined morphine milligram
72.34equivalent dosage recommendation or threshold. Health plan companies that participate in
73.1Minnesota health care programs under chapters 256B and 256L, and pharmacy benefit
73.2managers under contract with these health plan companies, must comply with section 1004
73.3of the federal SUPPORT Act, Public Law 115-271, when providing services to medical
73.4assistance and MinnesotaCare enrollees.
73.5    Subd. 3. Limits on applicability. This section does not apply to:
73.6(1) a physician's, advanced practice registered nurse's, or physician assistant's treatment
73.7of ~~an individual~~ a patient for chemical dependency resulting from the use of controlled
73.8substances in Schedules II to V of section 152.02;
73.9(2) the prescription or administration of controlled substances in Schedules II to V of
73.10section 152.02 to ~~an individual~~ a patient whom the physician, advanced practice registered
73.11nurse, or physician assistant knows to be using the controlled substances for nontherapeutic
73.12or drug diversion purposes;
73.13(3) the prescription or administration of controlled substances in Schedules II to V of
73.14section 152.02 for the purpose of terminating the life of ~~an individual~~ a patient having
73.15intractable pain; or
73.16(4) the prescription or administration of a controlled substance in Schedules II to V of
73.17section 152.02 that is not a controlled substance approved by the United States Food and
73.18Drug Administration for pain relief.
73.19    Subd. 4. Notice of risks. Prior to treating ~~an individual~~ a patient for intractable pain in
73.20accordance with subdivision 2, a physician, advanced practice registered nurse, or physician
73.21assistant shall discuss with the ~~individual~~ patient or the patient's legal guardian, if applicable,
73.22the risks associated with the controlled substances in Schedules II to V of section 152.02
73.23to be prescribed or administered in the course of the physician's, advanced practice registered
73.24nurse's, or physician assistant's treatment of ~~an individual~~ a patient, and document the
73.25discussion in the ~~individual's~~ patient's record as required in the patient-provider agreement
73.26described in subdivision 5.
73.27    Subd. 5. Patient-provider agreement. (a) Before treating a patient for intractable pain,
73.28a physician, advanced practice registered nurse, or physician assistant and the patient or the
73.29patient's legal guardian, if applicable, must mutually agree to the treatment and enter into
73.30a provider-patient agreement. The agreement must include a description of the prescriber's
73.31and the patient's expectations, responsibilities, and rights according to best practices and
73.32current standards of care.
74.1(b) The agreement must be signed by the patient or the patient's legal guardian, if
74.2applicable, and the physician, advanced practice registered nurse, or physician assistant and
74.3included in the patient's medical records. A copy of the signed agreement must be provided
74.4to the patient.
74.5(c) The agreement must be reviewed by the patient and the physician, advanced practice
74.6registered nurse, or physician assistant annually. If there is a change in the patient's treatment
74.7plan, the agreement must be updated and a revised agreement must be signed by the patient
74.8or the patient's legal guardian. A copy of the revised agreement must be included in the
74.9patient's medical record and a copy must be provided to the patient.
74.10(d) Absent clear evidence of drug diversion, nonadherence with the agreement must not
74.11be used as the sole reason to stop a patient's treatment with scheduled drugs. If a patient
74.12experiences difficulty adhering to the agreement, the prescriber must evaluate the patient
74.13for other conditions, including but not limited to substance use disorder, and must ensure
74.14that the patient's course of treatment is appropriately adjusted to reflect any change in
74.15diagnosis.
74.16(e) A patient-provider agreement is not required in an emergency or inpatient hospital
74.17setting.

74.18    Sec. 3. Minnesota Statutes 2021 Supplement, section 256B.0371, subdivision 4, as amended
74.19by Laws 2022, chapter 55, article 1, section 128, is amended to read:
74.20    Subd. 4. Dental utilization report. (a) The commissioner shall submit an annual report
74.21beginning March 15, 2022, and ending March 15, 2026, to the chairs and ranking minority
74.22members of the legislative committees with jurisdiction over health and human services
74.23policy and finance that includes the percentage for adults and children one through 20 years
74.24of age for the most recent complete calendar year receiving at least one dental visit for both
74.25fee-for-service and the prepaid medical assistance program. The report must include:
74.26(1) statewide utilization for both fee-for-service and for the prepaid medical assistance
74.27program;
74.28(2) utilization by county;
74.29(3) utilization by children receiving dental services through fee-for-service and through
74.30a managed care plan or county-based purchasing plan; and
74.31(4) utilization by adults receiving dental services through fee-for-service and through a
74.32managed care plan or county-based purchasing plan.
75.1(b) The report must also include a description of any corrective action plans required to
75.2be submitted under subdivision 2.
75.3(c) The initial report due on March 15, 2022, must include the utilization metrics described
75.4in paragraph (a) for each of the following calendar years: 2017, 2018, 2019, and 2020.
75.5(d) In the annual report due on March 15, 2023, and in each report due thereafter, the
75.6commissioner shall include the following:
75.7(1) the number of dentists enrolled with the commissioner as a medical assistance dental
75.8provider and the congressional district or districts in which the dentist provides services;
75.9(2) the number of enrolled dentists who provided fee-for-service dental services to
75.10medical assistance or MinnesotaCare patients within the previous calendar year in the
75.11following increments: one to nine patients, ten to 100 patients, and over 100 patients;
75.12(3) the number of enrolled dentists who provided dental services to medical assistance
75.13or MinnesotaCare patients through a managed care plan or county-based purchasing plan
75.14within the previous calendar year in the following increments: one to nine patients, ten to
75.15100 patients, and over 100 patients; and
75.16(4) the number of dentists who provided dental services to a new patient who was enrolled
75.17in medical assistance or MinnesotaCare within the previous calendar year.
75.18(e) The report due on March 15, 2023, must include the metrics described in paragraph
75.19(d) for each of the following years: 2017, 2018, 2019, 2020, and 2021.

75.20    Sec. 4. Minnesota Statutes 2020, section 256B.055, subdivision 2, is amended to read:
75.21    Subd. 2. Subsidized foster children. Medical assistance may be paid for a child eligible
75.22for or receiving foster care maintenance payments under Title IV-E of the Social Security
75.23Act, United States Code, title 42, sections 670 to 676, and for a child who is not eligible for
75.24Title IV-E of the Social Security Act but who is ~~determined eligible for~~ placed in foster
75.25care as determined by Minnesota Statutes or receiving kinship assistance under chapter
75.26256N.
75.27EFFECTIVE DATE.This section is effective the day following final enactment.

75.28    Sec. 5. Minnesota Statutes 2020, section 256B.056, subdivision 3b, is amended to read:
75.29    Subd. 3b. Treatment of trusts. (a) It is the public policy of this state that individuals
75.30use all available resources to pay for the cost of long-term care services, as defined in section
75.31256B.0595, before turning to Minnesota health care program funds, and that trust instruments
76.1should not be permitted to shield available resources of an individual or an individual's
76.2spouse from such use.
76.3~~(a)~~ (b) A "medical assistance qualifying trust" is a revocable or irrevocable trust, or
76.4similar legal device, established on or before August 10, 1993, by a person or the person's
76.5spouse under the terms of which the person receives or could receive payments from the
76.6trust principal or income and the trustee has discretion in making payments to the person
76.7from the trust principal or income. Notwithstanding that definition, a medical assistance
76.8qualifying trust does not include: (1) a trust set up by will; (2) a trust set up before April 7,
76.91986, solely to benefit a person with a developmental disability living in an intermediate
76.10care facility for persons with developmental disabilities; or (3) a trust set up by a person
76.11with payments made by the Social Security Administration pursuant to the United States
76.12Supreme Court decision in Sullivan v. Zebley, 110 S. Ct. 885 (1990). The maximum amount
76.13of payments that a trustee of a medical assistance qualifying trust may make to a person
76.14under the terms of the trust is considered to be available assets to the person, without regard
76.15to whether the trustee actually makes the maximum payments to the person and without
76.16regard to the purpose for which the medical assistance qualifying trust was established.
76.17~~(b)~~ (c) Trusts established after August 10, 1993, are treated according to United States
76.18Code, title 42, section 1396p(d).
76.19~~(c)~~ (d) For purposes of paragraph ~~(d)~~ (e), a pooled trust means a trust established under
76.20United States Code, title 42, section 1396p(d)(4)(C).
76.21~~(d)~~ (e) A beneficiary's interest in a pooled trust is considered an available asset unless
76.22the trust provides that upon the death of the beneficiary or termination of the trust during
76.23the beneficiary's lifetime, whichever is sooner, the department receives any amount, up to
76.24the amount of medical assistance benefits paid on behalf of the beneficiary, remaining in
76.25the beneficiary's trust account after a deduction for reasonable administrative fees and
76.26expenses, and an additional remainder amount. The retained remainder amount of the
76.27subaccount must not exceed ten percent of the account value at the time of the beneficiary's
76.28death or termination of the trust, and must only be used for the benefit of disabled individuals
76.29who have a beneficiary interest in the pooled trust.
76.30~~(e)~~ (f) Trusts may be established on or after December 12, 2016, by a person who has
76.31been determined to be disabled, according to United States Code, title 42, section
76.321396p(d)(4)(A), as amended by section 5007 of the 21st Century Cures Act, Public Law
76.33114-255.
76.34EFFECTIVE DATE.This section is effective the day following final enactment.

77.1    Sec. 6. Minnesota Statutes 2020, section 256B.056, subdivision 3c, is amended to read:
77.2    Subd. 3c. Asset limitations for families and children. (a) A household of two or more
77.3persons must not own more than $20,000 in total net assets, and a household of one person
77.4must not own more than $10,000 in total net assets. In addition to these maximum amounts,
77.5an eligible individual or family may accrue interest on these amounts, but they must be
77.6reduced to the maximum at the time of an eligibility redetermination. The value of assets
77.7that are not considered in determining eligibility for medical assistance for families and
77.8children is the value of those assets excluded under the AFDC state plan as of July 16, 1996,
77.9as required by the Personal Responsibility and Work Opportunity Reconciliation Act of
77.101996 (PRWORA), Public Law 104-193, with the following exceptions:
77.11(1) household goods and personal effects are not considered;
77.12(2) capital and operating assets of a trade or business up to $200,000 are not considered;
77.13(3) one motor vehicle is excluded for each person of legal driving age who is employed
77.14or seeking employment;
77.15(4) assets designated as burial expenses are excluded to the same extent they are excluded
77.16by the Supplemental Security Income program;
77.17(5) court-ordered settlements up to $10,000 are not considered;
77.18(6) individual retirement accounts and funds are not considered;
77.19(7) assets owned by children are not considered; and
77.20(8) ~~effective July 1, 2009,~~ certain assets owned by American Indians are excluded as
77.21required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public
77.22Law 111-5. For purposes of this clause, an American Indian is any person who meets the
77.23definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
77.24(b) ~~Beginning January 1, 2014, this subdivision~~ Paragraph (a) applies only to parents
77.25and caretaker relatives who qualify for medical assistance under subdivision 5.
77.26(c) Eligibility for children under age 21 must be determined without regard to the asset
77.27limitations described in paragraphs (a) and (b) and subdivision 3.

77.28    Sec. 7. Minnesota Statutes 2020, section 256B.056, subdivision 11, is amended to read:
77.29    Subd. 11. Treatment of annuities. (a) Any person requesting medical assistance payment
77.30of long-term care services shall provide a complete description of any interest either the
77.31person or the person's spouse has in annuities on a form designated by the department. The
78.1form shall include a statement that the state becomes a preferred remainder beneficiary of
78.2annuities or similar financial instruments by virtue of the receipt of medical assistance
78.3payment of long-term care services. The person and the person's spouse shall furnish the
78.4agency responsible for determining eligibility with complete current copies of their annuities
78.5and related documents and complete the form designating the state as the preferred remainder
78.6beneficiary for each annuity in which the person or the person's spouse has an interest.
78.7    (b) The department shall provide notice to the issuer of the department's right under this
78.8section as a preferred remainder beneficiary under the annuity or similar financial instrument
78.9for medical assistance furnished to the person or the person's spouse, and provide notice of
78.10the issuer's responsibilities as provided in paragraph (c).
78.11    (c) An issuer of an annuity or similar financial instrument who receives notice of the
78.12state's right to be named a preferred remainder beneficiary as described in paragraph (b)
78.13shall provide confirmation to the requesting agency that the state has been made a preferred
78.14remainder beneficiary. The issuer shall also notify the county agency when a change in the
78.15amount of income or principal being withdrawn from the annuity or other similar financial
78.16instrument or a change in the state's preferred remainder beneficiary designation under the
78.17annuity or other similar financial instrument occurs. The county agency shall provide the
78.18issuer with the name, address, and telephone number of a unit within the department that
78.19the issuer can contact to comply with this paragraph.
78.20    (d) "Preferred remainder beneficiary" for purposes of this subdivision and sections
78.21256B.0594 and 256B.0595 means the state is a remainder beneficiary in the first position
78.22in an amount equal to the amount of medical assistance paid on behalf of the institutionalized
78.23person, or is a remainder beneficiary in the second position if the institutionalized person
78.24designates and is survived by a remainder beneficiary who is (1) a spouse who does not
78.25reside in a medical institution, (2) a minor child, or (3) a child of any age who is blind or
78.26permanently and totally disabled as defined in the Supplemental Security Income program.
78.27Notwithstanding this paragraph, the state is the remainder beneficiary in the first position
78.28if the spouse or child disposes of the remainder for less than fair market value.
78.29    (e) For purposes of this subdivision, "institutionalized person" and "long-term care
78.30services" have the meanings given in section 256B.0595, subdivision 1, paragraph ~~(g)~~ (f).
78.31    (f) For purposes of this subdivision, "medical institution" means a skilled nursing facility,
78.32intermediate care facility, intermediate care facility for persons with developmental
78.33disabilities, nursing facility, or inpatient hospital.
78.34EFFECTIVE DATE.This section is effective the day following final enactment.

79.1    Sec. 8. Minnesota Statutes 2020, section 256B.0595, subdivision 1, is amended to read:
79.2    Subdivision 1. Prohibited transfers. (a) Effective for transfers made after August 10,
79.31993, an institutionalized person, an institutionalized person's spouse, or any person, court,
79.4or administrative body with legal authority to act in place of, on behalf of, at the direction
79.5of, or upon the request of the institutionalized person or institutionalized person's spouse,
79.6may not give away, sell, or dispose of, for less than fair market value, any asset or interest
79.7therein, except assets other than the homestead that are excluded under the Supplemental
79.8Security Income program, for the purpose of establishing or maintaining medical assistance
79.9eligibility. This applies to all transfers, including those made by a community spouse after
79.10the month in which the institutionalized spouse is determined eligible for medical assistance.
79.11For purposes of determining eligibility for long-term care services, any transfer of such
79.12assets within 36 months before or any time after an institutionalized person requests medical
79.13assistance payment of long-term care services, or 36 months before or any time after a
79.14medical assistance recipient becomes an institutionalized person, for less than fair market
79.15value may be considered. Any such transfer is presumed to have been made for the purpose
79.16of establishing or maintaining medical assistance eligibility and the institutionalized person
79.17is ineligible for long-term care services for the period of time determined under subdivision
79.182, unless the institutionalized person furnishes convincing evidence to establish that the
79.19transaction was exclusively for another purpose, or unless the transfer is permitted under
79.20subdivision 3 or 4. In the case of payments from a trust or portions of a trust that are
79.21considered transfers of assets under federal law, or in the case of any other disposal of assets
79.22made on or after February 8, 2006, any transfers made within 60 months before or any time
79.23after an institutionalized person requests medical assistance payment of long-term care
79.24services and within 60 months before or any time after a medical assistance recipient becomes
79.25an institutionalized person, may be considered.
79.26    (b) This section applies to transfers, for less than fair market value, of income or assets,
79.27including assets that are considered income in the month received, such as inheritances,
79.28court settlements, and retroactive benefit payments or income to which the institutionalized
79.29person or the institutionalized person's spouse is entitled but does not receive due to action
79.30by the institutionalized person, the institutionalized person's spouse, or any person, court,
79.31or administrative body with legal authority to act in place of, on behalf of, at the direction
79.32of, or upon the request of the institutionalized person or the institutionalized person's spouse.
79.33    (c) This section applies to payments for care or personal services provided by a relative,
79.34unless the compensation was stipulated in a notarized, written agreement ~~which~~ that was
79.35in existence when the service was performed, the care or services directly benefited the
80.1person, and the payments made represented reasonable compensation for the care or services
80.2provided. A notarized written agreement is not required if payment for the services was
80.3made within 60 days after the service was provided.
80.4    ~~(d) This section applies to the portion of any asset or interest that an institutionalized~~
80.5~~person, an institutionalized person's spouse, or any person, court, or administrative body~~
80.6~~with legal authority to act in place of, on behalf of, at the direction of, or upon the request~~
80.7~~of the institutionalized person or the institutionalized person's spouse, transfers to any~~
80.8~~annuity that exceeds the value of the benefit likely to be returned to the institutionalized~~
80.9~~person or institutionalized person's spouse while alive, based on estimated life expectancy~~
80.10~~as determined according to the current actuarial tables published by the Office of the Chief~~
80.11~~Actuary of the Social Security Administration. The commissioner may adopt rules reducing~~
80.12~~life expectancies based on the need for long-term care. This section applies to an annuity~~
80.13~~purchased on or after March 1, 2002, that:~~
80.14    ~~(1) is not purchased from an insurance company or financial institution that is subject~~
80.15~~to licensing or regulation by the Minnesota Department of Commerce or a similar regulatory~~
80.16~~agency of another state;~~
80.17    ~~(2) does not pay out principal and interest in equal monthly installments; or~~
80.18    ~~(3) does not begin payment at the earliest possible date after annuitization.~~
80.19    ~~(e)~~ (d) Effective for transactions, including the purchase of an annuity, occurring on or
80.20after February 8, 2006, by or on behalf of an institutionalized person who has applied for
80.21or is receiving long-term care services or the institutionalized person's spouse shall be treated
80.22as the disposal of an asset for less than fair market value unless the department is named a
80.23preferred remainder beneficiary as described in section 256B.056, subdivision 11. Any
80.24subsequent change to the designation of the department as a preferred remainder beneficiary
80.25shall result in the annuity being treated as a disposal of assets for less than fair market value.
80.26The amount of such transfer shall be the maximum amount the institutionalized person or
80.27the institutionalized person's spouse could receive from the annuity or similar financial
80.28instrument. Any change in the amount of the income or principal being withdrawn from the
80.29annuity or other similar financial instrument at the time of the most recent disclosure shall
80.30be deemed to be a transfer of assets for less than fair market value unless the institutionalized
80.31person or the institutionalized person's spouse demonstrates that the transaction was for fair
80.32market value. In the event a distribution of income or principal has been improperly
80.33distributed or disbursed from an annuity or other retirement planning instrument of an
80.34institutionalized person or the institutionalized person's spouse, a cause of action exists
81.1against the individual receiving the improper distribution for the cost of medical assistance
81.2services provided or the amount of the improper distribution, whichever is less.
81.3    ~~(f)~~ (e) Effective for transactions, including the purchase of an annuity, occurring on or
81.4after February 8, 2006, by or on behalf of an institutionalized person applying for or receiving
81.5long-term care services shall be treated as a disposal of assets for less than fair market value
81.6unless it is:
81.7    (1) an annuity described in subsection (b) or (q) of section 408 of the Internal Revenue
81.8Code of 1986; or
81.9    (2) purchased with proceeds from:
81.10    (i) an account or trust described in subsection (a), (c), or (p) of section 408 of the Internal
81.11Revenue Code;
81.12    (ii) a simplified employee pension within the meaning of section 408(k) of the Internal
81.13Revenue Code; or
81.14    (iii) a Roth IRA described in section 408A of the Internal Revenue Code; or
81.15    (3) an annuity that is irrevocable and nonassignable; is actuarially sound as determined
81.16in accordance with actuarial publications of the Office of the Chief Actuary of the Social
81.17Security Administration; and provides for payments in equal amounts during the term of
81.18the annuity, with no deferral and no balloon payments made.
81.19    ~~(g)~~ (f) For purposes of this section, long-term care services include services in a nursing
81.20facility, services that are eligible for payment according to section 256B.0625, subdivision
81.212, because they are provided in a swing bed, intermediate care facility for persons with
81.22developmental disabilities, and home and community-based services provided pursuant to
81.23chapter 256S and sections 256B.092 and 256B.49. For purposes of this subdivision and
81.24subdivisions 2, 3, and 4, "institutionalized person" includes a person who is an inpatient in
81.25a nursing facility or in a swing bed, or intermediate care facility for persons with
81.26developmental disabilities or who is receiving home and community-based services under
81.27chapter 256S and sections 256B.092 and 256B.49.
81.28    ~~(h)~~ (g) This section applies to funds used to purchase a promissory note, loan, or mortgage
81.29unless the note, loan, or mortgage:
81.30    (1) has a repayment term that is actuarially sound;
81.31    (2) provides for payments to be made in equal amounts during the term of the loan, with
81.32no deferral and no balloon payments made; and
82.1    (3) prohibits the cancellation of the balance upon the death of the lender.
82.2    (h) In the case of a promissory note, loan, or mortgage that does not meet an exception
82.3in paragraph (g), clauses (1) to (3), the value of such note, loan, or mortgage shall be the
82.4outstanding balance due as of the date of the institutionalized person's request for medical
82.5assistance payment of long-term care services.
82.6    (i) This section applies to the purchase of a life estate interest in another person's home
82.7unless the purchaser resides in the home for a period of at least one year after the date of
82.8purchase.
82.9(j) This section applies to transfers into a pooled trust that qualifies under United States
82.10Code, title 42, section 1396p(d)(4)(C), by:
82.11(1) a person age 65 or older or the person's spouse; or
82.12(2) any person, court, or administrative body with legal authority to act in place of, on
82.13behalf of, at the direction of, or upon the request of a person age 65 or older or the person's
82.14spouse.
82.15EFFECTIVE DATE.This section is effective the day following final enactment.

82.16    Sec. 9. Minnesota Statutes 2020, section 256B.0625, subdivision 64, is amended to read:
82.17    Subd. 64. Investigational drugs, biological products, devices, and clinical
82.18trials. Medical assistance and the early periodic screening, diagnosis, and treatment (EPSDT)
82.19program do not cover ~~the costs of any services that are incidental to, associated with, or~~
82.20~~resulting from the use of~~ investigational drugs, biological products, or devices as defined
82.21in section 151.375 or any other treatment that is part of an approved clinical trial as defined
82.22in section 62Q.526. Participation of an enrollee in an approved clinical trial does not preclude
82.23coverage of medically necessary services covered under this chapter that are not related to
82.24the approved clinical trial. Any items or services that are provided solely to satisfy data
82.25collection and analysis for a clinical trial, and not for direct clinical management of the
82.26enrollee, are not covered.

82.27    Sec. 10. Minnesota Statutes 2021 Supplement, section 256B.0638, subdivision 5, is
82.28amended to read:
82.29    Subd. 5. Program implementation. (a) The commissioner shall implement the programs
82.30within the Minnesota health care program to improve the health of and quality of care
82.31provided to Minnesota health care program enrollees. The commissioner shall annually
82.32collect and report to provider groups the sentinel measures of data showing individual opioid
83.1prescribers' opioid prescribing patterns compared to their anonymized peers. Provider groups
83.2shall distribute data to their affiliated, contracted, or employed opioid prescribers.
83.3(b) The commissioner shall notify an opioid prescriber and all provider groups with
83.4which the opioid prescriber is employed or affiliated when the opioid prescriber's prescribing
83.5pattern exceeds the opioid quality improvement standard thresholds. An opioid prescriber
83.6and any provider group that receives a notice under this paragraph shall submit to the
83.7commissioner a quality improvement plan for review and approval by the commissioner
83.8with the goal of bringing the opioid prescriber's prescribing practices into alignment with
83.9community standards. A quality improvement plan must include:
83.10(1) components of the program described in subdivision 4, paragraph (a);
83.11(2) internal practice-based measures to review the prescribing practice of the opioid
83.12prescriber and, where appropriate, any other opioid prescribers employed by or affiliated
83.13with any of the provider groups with which the opioid prescriber is employed or affiliated;
83.14and
83.15(3) appropriate use of the prescription monitoring program under section 152.126.
83.16(c) If, after a year from the commissioner's notice under paragraph (b), the opioid
83.17prescriber's prescribing practices do not improve so that they are consistent with community
83.18standards, the commissioner shall take one or more of the following steps:
83.19(1) monitor prescribing practices more frequently than annually;
83.20(2) monitor more aspects of the opioid prescriber's prescribing practices than the sentinel
83.21measures; or
83.22(3) require the opioid prescriber to participate in additional quality improvement efforts,
83.23including but not limited to mandatory use of the prescription monitoring program established
83.24under section 152.126.
83.25(d) The commissioner shall terminate from Minnesota health care programs all opioid
83.26prescribers and provider groups whose prescribing practices fall within the applicable opioid
83.27disenrollment standards.
83.28(e) No physician, advanced practice registered nurse, or physician assistant, acting in
83.29good faith based on the needs of the patient, may be disenrolled by the commissioner of
83.30human services solely for prescribing a dosage that equates to an upward deviation from
83.31morphine milligram equivalent dosage recommendations specified in state or federal opioid
83.32prescribing guidelines or policies, or quality improvement thresholds established under this
83.33section.

84.1    Sec. 11. Minnesota Statutes 2021 Supplement, section 256B.69, subdivision 9f, is amended
84.2to read:
84.3    Subd. 9f. Annual report on provider reimbursement rates. (a) The commissioner,
84.4by December 15 of each year, ~~beginning December 15, 2021,~~ shall submit to the chairs and
84.5ranking minority members of the legislative committees with jurisdiction over health care
84.6policy and finance a report on managed care and county-based purchasing plan provider
84.7reimbursement rates.
84.8(b) The report must include, for each managed care and county-based purchasing plan,
84.9the mean and median provider reimbursement rates by county for the calendar year preceding
84.10the reporting year, for the five most common billing codes statewide across all plans, in
84.11each of the following provider service categories if within the county there are more than
84.12three medical assistance enrolled providers providing the specific service within the specific
84.13category:
84.14(1) physician prenatal services;
84.15(2) physician preventive services;
84.16(3) physician services other than prenatal or preventive;
84.17(4) dental services;
84.18(5) inpatient hospital services;
84.19(6) outpatient hospital services; ~~and~~
84.20(7) mental health services; and
84.21(8) substance use disorder services.
84.22(c) The commissioner shall also include in the report:
84.23(1) the mean and median reimbursement rates across all plans by county for the calendar
84.24year preceding the reporting year for the billing codes and provider service categories
84.25described in paragraph (b); and
84.26(2) the mean and median fee-for-service reimbursement rates by county for the calendar
84.27year preceding the reporting year for the billing codes and provider service categories
84.28described in paragraph (b).

84.29    Sec. 12. [256B.6903] OMBUDSPERSON FOR MANAGED CARE.
84.30    Subdivision 1. Definitions. (a) For purposes of this section, the following terms have
84.31the meanings given them.
85.1(b) "Adverse benefit determination" has the meaning provided in Code of Federal
85.2Regulations, title 42, section 438.400, subpart (b).
85.3(c) "Appeal" means an oral or written request from an enrollee to the managed care
85.4organization for review of an adverse benefit determination.
85.5(d) "Commissioner" means the commissioner of human services.
85.6(e) "Complaint" means an enrollee's informal expression of dissatisfaction about any
85.7matter relating to the enrollee's prepaid health plan other than an adverse benefit
85.8determination.
85.9(f) "Data analyst" means the person employed by the ombudsperson that uses research
85.10methodologies to conduct research on data collected from prepaid health plans, including
85.11but not limited to scientific theory; hypothesis testing; survey research techniques; data
85.12collection; data manipulation; and statistical analysis interpretation, including multiple
85.13regression techniques.
85.14(g) "Enrollee" means a person enrolled in a prepaid health plan under section 256B.69.
85.15When applicable, an enrollee includes an enrollee's authorized representative.
85.16(h) "External review" means the process described under Code of Federal Regulations,
85.17title 42, section 438.408, subpart (f); and section 62Q.73, subdivision 2.
85.18(i) "Grievance" means an enrollee's expression of dissatisfaction about any matter relating
85.19to the enrollee's prepaid health plan other than an adverse benefit determination that follows
85.20the procedures outlined in Code of Federal Regulations, title 42, part 438, subpart (f). A
85.21grievance may include but is not limited to concerns relating to quality of care, services
85.22provided, or failure to respect an enrollee's rights under a prepaid health plan.
85.23(j) "Managed care advocate" means a county or Tribal employee who works with
85.24managed care enrollees when the enrollee has service, billing, or access problems with the
85.25enrollee's prepaid health plan.
85.26(k) "Prepaid health plan" means a plan under contract with the commissioner according
85.27to section 256B.69.
85.28(l) "State fair hearing" means the appeals process mandated under section 256.045,
85.29subdivision 3a.
85.30    Subd. 2. Ombudsperson. The commissioner must designate an ombudsperson to advocate
85.31for enrollees. At the time of enrollment in a prepaid health plan, the local agency must
85.32inform enrollees about the ombudsperson.
86.1    Subd. 3. Duties and cost. (a) The ombudsperson must work to ensure enrollees receive
86.2covered services as described in the enrollee's prepaid health plan by:
86.3(1) providing assistance and education to enrollees, when requested, regarding covered
86.4health care benefits or services; billing and access; or the grievance, appeal, or state fair
86.5hearing processes;
86.6(2) with the enrollee's permission and within the ombudsperson's discretion, using an
86.7informal review process to assist an enrollee with a resolution involving the enrollee's
86.8prepaid health plan's benefits;
86.9(3) assisting enrollees, when requested, with prepaid health plan grievances, appeals, or
86.10the state fair hearing process;
86.11(4) overseeing, reviewing, and approving documents used by enrollees relating to prepaid
86.12health plans' grievances, appeals, and state fair hearings;
86.13(5) reviewing all state fair hearings and requests by enrollees for external review;
86.14overseeing entities under contract to provide external reviews, processes, and payments for
86.15services; and utilizing aggregated results of external reviews to recommend health care
86.16benefits policy changes; and
86.17(6) providing trainings to managed care advocates.
86.18(b) The ombudsperson must not charge an enrollee for the ombudsperson's services.
86.19    Subd. 4. Powers. In exercising the ombudsperson's authority under this section, the
86.20ombudsperson may:
86.21(1) gather information and evaluate any practice, policy, procedure, or action by a prepaid
86.22health plan, state human services agency, county, or Tribe; and
86.23(2) prescribe the methods by which complaints are to be made, received, and acted upon.
86.24The ombudsperson's authority under this clause includes but is not limited to:
86.25(i) determining the scope and manner of a complaint;
86.26(ii) holding a prepaid health plan accountable to address a complaint in a timely manner
86.27as outlined in state and federal laws;
86.28(iii) requiring a prepaid health plan to respond in a timely manner to a request for data,
86.29case details, and other information as needed to help resolve a complaint or to improve a
86.30prepaid health plan's policy; and
87.1(iv) making recommendations for policy, administrative, or legislative changes regarding
87.2prepaid health plans to the proper partners.
87.3    Subd. 5. Data. (a) The data analyst must review and analyze prepaid health plan data
87.4on denial, termination, and reduction notices (DTRs), grievances, appeals, and state fair
87.5hearings by:
87.6(1) analyzing, reviewing, and reporting on DTRs, grievances, appeals, and state fair
87.7hearings data collected from each prepaid health plan;
87.8(2) collaborating with the commissioner's partners and the Department of Health for the
87.9Triennial Compliance Assessment under Code of Federal Regulations, title 42, section
87.10438.358, subpart (b);
87.11(3) reviewing state fair hearing decisions for policy or coverage issues that may affect
87.12enrollees; and
87.13(4) providing data required under Code of Federal Regulations, title 42, section 438.66
87.14(2016), to the Centers for Medicare and Medicaid Services.
87.15(b) The data analyst must share the data analyst's data observations and trends under
87.16this subdivision with the ombudsperson, prepaid health plans, and commissioner's partners.
87.17    Subd. 6. Collaboration and independence. (a) The ombudsperson must work in
87.18collaboration with the commissioner and the commissioner's partners when the
87.19ombudsperson's collaboration does not otherwise interfere with the ombudsperson's duties
87.20under this section.
87.21(b) The ombudsperson may act independently of the commissioner when:
87.22(1) providing information or testimony to the legislature; and
87.23(2) contacting and making reports to federal and state officials.
87.24    Subd. 7. Civil actions. The ombudsperson is not civilly liable for actions taken under
87.25this section if the action was taken in good faith, was within the scope of the ombudsperson's
87.26authority, and did not constitute willful or reckless misconduct.
87.27EFFECTIVE DATE.This section is effective the day following final enactment.

87.28    Sec. 13. Minnesota Statutes 2020, section 256B.77, subdivision 13, is amended to read:
87.29    Subd. 13. Ombudsman. Enrollees shall have access to ombudsman services established
87.30in section ~~256B.69, subdivision 20~~ 256B.6903, and advocacy services provided by the
87.31ombudsman for mental health and developmental disabilities established in sections 245.91
88.1to 245.97. The managed care ombudsman and the ombudsman for mental health and
88.2developmental disabilities shall coordinate services provided to avoid duplication of services.
88.3For purposes of the demonstration project, the powers and responsibilities of the Office of
88.4Ombudsman for Mental Health and Developmental Disabilities, as provided in sections
88.5245.91 to 245.97 are expanded to include all eligible individuals, health plan companies,
88.6agencies, and providers participating in the demonstration project.
88.7EFFECTIVE DATE.This section is effective the day following final enactment.

88.8    Sec. 14. DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
88.9ENTERAL NUTRITION AND SUPPLIES.
88.10Notwithstanding Minnesota Statutes, section 256B.766, paragraph (i), but subject to
88.11Minnesota Statutes, section 256B.766, paragraph (l), effective for dates of service on or
88.12after the effective date of this section through June 30, 2023, the commissioner of human
88.13services shall not adjust rates paid for enteral nutrition and supplies.
88.14EFFECTIVE DATE.This section is effective the day following final enactment.

88.15    Sec. 15. TEMPORARY TELEPHONE-ONLY TELEHEALTH AUTHORIZATION.
88.16Beginning July 1, 2021, and until the COVID-19 federal public health emergency ends
88.17or July 1, 2023, whichever is earlier, telehealth visits, as described in Minnesota Statutes,
88.18section 256B.0625, subdivision 3b, provided through telephone may satisfy the face-to-face
88.19requirements for reimbursement under the payment methods that apply to a federally qualified
88.20health center, rural health clinic, Indian health service, 638 Tribal clinic, and certified
88.21community behavioral health clinic, if the service would have otherwise qualified for
88.22payment if performed in person.
88.23EFFECTIVE DATE.This section is effective retroactively from July 1, 2021, and
88.24expires when the COVID-19 federal public health emergency ends or July 1, 2023, whichever
88.25is earlier. The commissioner of human services shall notify the revisor of statutes when this
88.26section expires.

88.27    Sec. 16. REPEALER.
88.28(a) Minnesota Statutes 2020, section 256B.057, subdivision 7, is repealed on July 1,
88.292022.
88.30(b) Minnesota Statutes 2020, sections 256B.69, subdivision 20; 501C.0408, subdivision
88.314; and 501C.1206, are repealed the day following final enactment.

89.1ARTICLE 3

89.2HEALTH-RELATED LICENSING BOARDS

89.3    Section 1. Minnesota Statutes 2020, section 148B.33, is amended by adding a subdivision
89.4to read:
89.5    Subd. 1a. Supervision requirement; postgraduate experience. The board must allow
89.6an applicant to satisfy the requirement for supervised postgraduate experience in marriage
89.7and family therapy with all required hours of supervision provided through real-time,
89.8two-way interactive audio and visual communication.
89.9EFFECTIVE DATE.This section is effective the day following final enactment and
89.10applies to supervision requirements in effect on or after that date.

89.11    Sec. 2. Minnesota Statutes 2021 Supplement, section 148B.5301, subdivision 2, is amended
89.12to read:
89.13    Subd. 2. Supervision. (a) To qualify as a LPCC, an applicant must have completed
89.144,000 hours of post-master's degree supervised professional practice in the delivery of
89.15clinical services in the diagnosis and treatment of mental illnesses and disorders in both
89.16children and adults. The supervised practice shall be conducted according to the requirements
89.17in paragraphs (b) to (e).
89.18(b) The supervision must have been received under a contract that defines clinical practice
89.19and supervision from a mental health professional who is qualified according to section
89.20245I.04, subdivision 2, or by a board-approved supervisor, who has at least two years of
89.21postlicensure experience in the delivery of clinical services in the diagnosis and treatment
89.22of mental illnesses and disorders. All supervisors must meet the supervisor requirements in
89.23Minnesota Rules, part 2150.5010.
89.24(c) The supervision must be obtained at the rate of two hours of supervision per 40 hours
89.25of professional practice. The supervision must be evenly distributed over the course of the
89.26supervised professional practice. At least 75 percent of the required supervision hours must
89.27be received in person or through real-time, two-way interactive audio and visual
89.28communication, and the board must allow an applicant to satisfy this supervision requirement
89.29with all required hours of supervision received through real-time, two-way interactive audio
89.30and visual communication. The remaining 25 percent of the required hours may be received
89.31by telephone or by audio or audiovisual electronic device. At least 50 percent of the required
89.32hours of supervision must be received on an individual basis. The remaining 50 percent
89.33may be received in a group setting.
90.1(d) The supervised practice must include at least 1,800 hours of clinical client contact.
90.2(e) The supervised practice must be clinical practice. Supervision includes the observation
90.3by the supervisor of the successful application of professional counseling knowledge, skills,
90.4and values in the differential diagnosis and treatment of psychosocial function, disability,
90.5or impairment, including addictions and emotional, mental, and behavioral disorders.
90.6EFFECTIVE DATE.This section is effective the day following final enactment and
90.7applies to supervision requirements in effect on or after that date.

90.8    Sec. 3. Minnesota Statutes 2020, section 148E.100, subdivision 3, is amended to read:
90.9    Subd. 3. Types of supervision. Of the 100 hours of supervision required under
90.10subdivision 1:
90.11    (1) 50 hours must be provided through one-on-one supervision~~, including: (i) a minimum~~
90.12~~of 25 hours of in-person supervision, and (ii) no more than 25 hours of supervision~~. The
90.13supervision must be provided either in person or via eye-to-eye electronic media, while
90.14maintaining visual contact. The board must allow a licensed social worker to satisfy the
90.15supervision requirement of this clause with all required hours of supervision provided via
90.16eye-to-eye electronic media, while maintaining visual contact; and
90.17    (2) 50 hours must be provided through: (i) one-on-one supervision, or (ii) group
90.18supervision. The supervision may be in person, by telephone, or via eye-to-eye electronic
90.19media, while maintaining visual contact. The supervision must not be provided by e-mail.
90.20Group supervision is limited to six supervisees.
90.21EFFECTIVE DATE.This section is effective the day following final enactment and
90.22applies to supervision requirements in effect on or after that date.

90.23    Sec. 4. Minnesota Statutes 2020, section 148E.105, subdivision 3, as amended by Laws
90.242022, chapter 55, article 1, section 42, is amended to read:
90.25    Subd. 3. Types of supervision. Of the 100 hours of supervision required under
90.26subdivision 1:
90.27    (1) 50 hours must be provided through one-on-one supervision~~, including: (i) a minimum~~
90.28~~of 25 hours of in-person supervision, and (ii) no more than 25 hours of supervision~~. The
90.29supervision must be provided either in person or via eye-to-eye electronic media, while
90.30maintaining visual contact. The board must allow a licensed graduate social worker to satisfy
90.31the supervision requirement of this clause with all required hours of supervision provided
90.32via eye-to-eye electronic media, while maintaining visual contact; and
91.1    (2) 50 hours must be provided through: (i) one-on-one supervision, or (ii) group
91.2supervision. The supervision may be in person, by telephone, or via eye-to-eye electronic
91.3media, while maintaining visual contact. The supervision must not be provided by e-mail.
91.4Group supervision is limited to six supervisees.
91.5EFFECTIVE DATE.This section is effective the day following final enactment and
91.6applies to supervision requirements in effect on or after that date.

91.7    Sec. 5. Minnesota Statutes 2020, section 148E.106, subdivision 3, is amended to read:
91.8    Subd. 3. Types of supervision. Of the 200 hours of supervision required under
91.9subdivision 1:
91.10    (1) 100 hours must be provided through one-on-one supervision~~, including: (i) a minimum~~
91.11~~of 50 hours of in-person supervision, and (ii) no more than 50 hours of supervision~~. The
91.12supervision must be provided either in person or via eye-to-eye electronic media, while
91.13maintaining visual contact. The board must allow a licensed graduate social worker to satisfy
91.14the supervision requirement of this clause with all required hours of supervision provided
91.15via eye-to-eye electronic media, while maintaining visual contact; and
91.16    (2) 100 hours must be provided through: (i) one-on-one supervision, or (ii) group
91.17supervision. The supervision may be in person, by telephone, or via eye-to-eye electronic
91.18media, while maintaining visual contact. The supervision must not be provided by e-mail.
91.19Group supervision is limited to six supervisees.
91.20EFFECTIVE DATE.This section is effective the day following final enactment and
91.21applies to supervision requirements in effect on or after that date.

91.22    Sec. 6. Minnesota Statutes 2020, section 148E.110, subdivision 7, is amended to read:
91.23    Subd. 7. Supervision; clinical social work practice after licensure as licensed
91.24independent social worker. Of the 200 hours of supervision required under subdivision
91.255:
91.26(1) 100 hours must be provided through one-on-one supervision~~, including:~~. The
91.27supervision must be provided either in person or via eye-to-eye electronic media, while
91.28maintaining visual contact. The board must allow a licensed independent social worker to
91.29satisfy the supervision requirement of this clause with all required hours of supervision
91.30provided via eye-to-eye electronic media, while maintaining visual contact; and
91.31~~(i) a minimum of 50 hours of in-person supervision; and~~
92.1~~(ii) no more than 50 hours of supervision via eye-to-eye electronic media, while~~
92.2~~maintaining visual contact; and~~
92.3(2) 100 hours must be provided through:
92.4(i) one-on-one supervision; or
92.5(ii) group supervision.
92.6The supervision may be in person, by telephone, or via eye-to-eye electronic media, while
92.7maintaining visual contact. The supervision must not be provided by e-mail. Group
92.8supervision is limited to six supervisees.
92.9EFFECTIVE DATE.This section is effective the day following final enactment and
92.10applies to supervision requirements in effect on or after that date.

92.11    Sec. 7. Minnesota Statutes 2020, section 150A.06, subdivision 1c, is amended to read:
92.12    Subd. 1c. Specialty dentists. (a) The board may grant one or more specialty licenses in
92.13the specialty areas of dentistry that are recognized by the Commission on Dental
92.14Accreditation.
92.15(b) An applicant for a specialty license shall:
92.16(1) have successfully completed a postdoctoral specialty program accredited by the
92.17Commission on Dental Accreditation, or have announced a limitation of practice before
92.181967;
92.19(2) have been certified by a specialty board approved by the Minnesota Board of
92.20Dentistry, or provide evidence of having passed a clinical examination for licensure required
92.21for practice in any state or Canadian province, or in the case of oral and maxillofacial
92.22surgeons only, have a Minnesota medical license in good standing;
92.23(3) have been in active practice or a postdoctoral specialty education program or United
92.24States government service at least 2,000 hours in the 36 months prior to applying for a
92.25specialty license;
92.26(4) if requested by the board, be interviewed by a committee of the board, which may
92.27include the assistance of specialists in the evaluation process, and satisfactorily respond to
92.28questions designed to determine the applicant's knowledge of dental subjects and ability to
92.29practice;
92.30(5) if requested by the board, present complete records on a sample of patients treated
92.31by the applicant. The sample must be drawn from patients treated by the applicant during
93.1the 36 months preceding the date of application. The number of records shall be established
93.2by the board. The records shall be reasonably representative of the treatment typically
93.3provided by the applicant for each specialty area;
93.4(6) at board discretion, pass a board-approved English proficiency test if English is not
93.5the applicant's primary language;
93.6(7) pass all components of the National Board Dental Examinations;
93.7(8) pass the Minnesota Board of Dentistry jurisprudence examination;
93.8(9) abide by professional ethical conduct requirements; and
93.9(10) meet all other requirements prescribed by the Board of Dentistry.
93.10(c) The application must include:
93.11(1) a completed application furnished by the board;
93.12~~(2) at least two character references from two different dentists for each specialty area,~~
93.13~~one of whom must be a dentist practicing in the same specialty area, and the other from the~~
93.14~~director of each specialty program attended;~~
93.15~~(3) a licensed physician's statement attesting to the applicant's physical and mental~~
93.16~~condition;~~
93.17~~(4) a statement from a licensed ophthalmologist or optometrist attesting to the applicant's~~
93.18~~visual acuity;~~
93.19~~(5)~~ (2) a nonrefundable fee; and
93.20~~(6)~~ (3) a ~~notarized, unmounted passport-type photograph, three inches by three inches,~~
93.21~~taken not more than six months before the date of application~~ copy of the applicant's
93.22government issued photo identification card.
93.23(d) A specialty dentist holding one or more specialty licenses is limited to practicing in
93.24the dentist's designated specialty area or areas. The scope of practice must be defined by
93.25each national specialty board recognized by the Commission on Dental Accreditation.
93.26(e) A specialty dentist holding a general dental license is limited to practicing in the
93.27dentist's designated specialty area or areas if the dentist has announced a limitation of
93.28practice. The scope of practice must be defined by each national specialty board recognized
93.29by the Commission on Dental Accreditation.
94.1(f) All specialty dentists who have fulfilled the specialty dentist requirements and who
94.2intend to limit their practice to a particular specialty area or areas may apply for one or more
94.3specialty licenses.

94.4    Sec. 8. Minnesota Statutes 2020, section 150A.06, subdivision 2c, is amended to read:
94.5    Subd. 2c. Guest license. (a) The board shall grant a guest license to practice as a dentist,
94.6dental hygienist, or licensed dental assistant if the following conditions are met:
94.7(1) the dentist, dental hygienist, or dental assistant is currently licensed in good standing
94.8in another United States jurisdiction;
94.9(2) the dentist, dental hygienist, or dental assistant is currently engaged in the practice
94.10of that person's respective profession in another United States jurisdiction;
94.11(3) the dentist, dental hygienist, or dental assistant will limit that person's practice to a
94.12public health setting in Minnesota that (i) is approved by the board; (ii) was established by
94.13a nonprofit organization that is tax exempt under chapter 501(c)(3) of the Internal Revenue
94.14Code of 1986; and (iii) provides dental care to patients who have difficulty accessing dental
94.15care;
94.16(4) the dentist, dental hygienist, or dental assistant agrees to treat indigent patients who
94.17meet the eligibility criteria established by the clinic; and
94.18(5) the dentist, dental hygienist, or dental assistant has applied to the board for a guest
94.19license and has paid a nonrefundable license fee to the board ~~not to exceed $75~~.
94.20(b) A guest license must be renewed annually with the board and an annual renewal fee
94.21~~not to exceed $75~~ must be paid to the board. Guest licenses expire on December 31 of each
94.22year.
94.23(c) A dentist, dental hygienist, or dental assistant practicing under a guest license under
94.24this subdivision shall have the same obligations as a dentist, dental hygienist, or dental
94.25assistant who is licensed in Minnesota and shall be subject to the laws and rules of Minnesota
94.26and the regulatory authority of the board. If the board suspends or revokes the guest license
94.27of, or otherwise disciplines, a dentist, dental hygienist, or dental assistant practicing under
94.28this subdivision, the board shall promptly report such disciplinary action to the dentist's,
94.29dental hygienist's, or dental assistant's regulatory board in the jurisdictions in which they
94.30are licensed.
94.31(d) The board may grant a guest license to a dentist, dental hygienist, or dental assistant
94.32licensed in another United States jurisdiction to provide dental care to patients on a voluntary
95.1basis without compensation for a limited period of time. The board shall not assess a fee
95.2for the guest license for volunteer services issued under this paragraph.
95.3(e) The board shall issue a guest license for volunteer services if:
95.4(1) the board determines that the applicant's services will provide dental care to patients
95.5who have difficulty accessing dental care;
95.6(2) the care will be provided without compensation; and
95.7(3) the applicant provides adequate proof of the status of all licenses to practice in other
95.8jurisdictions. The board may require such proof on an application form developed by the
95.9board.
95.10(f) The guest license for volunteer services shall limit the licensee to providing dental
95.11care services for a period of time not to exceed ten days in a calendar year. Guest licenses
95.12expire on December 31 of each year.
95.13(g) The holder of a guest license for volunteer services shall be subject to state laws and
95.14rules regarding dentistry and the regulatory authority of the board. The board may revoke
95.15the license of a dentist, dental hygienist, or dental assistant practicing under this subdivision
95.16or take other regulatory action against the dentist, dental hygienist, or dental assistant. If an
95.17action is taken, the board shall report the action to the regulatory board of those jurisdictions
95.18where an active license is held by the dentist, dental hygienist, or dental assistant.

95.19    Sec. 9. Minnesota Statutes 2020, section 150A.06, subdivision 6, is amended to read:
95.20    Subd. 6. Display of name and certificates. (a) The renewal certificate of ~~every dentist,~~
95.21~~dental therapist, dental hygienist, or dental assistant~~ every licensee or registrant must be
95.22conspicuously displayed in plain sight of patients in every office in which that person
95.23practices. Duplicate renewal certificates may be obtained from the board.
95.24(b) Near or on the entrance door to every office where dentistry is practiced, the name
95.25of each dentist practicing there, as inscribed on the current license certificate, must be
95.26displayed in plain sight.
95.27(c) The board must allow the display of a mini-license for guest license holders
95.28performing volunteer dental services. There is no fee for the mini-license for guest volunteers.

96.1    Sec. 10. Minnesota Statutes 2020, section 150A.06, is amended by adding a subdivision
96.2to read:
96.3    Subd. 12. Licensure by credentials for dental therapy. (a) Any dental therapist may,
96.4upon application and payment of a fee established by the board, apply for licensure based
96.5on an evaluation of the applicant's education, experience, and performance record. The
96.6applicant may be interviewed by the board to determine if the applicant:
96.7(1) graduated with a baccalaureate or master's degree from a dental therapy program
96.8accredited by the Commission on Dental Accreditation;
96.9(2) provided evidence of successfully completing the board's jurisprudence examination;
96.10(3) actively practiced at least 2,000 hours within 36 months of the application date or
96.11passed a board-approved reentry program within 36 months of the application date;
96.12(4) either:
96.13(i) is currently licensed in another state or Canadian province and not subject to any
96.14pending or final disciplinary action; or
96.15(ii) was previously licensed in another state or Canadian province in good standing and
96.16not subject to any final or pending disciplinary action at the time of surrender;
96.17(5) passed a board-approved English proficiency test if English is not the applicant's
96.18primary language required at the board's discretion; and
96.19(6) met all curriculum equivalency requirements regarding dental therapy scope of
96.20practice in Minnesota.
96.21(b) The 2,000 practice hours required by clause (3) may count toward the 2,000 practice
96.22hours required for consideration for advanced dental therapy certification, provided that all
96.23other requirements of section 150A.106, subdivision 1, are met.
96.24(c) The board, at its discretion, may waive specific licensure requirements in paragraph
96.25(a).
96.26(d) The board must license an applicant who fulfills the conditions of this subdivision
96.27and demonstrates the minimum knowledge in dental subjects required for licensure under
96.28subdivision 1d to practice the applicant's profession.
96.29(e) The board must deny the application if the applicant does not demonstrate the
96.30minimum knowledge in dental subjects required for licensure under subdivision 1d. If
96.31licensure is denied, the board may notify the applicant of any specific remedy the applicant
97.1could take to qualify for licensure. A denial does not prohibit the applicant from applying
97.2for licensure under subdivision 1d.
97.3(f) A candidate may appeal a denied application to the board according to subdivision
97.44a.

97.5    Sec. 11. Minnesota Statutes 2020, section 150A.09, is amended to read:
97.6150A.09 ~~REGISTRATION OF~~ LICENSES ~~AND~~ OR REGISTRATION
97.7CERTIFICATES.
97.8    Subdivision 1. Registration information and procedure. On or before the license
97.9certificate expiration date every ~~licensed dentist, dental therapist, dental hygienist, and~~
97.10~~dental assistant~~ licensee or registrant shall ~~transmit to the executive secretary of the board,~~
97.11~~pertinent information~~ submit the renewal required by the board, together with the applicable
97.12fee ~~established by the board~~ under section 150A.091. At least 30 days before a license
97.13certificate expiration date, the board shall send a written notice stating the amount and due
97.14date of the fee ~~and the information to be provided to every licensed dentist, dental therapist,~~
97.15~~dental hygienist, and dental assistant~~.
97.16    Subd. 3. Current address, change of address. Every ~~dentist, dental therapist, dental~~
97.17~~hygienist, and dental assistant~~ licensee or registrant shall maintain with the board a correct
97.18and current mailing address and electronic mail address. For dentists engaged in the practice
97.19of dentistry, the postal address shall be that of the location of the primary dental practice.
97.20Within 30 days after changing postal or electronic mail addresses, every ~~dentist, dental~~
97.21~~therapist, dental hygienist, and dental assistant~~ licensee or registrant shall provide the board
97.22~~written~~ notice ~~of the new address either personally or by first class mail~~.
97.23    Subd. 4. Duplicate certificates. Duplicate licenses or duplicate certificates of ~~license~~
97.24renewal may be issued by the board upon satisfactory proof of the need for the duplicates
97.25and upon payment of the fee established by the board.
97.26    Subd. 5. Late fee. A late fee established by the board shall be paid if the ~~information~~
97.27~~and~~ fee required by subdivision 1 is not received by ~~the executive secretary of~~ the board on
97.28or before the registration or ~~license~~ renewal date.

97.29    Sec. 12. Minnesota Statutes 2020, section 150A.091, subdivision 2, is amended to read:
97.30    Subd. 2. Application and initial license or registration fees. Each applicant shall
97.31submit with a license, advanced dental therapist certificate, or permit application a
98.1nonrefundable fee in the following amounts in order to administratively process an
98.2application:
98.3(1) dentist, ~~$140~~ $308;
98.4(2) full faculty dentist, ~~$140~~ $308;
98.5(3) limited faculty dentist, $140;
98.6(4) resident dentist or dental provider, $55;
98.7(5) advanced dental therapist, $100;
98.8(6) dental therapist, ~~$100~~ $220;
98.9(7) dental hygienist, ~~$55~~ $115;
98.10(8) licensed dental assistant, ~~$55; and~~ $115;
98.11(9) dental assistant with ~~a permit~~ registration as described in Minnesota Rules, part
98.123100.8500, subpart 3, ~~$15.~~ $27; and
98.13(10) guest license, $50.

98.14    Sec. 13. Minnesota Statutes 2020, section 150A.091, subdivision 5, is amended to read:
98.15    Subd. 5. Biennial license or ~~permit~~ registration renewal fees. Each of the following
98.16applicants shall submit with a biennial license or permit renewal application a fee as
98.17established by the board, not to exceed the following amounts:
98.18(1) dentist or full faculty dentist, $475;
98.19(2) dental therapist, $300;
98.20(3) dental hygienist, $200;
98.21(4) licensed dental assistant, $150; and
98.22(5) dental assistant with a ~~permit~~ registration as described in Minnesota Rules, part
98.233100.8500, subpart 3, $24.

98.24    Sec. 14. Minnesota Statutes 2020, section 150A.091, subdivision 8, is amended to read:
98.25    Subd. 8. Duplicate license or certificate fee. Each applicant shall submit, with a request
98.26for issuance of a duplicate of the original license, or of an annual or biennial renewal
98.27certificate for a license or permit, a fee in the following amounts:
99.1(1) original dentist, full faculty dentist, dental therapist, dental hygiene, or dental assistant
99.2license, $35; and
99.3(2) annual or biennial renewal certificates, $10~~; and~~.
99.4~~(3) wallet-sized license and renewal certificate, $15.~~

99.5    Sec. 15. Minnesota Statutes 2020, section 150A.091, subdivision 9, is amended to read:
99.6    Subd. 9. Licensure by credentials. Each applicant for licensure as a dentist, dental
99.7hygienist, or dental assistant by credentials pursuant to section 150A.06, subdivisions 4 and
99.88, and Minnesota Rules, part 3100.1400, shall submit with the license application a fee in
99.9the following amounts:
99.10(1) dentist, ~~$725~~ $893;
99.11(2) dental hygienist, ~~$175; and~~ $235;
99.12(3) dental assistant, ~~$35.~~ $71; and
99.13(4) dental therapist, $340.

99.14    Sec. 16. Minnesota Statutes 2020, section 150A.091, is amended by adding a subdivision
99.15to read:
99.16    Subd. 21. Failure to practice with a current license. (a) If a licensee practices without
99.17a current license and pursues reinstatement, the board may take the following administrative
99.18actions based on the length of time practicing without a current license:
99.19(1) for under one month, the board may not assess a penalty fee;
99.20(2) for one month to six months, the board may assess a penalty of $250;
99.21(3) for over six months, the board may assess a penalty of $500; and
99.22(4) for over 12 months, the board may assess a penalty of $1,000.
99.23(b) In addition to the penalty fee, the board shall initiate the complaint process against
99.24the licensee for failure to practice with a current license for over 12 months.

99.25    Sec. 17. Minnesota Statutes 2020, section 150A.091, is amended by adding a subdivision
99.26to read:
99.27    Subd. 22. Delegating regulated procedures to an individual with a terminated
99.28license. (a) If a dentist or dental therapist delegates regulated procedures to another dental
99.29professional who had their license terminated, the board may take the following
100.1administrative actions against the delegating dentist or dental therapist based on the length
100.2of time they delegated regulated procedures:
100.3(1) for under one month, the board may not assess a penalty fee;
100.4(2) for one month to six months, the board may assess a penalty of $100;
100.5(3) for over six months, the board may assess a penalty of $250; and
100.6(4) for over 12 months, the board may assess a penalty of $500.
100.7(b) In addition to the penalty fee, the board shall initiate the complaint process against
100.8a dentist or dental therapist who delegated regulated procedures to a dental professional
100.9with a terminated license for over 12 months.

100.10    Sec. 18. Minnesota Statutes 2020, section 150A.10, subdivision 1a, is amended to read:
100.11    Subd. 1a. Collaborative practice authorization for dental hygienists in community
100.12settings. (a) Notwithstanding subdivision 1, a dental hygienist licensed under this chapter
100.13may be employed or retained by a health care facility, program, or nonprofit organization,
100.14or licensed dentist to perform the dental hygiene services listed in Minnesota Rules, part
100.153100.8700, subpart 1, without the patient first being examined by a licensed dentist if the
100.16dental hygienist:
100.17(1) has entered into a collaborative agreement with a licensed dentist that designates
100.18authorization for the services provided by the dental hygienist; and
100.19(2) has documented completion of a course on medical emergencies within each
100.20continuing education cycle.
100.21(b) A collaborating dentist must be licensed under this chapter and may enter into a
100.22collaborative agreement with no more than four dental hygienists unless otherwise authorized
100.23by the board. The board shall develop parameters and a process for obtaining authorization
100.24to collaborate with more than four dental hygienists. The collaborative agreement must
100.25include:
100.26(1) consideration for medically compromised patients and medical conditions for which
100.27a dental evaluation and treatment plan must occur prior to the provision of dental hygiene
100.28services;
100.29(2) age- and procedure-specific standard collaborative practice protocols, including
100.30recommended intervals for the performance of dental hygiene services and a period of time
100.31in which an examination by a dentist should occur;
101.1(3) copies of consent to treatment form provided to the patient by the dental hygienist;
101.2(4) specific protocols for the placement of pit and fissure sealants and requirements for
101.3follow-up care to ~~assure the~~ ensure efficacy ~~of the sealants after application~~; and
101.4(5) the procedure for creating and maintaining dental records for patients who are treated
101.5by the dental hygienist under Minnesota Rules, part 3100.9600, including specifying where
101.6records will be located.
101.7~~The collaborative agreement must be signed and maintained by the dentist, the dental~~
101.8~~hygienist, and the facility, program, or organization; must be reviewed annually by the~~
101.9~~collaborating dentist and dental hygienist and must be made available to the board upon~~
101.10~~request.~~
101.11(c) The collaborative agreement must be:
101.12(1) signed and maintained by the dentist; the dental hygienist; and the facility, program,
101.13or organization;
101.14(2) reviewed annually by the collaborating dentist and the dental hygienist; and
101.15(3) made available to the board upon request.
101.16~~(c)~~ (d) Before performing any services authorized under this subdivision, a dental
101.17hygienist must provide the patient with a consent to treatment form which must include a
101.18statement advising the patient that the dental hygiene services provided are not a substitute
101.19for a dental examination by a licensed dentist. When the patient requires a referral for
101.20additional dental services, the dental hygienist shall complete a referral form and provide
101.21a copy to the patient, the facility, if applicable, the dentist to whom the patient is being
101.22referred, and the collaborating dentist, if specified in the collaborative agreement. A copy
101.23of the referral form shall be maintained in the patient's health care record. The patient does
101.24not become a new patient of record of the dentist to whom the patient was referred until the
101.25dentist accepts the patient for follow-up services after referral from the dental hygienist.
101.26~~(d)~~ (e) For the purposes of this subdivision, a "health care facility, program, or nonprofit
101.27organization" includes a hospital; nursing home; home health agency; group home serving
101.28the elderly, disabled, or juveniles; state-operated facility licensed by the commissioner of
101.29human services or the commissioner of corrections; a state agency administered public
101.30health program or event; and federal, state, or local public health facility, community clinic,
101.31tribal clinic, school authority, Head Start program, or nonprofit organization that serves
101.32individuals who are uninsured or who are Minnesota health care public program recipients.
102.1~~(e)~~ (f) For purposes of this subdivision, a "collaborative agreement" means a written
102.2agreement with a licensed dentist who authorizes and accepts responsibility for the services
102.3performed by the dental hygienist.
102.4(g) A collaborative practice dental hygienist must be reimbursed for all services performed
102.5through a health care facility, program, nonprofit organization, or licensed dentist.

102.6    Sec. 19. Minnesota Statutes 2020, section 150A.105, subdivision 8, is amended to read:
102.7    Subd. 8. Definitions. (a) For the purposes of this section, the following definitions apply.
102.8    (b) "Practice settings that serve the low-income and underserved" mean:
102.9    (1) critical access dental provider settings as designated by the commissioner of human
102.10services under section 256B.76, subdivision 4;
102.11    (2) dental hygiene collaborative practice settings identified in section 150A.10,
102.12subdivision 1a, paragraph ~~(d)~~ (e), and including medical facilities, assisted living facilities,
102.13federally qualified health centers, and organizations eligible to receive a community clinic
102.14grant under section 145.9268, subdivision 1;
102.15    (3) military and veterans administration hospitals, clinics, and care settings;
102.16    (4) a patient's residence or home when the patient is home-bound or receiving or eligible
102.17to receive home care services or home and community-based waivered services, regardless
102.18of the patient's income;
102.19    (5) oral health educational institutions; or
102.20    (6) any other clinic or practice setting, including mobile dental units, in which at least
102.2150 percent of the total patient base of the dental therapist or advanced dental therapist
102.22consists of patients who:
102.23    (i) are enrolled in a Minnesota health care program;
102.24    (ii) have a medical disability or chronic condition that creates a significant barrier to
102.25receiving dental care;
102.26    (iii) do not have dental health coverage, either through a public health care program or
102.27private insurance, and have an annual gross family income equal to or less than 200 percent
102.28of the federal poverty guidelines; or
102.29(iv) do not have dental health coverage, either through a state public health care program
102.30or private insurance, and whose family gross income is equal to or less than 200 percent of
102.31the federal poverty guidelines.
103.1    (c) "Dental health professional shortage area" means an area that meets the criteria
103.2established by the secretary of the United States Department of Health and Human Services
103.3and is designated as such under United States Code, title 42, section 254e.

103.4    Sec. 20. Minnesota Statutes 2020, section 151.01, subdivision 27, is amended to read:
103.5    Subd. 27. Practice of pharmacy. "Practice of pharmacy" means:
103.6    (1) interpretation and evaluation of prescription drug orders;
103.7    (2) compounding, labeling, and dispensing drugs and devices (except labeling by a
103.8manufacturer or packager of nonprescription drugs or commercially packaged legend drugs
103.9and devices);
103.10    (3) participation in clinical interpretations and monitoring of drug therapy for assurance
103.11of safe and effective use of drugs, including the performance of laboratory tests that are
103.12waived under the federal Clinical Laboratory Improvement Act of 1988, United States Code,
103.13title 42, section 263a et seq., provided that a pharmacist may interpret the results of laboratory
103.14tests but may modify drug therapy only pursuant to a protocol or collaborative practice
103.15agreement;
103.16    (4) participation in drug and therapeutic device selection; drug administration for first
103.17dosage and medical emergencies; intramuscular and subcutaneous drug administration ~~used~~
103.18~~for the treatment of alcohol or opioid dependence~~ under a prescription drug order; drug
103.19regimen reviews; and drug or drug-related research;
103.20(5) drug administration, through intramuscular and subcutaneous administration used
103.21to treat mental illnesses as permitted under the following conditions:
103.22(i) upon the order of a prescriber and the prescriber is notified after administration is
103.23complete; or
103.24(ii) pursuant to a protocol or collaborative practice agreement as defined by section
103.25151.01, subdivisions 27b and 27c, and participation in the initiation, management,
103.26modification, administration, and discontinuation of drug therapy is according to the protocol
103.27or collaborative practice agreement between the pharmacist and a dentist, optometrist,
103.28physician, podiatrist, or veterinarian, or an advanced practice registered nurse authorized
103.29to prescribe, dispense, and administer under section 148.235. Any changes in drug therapy
103.30or medication administration made pursuant to a protocol or collaborative practice agreement
103.31must be documented by the pharmacist in the patient's medical record or reported by the
103.32pharmacist to a practitioner responsible for the patient's care;
104.1    (6) participation in administration of influenza vaccines and vaccines approved by the
104.2United States Food and Drug Administration related to COVID-19 or SARS-CoV-2 to all
104.3eligible individuals six years of age and older and all other vaccines to patients 13 years of
104.4age and older by written protocol with a physician licensed under chapter 147, a physician
104.5assistant authorized to prescribe drugs under chapter 147A, or an advanced practice registered
104.6nurse authorized to prescribe drugs under section 148.235, provided that:
104.7(i) the protocol includes, at a minimum:
104.8(A) the name, dose, and route of each vaccine that may be given;
104.9(B) the patient population for whom the vaccine may be given;
104.10(C) contraindications and precautions to the vaccine;
104.11(D) the procedure for handling an adverse reaction;
104.12(E) the name, signature, and address of the physician, physician assistant, or advanced
104.13practice registered nurse;
104.14(F) a telephone number at which the physician, physician assistant, or advanced practice
104.15registered nurse can be contacted; and
104.16(G) the date and time period for which the protocol is valid;
104.17    (ii) the pharmacist has successfully completed a program approved by the Accreditation
104.18Council for Pharmacy Education specifically for the administration of immunizations or a
104.19program approved by the board;
104.20    (iii) the pharmacist utilizes the Minnesota Immunization Information Connection to
104.21assess the immunization status of individuals prior to the administration of vaccines, except
104.22when administering influenza vaccines to individuals age nine and older;
104.23    (iv) the pharmacist reports the administration of the immunization to the Minnesota
104.24Immunization Information Connection; and
104.25(v) the pharmacist complies with guidelines for vaccines and immunizations established
104.26by the federal Advisory Committee on Immunization Practices, except that a pharmacist
104.27does not need to comply with those portions of the guidelines that establish immunization
104.28schedules when administering a vaccine pursuant to a valid, patient-specific order issued
104.29by a physician licensed under chapter 147, a physician assistant authorized to prescribe
104.30drugs under chapter 147A, or an advanced practice registered nurse authorized to prescribe
104.31drugs under section 148.235, provided that the order is consistent with the United States
104.32Food and Drug Administration approved labeling of the vaccine;
105.1    (7) participation in the initiation, management, modification, and discontinuation of
105.2drug therapy according to a written protocol or collaborative practice agreement between:
105.3(i) one or more pharmacists and one or more dentists, optometrists, physicians, podiatrists,
105.4or veterinarians; or (ii) one or more pharmacists and one or more physician assistants
105.5authorized to prescribe, dispense, and administer under chapter 147A, or advanced practice
105.6registered nurses authorized to prescribe, dispense, and administer under section 148.235.
105.7Any changes in drug therapy made pursuant to a protocol or collaborative practice agreement
105.8must be documented by the pharmacist in the patient's medical record or reported by the
105.9pharmacist to a practitioner responsible for the patient's care;
105.10    (8) participation in the storage of drugs and the maintenance of records;
105.11    (9) patient counseling on therapeutic values, content, hazards, and uses of drugs and
105.12devices;
105.13    (10) offering or performing those acts, services, operations, or transactions necessary
105.14in the conduct, operation, management, and control of a pharmacy;
105.15    (11) participation in the initiation, management, modification, and discontinuation of
105.16therapy with opiate antagonists, as defined in section 604A.04, subdivision 1, pursuant to:
105.17    (i) a written protocol as allowed under clause (7); or
105.18    (ii) a written protocol with a community health board medical consultant or a practitioner
105.19designated by the commissioner of health, as allowed under section 151.37, subdivision 13;
105.20~~and~~
105.21    (12) prescribing self-administered hormonal contraceptives; nicotine replacement
105.22medications; and opiate antagonists for the treatment of an acute opiate overdose pursuant
105.23to section 151.37, subdivision 14, 15, or 16.; and
105.24(13) participation in the placement of drug monitoring devices according to a prescription,
105.25protocol, or collaborative practice agreement.

105.26    Sec. 21. Minnesota Statutes 2020, section 153.16, subdivision 1, is amended to read:
105.27    Subdivision 1. License requirements. The board shall issue a license to practice podiatric
105.28medicine to a person who meets the following requirements:
105.29(a) The applicant for a license shall file a written notarized application on forms provided
105.30by the board, showing to the board's satisfaction that the applicant is of good moral character
105.31and satisfies the requirements of this section.
106.1(b) The applicant shall present evidence satisfactory to the board of being a graduate of
106.2a podiatric medical school approved by the board based upon its faculty, curriculum, facilities,
106.3accreditation by a recognized national accrediting organization approved by the board, and
106.4other relevant factors.
106.5(c) The applicant must have received a passing score on each part of the national board
106.6examinations, parts one and two, prepared and graded by the National Board of Podiatric
106.7Medical Examiners. The passing score for each part of the national board examinations,
106.8parts one and two, is as defined by the National Board of Podiatric Medical Examiners.
106.9(d) Applicants graduating after ~~1986~~ 1990 from a podiatric medical school shall present
106.10evidence of successful completion of a residency program approved by a national accrediting
106.11podiatric medicine organization.
106.12(e) The applicant shall appear in person before the board or its designated representative
106.13to show that the applicant satisfies the requirements of this section, including knowledge
106.14of laws, rules, and ethics pertaining to the practice of podiatric medicine. The board may
106.15establish as internal operating procedures the procedures or requirements for the applicant's
106.16personal presentation. Upon completion of all other application requirements, a doctor of
106.17podiatric medicine applying for a temporary military license has six months in which to
106.18comply with this subdivision.
106.19(f) The applicant shall pay a fee established by the board by rule. The fee shall not be
106.20refunded.
106.21(g) The applicant must not have engaged in conduct warranting disciplinary action
106.22against a licensee. If the applicant does not satisfy the requirements of this paragraph, the
106.23board may refuse to issue a license unless it determines that the public will be protected
106.24through issuance of a license with conditions and limitations the board considers appropriate.
106.25(h) Upon payment of a fee as the board may require, an applicant who fails to pass an
106.26examination and is refused a license is entitled to reexamination within one year of the
106.27board's refusal to issue the license. No more than two reexaminations are allowed without
106.28a new application for a license.
106.29EFFECTIVE DATE.This section is effective the day following final enactment.

106.30    Sec. 22. Laws 2021, First Special Session chapter 7, article 16, section 5, is amended to
106.31read:

106.32
106.33

Sec. 5. EMERGENCY MEDICAL SERVICES
REGULATORY BOARD

4,780,000

4,576,000

107.1(a) Cooper/Sams Volunteer Ambulance
107.2Program. $950,000 in fiscal year 2022 and
107.3$950,000 in fiscal year 2023 are for the
107.4Cooper/Sams volunteer ambulance program
107.5under Minnesota Statutes, section 144E.40.
107.6(1) Of this amount, $861,000 in fiscal year
107.72022 and $861,000 in fiscal year 2023 are for
107.8the ambulance service personnel longevity
107.9award and incentive program under Minnesota
107.10Statutes, section 144E.40.
107.11(2) Of this amount, $89,000 in fiscal year 2022
107.12and $89,000 in fiscal year 2023 are for the
107.13operations of the ambulance service personnel
107.14longevity award and incentive program under
107.15Minnesota Statutes, section 144E.40.
107.16(b) EMSRB Operations. $1,880,000 in fiscal
107.17year 2022 and $1,880,000 in fiscal year 2023
107.18are for board operations.
107.19~~(c)~~ ~~Regional Grants for Continuing~~
107.20~~Education.~~ ~~$585,000 in fiscal year 2022 and~~
107.21~~$585,000 in fiscal year 2023 are for regional~~
107.22~~emergency medical services programs, to be~~
107.23~~distributed equally to the eight emergency~~
107.24~~medical service regions under Minnesota~~
107.25~~Statutes, section~~ ~~144E.52~~.
107.26~~(d)~~ ~~Regional Grants for Local and Regional~~
107.27~~Emergency Medical Services~~. (c)
107.28Emergency Medical Services Fund.
107.29~~$800,000~~ $1,385,000 in fiscal year 2022 and
107.30~~$800,000~~ $1,385,000 in fiscal year 2023 are
107.31for distribution to regional emergency medical
107.32services ~~regions~~ systems for ~~regional~~
107.33~~emergency medical services programs~~ the
107.34purposes specified in Minnesota Statutes,
108.1section 144E.50. Notwithstanding Minnesota
108.2Statutes, section 144E.50, subdivision 5, in
108.3each year the board shall distribute the
108.4appropriation equally among the eight
108.5emergency medical services ~~regions~~ systems
108.6designated by the board. ~~This is a onetime~~
108.7~~appropriation~~ The general fund base for this
108.8appropriation is $585,000 in fiscal year 2024
108.9and $585,000 in fiscal year 2025.
108.10~~(e)~~ (d) Ambulance Training Grants.
108.11$565,000 in fiscal year 2022 and $361,000 in
108.12fiscal year 2023 are for training grants under
108.13Minnesota Statutes, section 144E.35.
108.14~~(f)~~ (e) Base Level Adjustment. The general
108.15fund base is $3,776,000 in fiscal year 2024
108.16and $3,776,000 in fiscal year 2025.
108.17EFFECTIVE DATE.This section is effective the day following final enactment.

108.18    Sec. 23. TEMPORARY REQUIREMENTS GOVERNING AMBULANCE SERVICE
108.19OPERATIONS AND THE PROVISION OF EMERGENCY MEDICAL SERVICES.
108.20    Subdivision 1. Application. Notwithstanding any law to the contrary in Minnesota
108.21Statutes, chapter 144E, an ambulance service may operate according to this section, and
108.22emergency medical technicians, advanced emergency medical technicians, and paramedics
108.23may provide emergency medical services according to this section.
108.24    Subd. 2. Definitions. (a) The terms defined in this subdivision apply to this section.
108.25(b) "Advanced emergency medical technician" has the meaning given in Minnesota
108.26Statutes, section 144E.001, subdivision 5d.
108.27(c) "Advanced life support" has the meaning given in Minnesota Statutes, section
108.28144E.001, subdivision 1b.
108.29(d) "Ambulance" has the meaning given in Minnesota Statutes, section 144E.001,
108.30subdivision 2.
108.31(e) "Ambulance service personnel" has the meaning given in Minnesota Statutes, section
108.32144E.001, subdivision 3a.
109.1(f) "Basic life support" has the meaning given in Minnesota Statutes, section 144E.001,
109.2subdivision 4b.
109.3(g) "Board" means the Emergency Medical Services Regulatory Board.
109.4(h) "Emergency medical technician" has the meaning given in Minnesota Statutes, section
109.5144E.001, subdivision 5c.
109.6(i) "Paramedic" has the meaning given in Minnesota Statutes, section 144E.001,
109.7subdivision 5e.
109.8(j) "Primary service area" means the area designated by the board according to Minnesota
109.9Statutes, section 144E.06, to be served by an ambulance service.
109.10    Subd. 3. Staffing. (a) For emergency ambulance calls and interfacility transfers in an
109.11ambulance service's primary service area, an ambulance service must staff an ambulance
109.12that provides basic life support with at least:
109.13(1) one emergency medical technician, who must be in the patient compartment when
109.14a patient is being transported; and
109.15(2) one individual to drive the ambulance. The driver must hold a valid driver's license
109.16from any state, must have attended an emergency vehicle driving course approved by the
109.17ambulance service, and must have completed a course on cardiopulmonary resuscitation
109.18approved by the ambulance service.
109.19(b) For emergency ambulance calls and interfacility transfers in an ambulance service's
109.20primary service area, an ambulance service must staff an ambulance that provides advanced
109.21life support with at least:
109.22(1) one paramedic; one registered nurse who meets the requirements in Minnesota
109.23Statutes, section 144E.001, subdivision 3a, clause (2); or one physician assistant who meets
109.24the requirements in Minnesota Statutes, section 144E.001, subdivision 3a, clause (3), and
109.25who must be in the patient compartment when a patient is being transported; and
109.26(2) one individual to drive the ambulance. The driver must hold a valid driver's license
109.27from any state, must have attended an emergency vehicle driving course approved by the
109.28ambulance service, and must have completed a course on cardiopulmonary resuscitation
109.29approved by the ambulance service.
109.30(c) The ambulance service director and medical director must approve the staffing of
109.31an ambulance according to this subdivision.
110.1(d) An ambulance service staffing an ambulance according to this subdivision must
110.2immediately notify the board in writing and in a manner prescribed by the board. The notice
110.3must specify how the ambulance service is staffing its basic life support or advanced life
110.4support ambulances and the time period the ambulance service plans to staff the ambulances
110.5according to this subdivision. If an ambulance service continues to staff an ambulance
110.6according to this subdivision after the date provided to the board in its initial notice, the
110.7ambulance service must provide a new notice to the board in a manner that complies with
110.8this paragraph.
110.9(e) If an individual serving as a driver under this subdivision commits an act listed in
110.10Minnesota Statutes, section 144E.27, subdivision 5, paragraph (a), the board may temporarily
110.11suspend or prohibit the individual from driving an ambulance or place conditions on the
110.12individual's ability to drive an ambulance using the procedures and authority in Minnesota
110.13Statutes, section 144E.27, subdivisions 5 and 6.
110.14    Subd. 4. Use of expired emergency medications and medical supplies. (a) If an
110.15ambulance service experiences a shortage of an emergency medication or medical supply,
110.16ambulance service personnel may use an emergency medication or medical supply for up
110.17to six months after the emergency medication's or medical supply's specified expiration
110.18date, provided:
110.19(1) the ambulance service director and medical director approve the use of the expired
110.20emergency medication or medical supply;
110.21(2) ambulance service personnel use an expired emergency medication or medical supply
110.22only after depleting the ambulance service's supply of that emergency medication or medical
110.23supply that is unexpired;
110.24(3) the ambulance service has stored and maintained the expired emergency medication
110.25or medical supply according to the manufacturer's instructions;
110.26(4) if possible, ambulance service personnel obtain consent from the patient to use the
110.27expired emergency medication or medical supply prior to its use; and
110.28(5) when the ambulance service obtains a supply of that emergency medication or medical
110.29supply that is unexpired, ambulance service personnel cease use of the expired emergency
110.30medication or medical supply and instead use the unexpired emergency medication or
110.31medical supply.
111.1(b) Before approving the use of an expired emergency medication, an ambulance service
111.2director and medical director must consult with the Board of Pharmacy regarding the safety
111.3and efficacy of using the expired emergency medication.
111.4(c) An ambulance service must keep a record of all expired emergency medications and
111.5all expired medical supplies used and must submit that record in writing to the board in a
111.6time and manner specified by the board. The record must list the specific expired emergency
111.7medications and medical supplies used and the time period during which ambulance service
111.8personnel used the expired emergency medication or medical supply.
111.9    Subd. 5. Provision of emergency medical services after certification expires. (a) At
111.10the request of an emergency medical technician, advanced emergency medical technician,
111.11or paramedic, and with the approval of the ambulance service director, an ambulance service
111.12medical director may authorize the emergency medical technician, advanced emergency
111.13medical technician, or paramedic to provide emergency medical services for the ambulance
111.14service for up to three months after the certification of the emergency medical technician,
111.15advanced emergency medical technician, or paramedic expires.
111.16(b) An ambulance service must immediately notify the board each time its medical
111.17director issues an authorization under paragraph (a). The notice must be provided in writing
111.18and in a manner prescribed by the board and must include information on the time period
111.19each emergency medical technician, advanced emergency medical technician, or paramedic
111.20will provide emergency medical services according to an authorization under this subdivision;
111.21information on why the emergency medical technician, advanced emergency medical
111.22technician, or paramedic needs the authorization; and an attestation from the medical director
111.23that the authorization is necessary to help the ambulance service adequately staff its
111.24ambulances.
111.25    Subd. 6. Reports. The board must provide quarterly reports to the chairs and ranking
111.26minority members of the legislative committees with jurisdiction over the board regarding
111.27actions taken by ambulance services according to subdivisions 3, 4, and 5. The board must
111.28submit reports by June 30, September 30, and December 31 of 2022; and by March 31, June
111.2930, September 30, and December 31 of 2023. Each report must include the following
111.30information:
111.31(1) for each ambulance service staffing basic life support or advanced life support
111.32ambulances according to subdivision 3, the primary service area served by the ambulance
111.33service, the number of ambulances staffed according to subdivision 3, and the time period
112.1the ambulance service has staffed and plans to staff the ambulances according to subdivision
112.23;
112.3(2) for each ambulance service that authorized the use of an expired emergency
112.4medication or medical supply according to subdivision 4, the expired emergency medications
112.5and medical supplies authorized for use and the time period the ambulance service used
112.6each expired emergency medication or medical supply; and
112.7(3) for each ambulance service that authorized the provision of emergency medical
112.8services according to subdivision 5, the number of emergency medical technicians, advanced
112.9emergency medical technicians, and paramedics providing emergency medical services
112.10under an expired certification and the time period each emergency medical technician,
112.11advanced emergency medical technician, or paramedic provided and will provide emergency
112.12medical services under an expired certification.
112.13    Subd. 7. Expiration. This section expires January 1, 2024.
112.14EFFECTIVE DATE.This section is effective the day following final enactment.

112.15    Sec. 24. EXPEDITED REREGISTRATION FOR LAPSED NURSING LICENSES.
112.16(a) Notwithstanding Minnesota Statutes, section 148.231, a nurse who desires to resume
112.17the practice of professional or practical nursing at a licensed nursing facility or licensed
112.18assisted living facility but whose license to practice nursing has lapsed effective on or after
112.19January 1, 2019, may submit an application to the Board of Nursing for reregistration. The
112.20application must be submitted and received by the board between March 31, 2022, and
112.21March 31, 2023, and must be accompanied with the reregistration fee specified in Minnesota
112.22Statutes, section 148.243, subdivision 5. The applicant must include with the application
112.23the name and location of the facility where the nurse is or will be employed.
112.24(b) The board shall issue a current registration if upon a licensure history review, the
112.25board determines that at the time the nurse's license lapsed:
112.26(1) the nurse's license was in good standing; and
112.27(2) the nurse was not the subject of any pending investigations or disciplinary actions
112.28or was not disqualified to practice in any way.
112.29The board shall waive any other requirements for reregistration including any continuing
112.30education requirements.
112.31(c) The registration issued under this section shall remain valid until the nurse's next
112.32registration period. If the nurse desires to continue to practice after that date, the nurse must
113.1meet the reregistration requirements under Minnesota Statutes, section 148.231, including
113.2any penalty fees required.
113.3EFFECTIVE DATE.This section is effective the day following final enactment.

113.4    Sec. 25. APPROPRIATION; BOARD OF DENTISTRY.
113.5$3,000 in fiscal year 2023 is appropriated from the state government special revenue
113.6fund to the Board of Dentistry to process new credential applications and to administer
113.7administrative fines. This is a onetime appropriation.

113.8    Sec. 26. REPEALER.
113.9Minnesota Statutes 2020, section 150A.091, subdivisions 3, 15, and 17, are repealed.

113.10ARTICLE 4

113.11COMMUNITY SUPPORTS AND BEHAVIORAL HEALTH POLICY

113.12    Section 1. Minnesota Statutes 2021 Supplement, section 62A.673, subdivision 2, is
113.13amended to read:
113.14    Subd. 2. Definitions. (a) For purposes of this section, the terms defined in this subdivision
113.15have the meanings given.
113.16(b) "Distant site" means a site at which a health care provider is located while providing
113.17health care services or consultations by means of telehealth.
113.18(c) "Health care provider" means a health care professional who is licensed or registered
113.19by the state to perform health care services within the provider's scope of practice and in
113.20accordance with state law. A health care provider includes a mental health professional as
113.21~~defined~~ under section ~~245.462, subdivision 18, or~~ ~~245.4871, subdivision 27~~ 245I.04,
113.22subdivision 2; a mental health practitioner ~~as defined~~ under section ~~245.462, subdivision~~
113.2317~~, or~~ ~~245.4871, subdivision 26~~ 245I.04, subdivision 4; a clinical trainee under section
113.24245I.04, subdivision 6; a treatment coordinator under section 245G.11, subdivision 7; an
113.25alcohol and drug counselor under section 245G.11, subdivision 5; and a recovery peer under
113.26section 245G.11, subdivision 8.
113.27(d) "Health carrier" has the meaning given in section 62A.011, subdivision 2.
113.28(e) "Health plan" has the meaning given in section 62A.011, subdivision 3. Health plan
113.29includes dental plans as defined in section 62Q.76, subdivision 3, but does not include dental
114.1plans that provide indemnity-based benefits, regardless of expenses incurred, and are designed
114.2to pay benefits directly to the policy holder.
114.3(f) "Originating site" means a site at which a patient is located at the time health care
114.4services are provided to the patient by means of telehealth. For purposes of store-and-forward
114.5technology, the originating site also means the location at which a health care provider
114.6transfers or transmits information to the distant site.
114.7(g) "Store-and-forward technology" means the asynchronous electronic transfer or
114.8transmission of a patient's medical information or data from an originating site to a distant
114.9site for the purposes of diagnostic and therapeutic assistance in the care of a patient.
114.10(h) "Telehealth" means the delivery of health care services or consultations through the
114.11use of real time two-way interactive audio and visual communications to provide or support
114.12health care delivery and facilitate the assessment, diagnosis, consultation, treatment,
114.13education, and care management of a patient's health care. Telehealth includes the application
114.14of secure video conferencing, store-and-forward technology, and synchronous interactions
114.15between a patient located at an originating site and a health care provider located at a distant
114.16site. Until July 1, 2023, telehealth also includes audio-only communication between a health
114.17care provider and a patient in accordance with subdivision 6, paragraph (b). Telehealth does
114.18not include communication between health care providers that consists solely of a telephone
114.19conversation, e-mail, or facsimile transmission. Telehealth does not include communication
114.20between a health care provider and a patient that consists solely of an e-mail or facsimile
114.21transmission. Telehealth does not include telemonitoring services as defined in paragraph
114.22(i).
114.23(i) "Telemonitoring services" means the remote monitoring of clinical data related to
114.24the enrollee's vital signs or biometric data by a monitoring device or equipment that transmits
114.25the data electronically to a health care provider for analysis. Telemonitoring is intended to
114.26collect an enrollee's health-related data for the purpose of assisting a health care provider
114.27in assessing and monitoring the enrollee's medical condition or status.
114.28EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
114.29whichever is later. The commissioner of human services shall notify the revisor of statutes
114.30when federal approval is obtained.

115.1    Sec. 2. Minnesota Statutes 2021 Supplement, section 148F.11, subdivision 1, is amended
115.2to read:
115.3    Subdivision 1. Other professionals. (a) Nothing in this chapter prevents members of
115.4other professions or occupations from performing functions for which they are qualified or
115.5licensed. This exception includes, but is not limited to: licensed physicians; registered nurses;
115.6licensed practical nurses; licensed psychologists and licensed psychological practitioners;
115.7members of the clergy provided such services are provided within the scope of regular
115.8ministries; American Indian medicine men and women; licensed attorneys; probation officers;
115.9licensed marriage and family therapists; licensed social workers; social workers employed
115.10by city, county, or state agencies; licensed professional counselors; licensed professional
115.11clinical counselors; licensed school counselors; registered occupational therapists or
115.12occupational therapy assistants; Upper Midwest Indian Council on Addictive Disorders
115.13(UMICAD) certified counselors when providing services to Native American people; city,
115.14county, or state employees when providing assessments or case management under Minnesota
115.15Rules, chapter 9530; and ~~individuals defined in section~~ ~~256B.0623, subdivision 5, clauses~~
115.16~~(1) to (6),~~ staff persons providing co-occurring substance use disorder treatment in adult
115.17mental health rehabilitative programs certified or licensed by the Department of Human
115.18Services under section 245I.23, 256B.0622, or 256B.0623.
115.19(b) Nothing in this chapter prohibits technicians and resident managers in programs
115.20licensed by the Department of Human Services from discharging their duties as provided
115.21in Minnesota Rules, chapter 9530.
115.22(c) Any person who is exempt from licensure under this section must not use a title
115.23incorporating the words "alcohol and drug counselor" or "licensed alcohol and drug
115.24counselor" or otherwise hold himself or herself out to the public by any title or description
115.25stating or implying that he or she is engaged in the practice of alcohol and drug counseling,
115.26or that he or she is licensed to engage in the practice of alcohol and drug counseling, unless
115.27that person is also licensed as an alcohol and drug counselor. Persons engaged in the practice
115.28of alcohol and drug counseling are not exempt from the board's jurisdiction solely by the
115.29use of one of the titles in paragraph (a).
115.30EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
115.31whichever is later. The commissioner of human services shall notify the revisor of statutes
115.32when federal approval is obtained.

116.1    Sec. 3. Minnesota Statutes 2020, section 245.462, subdivision 4, is amended to read:
116.2    Subd. 4. Case management service provider. (a) "Case management service provider"
116.3means a case manager or case manager associate employed by the county or other entity
116.4authorized by the county board to provide case management services specified in section
116.5245.4711.
116.6(b) A case manager must:
116.7(1) be skilled in the process of identifying and assessing a wide range of client needs;
116.8(2) be knowledgeable about local community resources and how to use those resources
116.9for the benefit of the client;
116.10(3) be a mental health practitioner as defined in section 245I.04, subdivision 4, or have
116.11a bachelor's degree in one of the behavioral sciences or related fields including, but not
116.12limited to, social work, psychology, or nursing from an accredited college or university or.
116.13A case manager who is not a mental health practitioner and who does not have a bachelor's
116.14degree in one of the behavioral sciences or related fields must meet the requirements of
116.15paragraph (c); and
116.16(4) meet the supervision and continuing education requirements described in paragraphs
116.17(d), (e), and (f), as applicable.
116.18(c) Case managers without a bachelor's degree must meet one of the requirements in
116.19clauses (1) to (3):
116.20(1) have three or four years of experience as a case manager associate as defined in this
116.21section;
116.22(2) be a registered nurse without a bachelor's degree and have a combination of
116.23specialized training in psychiatry and work experience consisting of community interaction
116.24and involvement or community discharge planning in a mental health setting totaling three
116.25years; or
116.26(3) be a person who qualified as a case manager under the 1998 Department of Human
116.27Service waiver provision and meet the continuing education and mentoring requirements
116.28in this section.
116.29(d) A case manager with at least 2,000 hours of supervised experience in the delivery
116.30of services to adults with mental illness must receive regular ongoing supervision and clinical
116.31supervision totaling 38 hours per year of which at least one hour per month must be clinical
116.32supervision regarding individual service delivery with a case management supervisor. The
117.1remaining 26 hours of supervision may be provided by a case manager with two years of
117.2experience. Group supervision may not constitute more than one-half of the required
117.3supervision hours. Clinical supervision must be documented in the client record.
117.4(e) A case manager without 2,000 hours of supervised experience in the delivery of
117.5services to adults with mental illness must:
117.6(1) receive clinical supervision regarding individual service delivery from a mental
117.7health professional at least one hour per week until the requirement of 2,000 hours of
117.8experience is met; and
117.9(2) complete 40 hours of training approved by the commissioner in case management
117.10skills and the characteristics and needs of adults with serious and persistent mental illness.
117.11(f) A case manager who is not licensed, registered, or certified by a health-related
117.12licensing board must receive 30 hours of continuing education and training in mental illness
117.13and mental health services every two years.
117.14(g) A case manager associate (CMA) must:
117.15(1) work under the direction of a case manager or case management supervisor;
117.16(2) be at least 21 years of age;
117.17(3) have at least a high school diploma or its equivalent; and
117.18(4) meet one of the following criteria:
117.19(i) have an associate of arts degree in one of the behavioral sciences or human services;
117.20    (ii) be a certified peer specialist under section 256B.0615;
117.21(iii) be a registered nurse without a bachelor's degree;
117.22(iv) within the previous ten years, have three years of life experience with serious and
117.23persistent mental illness as defined in subdivision 20; or as a child had severe emotional
117.24disturbance as defined in section 245.4871, subdivision 6; or have three years life experience
117.25as a primary caregiver to an adult with serious and persistent mental illness within the
117.26previous ten years;
117.27(v) have 6,000 hours work experience as a nondegreed state hospital technician; or
117.28(vi) have at least 6,000 hours of supervised experience in the delivery of services to
117.29persons with mental illness.
117.30Individuals meeting one of the criteria in items (i) to (v) may qualify as a case manager
117.31after four years of supervised work experience as a case manager associate. Individuals
118.1meeting the criteria in item (vi) may qualify as a case manager after three years of supervised
118.2experience as a case manager associate.
118.3(h) A case management associate must meet the following supervision, mentoring, and
118.4continuing education requirements:
118.5(1) have 40 hours of preservice training described under paragraph (e), clause (2);
118.6(2) receive at least 40 hours of continuing education in mental illness and mental health
118.7services annually; and
118.8(3) receive at least five hours of mentoring per week from a case management mentor.
118.9A "case management mentor" means a qualified, practicing case manager or case management
118.10supervisor who teaches or advises and provides intensive training and clinical supervision
118.11to one or more case manager associates. Mentoring may occur while providing direct services
118.12to consumers in the office or in the field and may be provided to individuals or groups of
118.13case manager associates. At least two mentoring hours per week must be individual and
118.14face-to-face.
118.15(i) A case management supervisor must meet the criteria for mental health professionals,
118.16as specified in subdivision 18.
118.17(j) An immigrant who does not have the qualifications specified in this subdivision may
118.18provide case management services to adult immigrants with serious and persistent mental
118.19illness who are members of the same ethnic group as the case manager if the person:
118.20(1) is currently enrolled in and is actively pursuing credits toward the completion of a
118.21bachelor's degree in one of the behavioral sciences or a related field including, but not
118.22limited to, social work, psychology, or nursing from an accredited college or university;
118.23(2) completes 40 hours of training as specified in this subdivision; and
118.24(3) receives clinical supervision at least once a week until the requirements of this
118.25subdivision are met.

118.26    Sec. 4. Minnesota Statutes 2021 Supplement, section 245.467, subdivision 2, is amended
118.27to read:
118.28    Subd. 2. Diagnostic assessment. ~~Providers~~ A provider of services governed by this
118.29section must complete a diagnostic assessment of a client according to the standards of
118.30section 245I.10~~, subdivisions 4 to 6~~.
119.1EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
119.2whichever is later. The commissioner of human services shall notify the revisor of statutes
119.3when federal approval is obtained.

119.4    Sec. 5. Minnesota Statutes 2021 Supplement, section 245.467, subdivision 3, is amended
119.5to read:
119.6    Subd. 3. Individual treatment plans. ~~Providers~~ A provider of services governed by
119.7this section must complete an individual treatment plan for a client according to the standards
119.8of section 245I.10, subdivisions 7 and 8.
119.9EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
119.10whichever is later. The commissioner of human services shall notify the revisor of statutes
119.11when federal approval is obtained.

119.12    Sec. 6. Minnesota Statutes 2021 Supplement, section 245.4871, subdivision 21, is amended
119.13to read:
119.14    Subd. 21. Individual treatment plan. (a) "Individual treatment plan" means the
119.15formulation of planned services that are responsive to the needs and goals of a client. An
119.16individual treatment plan must be completed according to section 245I.10, subdivisions 7
119.17and 8.
119.18(b) A children's residential facility licensed under Minnesota Rules, chapter 2960, is
119.19exempt from the requirements of section 245I.10, subdivisions 7 and 8. Instead, the individual
119.20treatment plan must:
119.21(1) include a written plan of intervention, treatment, and services for a child with an
119.22emotional disturbance that the service provider develops under the clinical supervision of
119.23a mental health professional on the basis of a diagnostic assessment;
119.24(2) be developed in conjunction with the family unless clinically inappropriate; and
119.25(3) identify goals and objectives of treatment, treatment strategy, a schedule for
119.26accomplishing treatment goals and objectives, and the individuals responsible for providing
119.27treatment to the child with an emotional disturbance.
119.28EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
119.29whichever is later. The commissioner of human services shall notify the revisor of statutes
119.30when federal approval is obtained.

120.1    Sec. 7. Minnesota Statutes 2021 Supplement, section 245.4876, subdivision 2, is amended
120.2to read:
120.3    Subd. 2. Diagnostic assessment. ~~Providers~~ A provider of services governed by this
120.4section ~~shall~~ must complete a diagnostic assessment of a client according to the standards
120.5of section 245I.10~~, subdivisions 4 to 6~~. Notwithstanding the required timelines for completing
120.6a diagnostic assessment in section 245I.10, a children's residential facility licensed under
120.7Minnesota Rules, chapter 2960, that provides mental health services to children must, within
120.8ten days of the client's admission: (1) complete the client's diagnostic assessment; or (2)
120.9review and update the client's diagnostic assessment with a summary of the child's current
120.10mental health status and service needs if a diagnostic assessment is available that was
120.11completed within 180 days preceding admission and the client's mental health status has
120.12not changed markedly since the diagnostic assessment.
120.13EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
120.14whichever is later. The commissioner of human services shall notify the revisor of statutes
120.15when federal approval is obtained.

120.16    Sec. 8. Minnesota Statutes 2021 Supplement, section 245.4876, subdivision 3, is amended
120.17to read:
120.18    Subd. 3. Individual treatment plans. ~~Providers~~ A provider of services governed by
120.19this section ~~shall~~ must complete an individual treatment plan for a client according to the
120.20standards of section 245I.10, subdivisions 7 and 8. A children's residential facility licensed
120.21according to Minnesota Rules, chapter 2960, is exempt from the requirements in section
120.22245I.10, subdivisions 7 and 8. Instead, the facility must involve the child and the child's
120.23family in all phases of developing and implementing the individual treatment plan to the
120.24extent appropriate and must review the individual treatment plan every 90 days after intake.
120.25EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
120.26whichever is later. The commissioner of human services shall notify the revisor of statutes
120.27when federal approval is obtained.

120.28    Sec. 9. Minnesota Statutes 2021 Supplement, section 245.735, subdivision 3, is amended
120.29to read:
120.30    Subd. 3. Certified community behavioral health clinics. (a) The commissioner shall
120.31establish a state certification process for certified community behavioral health clinics
120.32(CCBHCs) that satisfy all federal requirements necessary for CCBHCs certified under this
120.33section to be eligible for reimbursement under medical assistance, without service area
121.1limits based on geographic area or region. The commissioner shall consult with CCBHC
121.2stakeholders before establishing and implementing changes in the certification process and
121.3requirements. Entities that choose to be CCBHCs must:
121.4(1) comply with state licensing requirements and other requirements issued by the
121.5commissioner;
121.6(2) employ or contract for clinic staff who have backgrounds in diverse disciplines,
121.7including licensed mental health professionals and licensed alcohol and drug counselors,
121.8and staff who are culturally and linguistically trained to meet the needs of the population
121.9the clinic serves;
121.10(3) ensure that clinic services are available and accessible to individuals and families of
121.11all ages and genders and that crisis management services are available 24 hours per day;
121.12(4) establish fees for clinic services for individuals who are not enrolled in medical
121.13assistance using a sliding fee scale that ensures that services to patients are not denied or
121.14limited due to an individual's inability to pay for services;
121.15(5) comply with quality assurance reporting requirements and other reporting
121.16requirements, including any required reporting of encounter data, clinical outcomes data,
121.17and quality data;
121.18(6) provide crisis mental health and substance use services, withdrawal management
121.19services, emergency crisis intervention services, and stabilization services through existing
121.20mobile crisis services; screening, assessment, and diagnosis services, including risk
121.21assessments and level of care determinations; person- and family-centered treatment planning;
121.22outpatient mental health and substance use services; targeted case management; psychiatric
121.23rehabilitation services; peer support and counselor services and family support services;
121.24and intensive community-based mental health services, including mental health services
121.25for members of the armed forces and veterans. CCBHCs must directly provide the majority
121.26of these services to enrollees, but may coordinate some services with another entity through
121.27a collaboration or agreement, pursuant to paragraph (b);
121.28(7) provide coordination of care across settings and providers to ensure seamless
121.29transitions for individuals being served across the full spectrum of health services, including
121.30acute, chronic, and behavioral needs. Care coordination may be accomplished through
121.31partnerships or formal contracts with:
122.1(i) counties, health plans, pharmacists, pharmacies, rural health clinics, federally qualified
122.2health centers, inpatient psychiatric facilities, substance use and detoxification facilities, or
122.3community-based mental health providers; and
122.4(ii) other community services, supports, and providers, including schools, child welfare
122.5agencies, juvenile and criminal justice agencies, Indian health services clinics, tribally
122.6licensed health care and mental health facilities, urban Indian health clinics, Department of
122.7Veterans Affairs medical centers, outpatient clinics, drop-in centers, acute care hospitals,
122.8and hospital outpatient clinics;
122.9(8) be certified as a mental health ~~clinics~~ clinic under section ~~245.69, subdivision 2~~
122.10245I.20;
122.11(9) comply with standards established by the commissioner relating to CCBHC
122.12screenings, assessments, and evaluations;
122.13(10) be licensed to provide substance use disorder treatment under chapter 245G;
122.14(11) be certified to provide children's therapeutic services and supports under section
122.15256B.0943;
122.16(12) be certified to provide adult rehabilitative mental health services under section
122.17256B.0623;
122.18(13) be enrolled to provide mental health crisis response services under ~~sections~~ section
122.19256B.0624 ~~and 256B.0944~~;
122.20(14) be enrolled to provide mental health targeted case management under section
122.21256B.0625, subdivision 20;
122.22(15) comply with standards relating to mental health case management in Minnesota
122.23Rules, parts 9520.0900 to 9520.0926;
122.24(16) provide services that comply with the evidence-based practices described in
122.25paragraph (e); and
122.26(17) comply with standards relating to peer services under sections 256B.0615,
122.27256B.0616, and 245G.07, ~~subdivision 1, paragraph (a), clause (5)~~ subdivision 2, clause (8),
122.28as applicable when peer services are provided.
122.29(b) If a certified CCBHC is unable to provide one or more of the services listed in
122.30paragraph (a), clauses (6) to (17), the CCBHC may contract with another entity that has the
122.31required authority to provide that service and that meets the following criteria as a designated
122.32collaborating organization:
123.1(1) the entity has a formal agreement with the CCBHC to furnish one or more of the
123.2services under paragraph (a), clause (6);
123.3(2) the entity provides assurances that it will provide services according to CCBHC
123.4service standards and provider requirements;
123.5(3) the entity agrees that the CCBHC is responsible for coordinating care and has clinical
123.6and financial responsibility for the services that the entity provides under the agreement;
123.7and
123.8(4) the entity meets any additional requirements issued by the commissioner.
123.9(c) Notwithstanding any other law that requires a county contract or other form of county
123.10approval for certain services listed in paragraph (a), clause (6), a clinic that otherwise meets
123.11CCBHC requirements may receive the prospective payment under section 256B.0625,
123.12subdivision 5m, for those services without a county contract or county approval. As part of
123.13the certification process in paragraph (a), the commissioner shall require a letter of support
123.14from the CCBHC's host county confirming that the CCBHC and the county or counties it
123.15serves have an ongoing relationship to facilitate access and continuity of care, especially
123.16for individuals who are uninsured or who may go on and off medical assistance.
123.17(d) When the standards listed in paragraph (a) or other applicable standards conflict or
123.18address similar issues in duplicative or incompatible ways, the commissioner may grant
123.19variances to state requirements if the variances do not conflict with federal requirements
123.20for services reimbursed under medical assistance. If standards overlap, the commissioner
123.21may substitute all or a part of a licensure or certification that is substantially the same as
123.22another licensure or certification. The commissioner shall consult with stakeholders, as
123.23described in subdivision 4, before granting variances under this provision. For the CCBHC
123.24that is certified but not approved for prospective payment under section 256B.0625,
123.25subdivision 5m, the commissioner may grant a variance under this paragraph if the variance
123.26does not increase the state share of costs.
123.27(e) The commissioner shall issue a list of required evidence-based practices to be
123.28delivered by CCBHCs, and may also provide a list of recommended evidence-based practices.
123.29The commissioner may update the list to reflect advances in outcomes research and medical
123.30services for persons living with mental illnesses or substance use disorders. The commissioner
123.31shall take into consideration the adequacy of evidence to support the efficacy of the practice,
123.32the quality of workforce available, and the current availability of the practice in the state.
123.33At least 30 days before issuing the initial list and any revisions, the commissioner shall
123.34provide stakeholders with an opportunity to comment.
124.1(f) The commissioner shall recertify CCBHCs at least every three years. The
124.2commissioner shall establish a process for decertification and shall require corrective action,
124.3medical assistance repayment, or decertification of a CCBHC that no longer meets the
124.4requirements in this section or that fails to meet the standards provided by the commissioner
124.5in the application and certification process.
124.6EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
124.7whichever is later. The commissioner of human services shall notify the revisor of statutes
124.8when federal approval is obtained.

124.9    Sec. 10. Minnesota Statutes 2021 Supplement, section 245A.03, subdivision 7, is amended
124.10to read:
124.11    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an initial license
124.12for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult
124.13foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter
124.14for a physical location that will not be the primary residence of the license holder for the
124.15entire period of licensure. If a family child foster care home or family adult foster care home
124.16license is issued during this moratorium, and the license holder changes the license holder's
124.17primary residence away from the physical location of the foster care license, the
124.18commissioner shall revoke the license according to section 245A.07. The commissioner
124.19shall not issue an initial license for a community residential setting licensed under chapter
124.20245D. When approving an exception under this paragraph, the commissioner shall consider
124.21the resource need determination process in paragraph (h), the availability of foster care
124.22licensed beds in the geographic area in which the licensee seeks to operate, the results of a
124.23person's choices during their annual assessment and service plan review, and the
124.24recommendation of the local county board. The determination by the commissioner is final
124.25and not subject to appeal. Exceptions to the moratorium include:
124.26(1) foster care settings where at least 80 percent of the residents are 55 years of age or
124.27older;
124.28(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
124.29community residential setting licenses replacing adult foster care licenses in existence on
124.30December 31, 2013, and determined to be needed by the commissioner under paragraph
124.31(b);
124.32(3) new foster care licenses or community residential setting licenses determined to be
124.33needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD,
124.34or regional treatment center; restructuring of state-operated services that limits the capacity
125.1of state-operated facilities; or allowing movement to the community for people who no
125.2longer require the level of care provided in state-operated facilities as provided under section
125.3256B.092, subdivision 13, or 256B.49, subdivision 24;
125.4(4) new foster care licenses or community residential setting licenses determined to be
125.5needed by the commissioner under paragraph (b) for persons requiring hospital level care;
125.6or
125.7~~(5) new foster care licenses or community residential setting licenses for people receiving~~
125.8~~services under chapter~~ ~~245D~~ ~~and residing in an unlicensed setting before May 1, 2017, and~~
125.9~~for which a license is required. This exception does not apply to people living in their own~~
125.10~~home. For purposes of this clause, there is a presumption that a foster care or community~~
125.11~~residential setting license is required for services provided to three or more people in a~~
125.12~~dwelling unit when the setting is controlled by the provider. A license holder subject to this~~
125.13~~exception may rebut the presumption that a license is required by seeking a reconsideration~~
125.14~~of the commissioner's determination. The commissioner's disposition of a request for~~
125.15~~reconsideration is final and not subject to appeal under chapter~~ 14~~. The exception is available~~
125.16~~until June 30, 2018. This exception is available when:~~
125.17~~(i) the person's case manager provided the person with information about the choice of~~
125.18~~service, service provider, and location of service, including in the person's home, to help~~
125.19~~the person make an informed choice; and~~
125.20~~(ii) the person's services provided in the licensed foster care or community residential~~
125.21~~setting are less than or equal to the cost of the person's services delivered in the unlicensed~~
125.22~~setting as determined by the lead agency; or~~
125.23~~(6)~~ (5) new foster care licenses or community residential setting licenses for people
125.24receiving customized living or 24-hour customized living services under the brain injury
125.25or community access for disability inclusion waiver plans under section 256B.49 and residing
125.26in the customized living setting before July 1, 2022, for which a license is required. A
125.27customized living service provider subject to this exception may rebut the presumption that
125.28a license is required by seeking a reconsideration of the commissioner's determination. The
125.29commissioner's disposition of a request for reconsideration is final and not subject to appeal
125.30under chapter 14. The exception is available until June 30, 2023. This exception is available
125.31when:
125.32(i) the person's customized living services are provided in a customized living service
125.33setting serving four or fewer people under the brain injury or community access for disability
126.1inclusion waiver plans under section 256B.49 in a single-family home operational on or
126.2before June 30, 2021. Operational is defined in section 256B.49, subdivision 28;
126.3(ii) the person's case manager provided the person with information about the choice of
126.4service, service provider, and location of service, including in the person's home, to help
126.5the person make an informed choice; and
126.6(iii) the person's services provided in the licensed foster care or community residential
126.7setting are less than or equal to the cost of the person's services delivered in the customized
126.8living setting as determined by the lead agency.
126.9(b) The commissioner shall determine the need for newly licensed foster care homes or
126.10community residential settings as defined under this subdivision. As part of the determination,
126.11the commissioner shall consider the availability of foster care capacity in the area in which
126.12the licensee seeks to operate, and the recommendation of the local county board. The
126.13determination by the commissioner must be final. A determination of need is not required
126.14for a change in ownership at the same address.
126.15(c) When an adult resident served by the program moves out of a foster home that is not
126.16the primary residence of the license holder according to section 256B.49, subdivision 15,
126.17paragraph (f), or the adult community residential setting, the county shall immediately
126.18inform the Department of Human Services Licensing Division. The department may decrease
126.19the statewide licensed capacity for adult foster care settings.
126.20(d) Residential settings that would otherwise be subject to the decreased license capacity
126.21established in paragraph (c) shall be exempt if the license holder's beds are occupied by
126.22residents whose primary diagnosis is mental illness and the license holder is certified under
126.23the requirements in subdivision 6a or section 245D.33.
126.24(e) A resource need determination process, managed at the state level, using the available
126.25reports required by section 144A.351, and other data and information shall be used to
126.26determine where the reduced capacity determined under section 256B.493 will be
126.27implemented. The commissioner shall consult with the stakeholders described in section
126.28144A.351, and employ a variety of methods to improve the state's capacity to meet the
126.29informed decisions of those people who want to move out of corporate foster care or
126.30community residential settings, long-term service needs within budgetary limits, including
126.31seeking proposals from service providers or lead agencies to change service type, capacity,
126.32or location to improve services, increase the independence of residents, and better meet
126.33needs identified by the long-term services and supports reports and statewide data and
126.34information.
127.1(f) At the time of application and reapplication for licensure, the applicant and the license
127.2holder that are subject to the moratorium or an exclusion established in paragraph (a) are
127.3required to inform the commissioner whether the physical location where the foster care
127.4will be provided is or will be the primary residence of the license holder for the entire period
127.5of licensure. If the primary residence of the applicant or license holder changes, the applicant
127.6or license holder must notify the commissioner immediately. The commissioner shall print
127.7on the foster care license certificate whether or not the physical location is the primary
127.8residence of the license holder.
127.9(g) License holders of foster care homes identified under paragraph (f) that are not the
127.10primary residence of the license holder and that also provide services in the foster care home
127.11that are covered by a federally approved home and community-based services waiver, as
127.12authorized under chapter 256S or section 256B.092 or 256B.49, must inform the human
127.13services licensing division that the license holder provides or intends to provide these
127.14waiver-funded services.
127.15(h) The commissioner may adjust capacity to address needs identified in section
127.16144A.351. Under this authority, the commissioner may approve new licensed settings or
127.17delicense existing settings. Delicensing of settings will be accomplished through a process
127.18identified in section 256B.493. Annually, by August 1, the commissioner shall provide
127.19information and data on capacity of licensed long-term services and supports, actions taken
127.20under the subdivision to manage statewide long-term services and supports resources, and
127.21any recommendations for change to the legislative committees with jurisdiction over the
127.22health and human services budget.
127.23(i) The commissioner must notify a license holder when its corporate foster care or
127.24community residential setting licensed beds are reduced under this section. The notice of
127.25reduction of licensed beds must be in writing and delivered to the license holder by certified
127.26mail or personal service. The notice must state why the licensed beds are reduced and must
127.27inform the license holder of its right to request reconsideration by the commissioner. The
127.28license holder's request for reconsideration must be in writing. If mailed, the request for
127.29reconsideration must be postmarked and sent to the commissioner within 20 calendar days
127.30after the license holder's receipt of the notice of reduction of licensed beds. If a request for
127.31reconsideration is made by personal service, it must be received by the commissioner within
127.3220 calendar days after the license holder's receipt of the notice of reduction of licensed beds.
127.33(j) The commissioner shall not issue an initial license for children's residential treatment
127.34services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter
127.35for a program that Centers for Medicare and Medicaid Services would consider an institution
128.1for mental diseases. Facilities that serve only private pay clients are exempt from the
128.2moratorium described in this paragraph. The commissioner has the authority to manage
128.3existing statewide capacity for children's residential treatment services subject to the
128.4moratorium under this paragraph and may issue an initial license for such facilities if the
128.5initial license would not increase the statewide capacity for children's residential treatment
128.6services subject to the moratorium under this paragraph.
128.7EFFECTIVE DATE.This section is effective the day following final enactment.

128.8    Sec. 11. Minnesota Statutes 2020, section 245A.11, subdivision 2, is amended to read:
128.9    Subd. 2. Permitted single-family residential use. (a) Residential programs with a
128.10licensed capacity of six or fewer persons shall be considered a permitted single-family
128.11residential use of property for the purposes of zoning and other land use regulations, except
128.12that a residential program whose primary purpose is to treat juveniles who have violated
128.13criminal statutes relating to sex offenses or have been adjudicated delinquent on the basis
128.14of conduct in violation of criminal statutes relating to sex offenses shall not be considered
128.15a permitted use. This exception shall not apply to residential programs licensed before July
128.161, 1995. Programs otherwise allowed under this subdivision shall not be prohibited by
128.17operation of restrictive covenants or similar restrictions, regardless of when entered into,
128.18which cannot be met because of the nature of the licensed program, including provisions
128.19which require the home's occupants be related, and that the home must be occupied by the
128.20owner, or similar provisions.
128.21(b) Unless otherwise provided in any town, municipal, or county zoning regulation,
128.22licensed residential services provided to more than four persons with developmental
128.23disabilities in a supervised living facility, including intermediate care facilities for persons
128.24with developmental disabilities, with a licensed capacity of seven to eight persons shall be
128.25considered a permitted single-family residential use of property for the purposes of zoning
128.26and other land use regulations. A town, municipal, or county zoning authority may require
128.27a conditional use or special use permit to assure proper maintenance and operation of the
128.28residential program. Conditions imposed on the residential program must not be more
128.29restrictive than those imposed on other conditional uses or special uses of residential property
128.30in the same zones, unless the additional conditions are necessary to protect the health and
128.31safety of the persons being served by the program. This paragraph expires July 1, 2023.
128.32EFFECTIVE DATE.This section is effective July 1, 2022.

129.1    Sec. 12. Minnesota Statutes 2020, section 245A.11, subdivision 2a, is amended to read:
129.2    Subd. 2a. Adult foster care and community residential setting license capacity. (a)
129.3The commissioner shall issue adult foster care and community residential setting licenses
129.4with a maximum licensed capacity of four beds, including nonstaff roomers and boarders,
129.5except that the commissioner may issue a license with a capacity of five beds, including
129.6roomers and boarders, according to paragraphs (b) to (g).
129.7(b) The license holder may have a maximum license capacity of five if all persons in
129.8care are age 55 or over and do not have a serious and persistent mental illness or a
129.9developmental disability.
129.10(c) The commissioner may grant variances to paragraph (b) to allow a facility with a
129.11licensed capacity of up to five persons to admit an individual under the age of 55 if the
129.12variance complies with section 245A.04, subdivision 9, and approval of the variance is
129.13recommended by the county in which the licensed facility is located.
129.14(d) The commissioner may grant variances to paragraph (a) to allow the use of an
129.15additional bed, up to ~~five~~ six, for emergency crisis services for a person with serious and
129.16persistent mental illness or a developmental disability, regardless of age, if the variance
129.17complies with section 245A.04, subdivision 9, and approval of the variance is recommended
129.18by the county in which the licensed facility is located.
129.19(e) The commissioner may grant a variance to paragraph (b) to allow for the use of an
129.20additional bed, up to ~~five~~ six, for respite services, as defined in section 245A.02, for persons
129.21with disabilities, regardless of age, if the variance complies with sections 245A.03,
129.22subdivision 7, and 245A.04, subdivision 9, and approval of the variance is recommended
129.23by the county in which the licensed facility is located. Respite care may be provided under
129.24the following conditions:
129.25(1) staffing ratios cannot be reduced below the approved level for the individuals being
129.26served in the home on a permanent basis;
129.27(2) no more than two different individuals can be accepted for respite services in any
129.28calendar month and the total respite days may not exceed 120 days per program in any
129.29calendar year;
129.30(3) the person receiving respite services must have his or her own bedroom, which could
129.31be used for alternative purposes when not used as a respite bedroom, and cannot be the
129.32room of another person who lives in the facility; and
130.1(4) individuals living in the facility must be notified when the variance is approved. The
130.2provider must give 60 days' notice in writing to the residents and their legal representatives
130.3prior to accepting the first respite placement. Notice must be given to residents at least two
130.4days prior to service initiation, or as soon as the license holder is able if they receive notice
130.5of the need for respite less than two days prior to initiation, each time a respite client will
130.6be served, unless the requirement for this notice is waived by the resident or legal guardian.
130.7(f) The commissioner may issue an adult foster care or community residential setting
130.8license with a capacity of five adults if the fifth bed does not increase the overall statewide
130.9capacity of licensed adult foster care or community residential setting beds in homes that
130.10are not the primary residence of the license holder, as identified in a plan submitted to the
130.11commissioner by the county, when the capacity is recommended by the county licensing
130.12agency of the county in which the facility is located and if the recommendation verifies
130.13that:
130.14(1) the facility meets the physical environment requirements in the adult foster care
130.15licensing rule;
130.16(2) the five-bed living arrangement is specified for each resident in the resident's:
130.17(i) individualized plan of care;
130.18(ii) individual service plan under section 256B.092, subdivision 1b, if required; or
130.19(iii) individual resident placement agreement under Minnesota Rules, part 9555.5105,
130.20subpart 19, if required;
130.21(3) the license holder obtains written and signed informed consent from each resident
130.22or resident's legal representative documenting the resident's informed choice to remain
130.23living in the home and that the resident's refusal to consent would not have resulted in
130.24service termination; and
130.25(4) the facility was licensed for adult foster care before March 1, 2016.
130.26(g) The commissioner shall not issue a new adult foster care license under paragraph (f)
130.27after December 31, 2020. The commissioner shall allow a facility with an adult foster care
130.28license issued under paragraph (f) before December 31, 2020, to continue with a capacity
130.29of five adults if the license holder continues to comply with the requirements in paragraph
130.30(f).
130.31(h) Notwithstanding Minnesota Rules, part 9520.0500, adult foster care and community
130.32residential setting licenses with a capacity of up to six adults as allowed under this subdivision
131.1are not required to be licensed as an adult mental health residential program according to
131.2Minnesota Rules, parts 9520.0500 to 9520.0670.
131.3EFFECTIVE DATE.This section is effective upon federal approval. The amendments
131.4to paragraphs (d) and (e) expire 365 calendar days after federal approval is obtained and
131.5the language of Minnesota Statutes 2020, section 245A.11, subdivision 2a, paragraphs (d)
131.6and (e), is revived and reenacted as of that date. The commissioner of human services shall
131.7notify the revisor of statutes when federal approval is obtained.

131.8    Sec. 13. Minnesota Statutes 2020, section 245A.11, is amended by adding a subdivision
131.9to read:
131.10    Subd. 2c. Residential programs in intermediate care facilities; license
131.11capacity. Notwithstanding subdivision 4 and section 252.28, subdivision 3, for licensed
131.12residential services provided to more than four persons with developmental disabilities in
131.13a supervised living facility, including intermediate care facilities for persons with
131.14developmental disabilities, located in a single-family home and in a town, municipal, or
131.15county zoning authority that will permit a licensed capacity of seven or eight persons in a
131.16single-family home, the commissioner may increase the licensed capacity of the program
131.17to seven or eight if the seventh or eighth bed does not increase the overall statewide capacity
131.18in intermediate care facilities for persons with developmental disabilities. If the licensed
131.19capacity of these facilities is increased under this subdivision, the capacity of the license
131.20may remain at the increased number of persons. This subdivision expires July 1, 2023.
131.21EFFECTIVE DATE.This section is effective July 1, 2022.

131.22    Sec. 14. Minnesota Statutes 2020, section 245D.12, is amended to read:
131.23245D.12 INTEGRATED COMMUNITY SUPPORTS; SETTING CAPACITY
131.24REPORT.
131.25(a) The license holder providing integrated community support, as defined in section
131.26245D.03, subdivision 1, paragraph (c), clause (8), must submit a setting capacity report to
131.27the commissioner to ensure the identified location of service delivery meets the criteria of
131.28the home and community-based service requirements as specified in section 256B.492.
131.29(b) The license holder shall provide the setting capacity report on the forms and in the
131.30manner prescribed by the commissioner. The report must include:
132.1(1) the address of the multifamily housing building where the license holder delivers
132.2integrated community supports and owns, leases, or has a direct or indirect financial
132.3relationship with the property owner;
132.4(2) the total number of living units in the multifamily housing building described in
132.5clause (1) where integrated community supports are delivered;
132.6(3) the total number of living units in the multifamily housing building described in
132.7clause (1), including the living units identified in clause (2); ~~and~~
132.8(4) the total number of people who could reside in the living units in the multifamily
132.9housing building described in clause (2) and receive integrated community supports; and
132.10~~(4)~~ (5) the percentage of living units that are controlled by the license holder in the
132.11multifamily housing building by dividing clause (2) by clause (3).
132.12(c) Only one license holder may deliver integrated community supports at the address
132.13of the multifamily housing building.
132.14EFFECTIVE DATE.This section is effective the day following final enactment.

132.15    Sec. 15. Minnesota Statutes 2020, section 245G.01, is amended by adding a subdivision
132.16to read:
132.17    Subd. 13b. Guest speaker. "Guest speaker" means an individual who is not an alcohol
132.18and drug counselor qualified according to section 245G.11, subdivision 5; is not qualified
132.19according to the commissioner's list of professionals under section 245G.07, subdivision
132.203; and who works under the direct observation of an alcohol and drug counselor to present
132.21to clients on topics in which the guest speaker has expertise and that the license holder has
132.22determined to be beneficial to a client's recovery. Tribally licensed programs have autonomy
132.23to identify the qualifications of their guest speakers.

132.24    Sec. 16. Minnesota Statutes 2020, section 245G.07, is amended by adding a subdivision
132.25to read:
132.26    Subd. 3a. Use of guest speakers. (a) The license holder may allow a guest speaker to
132.27present information to clients as part of a treatment service provided by an alcohol and drug
132.28counselor, according to the requirements of this subdivision.
132.29(b) An alcohol and drug counselor must visually observe and listen to the presentation
132.30of information by a guest speaker the entire time the guest speaker presents information to
133.1the clients. The alcohol and drug counselor is responsible for all information the guest
133.2speaker presents to the clients.
133.3(c) The presentation of information by a guest speaker constitutes a direct contact service,
133.4as defined in section 245C.02, subdivision 11.
133.5(d) The license holder must provide the guest speaker with all training required for staff
133.6members. If the guest speaker provides direct contact services one day a month or less, the
133.7license holder must only provide the guest speaker with orientation training on the following
133.8subjects before the guest speaker provides direct contact services:
133.9(1) mandatory reporting of maltreatment, as specified in sections 245A.65, 626.557, and
133.10626.5572 and chapter 260E;
133.11(2) applicable client confidentiality rules and regulations;
133.12(3) ethical standards for client interactions; and
133.13(4) emergency procedures.

133.14    Sec. 17. Minnesota Statutes 2020, section 245G.12, is amended to read:
133.15245G.12 PROVIDER POLICIES AND PROCEDURES.
133.16A license holder must develop a written policies and procedures manual, indexed
133.17according to section 245A.04, subdivision 14, paragraph (c), that provides staff members
133.18immediate access to all policies and procedures and provides a client and other authorized
133.19parties access to all policies and procedures. The manual must contain the following
133.20materials:
133.21(1) assessment and treatment planning policies, including screening for mental health
133.22concerns and treatment objectives related to the client's identified mental health concerns
133.23in the client's treatment plan;
133.24(2) policies and procedures regarding HIV according to section 245A.19;
133.25(3) the license holder's methods and resources to provide information on tuberculosis
133.26and tuberculosis screening to each client and to report a known tuberculosis infection
133.27according to section 144.4804;
133.28(4) personnel policies according to section 245G.13;
133.29(5) policies and procedures that protect a client's rights according to section 245G.15;
133.30(6) a medical services plan according to section 245G.08;
134.1(7) emergency procedures according to section 245G.16;
134.2(8) policies and procedures for maintaining client records according to section 245G.09;
134.3(9) procedures for reporting the maltreatment of minors according to chapter 260E, and
134.4vulnerable adults according to sections 245A.65, 626.557, and 626.5572;
134.5(10) a description of treatment services that: (i) includes the amount and type of services
134.6provided; (ii) identifies which services meet the definition of group counseling under section
134.7245G.01, subdivision 13a; ~~and~~ (iii) identifies which groups and topics on which a guest
134.8speaker could provide services under the direct observation of an alcohol and drug counselor;
134.9and (iv) defines the program's treatment week;
134.10(11) the methods used to achieve desired client outcomes;
134.11(12) the hours of operation; and
134.12(13) the target population served.

134.13    Sec. 18. Minnesota Statutes 2021 Supplement, section 245I.02, subdivision 19, is amended
134.14to read:
134.15    Subd. 19. Level of care assessment. "Level of care assessment" means the level of care
134.16decision support tool appropriate to the client's age. For a client five years of age or younger,
134.17a level of care assessment is the Early Childhood Service Intensity Instrument (ESCII). For
134.18a client six to 17 years of age, a level of care assessment is the Child and Adolescent Service
134.19Intensity Instrument (CASII). For a client 18 years of age or older, a level of care assessment
134.20is the Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS)
134.21or another tool authorized by the commissioner.

134.22    Sec. 19. Minnesota Statutes 2021 Supplement, section 245I.02, subdivision 36, is amended
134.23to read:
134.24    Subd. 36. Staff person. "Staff person" means an individual who works under a license
134.25holder's direction or under a contract with a license holder. Staff person includes an intern,
134.26consultant, contractor, individual who works part-time, and an individual who does not
134.27provide direct contact services to clients but does have physical access to clients. Staff
134.28person includes a volunteer who provides treatment services to a client or a volunteer whom
134.29the license holder regards as a staff person for the purpose of meeting staffing or service
134.30delivery requirements. A staff person must be 18 years of age or older.
135.1EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
135.2whichever is later. The commissioner of human services shall notify the revisor of statutes
135.3when federal approval is obtained.

135.4    Sec. 20. Minnesota Statutes 2021 Supplement, section 245I.03, subdivision 5, is amended
135.5to read:
135.6    Subd. 5. Health services and medications. If a license holder is licensed as a residential
135.7program, stores or administers client medications, or observes clients self-administer
135.8medications, the license holder must ensure that a staff person who is a registered nurse or
135.9licensed prescriber reviews and approves of the license holder's policies and procedures to
135.10comply with the health services and medications requirements in section 245I.11, the training
135.11requirements in section 245I.05, subdivision 6 5, and the documentation requirements in
135.12section 245I.08, subdivision 5.
135.13EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
135.14whichever is later. The commissioner of human services shall notify the revisor of statutes
135.15when federal approval is obtained.

135.16    Sec. 21. Minnesota Statutes 2021 Supplement, section 245I.03, subdivision 9, is amended
135.17to read:
135.18    Subd. 9. Volunteers. A If a license holder uses volunteers, the license holder must have
135.19policies and procedures for using volunteers, including when a the license holder must
135.20submit a background study for a volunteer, and the specific tasks that a volunteer may
135.21perform.
135.22EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
135.23whichever is later. The commissioner of human services shall notify the revisor of statutes
135.24when federal approval is obtained.

135.25    Sec. 22. Minnesota Statutes 2021 Supplement, section 245I.04, subdivision 4, is amended
135.26to read:
135.27    Subd. 4. Mental health practitioner qualifications. (a) An individual who is qualified
135.28in at least one of the ways described in paragraph (b) to (d) may serve as a mental health
135.29practitioner.
135.30(b) An individual is qualified as a mental health practitioner through relevant coursework
135.31if the individual completes at least 30 semester hours or 45 quarter hours in behavioral
135.32sciences or related fields and:
136.1(1) has at least 2,000 hours of experience providing services to individuals with:
136.2(i) a mental illness or a substance use disorder; or
136.3(ii) a traumatic brain injury or a developmental disability, and completes the additional
136.4training described in section 245I.05, subdivision 3, paragraph (c), before providing direct
136.5contact services to a client;
136.6(2) is fluent in the non-English language of the ethnic group to which at least 50 percent
136.7of the individual's clients belong, and completes the additional training described in section
136.8245I.05, subdivision 3, paragraph (c), before providing direct contact services to a client;
136.9(3) is working in a day treatment program under section 256B.0671, subdivision 3, or
136.10256B.0943; or
136.11(4) has completed a practicum or internship that (i) required direct interaction with adult
136.12clients or child clients, and (ii) was focused on behavioral sciences or related fields.; or
136.13(5) is in the process of completing a practicum or internship as part of a formal
136.14undergraduate or graduate training program in social work, psychology, or counseling.
136.15(c) An individual is qualified as a mental health practitioner through work experience
136.16if the individual:
136.17(1) has at least 4,000 hours of experience in the delivery of services to individuals with:
136.18(i) a mental illness or a substance use disorder; or
136.19(ii) a traumatic brain injury or a developmental disability, and completes the additional
136.20training described in section 245I.05, subdivision 3, paragraph (c), before providing direct
136.21contact services to clients; or
136.22(2) receives treatment supervision at least once per week until meeting the requirement
136.23in clause (1) of 4,000 hours of experience and has at least 2,000 hours of experience providing
136.24services to individuals with:
136.25(i) a mental illness or a substance use disorder; or
136.26(ii) a traumatic brain injury or a developmental disability, and completes the additional
136.27training described in section 245I.05, subdivision 3, paragraph (c), before providing direct
136.28contact services to clients.
136.29(d) An individual is qualified as a mental health practitioner if the individual has a
136.30master's or other graduate degree in behavioral sciences or related fields.
137.1EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
137.2whichever is later. The commissioner of human services shall notify the revisor of statutes
137.3when federal approval is obtained.

137.4    Sec. 23. Minnesota Statutes 2021 Supplement, section 245I.05, subdivision 3, is amended
137.5to read:
137.6    Subd. 3. Initial training. (a) A staff person must receive training about:
137.7(1) vulnerable adult maltreatment under section 245A.65, subdivision 3; and
137.8(2) the maltreatment of minor reporting requirements and definitions in chapter 260E
137.9within 72 hours of first providing direct contact services to a client.
137.10(b) Before providing direct contact services to a client, a staff person must receive training
137.11about:
137.12(1) client rights and protections under section 245I.12;
137.13(2) the Minnesota Health Records Act, including client confidentiality, family engagement
137.14under section 144.294, and client privacy;
137.15(3) emergency procedures that the staff person must follow when responding to a fire,
137.16inclement weather, a report of a missing person, and a behavioral or medical emergency;
137.17(4) specific activities and job functions for which the staff person is responsible, including
137.18the license holder's program policies and procedures applicable to the staff person's position;
137.19(5) professional boundaries that the staff person must maintain; and
137.20(6) specific needs of each client to whom the staff person will be providing direct contact
137.21services, including each client's developmental status, cognitive functioning, and physical
137.22and mental abilities.
137.23(c) Before providing direct contact services to a client, a mental health rehabilitation
137.24worker, mental health behavioral aide, or mental health practitioner ~~qualified under~~ required
137.25to receive the training according to section 245I.04, subdivision 4, must receive 30 hours
137.26of training about:
137.27(1) mental illnesses;
137.28(2) client recovery and resiliency;
137.29(3) mental health de-escalation techniques;
137.30(4) co-occurring mental illness and substance use disorders; and
138.1(5) psychotropic medications and medication side effects.
138.2(d) Within 90 days of first providing direct contact services to an adult client, a clinical
138.3trainee, mental health practitioner, mental health certified peer specialist, or mental health
138.4rehabilitation worker must receive training about:
138.5(1) trauma-informed care and secondary trauma;
138.6(2) person-centered individual treatment plans, including seeking partnerships with
138.7family and other natural supports;
138.8(3) co-occurring substance use disorders; and
138.9(4) culturally responsive treatment practices.
138.10(e) Within 90 days of first providing direct contact services to a child client, a clinical
138.11trainee, mental health practitioner, mental health certified family peer specialist, mental
138.12health certified peer specialist, or mental health behavioral aide must receive training about
138.13the topics in clauses (1) to (5). This training must address the developmental characteristics
138.14of each child served by the license holder and address the needs of each child in the context
138.15of the child's family, support system, and culture. Training topics must include:
138.16(1) trauma-informed care and secondary trauma, including adverse childhood experiences
138.17(ACEs);
138.18(2) family-centered treatment plan development, including seeking partnership with a
138.19child client's family and other natural supports;
138.20(3) mental illness and co-occurring substance use disorders in family systems;
138.21(4) culturally responsive treatment practices; and
138.22(5) child development, including cognitive functioning, and physical and mental abilities.
138.23(f) For a mental health behavioral aide, the training under paragraph (e) must include
138.24parent team training using a curriculum approved by the commissioner.
138.25EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
138.26whichever is later. The commissioner of human services shall notify the revisor of statutes
138.27when federal approval is obtained.

139.1    Sec. 24. Minnesota Statutes 2021 Supplement, section 245I.08, subdivision 4, is amended
139.2to read:
139.3    Subd. 4. Progress notes. A license holder must use a progress note to document each
139.4occurrence of a mental health service that a staff person provides to a client. A progress
139.5note must include the following:
139.6(1) the type of service;
139.7(2) the date of service;
139.8(3) the start and stop time of the service unless the license holder is licensed as a
139.9residential program;
139.10(4) the location of the service;
139.11(5) the scope of the service, including: (i) the targeted goal and objective; (ii) the
139.12intervention that the staff person provided to the client and the methods that the staff person
139.13used; (iii) the client's response to the intervention; (iv) the staff person's plan to take future
139.14actions, including changes in treatment that the staff person will implement if the intervention
139.15was ineffective; and (v) the service modality;
139.16(6) the signature~~, printed name,~~ and credentials of the staff person who provided the
139.17service to the client;
139.18(7) the mental health provider travel documentation required by section 256B.0625, if
139.19applicable; and
139.20(8) significant observations by the staff person, if applicable, including: (i) the client's
139.21current risk factors; (ii) emergency interventions by staff persons; (iii) consultations with
139.22or referrals to other professionals, family, or significant others; and (iv) changes in the
139.23client's mental or physical symptoms.
139.24EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
139.25whichever is later. The commissioner of human services shall notify the revisor of statutes
139.26when federal approval is obtained.

139.27    Sec. 25. Minnesota Statutes 2021 Supplement, section 245I.09, subdivision 2, is amended
139.28to read:
139.29    Subd. 2. Record retention. A license holder must retain client records of a discharged
139.30client for a minimum of five years from the date of the client's discharge. A license holder
139.31who ~~ceases to provide treatment services to a client~~ closes a program must retain ~~the~~ a
139.32client's records for a minimum of five years from the date that the license holder stopped
140.1providing services to the client and must notify the commissioner of the location of the
140.2client records and the name of the individual responsible for storing and maintaining the
140.3client records.
140.4EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
140.5whichever is later. The commissioner of human services shall notify the revisor of statutes
140.6when federal approval is obtained.

140.7    Sec. 26. Minnesota Statutes 2021 Supplement, section 245I.10, subdivision 2, is amended
140.8to read:
140.9    Subd. 2. Generally. (a) A license holder must use a client's diagnostic assessment or
140.10crisis assessment to determine a client's eligibility for mental health services, except as
140.11provided in this section.
140.12(b) Prior to completing a client's initial diagnostic assessment, a license holder may
140.13provide a client with the following services:
140.14(1) an explanation of findings;
140.15(2) neuropsychological testing, neuropsychological assessment, and psychological
140.16testing;
140.17(3) any combination of psychotherapy sessions, family psychotherapy sessions, and
140.18family psychoeducation sessions not to exceed three sessions;
140.19(4) crisis assessment services according to section 256B.0624; and
140.20(5) ten days of intensive residential treatment services according to the assessment and
140.21treatment planning standards in section ~~245.23~~ 245I.23, subdivision 7.
140.22(c) Based on the client's needs that a crisis assessment identifies under section 256B.0624,
140.23a license holder may provide a client with the following services:
140.24(1) crisis intervention and stabilization services under section 245I.23 or 256B.0624;
140.25and
140.26(2) any combination of psychotherapy sessions, group psychotherapy sessions, family
140.27psychotherapy sessions, and family psychoeducation sessions not to exceed ten sessions
140.28within a 12-month period without prior authorization.
140.29(d) Based on the client's needs in the client's brief diagnostic assessment, a license holder
140.30may provide a client with any combination of psychotherapy sessions, group psychotherapy
140.31sessions, family psychotherapy sessions, and family psychoeducation sessions not to exceed
141.1ten sessions within a 12-month period without prior authorization for any new client or for
141.2an existing client who the license holder projects will need fewer than ten sessions during
141.3the next 12 months.
141.4(e) Based on the client's needs that a hospital's medical history and presentation
141.5examination identifies, a license holder may provide a client with:
141.6(1) any combination of psychotherapy sessions, group psychotherapy sessions, family
141.7psychotherapy sessions, and family psychoeducation sessions not to exceed ten sessions
141.8within a 12-month period without prior authorization for any new client or for an existing
141.9client who the license holder projects will need fewer than ten sessions during the next 12
141.10months; and
141.11(2) up to five days of day treatment services or partial hospitalization.
141.12(f) A license holder must complete a new standard diagnostic assessment of a client:
141.13(1) when the client requires services of a greater number or intensity than the services
141.14that paragraphs (b) to (e) describe;
141.15(2) at least annually following the client's initial diagnostic assessment if the client needs
141.16additional mental health services and the client does not meet the criteria for a brief
141.17assessment;
141.18(3) when the client's mental health condition has changed markedly since the client's
141.19most recent diagnostic assessment; or
141.20(4) when the client's current mental health condition does not meet the criteria of the
141.21client's current diagnosis.
141.22(g) For an existing client, the license holder must ensure that a new standard diagnostic
141.23assessment includes a written update containing all significant new or changed information
141.24about the client, and an update regarding what information has not significantly changed,
141.25including a discussion with the client about changes in the client's life situation, functioning,
141.26presenting problems, and progress with achieving treatment goals since the client's last
141.27diagnostic assessment was completed.
141.28EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
141.29whichever is later. The commissioner of human services shall notify the revisor of statutes
141.30when federal approval is obtained.

142.1    Sec. 27. Minnesota Statutes 2021 Supplement, section 245I.10, subdivision 6, is amended
142.2to read:
142.3    Subd. 6. Standard diagnostic assessment; required elements. (a) Only a mental health
142.4professional or a clinical trainee may complete a standard diagnostic assessment of a client.
142.5A standard diagnostic assessment of a client must include a face-to-face interview with a
142.6client and a written evaluation of the client. The assessor must complete a client's standard
142.7diagnostic assessment within the client's cultural context.
142.8(b) When completing a standard diagnostic assessment of a client, the assessor must
142.9gather and document information about the client's current life situation, including the
142.10following information:
142.11(1) the client's age;
142.12(2) the client's current living situation, including the client's housing status and household
142.13members;
142.14(3) the status of the client's basic needs;
142.15(4) the client's education level and employment status;
142.16(5) the client's current medications;
142.17(6) any immediate risks to the client's health and safety;
142.18(7) the client's perceptions of the client's condition;
142.19(8) the client's description of the client's symptoms, including the reason for the client's
142.20referral;
142.21(9) the client's history of mental health treatment; and
142.22(10) cultural influences on the client.
142.23(c) If the assessor cannot obtain the information that this ~~subdivision~~ paragraph requires
142.24without retraumatizing the client or harming the client's willingness to engage in treatment,
142.25the assessor must identify which topics will require further assessment during the course
142.26of the client's treatment. The assessor must gather and document information related to the
142.27following topics:
142.28(1) the client's relationship with the client's family and other significant personal
142.29relationships, including the client's evaluation of the quality of each relationship;
142.30(2) the client's strengths and resources, including the extent and quality of the client's
142.31social networks;
143.1(3) important developmental incidents in the client's life;
143.2(4) maltreatment, trauma, potential brain injuries, and abuse that the client has suffered;
143.3(5) the client's history of or exposure to alcohol and drug usage and treatment; and
143.4(6) the client's health history and the client's family health history, including the client's
143.5physical, chemical, and mental health history.
143.6(d) When completing a standard diagnostic assessment of a client, an assessor must use
143.7a recognized diagnostic framework.
143.8(1) When completing a standard diagnostic assessment of a client who is five years of
143.9age or younger, the assessor must use the current edition of the DC: 0-5 Diagnostic
143.10Classification of Mental Health and Development Disorders of Infancy and Early Childhood
143.11published by Zero to Three.
143.12(2) When completing a standard diagnostic assessment of a client who is six years of
143.13age or older, the assessor must use the current edition of the Diagnostic and Statistical
143.14Manual of Mental Disorders published by the American Psychiatric Association.
143.15(3) When completing a standard diagnostic assessment of a client who is five years of
143.16age or younger, an assessor must administer the Early Childhood Service Intensity Instrument
143.17(ECSII) to the client and include the results in the client's assessment.
143.18(4) When completing a standard diagnostic assessment of a client who is six to 17 years
143.19of age, an assessor must administer the Child and Adolescent Service Intensity Instrument
143.20(CASII) to the client and include the results in the client's assessment.
143.21(5) When completing a standard diagnostic assessment of a client who is 18 years of
143.22age or older, an assessor must use either (i) the CAGE-AID Questionnaire or (ii) the criteria
143.23in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders
143.24published by the American Psychiatric Association to screen and assess the client for a
143.25substance use disorder.
143.26(e) When completing a standard diagnostic assessment of a client, the assessor must
143.27include and document the following components of the assessment:
143.28(1) the client's mental status examination;
143.29(2) the client's baseline measurements; symptoms; behavior; skills; abilities; resources;
143.30vulnerabilities; safety needs, including client information that supports the assessor's findings
143.31after applying a recognized diagnostic framework from paragraph (d); and any differential
143.32diagnosis of the client;
144.1(3) an explanation of: (i) how the assessor diagnosed the client using the information
144.2from the client's interview, assessment, psychological testing, and collateral information
144.3about the client; (ii) the client's needs; (iii) the client's risk factors; (iv) the client's strengths;
144.4and (v) the client's responsivity factors.
144.5(f) When completing a standard diagnostic assessment of a client, the assessor must
144.6consult the client and the client's family about which services that the client and the family
144.7prefer to treat the client. The assessor must make referrals for the client as to services required
144.8by law.
144.9EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
144.10whichever is later. The commissioner of human services shall notify the revisor of statutes
144.11when federal approval is obtained.

144.12    Sec. 28. Minnesota Statutes 2021 Supplement, section 245I.20, subdivision 5, is amended
144.13to read:
144.14    Subd. 5. Treatment supervision specified. (a) A mental health professional must remain
144.15responsible for each client's case. The certification holder must document the name of the
144.16mental health professional responsible for each case and the dates that the mental health
144.17professional is responsible for the client's case from beginning date to end date. The
144.18certification holder must assign each client's case for assessment, diagnosis, and treatment
144.19services to a treatment team member who is competent in the assigned clinical service, the
144.20recommended treatment strategy, and in treating the client's characteristics.
144.21(b) Treatment supervision of mental health practitioners and clinical trainees required
144.22by section 245I.06 must include case reviews as described in this paragraph. Every two
144.23months, a mental health professional must complete and document a case review of each
144.24client assigned to the mental health professional when the client is receiving clinical services
144.25from a mental health practitioner or clinical trainee. The case review must include a
144.26consultation process that thoroughly examines the client's condition and treatment, including:
144.27(1) a review of the client's reason for seeking treatment, diagnoses and assessments, and
144.28the individual treatment plan; (2) a review of the appropriateness, duration, and outcome
144.29of treatment provided to the client; and (3) treatment recommendations.

145.1    Sec. 29. Minnesota Statutes 2021 Supplement, section 245I.23, subdivision 22, is amended
145.2to read:
145.3    Subd. 22. Additional policy and procedure requirements. (a) In addition to the policies
145.4and procedures in section 245I.03, the license holder must establish, enforce, and maintain
145.5the policies and procedures in this subdivision.
145.6(b) The license holder must have policies and procedures for receiving referrals and
145.7making admissions determinations about referred persons under subdivisions ~~14 to 16~~ 15
145.8to 17.
145.9(c) The license holder must have policies and procedures for discharging clients under
145.10subdivision 17 18. In the policies and procedures, the license holder must identify the staff
145.11persons who are authorized to discharge clients from the program.
145.12EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
145.13whichever is later. The commissioner of human services shall notify the revisor of statutes
145.14when federal approval is obtained.

145.15    Sec. 30. Minnesota Statutes 2021 Supplement, section 254B.05, subdivision 5, is amended
145.16to read:
145.17    Subd. 5. Rate requirements. (a) The commissioner shall establish rates for substance
145.18use disorder services and service enhancements funded under this chapter.
145.19(b) Eligible substance use disorder treatment services include:
145.20(1) outpatient treatment services that are licensed according to sections 245G.01 to
145.21245G.17, or applicable tribal license;
145.22(2) comprehensive assessments provided according to sections 245.4863, paragraph (a),
145.23and 245G.05;
145.24(3) care coordination services provided according to section 245G.07, subdivision 1,
145.25paragraph (a), clause (5);
145.26(4) peer recovery support services provided according to section 245G.07, subdivision
145.272, clause (8);
145.28(5) on July 1, 2019, or upon federal approval, whichever is later, withdrawal management
145.29services provided according to chapter 245F;
145.30(6) medication-assisted therapy services that are licensed according to sections 245G.01
145.31to 245G.17 and 245G.22, or applicable tribal license;
146.1(7) medication-assisted therapy plus enhanced treatment services that meet the
146.2requirements of clause (6) and provide nine hours of clinical services each week;
146.3(8) high, medium, and low intensity residential treatment services that are licensed
146.4according to sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license which
146.5provide, respectively, 30, 15, and five hours of clinical services each week;
146.6(9) hospital-based treatment services that are licensed according to sections 245G.01 to
146.7245G.17 or applicable tribal license and licensed as a hospital under sections 144.50 to
146.8144.56;
146.9(10) adolescent treatment programs that are licensed as outpatient treatment programs
146.10according to sections 245G.01 to 245G.18 or as residential treatment programs according
146.11to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or
146.12applicable tribal license;
146.13(11) high-intensity residential treatment services that are licensed according to sections
146.14245G.01 to 245G.17 and 245G.21 or applicable tribal license, which provide 30 hours of
146.15clinical services each week provided by a state-operated vendor or to clients who have been
146.16civilly committed to the commissioner, present the most complex and difficult care needs,
146.17and are a potential threat to the community; and
146.18(12) room and board facilities that meet the requirements of subdivision 1a.
146.19(c) The commissioner shall establish higher rates for programs that meet the requirements
146.20of paragraph (b) and one of the following additional requirements:
146.21(1) programs that serve parents with their children if the program:
146.22(i) provides on-site child care during the hours of treatment activity that:
146.23(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter
146.249503; or
146.25(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph
146.26(a), clause (6), and meets the requirements under section 245G.19, subdivision 4; or
146.27(ii) arranges for off-site child care during hours of treatment activity at a facility that is
146.28licensed under chapter 245A as:
146.29(A) a child care center under Minnesota Rules, chapter 9503; or
146.30(B) a family child care home under Minnesota Rules, chapter 9502;
147.1(2) culturally specific or culturally responsive programs as defined in section 254B.01,
147.2subdivision 4a;
147.3(3) disability responsive programs as defined in section 254B.01, subdivision 4b;
147.4(4) programs that offer medical services delivered by appropriately credentialed health
147.5care staff in an amount equal to two hours per client per week if the medical needs of the
147.6client and the nature and provision of any medical services provided are documented in the
147.7client file; or
147.8(5) programs that offer services to individuals with co-occurring mental health and
147.9chemical dependency problems if:
147.10(i) the program meets the co-occurring requirements in section 245G.20;
147.11(ii) 25 percent of the counseling staff are licensed mental health professionals~~, as defined~~
147.12~~in section~~ ~~245.462, subdivision 18, clauses (1) to (6)~~ under section 245I.04, subdivision 2,
147.13or are students or licensing candidates under the supervision of a licensed alcohol and drug
147.14counselor supervisor and ~~licensed~~ mental health professional under section 245I.04,
147.15subdivision 2, except that no more than 50 percent of the mental health staff may be students
147.16or licensing candidates with time documented to be directly related to provisions of
147.17co-occurring services;
147.18(iii) clients scoring positive on a standardized mental health screen receive a mental
147.19health diagnostic assessment within ten days of admission;
147.20(iv) the program has standards for multidisciplinary case review that include a monthly
147.21review for each client that, at a minimum, includes a licensed mental health professional
147.22and licensed alcohol and drug counselor, and their involvement in the review is documented;
147.23(v) family education is offered that addresses mental health and substance abuse disorders
147.24and the interaction between the two; and
147.25(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder
147.26training annually.
147.27(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program
147.28that provides arrangements for off-site child care must maintain current documentation at
147.29the chemical dependency facility of the child care provider's current licensure to provide
147.30child care services. Programs that provide child care according to paragraph (c), clause (1),
147.31must be deemed in compliance with the licensing requirements in section 245G.19.
148.1(e) Adolescent residential programs that meet the requirements of Minnesota Rules,
148.2parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements
148.3in paragraph (c), clause (4), items (i) to (iv).
148.4(f) Subject to federal approval, substance use disorder services that are otherwise covered
148.5as direct face-to-face services may be provided via telehealth as defined in section 256B.0625,
148.6subdivision 3b. The use of telehealth to deliver services must be medically appropriate to
148.7the condition and needs of the person being served. Reimbursement shall be at the same
148.8rates and under the same conditions that would otherwise apply to direct face-to-face services.
148.9(g) For the purpose of reimbursement under this section, substance use disorder treatment
148.10services provided in a group setting without a group participant maximum or maximum
148.11client to staff ratio under chapter 245G shall not exceed a client to staff ratio of 48 to one.
148.12At least one of the attending staff must meet the qualifications as established under this
148.13chapter for the type of treatment service provided. A recovery peer may not be included as
148.14part of the staff ratio.
148.15(h) Payment for outpatient substance use disorder services that are licensed according
148.16to sections 245G.01 to 245G.17 is limited to six hours per day or 30 hours per week unless
148.17prior authorization of a greater number of hours is obtained from the commissioner.
148.18EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
148.19whichever is later. The commissioner of human services shall notify the revisor of statutes
148.20when federal approval is obtained.

148.21    Sec. 31. Minnesota Statutes 2021 Supplement, section 256B.0622, subdivision 2, is
148.22amended to read:
148.23    Subd. 2. Definitions. (a) For purposes of this section, the following terms have the
148.24meanings given them.
148.25(b) "ACT team" means the group of interdisciplinary mental health staff who work as
148.26a team to provide assertive community treatment.
148.27(c) "Assertive community treatment" means intensive nonresidential treatment and
148.28rehabilitative mental health services provided according to the assertive community treatment
148.29model. Assertive community treatment provides a single, fixed point of responsibility for
148.30treatment, rehabilitation, and support needs for clients. Services are offered 24 hours per
148.31day, seven days per week, in a community-based setting.
148.32(d) "Individual treatment plan" means a plan described by section 245I.10, subdivisions
148.337 and 8.
149.1(e) "Crisis assessment and intervention" means ~~mental health~~ mobile crisis response
149.2services ~~as defined in~~ under section 256B.0624~~, subdivision 2~~.
149.3(f) "Individual treatment team" means a minimum of three members of the ACT team
149.4who are responsible for consistently carrying out most of a client's assertive community
149.5treatment services.
149.6(g) "Primary team member" means the person who leads and coordinates the activities
149.7of the individual treatment team and is the individual treatment team member who has
149.8primary responsibility for establishing and maintaining a therapeutic relationship with the
149.9client on a continuing basis.
149.10(h) "Certified rehabilitation specialist" means a staff person who is qualified according
149.11to section 245I.04, subdivision 8.
149.12(i) "Clinical trainee" means a staff person who is qualified according to section 245I.04,
149.13subdivision 6.
149.14(j) "Mental health certified peer specialist" means a staff person who is qualified
149.15according to section 245I.04, subdivision 10.
149.16(k) "Mental health practitioner" means a staff person who is qualified according to section
149.17245I.04, subdivision 4.
149.18(l) "Mental health professional" means a staff person who is qualified according to
149.19section 245I.04, subdivision 2.
149.20(m) "Mental health rehabilitation worker" means a staff person who is qualified according
149.21to section 245I.04, subdivision 14.
149.22EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
149.23whichever is later. The commissioner of human services shall notify the revisor of statutes
149.24when federal approval is obtained.

149.25    Sec. 32. Minnesota Statutes 2021 Supplement, section 256B.0625, subdivision 3b, is
149.26amended to read:
149.27    Subd. 3b. Telehealth services. (a) Medical assistance covers medically necessary services
149.28and consultations delivered by a health care provider through telehealth in the same manner
149.29as if the service or consultation was delivered through in-person contact. Services or
149.30consultations delivered through telehealth shall be paid at the full allowable rate.
150.1(b) The commissioner may establish criteria that a health care provider must attest to in
150.2order to demonstrate the safety or efficacy of delivering a particular service through
150.3telehealth. The attestation may include that the health care provider:
150.4(1) has identified the categories or types of services the health care provider will provide
150.5through telehealth;
150.6(2) has written policies and procedures specific to services delivered through telehealth
150.7that are regularly reviewed and updated;
150.8(3) has policies and procedures that adequately address patient safety before, during,
150.9and after the service is delivered through telehealth;
150.10(4) has established protocols addressing how and when to discontinue telehealth services;
150.11and
150.12(5) has an established quality assurance process related to delivering services through
150.13telehealth.
150.14(c) As a condition of payment, a licensed health care provider must document each
150.15occurrence of a health service delivered through telehealth to a medical assistance enrollee.
150.16Health care service records for services delivered through telehealth must meet the
150.17requirements set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and must
150.18document:
150.19(1) the type of service delivered through telehealth;
150.20(2) the time the service began and the time the service ended, including an a.m. and p.m.
150.21designation;
150.22(3) the health care provider's basis for determining that telehealth is an appropriate and
150.23effective means for delivering the service to the enrollee;
150.24(4) the mode of transmission used to deliver the service through telehealth and records
150.25evidencing that a particular mode of transmission was utilized;
150.26(5) the location of the originating site and the distant site;
150.27(6) if the claim for payment is based on a physician's consultation with another physician
150.28through telehealth, the written opinion from the consulting physician providing the telehealth
150.29consultation; and
150.30(7) compliance with the criteria attested to by the health care provider in accordance
150.31with paragraph (b).
151.1(d) Telehealth visits~~, as described in this subdivision~~ provided through audio and visual
151.2communication, or accessible video-based platforms may be used to satisfy the face-to-face
151.3requirement for reimbursement under the payment methods that apply to a federally qualified
151.4health center, rural health clinic, Indian health service, 638 tribal clinic, and certified
151.5community behavioral health clinic, if the service would have otherwise qualified for
151.6payment if performed in person.
151.7~~(e) For mental health services or assessments delivered through telehealth that are based~~
151.8~~on an individual treatment plan, the provider may document the client's verbal approval or~~
151.9~~electronic written approval of the treatment plan or change in the treatment plan in lieu of~~
151.10~~the client's signature in accordance with Minnesota Rules, part~~ ~~9505.0371~~.
151.11~~(f)~~ (e) For purposes of this subdivision, unless otherwise covered under this chapter:
151.12(1) "telehealth" means the delivery of health care services or consultations ~~through the~~
151.13~~use of~~ using real-time two-way interactive audio and visual communication or accessible
151.14telehealth video-based platforms to provide or support health care delivery and facilitate
151.15the assessment, diagnosis, consultation, treatment, education, and care management of a
151.16patient's health care. Telehealth includes: the application of secure video conferencing,
151.17consisting of a real-time, full-motion synchronized video; store-and-forward technology,;
151.18and synchronous interactions, between a patient located at an originating site and a health
151.19care provider located at a distant site. Telehealth does not include communication between
151.20health care providers, or between a health care provider and a patient that consists solely
151.21of an audio-only communication, e-mail, or facsimile transmission or as specified by law;
151.22(2) "health care provider" means a health care provider as defined under section 62A.673,
151.23a community paramedic as defined under section 144E.001, subdivision 5f, a community
151.24health worker who meets the criteria under subdivision 49, paragraph (a), a mental health
151.25certified peer specialist under section ~~256B.0615, subdivision 5~~ 245I.04, subdivision 10, a
151.26mental health certified family peer specialist under section ~~256B.0616, subdivision 5~~ 245I.04,
151.27subdivision 12, a mental health rehabilitation worker under section ~~256B.0623, subdivision~~
151.28~~5, paragraph (a), clause (4), and paragraph (b)~~ 245I.04, subdivision 14, a mental health
151.29behavioral aide under section ~~256B.0943, subdivision 7, paragraph (b), clause (3)~~ 245I.04,
151.30subdivision 16, a treatment coordinator under section 245G.11, subdivision 7, an alcohol
151.31and drug counselor under section 245G.11, subdivision 5, or a recovery peer under section
151.32245G.11, subdivision 8; and
151.33(3) "originating site," "distant site," and "store-and-forward technology" have the
151.34meanings given in section 62A.673, subdivision 2.
152.1EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
152.2whichever is later. The commissioner of human services shall notify the revisor of statutes
152.3when federal approval is obtained.

152.4    Sec. 33. Minnesota Statutes 2020, section 256B.0659, subdivision 19, is amended to read:
152.5    Subd. 19. Personal care assistance choice option; qualifications; duties. (a) Under
152.6personal care assistance choice, the recipient or responsible party shall:
152.7(1) recruit, hire, schedule, and terminate personal care assistants according to the terms
152.8of the written agreement required under subdivision 20, paragraph (a);
152.9(2) develop a personal care assistance care plan based on the assessed needs and
152.10addressing the health and safety of the recipient with the assistance of a qualified professional
152.11as needed;
152.12(3) orient and train the personal care assistant with assistance as needed from the qualified
152.13professional;
152.14(4) ~~effective January 1, 2010,~~ supervise and evaluate the personal care assistant with the
152.15qualified professional, who is required to visit the recipient at least every 180 days;
152.16(5) monitor and verify in writing and report to the personal care assistance choice agency
152.17the number of hours worked by the personal care assistant and the qualified professional;
152.18(6) engage in an annual ~~face-to-face~~ reassessment as required in subdivision 3a to
152.19determine continuing eligibility and service authorization; and
152.20(7) use the same personal care assistance choice provider agency if shared personal
152.21assistance care is being used.
152.22(b) The personal care assistance choice provider agency shall:
152.23(1) meet all personal care assistance provider agency standards;
152.24(2) enter into a written agreement with the recipient, responsible party, and personal
152.25care assistants;
152.26(3) not be related as a parent, child, sibling, or spouse to the recipient or the personal
152.27care assistant; and
152.28(4) ensure arm's-length transactions without undue influence or coercion with the recipient
152.29and personal care assistant.
152.30(c) The duties of the personal care assistance choice provider agency are to:
153.1(1) be the employer of the personal care assistant and the qualified professional for
153.2employment law and related regulations including, but not limited to, purchasing and
153.3maintaining workers' compensation, unemployment insurance, surety and fidelity bonds,
153.4and liability insurance, and submit any or all necessary documentation including, but not
153.5limited to, workers' compensation, unemployment insurance, and labor market data required
153.6under section 256B.4912, subdivision 1a;
153.7(2) bill the medical assistance program for personal care assistance services and qualified
153.8professional services;
153.9(3) request and complete background studies that comply with the requirements for
153.10personal care assistants and qualified professionals;
153.11(4) pay the personal care assistant and qualified professional based on actual hours of
153.12services provided;
153.13(5) withhold and pay all applicable federal and state taxes;
153.14(6) verify and keep records of hours worked by the personal care assistant and qualified
153.15professional;
153.16(7) make the arrangements and pay taxes and other benefits, if any, and comply with
153.17any legal requirements for a Minnesota employer;
153.18(8) enroll in the medical assistance program as a personal care assistance choice agency;
153.19and
153.20(9) enter into a written agreement as specified in subdivision 20 before services are
153.21provided.

153.22    Sec. 34. Minnesota Statutes 2021 Supplement, section 256B.0671, subdivision 6, is
153.23amended to read:
153.24    Subd. 6. Dialectical behavior therapy. (a) Subject to federal approval, medical assistance
153.25covers intensive mental health outpatient treatment for dialectical behavior therapy ~~for~~
153.26~~adults~~. A dialectical behavior therapy provider must make reasonable and good faith efforts
153.27to report individual client outcomes to the commissioner using instruments and protocols
153.28that are approved by the commissioner.
153.29(b) "Dialectical behavior therapy" means an evidence-based treatment approach that a
153.30mental health professional or clinical trainee provides to a client or a group of clients in an
153.31intensive outpatient treatment program using a combination of individualized rehabilitative
153.32and psychotherapeutic interventions. A dialectical behavior therapy program involves:
154.1individual dialectical behavior therapy, group skills training, telephone coaching, and team
154.2consultation meetings.
154.3(c) To be eligible for dialectical behavior therapy, a client must:
154.4~~(1) be 18 years of age or older;~~
154.5~~(2)~~ (1) have mental health needs that available community-based services cannot meet
154.6or that the client must receive concurrently with other community-based services;
154.7~~(3)~~ (2) have either:
154.8(i) a diagnosis of borderline personality disorder; or
154.9(ii) multiple mental health diagnoses, exhibit behaviors characterized by impulsivity or
154.10intentional self-harm, and be at significant risk of death, morbidity, disability, or severe
154.11dysfunction in multiple areas of the client's life;
154.12~~(4)~~ (3) be cognitively capable of participating in dialectical behavior therapy as an
154.13intensive therapy program and be able and willing to follow program policies and rules to
154.14ensure the safety of the client and others; and
154.15~~(5)~~ (4) be at significant risk of one or more of the following if the client does not receive
154.16dialectical behavior therapy:
154.17(i) having a mental health crisis;
154.18(ii) requiring a more restrictive setting such as hospitalization;
154.19(iii) decompensating; or
154.20(iv) engaging in intentional self-harm behavior.
154.21(d) Individual dialectical behavior therapy combines individualized rehabilitative and
154.22psychotherapeutic interventions to treat a client's suicidal and other dysfunctional behaviors
154.23and to reinforce a client's use of adaptive skillful behaviors. A mental health professional
154.24or clinical trainee must provide individual dialectical behavior therapy to a client. A mental
154.25health professional or clinical trainee providing dialectical behavior therapy to a client must:
154.26(1) identify, prioritize, and sequence the client's behavioral targets;
154.27(2) treat the client's behavioral targets;
154.28(3) assist the client in applying dialectical behavior therapy skills to the client's natural
154.29environment through telephone coaching outside of treatment sessions;
154.30(4) measure the client's progress toward dialectical behavior therapy targets;
155.1(5) help the client manage mental health crises and life-threatening behaviors; and
155.2(6) help the client learn and apply effective behaviors when working with other treatment
155.3providers.
155.4(e) Group skills training combines individualized psychotherapeutic and psychiatric
155.5rehabilitative interventions conducted in a group setting to reduce the client's suicidal and
155.6other dysfunctional coping behaviors and restore function. Group skills training must teach
155.7the client adaptive skills in the following areas: (1) mindfulness; (2) interpersonal
155.8effectiveness; (3) emotional regulation; and (4) distress tolerance.
155.9(f) Group skills training must be provided by two mental health professionals or by a
155.10mental health professional co-facilitating with a clinical trainee or a mental health practitioner.
155.11Individual skills training must be provided by a mental health professional, a clinical trainee,
155.12or a mental health practitioner.
155.13(g) Before a program provides dialectical behavior therapy to a client, the commissioner
155.14must certify the program as a dialectical behavior therapy provider. To qualify for
155.15certification as a dialectical behavior therapy provider, a provider must:
155.16(1) allow the commissioner to inspect the provider's program;
155.17(2) provide evidence to the commissioner that the program's policies, procedures, and
155.18practices meet the requirements of this subdivision and chapter 245I;
155.19(3) be enrolled as a MHCP provider; and
155.20(4) have a manual that outlines the program's policies, procedures, and practices that
155.21meet the requirements of this subdivision.
155.22EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
155.23whichever is later. The commissioner of human services shall notify the revisor of statutes
155.24when federal approval is obtained.

155.25    Sec. 35. Minnesota Statutes 2021 Supplement, section 256B.0911, subdivision 3a, is
155.26amended to read:
155.27    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment, services
155.28planning, or other assistance intended to support community-based living, including persons
155.29who need assessment ~~in order~~ to determine waiver or alternative care program eligibility,
155.30must be visited by a long-term care consultation team within 20 calendar days after the date
155.31on which an assessment was requested or recommended. Upon statewide implementation
155.32of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person
156.1requesting personal care assistance services. The commissioner shall provide at least a
156.290-day notice to lead agencies prior to the effective date of this requirement. Assessments
156.3must be conducted according to paragraphs (b) to (r).
156.4(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified
156.5assessors to conduct the assessment. For a person with complex health care needs, a public
156.6health or registered nurse from the team must be consulted.
156.7(c) The MnCHOICES assessment provided by the commissioner to lead agencies must
156.8be used to complete a comprehensive, conversation-based, person-centered assessment.
156.9The assessment must include the health, psychological, functional, environmental, and
156.10social needs of the individual necessary to develop a person-centered community support
156.11plan that meets the individual's needs and preferences.
156.12(d) Except as provided in paragraph (r), the assessment must be conducted by a certified
156.13assessor in a face-to-face conversational interview with the person being assessed. The
156.14person's legal representative must provide input during the assessment process and may do
156.15so remotely if requested. At the request of the person, other individuals may participate in
156.16the assessment to provide information on the needs, strengths, and preferences of the person
156.17necessary to develop a community support plan that ensures the person's health and safety.
156.18Except for legal representatives or family members invited by the person, persons
156.19participating in the assessment may not be a provider of service or have any financial interest
156.20in the provision of services. For persons who are to be assessed for elderly waiver customized
156.21living or adult day services under chapter 256S, with the permission of the person being
156.22assessed or the person's designated or legal representative, the client's current or proposed
156.23provider of services may submit a copy of the provider's nursing assessment or written
156.24report outlining its recommendations regarding the client's care needs. The person conducting
156.25the assessment must notify the provider of the date by which this information is to be
156.26submitted. This information shall be provided to the person conducting the assessment prior
156.27to the assessment. For a person who is to be assessed for waiver services under section
156.28256B.092 or 256B.49, with the permission of the person being assessed or the person's
156.29designated legal representative, the person's current provider of services may submit a
156.30written report outlining recommendations regarding the person's care needs the person
156.31completed in consultation with someone who is known to the person and has interaction
156.32with the person on a regular basis. The provider must submit the report at least 60 days
156.33before the end of the person's current service agreement. The certified assessor must consider
156.34the content of the submitted report prior to finalizing the person's assessment or reassessment.
157.1(e) The certified assessor and the individual responsible for developing the coordinated
157.2service and support plan must complete the community support plan and the coordinated
157.3service and support plan no more than 60 calendar days from the assessment visit. The
157.4person or the person's legal representative must be provided with a written community
157.5support plan within the timelines established by the commissioner, regardless of whether
157.6the person is eligible for Minnesota health care programs.
157.7(f) For a person being assessed for elderly waiver services under chapter 256S, a provider
157.8who submitted information under paragraph (d) shall receive the final written community
157.9support plan when available and the Residential Services Workbook.
157.10(g) The written community support plan must include:
157.11(1) a summary of assessed needs as defined in paragraphs (c) and (d);
157.12(2) the individual's options and choices to meet identified needs, including:
157.13(i) all available options for case management services and providers;
157.14(ii) all available options for employment services, settings, and providers;
157.15(iii) all available options for living arrangements;
157.16(iv) all available options for self-directed services and supports, including self-directed
157.17budget options; and
157.18(v) service provided in a non-disability-specific setting;
157.19(3) identification of health and safety risks and how those risks will be addressed,
157.20including personal risk management strategies;
157.21(4) referral information; and
157.22(5) informal caregiver supports, if applicable.
157.23For a person determined eligible for state plan home care under subdivision 1a, paragraph
157.24(b), clause (1), the person or person's representative must also receive a copy of the home
157.25care service plan developed by the certified assessor.
157.26(h) A person may request assistance in identifying community supports without
157.27participating in a complete assessment. Upon a request for assistance identifying community
157.28support, the person must be transferred or referred to long-term care options counseling
157.29services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for
157.30telephone assistance and follow up.
157.31(i) The person has the right to make the final decision:
158.1(1) between institutional placement and community placement after the recommendations
158.2have been provided, except as provided in section 256.975, subdivision 7a, paragraph (d);
158.3(2) between community placement in a setting controlled by a provider and living
158.4independently in a setting not controlled by a provider;
158.5(3) between day services and employment services; and
158.6(4) regarding available options for self-directed services and supports, including
158.7self-directed funding options.
158.8(j) The lead agency must give the person receiving long-term care consultation services
158.9or the person's legal representative, materials, and forms supplied by the commissioner
158.10containing the following information:
158.11(1) written recommendations for community-based services and consumer-directed
158.12options;
158.13(2) documentation that the most cost-effective alternatives available were offered to the
158.14individual. For purposes of this clause, "cost-effective" means community services and
158.15living arrangements that cost the same as or less than institutional care. For an individual
158.16found to meet eligibility criteria for home and community-based service programs under
158.17chapter 256S or section 256B.49, "cost-effectiveness" has the meaning found in the federally
158.18approved waiver plan for each program;
158.19(3) the need for and purpose of preadmission screening conducted by long-term care
158.20options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects
158.21nursing facility placement. If the individual selects nursing facility placement, the lead
158.22agency shall forward information needed to complete the level of care determinations and
158.23screening for developmental disability and mental illness collected during the assessment
158.24to the long-term care options counselor using forms provided by the commissioner;
158.25(4) the role of long-term care consultation assessment and support planning in eligibility
158.26determination for waiver and alternative care programs, and state plan home care, case
158.27management, and other services as defined in subdivision 1a, paragraphs (a), clause (6),
158.28and (b);
158.29(5) information about Minnesota health care programs;
158.30(6) the person's freedom to accept or reject the recommendations of the team;
158.31(7) the person's right to confidentiality under the Minnesota Government Data Practices
158.32Act, chapter 13;
159.1(8) the certified assessor's decision regarding the person's need for institutional level of
159.2care as determined under criteria established in subdivision 4e and the certified assessor's
159.3decision regarding eligibility for all services and programs as defined in subdivision 1a,
159.4paragraphs (a), clause (6), and (b);
159.5(9) the person's right to appeal the certified assessor's decision regarding eligibility for
159.6all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and
159.7(8), and (b), and incorporating the decision regarding the need for institutional level of care
159.8or the lead agency's final decisions regarding public programs eligibility according to section
159.9256.045, subdivision 3. The certified assessor must verbally communicate this appeal right
159.10to the person and must visually point out where in the document the right to appeal is stated;
159.11and
159.12(10) documentation that available options for employment services, independent living,
159.13and self-directed services and supports were described to the individual.
159.14(k) An assessment that is completed as part of an eligibility determination for multiple
159.15programs for the alternative care, elderly waiver, developmental disabilities, community
159.16access for disability inclusion, community alternative care, and brain injury waiver programs
159.17under chapter 256S and sections 256B.0913, 256B.092, and 256B.49 is valid to establish
159.18service eligibility for no more than 60 calendar days after the date of the assessment.
159.19(l) The effective eligibility start date for programs in paragraph (k) can never be prior
159.20to the date of assessment. If an assessment was completed more than 60 days before the
159.21effective waiver or alternative care program eligibility start date, assessment and support
159.22plan information must be updated and documented in the department's Medicaid Management
159.23Information System (MMIS). Notwithstanding retroactive medical assistance coverage of
159.24state plan services, the effective date of eligibility for programs included in paragraph (k)
159.25cannot be prior to the date the most recent updated assessment is completed.
159.26(m) If an eligibility update is completed within 90 days of the previous assessment and
159.27documented in the department's Medicaid Management Information System (MMIS), the
159.28effective date of eligibility for programs included in paragraph (k) is the date of the previous
159.29face-to-face assessment when all other eligibility requirements are met.
159.30(n) If a person who receives home and community-based waiver services under section
159.31256B.0913, 256B.092, or 256B.49 or chapter 256S temporarily enters for 121 days or fewer
159.32a hospital, institution of mental disease, nursing facility, intensive residential treatment
159.33services program, transitional care unit, or inpatient substance use disorder treatment setting,
159.34the person may return to the community with home and community-based waiver services
160.1under the same waiver, without requiring an assessment or reassessment under this section,
160.2unless the person's annual reassessment is otherwise due. Nothing in this paragraph shall
160.3change annual long-term care consultation reassessment requirements, payment for
160.4institutional or treatment services, medical assistance financial eligibility, or any other law.
160.5(o) At the time of reassessment, the certified assessor shall assess each person receiving
160.6waiver residential supports and services currently residing in a community residential setting,
160.7licensed adult foster care home that is either not the primary residence of the license holder
160.8or in which the license holder is not the primary caregiver, family adult foster care residence,
160.9customized living setting, or supervised living facility to determine if that person would
160.10prefer to be served in a community-living setting as defined in section 256B.49, subdivision
160.1123, in a setting not controlled by a provider, or to receive integrated community supports
160.12as described in section 245D.03, subdivision 1, paragraph (c), clause (8). The certified
160.13assessor shall offer the person, through a person-centered planning process, the option to
160.14receive alternative housing and service options.
160.15(p) At the time of reassessment, the certified assessor shall assess each person receiving
160.16waiver day services to determine if that person would prefer to receive employment services
160.17as described in section 245D.03, subdivision 1, paragraph (c), clauses (5) to (7). The certified
160.18assessor shall describe to the person through a person-centered planning process the option
160.19to receive employment services.
160.20(q) At the time of reassessment, the certified assessor shall assess each person receiving
160.21non-self-directed waiver services to determine if that person would prefer an available
160.22service and setting option that would permit self-directed services and supports. The certified
160.23assessor shall describe to the person through a person-centered planning process the option
160.24to receive self-directed services and supports.
160.25(r) All assessments performed according to this subdivision must be face-to-face unless
160.26the assessment is a reassessment meeting the requirements of this paragraph. Remote
160.27reassessments conducted by interactive video or telephone may substitute for face-to-face
160.28reassessments. For services provided by the developmental disabilities waiver under section
160.29256B.092, and the community access for disability inclusion, community alternative care,
160.30and brain injury waiver programs under section 256B.49, remote reassessments may be
160.31substituted for two consecutive reassessments if followed by a face-to-face reassessment.
160.32For services provided by alternative care under section 256B.0913, essential community
160.33supports under section 256B.0922, and the elderly waiver under chapter 256S, remote
160.34reassessments may be substituted for one reassessment if followed by a face-to-face
160.35reassessment. A remote reassessment is permitted only if the lead agency provides informed
161.1choice and the person being reassessed~~, or the person's legal representative, and the lead~~
161.2~~agency case manager both agree that there is no change in the person's condition, there is~~
161.3~~no need for a change in service, and that a remote reassessment is appropriate~~ or the person's
161.4legal representative provides informed consent for a remote assessment. Lead agencies must
161.5document that informed choice was offered. The person being reassessed, or the person's
161.6legal representative, has the right to refuse a remote reassessment at any time. During a
161.7remote reassessment, if the certified assessor determines a face-to-face reassessment is
161.8necessary ~~in order~~ to complete the assessment, the lead agency shall schedule a face-to-face
161.9reassessment. All other requirements of a face-to-face reassessment shall apply to a remote
161.10reassessment, including updates to a person's support plan.

161.11    Sec. 36. Minnesota Statutes 2020, section 256B.092, subdivision 1a, is amended to read:
161.12    Subd. 1a. Case management services. (a) Each recipient of a home and community-based
161.13waiver shall be provided case management services by qualified vendors as described in
161.14the federally approved waiver application.
161.15(b) Case management service activities provided to or arranged for a person include:
161.16(1) development of the person-centered coordinated service and support plan under
161.17subdivision 1b;
161.18(2) informing the individual or the individual's legal guardian or conservator, or parent
161.19if the person is a minor, of service options, including all service options available under the
161.20waiver plan;
161.21(3) consulting with relevant medical experts or service providers;
161.22(4) assisting the person in the identification of potential providers of chosen services,
161.23including:
161.24(i) providers of services provided in a non-disability-specific setting;
161.25(ii) employment service providers;
161.26(iii) providers of services provided in settings that are not controlled by a provider; and
161.27(iv) providers of financial management services;
161.28(5) assisting the person to access services and assisting in appeals under section 256.045;
161.29(6) coordination of services, if coordination is not provided by another service provider;
162.1(7) evaluation and monitoring of the services identified in the coordinated service and
162.2support plan, which must incorporate at least one annual face-to-face visit by the case
162.3manager with each person; and
162.4(8) reviewing coordinated service and support plans and providing the lead agency with
162.5recommendations for service authorization based upon the individual's needs identified in
162.6the coordinated service and support plan.
162.7(c) Case management service activities that are provided to the person with a
162.8developmental disability shall be provided directly by county agencies or under contract.
162.9If a county agency contracts for case management services, the county agency must provide
162.10each recipient of home and community-based services who is receiving contracted case
162.11management services with the contact information the recipient may use to file a grievance
162.12with the county agency about the quality of the contracted services the recipient is receiving
162.13from a county-contracted case manager. Case management services must be provided by a
162.14public or private agency that is enrolled as a medical assistance provider determined by the
162.15commissioner to meet all of the requirements in the approved federal waiver plans. Case
162.16management services must not be provided to a recipient by a private agency that has a
162.17financial interest in the provision of any other services included in the recipient's coordinated
162.18service and support plan. For purposes of this section, "private agency" means any agency
162.19that is not identified as a lead agency under section 256B.0911, subdivision 1a, paragraph
162.20(e).
162.21(d) Case managers are responsible for service provisions listed in paragraphs (a) and
162.22(b). Case managers shall collaborate with consumers, families, legal representatives, and
162.23relevant medical experts and service providers in the development and annual review of the
162.24person-centered coordinated service and support plan and habilitation plan.
162.25(e) For persons who need a positive support transition plan as required in chapter 245D,
162.26the case manager shall participate in the development and ongoing evaluation of the plan
162.27with the expanded support team. At least quarterly, the case manager, in consultation with
162.28the expanded support team, shall evaluate the effectiveness of the plan based on progress
162.29evaluation data submitted by the licensed provider to the case manager. The evaluation must
162.30identify whether the plan has been developed and implemented in a manner to achieve the
162.31following within the required timelines:
162.32(1) phasing out the use of prohibited procedures;
162.33(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's
162.34timeline; and
163.1(3) accomplishment of identified outcomes.
163.2If adequate progress is not being made, the case manager shall consult with the person's
163.3expanded support team to identify needed modifications and whether additional professional
163.4support is required to provide consultation.
163.5(f) The Department of Human Services shall offer ongoing education in case management
163.6to case managers. Case managers shall receive no less than ten hours of case management
163.7education and disability-related training each year. The education and training must include
163.8person-centered planning. For the purposes of this section, "person-centered planning" or
163.9"person-centered" has the meaning given in section 256B.0911, subdivision 1a, paragraph
163.10(f).

163.11    Sec. 37. Minnesota Statutes 2021 Supplement, section 256B.0946, subdivision 1, is
163.12amended to read:
163.13    Subdivision 1. Required covered service components. (a) Subject to federal approval,
163.14medical assistance covers medically necessary intensive treatment services when the services
163.15are provided by a provider entity certified under and meeting the standards in this section.
163.16The provider entity must make reasonable and good faith efforts to report individual client
163.17outcomes to the commissioner, using instruments and protocols approved by the
163.18commissioner.
163.19(b) Intensive treatment services to children with mental illness residing in foster family
163.20settings that comprise specific required service components provided in clauses (1) to (6)
163.21are reimbursed by medical assistance when they meet the following standards:
163.22(1) psychotherapy provided by a mental health professional or a clinical trainee;
163.23(2) crisis planning;
163.24(3) individual, family, and group psychoeducation services provided by a mental health
163.25professional or a clinical trainee;
163.26(4) clinical care consultation provided by a mental health professional or a clinical
163.27trainee;
163.28(5) individual treatment plan development as defined in ~~Minnesota Rules, part~~ ~~9505.0371~~,
163.29~~subpart 7~~ section 245I.10, subdivisions 7 and 8; and
163.30(6) service delivery payment requirements as provided under subdivision 4.
164.1EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
164.2whichever is later. The commissioner of human services shall notify the revisor of statutes
164.3when federal approval is obtained.

164.4    Sec. 38. Minnesota Statutes 2021 Supplement, section 256B.0947, subdivision 2, is
164.5amended to read:
164.6    Subd. 2. Definitions. For purposes of this section, the following terms have the meanings
164.7given them.
164.8(a) "Intensive nonresidential rehabilitative mental health services" means child
164.9rehabilitative mental health services as defined in section 256B.0943, except that these
164.10services are provided by a multidisciplinary staff using a total team approach consistent
164.11with assertive community treatment, as adapted for youth, and are directed to recipients
164.12who are eight years of age or older and under 26 years of age who require intensive services
164.13to prevent admission to an inpatient psychiatric hospital or placement in a residential
164.14treatment facility or who require intensive services to step down from inpatient or residential
164.15care to community-based care.
164.16(b) "Co-occurring mental illness and substance use disorder" means a dual diagnosis of
164.17at least one form of mental illness and at least one substance use disorder. Substance use
164.18disorders include alcohol or drug abuse or dependence, excluding nicotine use.
164.19(c) "Standard diagnostic assessment" means the assessment described in section 245I.10,
164.20subdivision 6.
164.21(d) "Medication education services" means services provided individually or in groups,
164.22which focus on:
164.23(1) educating the client and client's family or significant nonfamilial supporters about
164.24mental illness and symptoms;
164.25(2) the role and effects of medications in treating symptoms of mental illness; and
164.26(3) the side effects of medications.
164.27Medication education is coordinated with medication management services and does not
164.28duplicate it. Medication education services are provided by physicians, pharmacists, or
164.29registered nurses with certification in psychiatric and mental health care.
164.30(e) "Mental health professional" means a staff person who is qualified according to
164.31section 245I.04, subdivision 2.
165.1(f) "Provider agency" means a for-profit or nonprofit organization established to
165.2administer an assertive community treatment for youth team.
165.3(g) "Substance use disorders" means one or more of the disorders defined in the diagnostic
165.4and statistical manual of mental disorders, current edition.
165.5(h) "Transition services" means:
165.6(1) activities, materials, consultation, and coordination that ensures continuity of the
165.7client's care in advance of and in preparation for the client's move from one stage of care
165.8or life to another by maintaining contact with the client and assisting the client to establish
165.9provider relationships;
165.10(2) providing the client with knowledge and skills needed posttransition;
165.11(3) establishing communication between sending and receiving entities;
165.12(4) supporting a client's request for service authorization and enrollment; and
165.13(5) establishing and enforcing procedures and schedules.
165.14~~A youth's transition from the children's mental health system and services to the adult~~
165.15~~mental health system and services and return to the client's home and entry or re-entry into~~
165.16~~community-based mental health services following discharge from an out-of-home placement~~
165.17~~or inpatient hospital stay.~~
165.18(i) "Treatment team" means all staff who provide services to recipients under this section.
165.19(j) "Family peer specialist" means a staff person who is qualified under section
165.20256B.0616.

165.21    Sec. 39. Minnesota Statutes 2021 Supplement, section 256B.0947, subdivision 6, is
165.22amended to read:
165.23    Subd. 6. Service standards. The standards in this subdivision apply to intensive
165.24nonresidential rehabilitative mental health services.
165.25(a) The treatment team must use team treatment, not an individual treatment model.
165.26(b) Services must be available at times that meet client needs.
165.27(c) Services must be age-appropriate and meet the specific needs of the client.
165.28(d) The level of care assessment as defined in section 245I.02, subdivision 19, and
165.29functional assessment as defined in section 245I.02, subdivision 17, must be updated at
166.1least every ~~90 days~~ six months or prior to discharge from the service, whichever comes
166.2first.
166.3(e) The treatment team must complete an individual treatment plan for each client,
166.4according to section 245I.10, subdivisions 7 and 8, and the individual treatment plan must:
166.5(1) be completed in consultation with the client's current therapist and key providers and
166.6provide for ongoing consultation with the client's current therapist to ensure therapeutic
166.7continuity and to facilitate the client's return to the community. For clients under the age of
166.818, the treatment team must consult with parents and guardians in developing the treatment
166.9plan;
166.10(2) if a need for substance use disorder treatment is indicated by validated assessment:
166.11(i) identify goals, objectives, and strategies of substance use disorder treatment;
166.12(ii) develop a schedule for accomplishing substance use disorder treatment goals and
166.13objectives; and
166.14(iii) identify the individuals responsible for providing substance use disorder treatment
166.15services and supports; and
166.16(3) provide for the client's transition out of intensive nonresidential rehabilitative mental
166.17health services by defining the team's actions to assist the client and subsequent providers
166.18in the transition to less intensive or "stepped down" services~~; and~~.
166.19~~(4) notwithstanding section~~ ~~245I.10, subdivision 8, be reviewed at least every 90 days~~
166.20~~and revised to document treatment progress or, if progress is not documented, to document~~
166.21~~changes in treatment.~~
166.22(f) The treatment team shall actively and assertively engage the client's family members
166.23and significant others by establishing communication and collaboration with the family and
166.24significant others and educating the family and significant others about the client's mental
166.25illness, symptom management, and the family's role in treatment, unless the team knows or
166.26has reason to suspect that the client has suffered or faces a threat of suffering any physical
166.27or mental injury, abuse, or neglect from a family member or significant other.
166.28(g) For a client age 18 or older, the treatment team may disclose to a family member,
166.29other relative, or a close personal friend of the client, or other person identified by the client,
166.30the protected health information directly relevant to such person's involvement with the
166.31client's care, as provided in Code of Federal Regulations, title 45, part 164.502(b). If the
166.32client is present, the treatment team shall obtain the client's agreement, provide the client
166.33with an opportunity to object, or reasonably infer from the circumstances, based on the
167.1exercise of professional judgment, that the client does not object. If the client is not present
167.2or is unable, by incapacity or emergency circumstances, to agree or object, the treatment
167.3team may, in the exercise of professional judgment, determine whether the disclosure is in
167.4the best interests of the client and, if so, disclose only the protected health information that
167.5is directly relevant to the family member's, relative's, friend's, or client-identified person's
167.6involvement with the client's health care. The client may orally agree or object to the
167.7disclosure and may prohibit or restrict disclosure to specific individuals.
167.8(h) The treatment team shall provide interventions to promote positive interpersonal
167.9relationships.
167.10EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
167.11whichever is later. The commissioner of human services shall notify the revisor of statutes
167.12when federal approval is obtained.

167.13    Sec. 40. Minnesota Statutes 2021 Supplement, section 256B.0949, subdivision 2, is
167.14amended to read:
167.15    Subd. 2. Definitions. (a) The terms used in this section have the meanings given in this
167.16subdivision.
167.17(b) "Advanced certification" means a person who has completed advanced certification
167.18in an approved modality under subdivision 13, paragraph (b).
167.19~~(b)~~ (c) "Agency" means the legal entity that is enrolled with Minnesota health care
167.20programs as a medical assistance provider according to Minnesota Rules, part 9505.0195,
167.21to provide EIDBI services and that has the legal responsibility to ensure that its employees
167.22or contractors carry out the responsibilities defined in this section. Agency includes a licensed
167.23individual professional who practices independently and acts as an agency.
167.24~~(c)~~ (d) "Autism spectrum disorder or a related condition" or "ASD or a related condition"
167.25means either autism spectrum disorder (ASD) as defined in the current version of the
167.26Diagnostic and Statistical Manual of Mental Disorders (DSM) or a condition that is found
167.27to be closely related to ASD, as identified under the current version of the DSM, and meets
167.28all of the following criteria:
167.29(1) is severe and chronic;
167.30(2) results in impairment of adaptive behavior and function similar to that of a person
167.31with ASD;
167.32(3) requires treatment or services similar to those required for a person with ASD; and
168.1(4) results in substantial functional limitations in three core developmental deficits of
168.2ASD: social or interpersonal interaction; functional communication, including nonverbal
168.3or social communication; and restrictive or repetitive behaviors or hyperreactivity or
168.4hyporeactivity to sensory input; and may include deficits or a high level of support in one
168.5or more of the following domains:
168.6(i) behavioral challenges and self-regulation;
168.7(ii) cognition;
168.8(iii) learning and play;
168.9(iv) self-care; or
168.10(v) safety.
168.11~~(d)~~ (e) "Person" means a person under 21 years of age.
168.12~~(e)~~ (f) "Clinical supervision" means the overall responsibility for the control and direction
168.13of EIDBI service delivery, including individual treatment planning, staff supervision,
168.14individual treatment plan progress monitoring, and treatment review for each person. Clinical
168.15supervision is provided by a qualified supervising professional (QSP) who takes full
168.16professional responsibility for the service provided by each supervisee.
168.17~~(f)~~ (g) "Commissioner" means the commissioner of human services, unless otherwise
168.18specified.
168.19~~(g)~~ (h) "Comprehensive multidisciplinary evaluation" or "CMDE" means a comprehensive
168.20evaluation of a person to determine medical necessity for EIDBI services based on the
168.21requirements in subdivision 5.
168.22~~(h)~~ (i) "Department" means the Department of Human Services, unless otherwise
168.23specified.
168.24~~(i)~~ (j) "Early intensive developmental and behavioral intervention benefit" or "EIDBI
168.25benefit" means a variety of individualized, intensive treatment modalities approved and
168.26published by the commissioner that are based in behavioral and developmental science
168.27consistent with best practices on effectiveness.
168.28~~(j)~~ (k) "Generalizable goals" means results or gains that are observed during a variety
168.29of activities over time with different people, such as providers, family members, other adults,
168.30and people, and in different environments including, but not limited to, clinics, homes,
168.31schools, and the community.
168.32~~(k)~~ (l) "Incident" means when any of the following occur:
169.1(1) an illness, accident, or injury that requires first aid treatment;
169.2(2) a bump or blow to the head; or
169.3(3) an unusual or unexpected event that jeopardizes the safety of a person or staff,
169.4including a person leaving the agency unattended.
169.5~~(l)~~ (m) "Individual treatment plan" or "ITP" means the person-centered, individualized
169.6written plan of care that integrates and coordinates person and family information from the
169.7CMDE for a person who meets medical necessity for the EIDBI benefit. An individual
169.8treatment plan must meet the standards in subdivision 6.
169.9~~(m)~~ (n) "Legal representative" means the parent of a child who is under 18 years of age,
169.10a court-appointed guardian, or other representative with legal authority to make decisions
169.11about service for a person. For the purpose of this subdivision, "other representative with
169.12legal authority to make decisions" includes a health care agent or an attorney-in-fact
169.13authorized through a health care directive or power of attorney.
169.14~~(n)~~ (o) "Mental health professional" means a staff person who is qualified according to
169.15section 245I.04, subdivision 2.
169.16~~(o)~~ (p) "Person-centered" means a service that both responds to the identified needs,
169.17interests, values, preferences, and desired outcomes of the person or the person's legal
169.18representative and respects the person's history, dignity, and cultural background and allows
169.19inclusion and participation in the person's community.
169.20~~(p)~~ (q) "Qualified EIDBI provider" means a person who is a QSP or a level I, level II,
169.21or level III treatment provider.

169.22    Sec. 41. Minnesota Statutes 2020, section 256B.0949, subdivision 8, is amended to read:
169.23    Subd. 8. Refining the benefit with stakeholders. Before making revisions to the EIDBI
169.24benefit or proposing statutory changes to this section, the commissioner must ~~refine the~~
169.25~~details of the benefit in consultation~~ consult with stakeholders and consider recommendations
169.26from the Department of Human Services Early Intensive Developmental and Behavioral
169.27Intervention Advisory Council, the early intensive developmental and behavioral intervention
169.28learning collaborative, and the Departments of Health, Education, Employment and Economic
169.29Development, and Human Services. ~~The details must~~ Revisions and proposed statutory
169.30changes subject to this subdivision include, but are not limited to, the following components:
169.31(1) a definition of the qualifications, standards, and roles of the treatment team, including
169.32recommendations after stakeholder consultation on whether board-certified behavior analysts
170.1and other professionals certified in other treatment approaches recognized by the department
170.2or trained in ASD or a related condition and child development should be added as
170.3professionals qualified to provide EIDBI clinical supervision or other functions under
170.4medical assistance;
170.5(2) refinement of uniform parameters for CMDE and ongoing ITP progress monitoring
170.6standards;
170.7(3) the design of an effective and consistent process for assessing the person's and the
170.8person's legal representative's and the person's caregiver's preferences and options to
170.9participate in the person's early intervention treatment and efficacy of methods to involve
170.10and educate the person's legal representative and caregiver in the treatment of the person;
170.11(4) formulation of a collaborative process in which professionals have opportunities to
170.12collectively inform provider standards and qualifications; standards for CMDE; medical
170.13necessity determination; efficacy of treatment apparatus, including modality, intensity,
170.14frequency, and duration; and ITP progress monitoring processes to support quality
170.15improvement of EIDBI services;
170.16(5) coordination of this benefit and its interaction with other services provided by the
170.17Departments of Human Services, Health, Employment and Economic Development, and
170.18Education;
170.19(6) evaluation, on an ongoing basis, of EIDBI services outcomes and efficacy of treatment
170.20modalities provided to people under this benefit; and
170.21(7) as provided under subdivision 17, determination of the availability of qualified EIDBI
170.22providers with necessary expertise and training in ASD or a related condition throughout
170.23the state to assess whether there are sufficient professionals to provide timely access and
170.24prevent delay in the CMDE and treatment of a person with ASD or a related condition.

170.25    Sec. 42. Minnesota Statutes 2021 Supplement, section 256B.0949, subdivision 13, is
170.26amended to read:
170.27    Subd. 13. Covered services. (a) The services described in paragraphs (b) to (l) are
170.28eligible for reimbursement by medical assistance under this section. Services must be
170.29provided by a qualified EIDBI provider and supervised by a QSP. An EIDBI service must
170.30address the person's medically necessary treatment goals and must be targeted to develop,
170.31enhance, or maintain the individual developmental skills of a person with ASD or a related
170.32condition to improve functional communication, including nonverbal or social
170.33communication, social or interpersonal interaction, restrictive or repetitive behaviors,
171.1hyperreactivity or hyporeactivity to sensory input, behavioral challenges and self-regulation,
171.2cognition, learning and play, self-care, and safety.
171.3(b) EIDBI treatment must be delivered consistent with the standards of an approved
171.4modality, as published by the commissioner. EIDBI modalities include:
171.5(1) applied behavior analysis (ABA);
171.6(2) developmental individual-difference relationship-based model (DIR/Floortime);
171.7(3) early start Denver model (ESDM);
171.8(4) PLAY project;
171.9(5) relationship development intervention (RDI); or
171.10(6) additional modalities not listed in clauses (1) to (5) upon approval by the
171.11commissioner.
171.12    (c) An EIDBI provider may use one or more of the EIDBI modalities in paragraph (b),
171.13clauses (1) to (5), as the primary modality for treatment as a covered service, or several
171.14EIDBI modalities in combination as the primary modality of treatment, as approved by the
171.15commissioner. An EIDBI provider that identifies and provides assurance of qualifications
171.16for a single specific treatment modality, including an EIDBI provider with advanced
171.17certification overseeing implementation, must document the required qualifications to meet
171.18fidelity to the specific model in a manner determined by the commissioner.
171.19(d) Each qualified EIDBI provider must identify and provide assurance of qualifications
171.20for professional licensure certification, or training in evidence-based treatment methods,
171.21and must document the required qualifications outlined in subdivision 15 in a manner
171.22determined by the commissioner.
171.23    (e) CMDE is a comprehensive evaluation of the person's developmental status to
171.24determine medical necessity for EIDBI services and meets the requirements of subdivision
171.255. The services must be provided by a qualified CMDE provider.
171.26(f) EIDBI intervention observation and direction is the clinical direction and oversight
171.27of EIDBI services by the QSP, level I treatment provider, or level II treatment provider,
171.28including developmental and behavioral techniques, progress measurement, data collection,
171.29function of behaviors, and generalization of acquired skills for the direct benefit of a person.
171.30EIDBI intervention observation and direction informs any modification of the current
171.31treatment protocol to support the outcomes outlined in the ITP.
172.1(g) Intervention is medically necessary direct treatment provided to a person with ASD
172.2or a related condition as outlined in their ITP. All intervention services must be provided
172.3under the direction of a QSP. Intervention may take place across multiple settings. The
172.4frequency and intensity of intervention services are provided based on the number of
172.5treatment goals, person and family or caregiver preferences, and other factors. Intervention
172.6services may be provided individually or in a group. Intervention with a higher provider
172.7ratio may occur when deemed medically necessary through the person's ITP.
172.8(1) Individual intervention is treatment by protocol administered by a single qualified
172.9EIDBI provider delivered to one person.
172.10(2) Group intervention is treatment by protocol provided by one or more qualified EIDBI
172.11providers, delivered to at least two people who receive EIDBI services.
172.12(3) Higher provider ratio intervention is treatment with protocol modification provided
172.13by two or more qualified EIDBI providers delivered to one person in an environment that
172.14meets the person's needs and under the direction of the QSP or level I provider.
172.15(h) ITP development and ITP progress monitoring is development of the initial, annual,
172.16and progress monitoring of an ITP. ITP development and ITP progress monitoring documents
172.17provide oversight and ongoing evaluation of a person's treatment and progress on targeted
172.18goals and objectives and integrate and coordinate the person's and the person's legal
172.19representative's information from the CMDE and ITP progress monitoring. This service
172.20must be reviewed and completed by the QSP, and may include input from a level I provider
172.21or a level II provider.
172.22(i) Family caregiver training and counseling is specialized training and education for a
172.23family or primary caregiver to understand the person's developmental status and help with
172.24the person's needs and development. This service must be provided by the QSP, level I
172.25provider, or level II provider.
172.26(j) A coordinated care conference is a voluntary meeting with the person and the person's
172.27family to review the CMDE or ITP progress monitoring and to integrate and coordinate
172.28services across providers and service-delivery systems to develop the ITP. This service
172.29~~must be provided by the QSP and~~ may include the CMDE provider or, QSP, a level I
172.30provider, or a level II provider.
172.31(k) Travel time is allowable billing for traveling to and from the person's home, school,
172.32a community setting, or place of service outside of an EIDBI center, clinic, or office from
172.33a specified location to provide in-person EIDBI intervention, observation and direction, or
173.1family caregiver training and counseling. The person's ITP must specify the reasons the
173.2provider must travel to the person.
173.3(l) Medical assistance covers medically necessary EIDBI services and consultations
173.4delivered ~~by a licensed health care provider~~ via telehealth, as defined under section
173.5256B.0625, subdivision 3b, in the same manner as if the service or consultation was delivered
173.6in person.

173.7    Sec. 43. Minnesota Statutes 2020, section 256G.02, subdivision 6, is amended to read:
173.8    Subd. 6. Excluded time. "Excluded time" means:
173.9(1) any period an applicant spends in a hospital, sanitarium, nursing home, shelter other
173.10than an emergency shelter, halfway house, foster home, community residential setting
173.11licensed under chapter 245D, semi-independent living domicile or services program,
173.12residential facility offering care, board and lodging facility or other institution for the
173.13hospitalization or care of human beings, as defined in section 144.50, 144A.01, or 245A.02,
173.14subdivision 14; maternity home, battered women's shelter, or correctional facility; or any
173.15facility based on an emergency hold under section 253B.05, subdivisions 1 and 2;
173.16(2) any period an applicant spends on a placement basis in a training and habilitation
173.17program, including: a rehabilitation facility or work or employment program as defined in
173.18section 268A.01; semi-independent living services provided under section 252.275, and
173.19chapter 245D; or day training and habilitation programs ~~and~~;
173.20(3) any period an applicant is receiving assisted living services, integrated community
173.21supports, or day support services; and
173.22~~(3)~~ (4) any placement for a person with an indeterminate commitment, including
173.23independent living.

173.24    Sec. 44. Minnesota Statutes 2020, section 256K.26, subdivision 2, is amended to read:
173.25    Subd. 2. Implementation. The commissioner, in consultation with the commissioners
173.26of the Department of Corrections and the Minnesota Housing Finance Agency, counties,
173.27Tribes, providers, and funders of supportive housing and services, shall develop application
173.28requirements and make funds available according to this section, with the goal of providing
173.29maximum flexibility in program design.

173.30    Sec. 45. Minnesota Statutes 2020, section 256K.26, subdivision 6, is amended to read:
173.31    Subd. 6. Outcomes. Projects will be selected to further the following outcomes:
174.1(1) reduce the number of Minnesota individuals and families that experience long-term
174.2homelessness;
174.3(2) increase the number of housing opportunities with supportive services;
174.4(3) develop integrated, cost-effective service models that address the multiple barriers
174.5to obtaining housing stability faced by people experiencing long-term homelessness,
174.6including abuse, neglect, chemical dependency, disability, chronic health problems, or other
174.7factors including ethnicity and race that may result in poor outcomes or service disparities;
174.8(4) encourage partnerships among counties, Tribes, community agencies, schools, and
174.9other providers so that the service delivery system is seamless for people experiencing
174.10long-term homelessness;
174.11(5) increase employability, self-sufficiency, and other social outcomes for individuals
174.12and families experiencing long-term homelessness; and
174.13(6) reduce inappropriate use of emergency health care, shelter, ~~chemical dependency~~
174.14substance use disorder treatment, foster care, child protection, corrections, and similar
174.15services used by people experiencing long-term homelessness.

174.16    Sec. 46. Minnesota Statutes 2020, section 256K.26, subdivision 7, is amended to read:
174.17    Subd. 7. Eligible services. Services eligible for funding under this section are all services
174.18needed to maintain households in permanent supportive housing, as determined by the
174.19~~county or~~ counties or Tribes administering the project or projects.

174.20    Sec. 47. Minnesota Statutes 2021 Supplement, section 256P.01, subdivision 6a, is amended
174.21to read:
174.22    Subd. 6a. Qualified professional. (a) For illness, injury, or incapacity, a "qualified
174.23professional" means a licensed physician, physician assistant, advanced practice registered
174.24nurse, physical therapist, occupational therapist, or licensed chiropractor, according to their
174.25scope of practice.
174.26(b) For developmental disability, learning disability, and intelligence testing, a "qualified
174.27professional" means a licensed physician, physician assistant, advanced practice registered
174.28nurse, licensed independent clinical social worker, licensed psychologist, certified school
174.29psychologist, or certified psychometrist working under the supervision of a licensed
174.30psychologist.
175.1(c) For mental health, a "qualified professional" means a licensed physician, advanced
175.2practice registered nurse, or qualified mental health professional under section 245I.04,
175.3subdivision 2.
175.4(d) For substance use disorder, a "qualified professional" means a licensed physician, a
175.5qualified mental health professional under section ~~245.462, subdivision 18, clauses (1) to~~
175.6~~(6)~~ 245I.04, subdivision 2, or an individual as defined in section 245G.11, subdivision 3,
175.74, or 5.
175.8EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
175.9whichever is later. The commissioner of human services shall notify the revisor of statutes
175.10when federal approval is obtained.

175.11    Sec. 48. Minnesota Statutes 2020, section 256Q.06, is amended by adding a subdivision
175.12to read:
175.13    Subd. 6. Account creation. If an eligible individual is unable to establish the eligible
175.14individual's own ABLE account, an ABLE account may be established on behalf of the
175.15eligible individual by the eligible individual's agent under a power of attorney or, if none,
175.16by the eligible individual's conservator or legal guardian, spouse, parent, sibling, or
175.17grandparent or a representative payee appointed for the eligible individual by the Social
175.18Security Administration, in that order.
175.19EFFECTIVE DATE.This section is effective the day following final enactment.

175.20    Sec. 49. Laws 2020, First Special Session chapter 7, section 1, subdivision 1, as amended
175.21by Laws 2021, First Special Session chapter 7, article 2, section 71, is amended to read:
175.22    Subdivision 1. Waivers and modifications; federal funding extension. When the
175.23peacetime emergency declared by the governor in response to the COVID-19 outbreak
175.24expires, is terminated, or is rescinded by the proper authority, the following waivers and
175.25modifications to human services programs issued by the commissioner of human services
175.26pursuant to Executive Orders 20-11 and 20-12 ~~that are required to comply with federal law~~
175.27may remain in effect for the time period set out in applicable federal law or for the time
175.28period set out in any applicable federally approved waiver or state plan amendment,
175.29whichever is later:
175.30(1) CV15: allowing telephone or video visits for waiver programs;
175.31(2) CV17: preserving health care coverage for Medical Assistance and MinnesotaCare;
176.1(3) CV18: implementation of federal changes to the Supplemental Nutrition Assistance
176.2Program;
176.3(4) CV20: eliminating cost-sharing for COVID-19 diagnosis and treatment;
176.4(5) CV24: allowing telephone or video use for targeted case management visits;
176.5(6) CV30: expanding telemedicine in health care, mental health, and substance use
176.6disorder settings;
176.7(7) CV37: implementation of federal changes to the Supplemental Nutrition Assistance
176.8Program;
176.9(8) CV39: implementation of federal changes to the Supplemental Nutrition Assistance
176.10Program;
176.11(9) CV42: implementation of federal changes to the Supplemental Nutrition Assistance
176.12Program;
176.13(10) CV43: expanding remote home and community-based waiver services;
176.14(11) CV44: allowing remote delivery of adult day services;
176.15(12) CV59: modifying eligibility period for the federally funded Refugee Cash Assistance
176.16Program;
176.17(13) CV60: modifying eligibility period for the federally funded Refugee Social Services
176.18Program; and
176.19(14) CV109: providing 15 percent increase for Minnesota Food Assistance Program and
176.20Minnesota Family Investment Program maximum food benefits.

176.21    Sec. 50. Laws 2021, First Special Session chapter 7, article 11, section 38, is amended to
176.22read:
176.23    Sec. 38. DIRECTION TO THE COMMISSIONER; SUBSTANCE USE DISORDER
176.24TREATMENT PAPERWORK REDUCTION.
176.25(a) The commissioner of human services, in consultation with counties, tribes, managed
176.26care organizations, substance use disorder treatment professional associations, and other
176.27relevant stakeholders, shall develop, assess, and recommend systems improvements to
176.28minimize regulatory paperwork and improve systems for substance use disorder programs
176.29licensed under Minnesota Statutes, chapter 245A, and regulated under Minnesota Statutes,
176.30chapters 245F and 245G, and Minnesota Rules, chapters 2960 and 9530. The commissioner
177.1of human services shall make available any resources needed from other divisions within
177.2the department to implement systems improvements.
177.3(b) The commissioner of health shall make available needed information and resources
177.4from the Division of Health Policy.
177.5(c) The Office of MN.IT Services shall provide advance consultation and implementation
177.6of the changes needed in data systems.
177.7(d) The commissioner of human services shall contract with a vendor that has experience
177.8with developing statewide system changes for multiple states at the payer and provider
177.9levels. If the commissioner, after exercising reasonable diligence, is unable to secure a
177.10vendor with the requisite qualifications, the commissioner may select the best qualified
177.11vendor available. When developing recommendations, the commissioner shall consider
177.12input from all stakeholders. The commissioner's recommendations shall maximize benefits
177.13for clients and utility for providers, regulatory agencies, and payers.
177.14(e) The commissioner of human services and the contracted vendor shall follow the
177.15recommendations from the report issued in response to Laws 2019, First Special Session
177.16chapter 9, article 6, section 76.
177.17(f) ~~By December 15, 2022~~ Within two years of contracting with a qualified vendor
177.18according to paragraph (d), the commissioner of human services shall take steps to implement
177.19paperwork reductions and systems improvements within the commissioner's authority and
177.20submit to the chairs and ranking minority members of the legislative committees with
177.21jurisdiction over health and human services a report that includes recommendations for
177.22changes in statutes that would further enhance systems improvements to reduce paperwork.
177.23The report shall include a summary of the approaches developed and assessed by the
177.24commissioner of human services and stakeholders and the results of any assessments
177.25conducted.

177.26    Sec. 51. REVISOR INSTRUCTION.
177.27In Minnesota Statutes and Minnesota Rules, the revisor of statutes shall change the term
177.28"chemical dependency" or similar terms to "substance use disorder." The revisor may make
177.29grammatical changes related to the term change.

177.30    Sec. 52. REPEALER.
177.31(a) Minnesota Statutes 2020, sections 254A.04; and 254B.14, subdivisions 1, 2, 3, 4,
177.32and 6, are repealed.
178.1(b) Minnesota Statutes 2021 Supplement, section 254B.14, subdivision 5, is repealed.

178.2ARTICLE 5

178.3COMMUNITY SUPPORTS

178.4    Section 1. Minnesota Statutes 2020, section 245D.10, subdivision 3a, is amended to read:
178.5    Subd. 3a. Service termination. (a) The license holder must establish policies and
178.6procedures for service termination that promote continuity of care and service coordination
178.7with the person and the case manager and with other licensed caregivers, if any, who also
178.8provide support to the person. The policy must include the requirements specified in
178.9paragraphs (b) to (f).
178.10(b) The license holder must permit each person to remain in the program or to continue
178.11receiving services and must not terminate services unless:
178.12(1) the termination is necessary for the person's welfare and the ~~facility~~ license holder
178.13cannot meet the person's needs;
178.14(2) the safety of the person or, others in the program, or staff is endangered and positive
178.15support strategies were attempted and have not achieved and effectively maintained safety
178.16for the person or others;
178.17(3) the health of the person or, others in the program, or staff would otherwise be
178.18endangered;
178.19(4) the ~~program~~ license holder has not been paid for services;
178.20(5) the program or license holder ceases to operate;
178.21(6) the person has been terminated by the lead agency from waiver eligibility; or
178.22(7) for state-operated community-based services, the person no longer demonstrates
178.23complex behavioral needs that cannot be met by private community-based providers
178.24identified in section 252.50, subdivision 5, paragraph (a), clause (1).
178.25(c) Prior to giving notice of service termination, the license holder must document actions
178.26taken to minimize or eliminate the need for termination. Action taken by the license holder
178.27must include, at a minimum:
178.28(1) consultation with the person's support team or expanded support team to identify
178.29and resolve issues leading to issuance of the termination notice;
178.30(2) a request to the case manager for intervention services identified in section 245D.03,
178.31subdivision 1, paragraph (c), clause (1), or other professional consultation or intervention
179.1services to support the person in the program. This requirement does not apply to notices
179.2of service termination issued under paragraph (b), clauses (4) and (7); and
179.3(3) for state-operated community-based services terminating services under paragraph
179.4(b), clause (7), the state-operated community-based services must engage in consultation
179.5with the person's support team or expanded support team to:
179.6(i) identify that the person no longer demonstrates complex behavioral needs that cannot
179.7be met by private community-based providers identified in section 252.50, subdivision 5,
179.8paragraph (a), clause (1);
179.9(ii) provide notice of intent to issue a termination of services to the lead agency when a
179.10finding has been made that a person no longer demonstrates complex behavioral needs that
179.11cannot be met by private community-based providers identified in section 252.50, subdivision
179.125, paragraph (a), clause (1);
179.13(iii) assist the lead agency and case manager in developing a person-centered transition
179.14plan to a private community-based provider to ensure continuity of care; and
179.15(iv) coordinate with the lead agency to ensure the private community-based service
179.16provider is able to meet the person's needs and criteria established in a person's
179.17person-centered transition plan.
179.18If, based on the best interests of the person, the circumstances at the time of the notice were
179.19such that the license holder was unable to take the action specified in clauses (1) and (2),
179.20the license holder must document the specific circumstances and the reason for being unable
179.21to do so.
179.22(d) The notice of service termination must meet the following requirements:
179.23(1) the license holder must notify the person or the person's legal representative and the
179.24case manager in writing of the intended service termination. If the service termination is
179.25from residential supports and services as defined in section 245D.03, subdivision 1, paragraph
179.26(c), clause (3), the license holder must also notify the commissioner in writing; and
179.27(2) the notice must include:
179.28(i) the reason for the action;
179.29(ii) except for a service termination under paragraph (b), clause (5), a summary of actions
179.30taken to minimize or eliminate the need for service termination or temporary service
179.31suspension as required under paragraph (c), and why these measures failed to prevent the
179.32termination or suspension;
180.1(iii) the person's right to appeal the termination of services under section 256.045,
180.2subdivision 3, paragraph (a); and
180.3(iv) the person's right to seek a temporary order staying the termination of services
180.4according to the procedures in section 256.045, subdivision 4a or 6, paragraph (c).
180.5(e) Notice of the proposed termination of service, including those situations that began
180.6with a temporary service suspension, must be given at least 90 days prior to termination of
180.7services under paragraph (b), clause (7), 60 days prior to termination when a license holder
180.8is providing intensive supports and services identified in section 245D.03, subdivision 1,
180.9paragraph (c), and 30 days prior to termination for all other services licensed under this
180.10chapter. This notice may be given in conjunction with a notice of temporary service
180.11suspension under subdivision 3.
180.12(f) During the service termination notice period, the license holder must:
180.13(1) work with the support team or expanded support team to develop reasonable
180.14alternatives to protect the person and others and to support continuity of care;
180.15(2) provide information requested by the person or case manager; and
180.16(3) maintain information about the service termination, including the written notice of
180.17intended service termination, in the service recipient record.
180.18(g) For notices issued under paragraph (b), clause (7), the lead agency shall provide
180.19notice to the commissioner and state-operated services at least 30 days before the conclusion
180.20of the 90-day termination period, if an appropriate alternative provider cannot be secured.
180.21Upon receipt of this notice, the commissioner and state-operated services shall reassess
180.22whether a private community-based service can meet the person's needs. If the commissioner
180.23determines that a private provider can meet the person's needs, state-operated services shall,
180.24if necessary, extend notice of service termination until placement can be made. If the
180.25commissioner determines that a private provider cannot meet the person's needs,
180.26state-operated services shall rescind the notice of service termination and re-engage with
180.27the lead agency in service planning for the person.
180.28(h) For state-operated community-based services, the license holder shall prioritize the
180.29capacity created within the existing service site by the termination of services under paragraph
180.30(b), clause (7), to serve persons described in section 252.50, subdivision 5, paragraph (a),
180.31clause (1).

181.1    Sec. 2. Minnesota Statutes 2020, section 256.045, subdivision 3, is amended to read:
181.2    Subd. 3. State agency hearings. (a) State agency hearings are available for the following:
181.3(1) any person applying for, receiving or having received public assistance, medical
181.4care, or a program of social services granted by the state agency or a county agency or the
181.5federal Food and Nutrition Act whose application for assistance is denied, not acted upon
181.6with reasonable promptness, or whose assistance is suspended, reduced, terminated, or
181.7claimed to have been incorrectly paid;
181.8(2) any patient or relative aggrieved by an order of the commissioner under section
181.9252.27;
181.10(3) a party aggrieved by a ruling of a prepaid health plan;
181.11(4) except as provided under chapter 245C, any individual or facility determined by a
181.12lead investigative agency to have maltreated a vulnerable adult under section 626.557 after
181.13they have exercised their right to administrative reconsideration under section 626.557;
181.14(5) any person whose claim for foster care payment according to a placement of the
181.15child resulting from a child protection assessment under chapter 260E is denied or not acted
181.16upon with reasonable promptness, regardless of funding source;
181.17(6) any person to whom a right of appeal according to this section is given by other
181.18provision of law;
181.19(7) an applicant aggrieved by an adverse decision to an application for a hardship waiver
181.20under section 256B.15;
181.21(8) an applicant aggrieved by an adverse decision to an application or redetermination
181.22for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;
181.23(9) except as provided under chapter 245A, an individual or facility determined to have
181.24maltreated a minor under chapter 260E, after the individual or facility has exercised the
181.25right to administrative reconsideration under chapter 260E;
181.26(10) except as provided under chapter 245C, an individual disqualified under sections
181.27245C.14 and 245C.15, following a reconsideration decision issued under section 245C.23,
181.28on the basis of serious or recurring maltreatment; a preponderance of the evidence that the
181.29individual has committed an act or acts that meet the definition of any of the crimes listed
181.30in section 245C.15, subdivisions 1 to 4; or for failing to make reports required under section
181.31260E.06, subdivision 1, or 626.557, subdivision 3. Hearings regarding a maltreatment
181.32determination under clause (4) or (9) and a disqualification under this clause in which the
182.1basis for a disqualification is serious or recurring maltreatment, shall be consolidated into
182.2a single fair hearing. In such cases, the scope of review by the human services judge shall
182.3include both the maltreatment determination and the disqualification. The failure to exercise
182.4the right to an administrative reconsideration shall not be a bar to a hearing under this section
182.5if federal law provides an individual the right to a hearing to dispute a finding of
182.6maltreatment;
182.7(11) any person with an outstanding debt resulting from receipt of public assistance,
182.8medical care, or the federal Food and Nutrition Act who is contesting a setoff claim by the
182.9Department of Human Services or a county agency. The scope of the appeal is the validity
182.10of the claimant agency's intention to request a setoff of a refund under chapter 270A against
182.11the debt;
182.12(12) a person issued a notice of service termination under section 245D.10, subdivision
182.133a, ~~from~~ by a licensed provider of any residential supports ~~and~~ or services ~~as defined~~ listed
182.14in section 245D.03, subdivision 1, ~~paragraph~~ paragraphs (b) and (c), ~~clause (3),~~ that is not
182.15otherwise subject to appeal under subdivision 4a;
182.16(13) an individual disability waiver recipient based on a denial of a request for a rate
182.17exception under section 256B.4914; or
182.18(14) a person issued a notice of service termination under section 245A.11, subdivision
182.1911, that is not otherwise subject to appeal under subdivision 4a.
182.20(b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or (10),
182.21is the only administrative appeal to the final agency determination specifically, including
182.22a challenge to the accuracy and completeness of data under section 13.04. Hearings requested
182.23under paragraph (a), clause (4), apply only to incidents of maltreatment that occur on or
182.24after October 1, 1995. Hearings requested by nursing assistants in nursing homes alleged
182.25to have maltreated a resident prior to October 1, 1995, shall be held as a contested case
182.26proceeding under the provisions of chapter 14. Hearings requested under paragraph (a),
182.27clause (9), apply only to incidents of maltreatment that occur on or after July 1, 1997. A
182.28hearing for an individual or facility under paragraph (a), clauses (4), (9), and (10), is only
182.29available when there is no district court action pending. If such action is filed in district
182.30court while an administrative review is pending that arises out of some or all of the events
182.31or circumstances on which the appeal is based, the administrative review must be suspended
182.32until the judicial actions are completed. If the district court proceedings are completed,
182.33dismissed, or overturned, the matter may be considered in an administrative hearing.
183.1(c) For purposes of this section, bargaining unit grievance procedures are not an
183.2administrative appeal.
183.3(d) The scope of hearings involving claims to foster care payments under paragraph (a),
183.4clause (5), shall be limited to the issue of whether the county is legally responsible for a
183.5child's placement under court order or voluntary placement agreement and, if so, the correct
183.6amount of foster care payment to be made on the child's behalf and shall not include review
183.7of the propriety of the county's child protection determination or child placement decision.
183.8(e) The scope of hearings under paragraph (a), clauses (12) and (14), shall be limited to
183.9whether the proposed termination of services is authorized under section 245D.10,
183.10subdivision 3a, paragraph (b), or 245A.11, subdivision 11, and whether the requirements
183.11of section 245D.10, subdivision 3a, paragraphs (c) to (e), or 245A.11, subdivision 2a,
183.12paragraphs (d) to (f), were met. If the appeal includes a request for a temporary stay of
183.13termination of services, the scope of the hearing shall also include whether the case
183.14management provider has finalized arrangements for a residential facility, a program, or
183.15services that will meet the assessed needs of the recipient by the effective date of the service
183.16termination.
183.17(f) A vendor of medical care as defined in section 256B.02, subdivision 7, or a vendor
183.18under contract with a county agency to provide social services is not a party and may not
183.19request a hearing under this section, except if assisting a recipient as provided in subdivision
183.204.
183.21(g) An applicant or recipient is not entitled to receive social services beyond the services
183.22prescribed under chapter 256M or other social services the person is eligible for under state
183.23law.
183.24(h) The commissioner may summarily affirm the county or state agency's proposed
183.25action without a hearing when the sole issue is an automatic change due to a change in state
183.26or federal law.
183.27(i) Unless federal or Minnesota law specifies a different time frame in which to file an
183.28appeal, an individual or organization specified in this section may contest the specified
183.29action, decision, or final disposition before the state agency by submitting a written request
183.30for a hearing to the state agency within 30 days after receiving written notice of the action,
183.31decision, or final disposition, or within 90 days of such written notice if the applicant,
183.32recipient, patient, or relative shows good cause, as defined in section 256.0451, subdivision
183.3313, why the request was not submitted within the 30-day time limit. The individual filing
183.34the appeal has the burden of proving good cause by a preponderance of the evidence.

184.1    Sec. 3. Minnesota Statutes 2020, section 256I.03, subdivision 6, is amended to read:
184.2    Subd. 6. Medical assistance room and board rate. "Medical assistance room and board
184.3rate" means an amount equal to ~~the medical assistance income standard~~ 81 percent of the
184.4federal poverty guideline for a single individual living alone in the community less the
184.5medical assistance personal needs allowance under section 256B.35. For the purposes of
184.6this section, the amount of the room and board rate that exceeds the medical assistance room
184.7and board rate is considered a remedial care cost. A remedial care cost may be used to meet
184.8a spenddown obligation under section 256B.056, subdivision 5. The medical assistance
184.9room and board rate is to be adjusted on the first day of January of each year.

184.10ARTICLE 6

184.11BEHAVIORAL HEALTH

184.12    Section 1. [4.046] OPIOIDS, SUBSTANCE USE, AND ADDICTION SUBCABINET.
184.13    Subdivision 1. Subcabinet established; purposes. The Opioids, Substance Use, and
184.14Addiction Subcabinet is established. The purposes of the subcabinet are to identify:
184.15(1) challenges that exist within state government that create silos around addiction,
184.16treatment, prevention, and recovery; that limit access to treatment options or addiction-related
184.17services for all Minnesotans; and that prevent successful treatment outcomes;
184.18(2) opportunities that exist within state government that support accessible and effective
184.19substance use disorder treatment options or addiction-related services;
184.20(3) barriers and gaps in service for all Minnesotans seeking treatment for opioid or
184.21substance use disorder, particularly those barriers and gaps affecting members of communities
184.22disproportionately impacted by substance use and addiction;
184.23(4) potential solutions to barriers and gaps identified in clause (3);
184.24(5) how the state can address addiction as a chronic disease, emphasizing that there are
184.25multiple ways to enter sobriety; and
184.26(6) policies and strategies that address prevention efforts, including addressing underlying
184.27causes of addiction and public awareness and education around the dangers of issues
184.28including but not limited to opioid abuse, use of fentanyl and other synthetic opioids, other
184.29substance use, excessive alcohol consumption, and addiction.
184.30    Subd. 2. Subcabinet membership. The subcabinet consists of the following members:
184.31(1) the commissioner of human services;
185.1(2) the commissioner of health;
185.2(3) the commissioner of education;
185.3(4) the commissioner of public safety;
185.4(5) the commissioner of corrections;
185.5(6) the commissioner of management and budget;
185.6(7) the commissioner of higher education;
185.7(8) the chair of the Interagency Council on Homelessness; and
185.8(9) the governor's director of addiction and recovery, who shall serve as chair of the
185.9subcabinet.
185.10    Subd. 3. Policy and strategy development. The subcabinet must engage in the following
185.11duties related to the development of opioid use, substance use, and addiction policy and
185.12strategy:
185.13(1) identify challenges and opportunities that exist relating to accessing treatment and
185.14support services and develop recommendations to overcome these barriers for all
185.15Minnesotans;
185.16(2) with input from affected communities, develop policies and strategies that will reduce
185.17barriers and gaps in service for all Minnesotans seeking treatment for opioid or substance
185.18use disorder, particularly for those Minnesotans who are members of communities
185.19disproportionately impacted by substance use and addiction;
185.20(3) develop policies and strategies that the state may adopt to expand Minnesota's recovery
185.21infrastructure, including detoxification or withdrawal management facilities, treatment
185.22facilities, and sober housing;
185.23(4) identify innovative services and strategies for effective treatment and support;
185.24(5) develop policies and strategies to expand services and support for people in Minnesota
185.25suffering from opioid or substance use disorder through partnership with the Opioid Epidemic
185.26Response Advisory Council and other relevant partnerships;
185.27(6) develop policies and strategies for agencies to manage addiction and the relationship
185.28it has with co-occurring conditions;
185.29(7) identify policies and strategies to address opioid or substance use disorder among
185.30Minnesotans experiencing homelessness; and
186.1(8) submit recommendations to the legislature addressing opioid use, substance use, and
186.2addiction in Minnesota.
186.3    Subd. 4. Public engagement. The subcabinet must develop and implement a framework
186.4to ensure meaningful public engagement is conducted by the subcabinet's agencies and
186.5boards. The purpose of the framework is to:
186.6(1) engage with and seek feedback from all affected Minnesotans, including members
186.7of the 11 Tribal Nations within Minnesota;
186.8(2) build partnerships and shared understanding with all affected Minnesotans, including
186.9members of Tribal communities in urban areas, communities of color, local communities,
186.10and industries, including but not limited to the health and business sectors;
186.11(3) provide a platform for dialogue about the needs and challenges of those in active
186.12addiction or in recovery and to identify effective solutions and how those solutions will
186.13impact the lives of people in Minnesota, including those who are members of communities
186.14disproportionately impacted by addiction, including opioid addiction; and
186.15(4) gather and share ideas for how Minnesotans can get involved with and stay informed
186.16about addiction issues that matter to them.
186.17    Subd. 5. Governor's Advisory Council on Opioids, Substance Use, and Addiction. (a)
186.18The Governor's Advisory Council on Opioids, Substance Use, and Addiction is established
186.19to advise the subcabinet on the purposes and duties described in this section. The advisory
186.20council consists of up to 18 members appointed by the governor. The governor must seek
186.21representation from community leaders, individuals with direct experience with addiction,
186.22individuals providing treatment services, and other relevant stakeholders in making
186.23appointments to the council. The governor will appoint one member as chair of the advisory
186.24council.
186.25(b) The advisory council must:
186.26(1) meet up to four times per year to identify opportunities for and barriers to the
186.27development and implementation of policies and strategies to expand access to effective
186.28services for people in Minnesota suffering from addiction;
186.29(2) examine what services and supports are needed in communities that are
186.30disproportionately impacted by the opioid epidemic; and
186.31(3) provide opportunities for Minnesotans who have directly experienced addiction to
186.32address needs, challenges, and solutions.
187.1(c) The terms, compensation, and removal of members of the advisory council are
187.2governed by section 15.059.
187.3    Subd. 6. Addiction and recovery director. The governor must appoint an addiction
187.4and recovery director, who shall serve as chair of the subcabinet. The director shall serve
187.5in the unclassified service and shall report to the governor. The director must:
187.6(1) make efforts to break down silos and work across agencies to better target the state's
187.7role in addressing addiction, treatment, and recovery;
187.8(2) assist in leading the subcabinet and the advisory council toward progress on
187.9measurable goals that track the state's efforts in combatting addiction; and
187.10(3) establish and manage external partnerships and build relationships with communities,
187.11community leaders, and those who have direct experience with addiction to ensure that all
187.12voices of recovery are represented in the work of the subcabinet and advisory council.
187.13    Subd. 7. Staff and administrative support. The commissioner of human services, in
187.14coordination with other state agencies and boards as applicable, must provide staffing and
187.15administrative support to the addiction and recovery director, the subcabinet, and the advisory
187.16council established in this section.
187.17EFFECTIVE DATE.This section is effective the day following final enactment.

187.18    Sec. 2. Minnesota Statutes 2020, section 13.46, subdivision 7, is amended to read:
187.19    Subd. 7. Mental health data. (a) Mental health data are private data on individuals and
187.20shall not be disclosed, except:
187.21(1) pursuant to section 13.05, as determined by the responsible authority for the
187.22community mental health center, mental health division, or provider;
187.23(2) pursuant to court order;
187.24(3) pursuant to a statute specifically authorizing access to or disclosure of mental health
187.25data or as otherwise provided by this subdivision;
187.26(4) to personnel of the welfare system working in the same program or providing services
187.27to the same individual or family to the extent necessary to coordinate services, provided
187.28that a health record may be disclosed only as provided under section 144.293;
187.29(5) to a health care provider governed by sections 144.291 to 144.298, to the extent
187.30necessary to coordinate services; or
187.31(6) with the consent of the client or patient.
188.1(b) An agency of the welfare system may not require an individual to consent to the
188.2release of mental health data as a condition for receiving services or for reimbursing a
188.3community mental health center, mental health division of a county, or provider under
188.4contract to deliver mental health services.
188.5(c) Notwithstanding section 245.69, subdivision 2, paragraph (f), or any other law to the
188.6contrary, ~~the responsible authority for~~ a community mental health center, mental health
188.7division of a county, or a mental health provider must disclose mental health data to a law
188.8enforcement agency if the law enforcement agency provides the name of a client or patient
188.9and communicates that the:
188.10(1) client or patient is currently involved in ~~an emergency interaction with~~ a mental
188.11health crisis as defined in section 256B.0624, subdivision 2, paragraph (j), to which the law
188.12enforcement agency has responded; and
188.13(2) data is necessary to protect the health or safety of the client or patient or of another
188.14person.
188.15The scope of disclosure under this paragraph is limited to the minimum necessary for
188.16law enforcement to safely respond to the ~~emergency~~ mental health crisis. Disclosure under
188.17this paragraph may include~~, but is not limited to,~~ the name and telephone number of the
188.18psychiatrist, psychologist, therapist, mental health professional, practitioner, or case manager
188.19of the client or patient, if known; and strategies to address the mental health crisis. A law
188.20enforcement agency that obtains mental health data under this paragraph shall maintain a
188.21record of the requestor, the provider of the ~~information~~ data, and the client or patient name.
188.22Mental health data obtained by a law enforcement agency under this paragraph are private
188.23data on individuals and must not be used by the law enforcement agency for any other
188.24purpose. A law enforcement agency that obtains mental health data under this paragraph
188.25shall inform the subject of the data that mental health data was obtained.
188.26(d) In the event of a request under paragraph (a), clause (6), a community mental health
188.27center, county mental health division, or provider must release mental health data to Criminal
188.28Mental Health Court personnel in advance of receiving a copy of a consent if the Criminal
188.29Mental Health Court personnel communicate that the:
188.30(1) client or patient is a defendant in a criminal case pending in the district court;
188.31(2) data being requested is limited to information that is necessary to assess whether the
188.32defendant is eligible for participation in the Criminal Mental Health Court; and
189.1(3) client or patient has consented to the release of the mental health data and a copy of
189.2the consent will be provided to the community mental health center, county mental health
189.3division, or provider within 72 hours of the release of the data.
189.4For purposes of this paragraph, "Criminal Mental Health Court" refers to a specialty
189.5criminal calendar of the Hennepin County District Court for defendants with mental illness
189.6and brain injury where a primary goal of the calendar is to assess the treatment needs of the
189.7defendants and to incorporate those treatment needs into voluntary case disposition plans.
189.8The data released pursuant to this paragraph may be used for the sole purpose of determining
189.9whether the person is eligible for participation in mental health court. This paragraph does
189.10not in any way limit or otherwise extend the rights of the court to obtain the release of mental
189.11health data pursuant to court order or any other means allowed by law.

189.12    Sec. 3. Minnesota Statutes 2020, section 144.294, subdivision 2, is amended to read:
189.13    Subd. 2. Disclosure to law enforcement agency. Notwithstanding section 144.293,
189.14subdivisions 2 and 4, a provider must disclose health records relating to a patient's mental
189.15health to a law enforcement agency if the law enforcement agency provides the name of
189.16the patient and communicates that the:
189.17    (1) patient is currently involved in ~~an emergency interaction with~~ a mental health crisis
189.18as defined in section 256B.0624, subdivision 2, paragraph (j), to which the law enforcement
189.19agency has responded; and
189.20    (2) disclosure of the records is necessary to protect the health or safety of the patient or
189.21of another person.
189.22    The scope of disclosure under this subdivision is limited to the minimum necessary for
189.23law enforcement to safely respond to the ~~emergency~~ mental health crisis. The disclosure
189.24may include the name and telephone number of the psychiatrist, psychologist, therapist,
189.25mental health professional, practitioner, or case manager of the patient, if known; and
189.26strategies to address the mental health crisis. A law enforcement agency that obtains health
189.27records under this subdivision shall maintain a record of the requestor, the provider of the
189.28information, and the patient's name. Health records obtained by a law enforcement agency
189.29under this subdivision are private data on individuals as defined in section 13.02, subdivision
189.3012, and must not be used by law enforcement for any other purpose. A law enforcement
189.31agency that obtains health records under this subdivision shall inform the patient that health
189.32records were obtained.

190.1    Sec. 4. Minnesota Statutes 2021 Supplement, section 245.4889, subdivision 1, is amended
190.2to read:
190.3    Subdivision 1. Establishment and authority. (a) The commissioner is authorized to
190.4make grants from available appropriations to assist:
190.5    (1) counties;
190.6    (2) Indian tribes;
190.7    (3) children's collaboratives under section 124D.23 or 245.493; or
190.8    (4) mental health service providers.
190.9    (b) The following services are eligible for grants under this section:
190.10    (1) services to children with emotional disturbances as defined in section 245.4871,
190.11subdivision 15, and their families;
190.12    (2) transition services under section 245.4875, subdivision 8, for young adults under
190.13age 21 and their families;
190.14    (3) respite care services for children with emotional disturbances or severe emotional
190.15disturbances who are at risk of out-of-home placement or already in out-of-home placement
190.16in family foster settings as defined in chapter 245A and at risk of change in out-of-home
190.17placement or placement in a residential facility or other higher level of care. Allowable
190.18activities and expenses for respite care services are defined under subdivision 4. A child is
190.19not required to have case management services to receive respite care services;
190.20    (4) children's mental health crisis services;
190.21    (5) mental health services for people from cultural and ethnic minorities, including
190.22supervision of clinical trainees who are Black, indigenous, or people of color;
190.23    (6) children's mental health screening and follow-up diagnostic assessment and treatment;
190.24    (7) services to promote and develop the capacity of providers to use evidence-based
190.25practices in providing children's mental health services;
190.26    (8) school-linked mental health services under section 245.4901;
190.27(9) building evidence-based mental health intervention capacity for children birth to age
190.28five;
190.29    (10) suicide prevention and counseling services that use text messaging statewide;
190.30(11) mental health first aid training;
191.1(12) training for parents, collaborative partners, and mental health providers on the
191.2impact of adverse childhood experiences and trauma and development of an interactive
191.3website to share information and strategies to promote resilience and prevent trauma;
191.4(13) transition age services to develop or expand mental health treatment and supports
191.5for adolescents and young adults 26 years of age or younger;
191.6(14) early childhood mental health consultation;
191.7(15) evidence-based interventions for youth at risk of developing or experiencing a first
191.8episode of psychosis, and a public awareness campaign on the signs and symptoms of
191.9psychosis;
191.10(16) psychiatric consultation for primary care practitioners; and
191.11(17) providers to begin operations and meet program requirements when establishing a
191.12new children's mental health program. These may be start-up grants.
191.13(c) Services under paragraph (b) must be designed to help each child to function and
191.14remain with the child's family in the community and delivered consistent with the child's
191.15treatment plan. Transition services to eligible young adults under this paragraph must be
191.16designed to foster independent living in the community.
191.17(d) As a condition of receiving grant funds, a grantee shall obtain all available third-party
191.18reimbursement sources, if applicable.
191.19EFFECTIVE DATE.This section is effective July 1, 2022.

191.20    Sec. 5. Minnesota Statutes 2020, section 245.4889, is amended by adding a subdivision
191.21to read:
191.22    Subd. 4. Respite care services. Respite care services under subdivision 1, paragraph
191.23(b), clause (3), include hourly or overnight stays at a licensed foster home or with a qualified
191.24and approved family member or friend and may occur at a child's or provider's home. Respite
191.25care services may also include the following activities and expenses:
191.26(1) recreational, sport, and nonsport extracurricular activities and programs for the child
191.27including camps, clubs, lessons, group outings, sports, or other activities and programs;
191.28(2) family activities, camps, and retreats that the family does together and provide a
191.29break from the family's circumstance;
192.1(3) cultural programs and activities for the child and family designed to address the
192.2unique needs of individuals who share a common language, racial, ethnic, or social
192.3background; and
192.4(4) costs of transportation, food, supplies, and equipment directly associated with
192.5approved respite care services and expenses necessary for the child and family to access
192.6and participate in respite care services.
192.7EFFECTIVE DATE.This section is effective July 1, 2022.

192.8    Sec. 6. Minnesota Statutes 2020, section 245.713, subdivision 2, is amended to read:
192.9    Subd. 2. Total funds available; allocation. Funds granted to the state by the federal
192.10government under United States Code, title 42, sections 300X to 300X-9 each federal fiscal
192.11year for mental health services must be allocated as follows:
192.12(a) Any amount set aside by the commissioner of human services for American Indian
192.13organizations within the state, which funds shall not duplicate any direct federal funding of
192.14American Indian organizations and which funds shall be at least 25 percent of the total
192.15federal allocation to the state for mental health services~~; provided that sufficient applications~~
192.16~~for funding are received by the commissioner which meet the specifications contained in~~
192.17~~requests for proposals~~. Money from this source may be used for special committees to advise
192.18the commissioner on mental health programs and services for American Indians and other
192.19minorities or underserved groups. For purposes of this subdivision, "American Indian
192.20organization" means an American Indian tribe or band or an organization providing mental
192.21health services that is legally incorporated as a nonprofit organization registered with the
192.22secretary of state and governed by a board of directors having at least a majority of American
192.23Indian directors.
192.24(b) An amount not to exceed five percent of the federal block grant allocation for mental
192.25health services to be retained by the commissioner for administration.
192.26(c) Any amount permitted under federal law which the commissioner approves for
192.27demonstration or research projects for severely disturbed children and adolescents, the
192.28underserved, special populations or multiply disabled mentally ill persons. The groups to
192.29be served, the extent and nature of services to be provided, the amount and duration of any
192.30grant awards are to be based on criteria set forth in the Alcohol, Drug Abuse and Mental
192.31Health Block Grant Law, United States Code, title 42, sections 300X to 300X-9, and on
192.32state policies and procedures determined necessary by the commissioner. Grant recipients
192.33must comply with applicable state and federal requirements and demonstrate fiscal and
193.1program management capabilities that will result in provision of quality, cost-effective
193.2services.
193.3(d) The amount required under federal law, for federally mandated expenditures.
193.4(e) An amount not to exceed 15 percent of the federal block grant allocation for mental
193.5health services to be retained by the commissioner for planning and evaluation.
193.6EFFECTIVE DATE.This section is effective July 1, 2022.

193.7    Sec. 7. Minnesota Statutes 2021 Supplement, section 256B.0625, subdivision 5m, is
193.8amended to read:
193.9    Subd. 5m. Certified community behavioral health clinic services. (a) Medical
193.10assistance covers services provided by a not-for-profit certified community behavioral health
193.11clinic (CCBHC) ~~services~~ that ~~meet~~ meets the requirements of section 245.735, subdivision
193.123.
193.13(b) The commissioner shall reimburse CCBHCs on a ~~per-visit~~ per-day basis ~~under the~~
193.14~~prospective payment~~ for each day that an eligible service is delivered using the CCBHC
193.15daily bundled rate system for medical assistance payments as described in paragraph (c).
193.16The commissioner shall include a quality incentive payment in the ~~prospective payment~~
193.17CCBHC daily bundled rate system as described in paragraph (e). There is no county share
193.18for medical assistance services when reimbursed through the CCBHC ~~prospective payment~~
193.19daily bundled rate system.
193.20(c) The commissioner shall ensure that the ~~prospective payment~~ CCBHC daily bundled
193.21rate system for CCBHC payments under medical assistance meets the following requirements:
193.22(1) the ~~prospective payment~~ CCBHC daily bundled rate shall be a provider-specific rate
193.23calculated for each CCBHC, based on the daily cost of providing CCBHC services and the
193.24total annual allowable CCBHC costs ~~for CCBHCs~~ divided by the total annual number of
193.25CCBHC visits. For calculating the payment rate, total annual visits include visits covered
193.26by medical assistance and visits not covered by medical assistance. Allowable costs include
193.27but are not limited to the salaries and benefits of medical assistance providers; the cost of
193.28CCBHC services provided under section 245.735, subdivision 3, paragraph (a), clauses (6)
193.29and (7); and other costs such as insurance or supplies needed to provide CCBHC services;
193.30(2) payment shall be limited to one payment per day per medical assistance enrollee ~~for~~
193.31~~each~~ when an eligible CCBHC ~~visit eligible for reimbursement~~ service is provided. A
193.32CCBHC visit is eligible for reimbursement if at least one of the CCBHC services listed
193.33under section 245.735, subdivision 3, paragraph (a), clause (6), is furnished to a medical
194.1assistance enrollee by a health care practitioner or licensed agency employed by or under
194.2contract with a CCBHC;
194.3(3) ~~new payment~~ initial CCBHC daily bundled rates ~~set by the commissioner~~ for newly
194.4certified CCBHCs under section 245.735, subdivision 3, shall be ~~based on rates for~~
194.5~~established CCBHCs with a similar scope of services. If no comparable CCBHC exists, the~~
194.6~~commissioner shall establish a clinic-specific rate using audited historical cost report data~~
194.7~~adjusted for the estimated cost of delivering CCBHC services, including the estimated cost~~
194.8~~of providing the full scope of services and the projected change in visits resulting from the~~
194.9~~change in scope~~ established by the commissioner using a provider-specific rate based on
194.10the newly certified CCBHC's audited historical cost report data adjusted for the expected
194.11cost of delivering CCBHC services. Estimates are subject to review by the commissioner
194.12and must include the expected cost of providing the full scope of CCBHC services and the
194.13expected number of visits for the rate period;
194.14(4) the commissioner shall rebase CCBHC rates once every three years following the
194.15last rebasing and no less than 12 months following an initial rate or a rate change due to a
194.16change in the scope of services;
194.17(5) the commissioner shall provide for a 60-day appeals process after notice of the results
194.18of the rebasing;
194.19(6) the ~~prospective payment~~ CCBHC daily bundled rate under this section does not apply
194.20to services rendered by CCBHCs to individuals who are dually eligible for Medicare and
194.21medical assistance when Medicare is the primary payer for the service. An entity that receives
194.22a ~~prospective payment~~ CCBHC daily bundled rate system ~~rate~~ that overlaps with the CCBHC
194.23rate is not eligible for the CCBHC rate;
194.24(7) payments for CCBHC services to individuals enrolled in managed care shall be
194.25coordinated with the state's phase-out of CCBHC wrap payments. The commissioner shall
194.26complete the phase-out of CCBHC wrap payments within 60 days of the implementation
194.27of the ~~prospective payment~~ CCBHC daily bundled rate system in the Medicaid Management
194.28Information System (MMIS), for CCBHCs reimbursed under this chapter, with a final
194.29settlement of payments due made payable to CCBHCs no later than 18 months thereafter;
194.30(8) the ~~prospective payment~~ CCBHC daily bundled rate for each CCBHC shall be updated
194.31by trending each provider-specific rate by the Medicare Economic Index for primary care
194.32services. This update shall occur each year in between rebasing periods determined by the
194.33commissioner in accordance with clause (4). CCBHCs must provide data on costs and visits
194.34to the state annually using the CCBHC cost report established by the commissioner; and
195.1(9) a CCBHC may request a rate adjustment for changes in the CCBHC's scope of
195.2services when such changes are expected to result in an adjustment to the CCBHC payment
195.3rate by 2.5 percent or more. The CCBHC must provide the commissioner with information
195.4regarding the changes in the scope of services, including the estimated cost of providing
195.5the new or modified services and any projected increase or decrease in the number of visits
195.6resulting from the change. Estimated costs are subject to review by the commissioner. Rate
195.7adjustments for changes in scope shall occur no more than once per year in between rebasing
195.8periods per CCBHC and are effective on the date of the annual CCBHC rate update.
195.9(d) Managed care plans and county-based purchasing plans shall reimburse CCBHC
195.10providers at the ~~prospective payment~~ CCBHC daily bundled rate. The commissioner shall
195.11monitor the effect of this requirement on the rate of access to the services delivered by
195.12CCBHC providers. If, for any contract year, federal approval is not received for this
195.13paragraph, the commissioner must adjust the capitation rates paid to managed care plans
195.14and county-based purchasing plans for that contract year to reflect the removal of this
195.15provision. Contracts between managed care plans and county-based purchasing plans and
195.16providers to whom this paragraph applies must allow recovery of payments from those
195.17providers if capitation rates are adjusted in accordance with this paragraph. Payment
195.18recoveries must not exceed the amount equal to any increase in rates that results from this
195.19provision. This paragraph expires if federal approval is not received for this paragraph at
195.20any time.
195.21(e) The commissioner shall implement a quality incentive payment program for CCBHCs
195.22that meets the following requirements:
195.23(1) a CCBHC shall receive a quality incentive payment upon meeting specific numeric
195.24thresholds for performance metrics established by the commissioner, in addition to payments
195.25for which the CCBHC is eligible under the ~~prospective payment~~ CCBHC daily bundled
195.26rate system described in paragraph (c);
195.27(2) a CCBHC must be certified and enrolled as a CCBHC for the entire measurement
195.28year to be eligible for incentive payments;
195.29(3) each CCBHC shall receive written notice of the criteria that must be met in order to
195.30receive quality incentive payments at least 90 days prior to the measurement year; and
195.31(4) a CCBHC must provide the commissioner with data needed to determine incentive
195.32payment eligibility within six months following the measurement year. The commissioner
195.33shall notify CCBHC providers of their performance on the required measures and the
195.34incentive payment amount within 12 months following the measurement year.
196.1(f) All claims to managed care plans for CCBHC services as provided under this section
196.2shall be submitted directly to, and paid by, the commissioner on the dates specified no later
196.3than January 1 of the following calendar year, if:
196.4(1) one or more managed care plans does not comply with the federal requirement for
196.5payment of clean claims to CCBHCs, as defined in Code of Federal Regulations, title 42,
196.6section 447.45(b), and the managed care plan does not resolve the payment issue within 30
196.7days of noncompliance; and
196.8(2) the total amount of clean claims not paid in accordance with federal requirements
196.9by one or more managed care plans is 50 percent of, or greater than, the total CCBHC claims
196.10eligible for payment by managed care plans.
196.11If the conditions in this paragraph are met between January 1 and June 30 of a calendar
196.12year, claims shall be submitted to and paid by the commissioner beginning on January 1 of
196.13the following year. If the conditions in this paragraph are met between July 1 and December
196.1431 of a calendar year, claims shall be submitted to and paid by the commissioner beginning
196.15on July 1 of the following year.

196.16    Sec. 8. Minnesota Statutes 2020, section 256B.0941, is amended by adding a subdivision
196.17to read:
196.18    Subd. 2a. Sleeping hours. During normal sleeping hours, a psychiatric residential
196.19treatment facility provider must provide at least one staff person for every six residents
196.20present within a living unit. A provider must adjust sleeping-hour staffing levels based on
196.21the clinical needs of the residents in the facility.

196.22    Sec. 9. Minnesota Statutes 2021 Supplement, section 256B.0943, subdivision 1, is amended
196.23to read:
196.24    Subdivision 1. Definitions. For purposes of this section, the following terms have the
196.25meanings given them.
196.26(a) "Children's therapeutic services and supports" means the flexible package of mental
196.27health services for children who require varying therapeutic and rehabilitative levels of
196.28intervention to treat a diagnosed emotional disturbance, as defined in section 245.4871,
196.29subdivision 15, or a diagnosed mental illness, as defined in section 245.462, subdivision
196.3020. The services are time-limited interventions that are delivered using various treatment
196.31modalities and combinations of services designed to reach treatment outcomes identified
196.32in the individual treatment plan.
197.1(b) "Clinical trainee" means a staff person who is qualified according to section 245I.04,
197.2subdivision 6.
197.3(c) "Crisis planning" has the meaning given in section 245.4871, subdivision 9a.
197.4(d) "Culturally competent provider" means a provider who understands and can utilize
197.5to a client's benefit the client's culture when providing services to the client. A provider
197.6may be culturally competent because the provider is of the same cultural or ethnic group
197.7as the client or the provider has developed the knowledge and skills through training and
197.8experience to provide services to culturally diverse clients.
197.9(e) "Day treatment program" for children means a site-based structured mental health
197.10program consisting of psychotherapy for three or more individuals and individual or group
197.11skills training provided by a team, under the treatment supervision of a mental health
197.12professional.
197.13(f) "Standard diagnostic assessment" means the assessment described in 245I.10,
197.14subdivision 6.
197.15(g) "Direct service time" means the time that a mental health professional, clinical trainee,
197.16mental health practitioner, or mental health behavioral aide spends face-to-face with a client
197.17and the client's family or providing covered services through telehealth as defined under
197.18section 256B.0625, subdivision 3b. Direct service time includes time in which the provider
197.19obtains a client's history, develops a client's treatment plan, records individual treatment
197.20outcomes, or provides service components of children's therapeutic services and supports.
197.21Direct service time does not include time doing work before and after providing direct
197.22services, including scheduling or maintaining clinical records.
197.23(h) "Direction of mental health behavioral aide" means the activities of a mental health
197.24professional, clinical trainee, or mental health practitioner in guiding the mental health
197.25behavioral aide in providing services to a client. The direction of a mental health behavioral
197.26aide must be based on the client's individual treatment plan and meet the requirements in
197.27subdivision 6, paragraph (b), clause (7).
197.28(i) "Emotional disturbance" has the meaning given in section 245.4871, subdivision 15.
197.29~~(j) "Individual behavioral plan" means a plan of intervention, treatment, and services~~
197.30~~for a child written by a mental health professional or a clinical trainee or mental health~~
197.31~~practitioner under the treatment supervision of a mental health professional, to guide the~~
197.32~~work of the mental health behavioral aide. The individual behavioral plan may be~~
198.1~~incorporated into the child's individual treatment plan so long as the behavioral plan is~~
198.2~~separately communicable to the mental health behavioral aide.~~
198.3~~(k)~~ (j) "Individual treatment plan" means the plan described in section 245I.10,
198.4subdivisions 7 and 8.
198.5~~(l)~~ (k) "Mental health behavioral aide services" means medically necessary one-on-one
198.6activities performed by a mental health behavioral aide qualified according to section
198.7245I.04, subdivision 16, to assist a child retain or generalize psychosocial skills as previously
198.8trained by a mental health professional, clinical trainee, or mental health practitioner and
198.9as described in the child's individual treatment plan and individual behavior plan. Activities
198.10involve working directly with the child or child's family as provided in subdivision 9,
198.11paragraph (b), clause (4).
198.12~~(m)~~ (l) "Mental health certified family peer specialist" means a staff person who is
198.13qualified according to section 245I.04, subdivision 12.
198.14~~(n)~~ (m) "Mental health practitioner" means a staff person who is qualified according to
198.15section 245I.04, subdivision 4.
198.16~~(o)~~ (n) "Mental health professional" means a staff person who is qualified according to
198.17section 245I.04, subdivision 2.
198.18~~(p)~~ (o) "Mental health service plan development" includes:
198.19(1) ~~the~~ development~~, review,~~ and revision of a child's individual treatment plan~~, including~~
198.20~~involvement of the client or client's parents, primary caregiver, or other person authorized~~
198.21~~to consent to mental health services for the client, and including arrangement of treatment~~
198.22~~and support activities specified in the individual treatment plan~~; and
198.23(2) administering and reporting the standardized outcome measurements in section
198.24245I.10, subdivision 6, paragraph (d), clauses (3) and (4), and other standardized outcome
198.25measurements approved by the commissioner, as periodically needed to evaluate the
198.26effectiveness of treatment.
198.27~~(q)~~ (p) "Mental illness," for persons at least age 18 but under age 21, has the meaning
198.28given in section 245.462, subdivision 20, paragraph (a).
198.29~~(r)~~ (q) "Psychotherapy" means the treatment described in section 256B.0671, subdivision
198.3011.
198.31~~(s)~~ (r) "Rehabilitative services" or "psychiatric rehabilitation services" means interventions
198.32to: (1) restore a child or adolescent to an age-appropriate developmental trajectory that had
199.1been disrupted by a psychiatric illness; or (2) enable the child to self-monitor, compensate
199.2for, cope with, counteract, or replace psychosocial skills deficits or maladaptive skills
199.3acquired over the course of a psychiatric illness. Psychiatric rehabilitation services for
199.4children combine coordinated psychotherapy to address internal psychological, emotional,
199.5and intellectual processing deficits, and skills training to restore personal and social
199.6functioning. Psychiatric rehabilitation services establish a progressive series of goals with
199.7each achievement building upon a prior achievement.
199.8~~(t)~~ (s) "Skills training" means individual, family, or group training, delivered by or under
199.9the supervision of a mental health professional, designed to facilitate the acquisition of
199.10psychosocial skills that are medically necessary to rehabilitate the child to an age-appropriate
199.11developmental trajectory heretofore disrupted by a psychiatric illness or to enable the child
199.12to self-monitor, compensate for, cope with, counteract, or replace skills deficits or
199.13maladaptive skills acquired over the course of a psychiatric illness. Skills training is subject
199.14to the service delivery requirements under subdivision 9, paragraph (b), clause (2).
199.15~~(u)~~ (t) "Treatment supervision" means the supervision described in section 245I.06.
199.16EFFECTIVE DATE.This section is effective January 1, 2023, or upon federal approval,
199.17whichever is later. The commissioner of human services shall notify the revisor of statutes
199.18when federal approval is obtained.

199.19    Sec. 10. Minnesota Statutes 2021 Supplement, section 256B.0943, subdivision 3, is
199.20amended to read:
199.21    Subd. 3. Determination of client eligibility. (a) A client's eligibility to receive children's
199.22therapeutic services and supports under this section shall be determined based on a standard
199.23diagnostic assessment by a mental health professional or a clinical trainee that is performed
199.24within one year before the initial start of service. The standard diagnostic assessment must:
199.25(1) determine whether a child under age 18 has a diagnosis of emotional disturbance or,
199.26if the person is between the ages of 18 and 21, whether the person has a mental illness;
199.27(2) document children's therapeutic services and supports as medically necessary to
199.28address an identified disability, functional impairment, and the individual client's needs and
199.29goals; and
199.30(3) be used in the development of the individual treatment plan.
199.31(b) Notwithstanding paragraph (a), a client may be determined to be eligible for up to
199.32five days of day treatment under this section based on a hospital's medical history and
199.33presentation examination of the client.
200.1(c) Children's therapeutic services and supports include development and rehabilitative
200.2services that support a child's developmental treatment needs.
200.3EFFECTIVE DATE.This section is effective January 1, 2023, or upon federal approval,
200.4whichever is later. The commissioner of human services shall notify the revisor of statutes
200.5when federal approval is obtained.

200.6    Sec. 11. Minnesota Statutes 2021 Supplement, section 256B.0943, subdivision 4, is
200.7amended to read:
200.8    Subd. 4. Provider entity certification. (a) The commissioner shall establish an initial
200.9provider entity application and certification process and recertification process to determine
200.10whether a provider entity has an administrative and clinical infrastructure that meets the
200.11requirements in subdivisions 5 and 6. A provider entity must be certified for the three core
200.12rehabilitation services of psychotherapy, skills training, and crisis planning. The
200.13commissioner shall recertify a provider entity ~~at least~~ every three years using the individual
200.14provider's certification anniversary or the calendar year end, whichever is later. The
200.15commissioner may approve a recertification extension, in the interest of sustaining services,
200.16when a certain date for recertification is identified. The commissioner shall establish a
200.17process for decertification of a provider entity and shall require corrective action, medical
200.18assistance repayment, or decertification of a provider entity that no longer meets the
200.19requirements in this section or that fails to meet the clinical quality standards or administrative
200.20standards provided by the commissioner in the application and certification process.
200.21(b) The commissioner must provide the following to providers for the certification,
200.22recertification, and decertification processes:
200.23(1) a structured listing of required provider certification criteria;
200.24(2) a formal written letter with a determination of certification, recertification, or
200.25decertification, signed by the commissioner or the appropriate division director; and
200.26(3) a formal written communication outlining the process for necessary corrective action
200.27and follow-up by the commissioner, if applicable.
200.28~~(b)~~ (c) For purposes of this section, a provider entity must meet the standards in this
200.29section and chapter 245I, as required under section 245I.011, subdivision 5, and be:
200.30(1) an Indian health services facility or a facility owned and operated by a tribe or tribal
200.31organization operating as a 638 facility under Public Law 93-638 certified by the state;
200.32(2) a county-operated entity certified by the state; or
201.1(3) a noncounty entity certified by the state.
201.2EFFECTIVE DATE.This section is effective January 1, 2023, or upon federal approval,
201.3whichever is later. The commissioner of human services shall notify the revisor of statutes
201.4when federal approval is obtained.

201.5    Sec. 12. Minnesota Statutes 2021 Supplement, section 256B.0943, subdivision 6, is
201.6amended to read:
201.7    Subd. 6. Provider entity clinical infrastructure requirements. (a) To be an eligible
201.8provider entity under this section, a provider entity must have a clinical infrastructure that
201.9utilizes diagnostic assessment, individual treatment plans, service delivery, and individual
201.10treatment plan review that are culturally competent, child-centered, and family-driven to
201.11achieve maximum benefit for the client. The provider entity must review, and update as
201.12necessary, the clinical policies and procedures every three years, must distribute the policies
201.13and procedures to staff initially and upon each subsequent update, and must train staff
201.14accordingly.
201.15    (b) The clinical infrastructure written policies and procedures must include policies and
201.16procedures for meeting the requirements in this subdivision:
201.17    (1) providing or obtaining a client's standard diagnostic assessment, including a standard
201.18diagnostic assessment. When required components of the standard diagnostic assessment
201.19are not provided in an outside or independent assessment or cannot be attained immediately,
201.20the provider entity must determine the missing information within 30 days and amend the
201.21child's standard diagnostic assessment or incorporate the information into the child's
201.22individual treatment plan;
201.23    (2) developing an individual treatment plan;
201.24    ~~(3) developing an individual behavior plan that documents and describes interventions~~
201.25~~to be provided by the mental health behavioral aide. The individual behavior plan must~~
201.26~~include:~~
201.27    ~~(i) detailed instructions on the psychosocial skills to be practiced;~~
201.28    ~~(ii) time allocated to each intervention;~~
201.29    ~~(iii) methods of documenting the child's behavior;~~
201.30    ~~(iv) methods of monitoring the child's progress in reaching objectives; and~~
201.31    ~~(v) goals to increase or decrease targeted behavior as identified in the individual treatment~~
201.32~~plan;~~
202.1    ~~(4)~~ (3) providing treatment supervision plans for staff according to section 245I.06.
202.2Treatment supervision does not include the authority to make or terminate court-ordered
202.3placements of the child. A treatment supervisor must be available for urgent consultation
202.4as required by the individual client's needs or the situation;
202.5    ~~(5) meeting day treatment program conditions in items (i) and (ii):~~
202.6    ~~(i) the treatment supervisor must be present and available on the premises more than 50~~
202.7~~percent of the time in a provider's standard working week during which the supervisee is~~
202.8~~providing a mental health service; and~~
202.9    ~~(ii) every 30 days, the treatment supervisor must review and sign the record indicating~~
202.10~~the supervisor has reviewed the client's care for all activities in the preceding 30-day period;~~
202.11    ~~(6) meeting the treatment supervision standards in items (i) and (ii) for all other services~~
202.12~~provided under CTSS:~~
202.13    ~~(i) the mental health professional is required to be present at the site of service delivery~~
202.14~~for observation as clinically appropriate when the clinical trainee, mental health practitioner,~~
202.15~~or mental health behavioral aide is providing CTSS services; and~~
202.16    ~~(ii) when conducted, the on-site presence of the mental health professional must be~~
202.17~~documented in the child's record and signed by the mental health professional who accepts~~
202.18~~full professional responsibility;~~
202.19    ~~(7) providing direction to a mental health behavioral aide. For entities that employ mental~~
202.20~~health behavioral aides, the treatment supervisor must be employed by the provider entity~~
202.21~~or other provider certified to provide mental health behavioral aide services to ensure~~
202.22~~necessary and appropriate oversight for the client's treatment and continuity of care. The~~
202.23~~staff giving direction must begin with the goals on the individual treatment plan, and instruct~~
202.24~~the mental health behavioral aide on how to implement therapeutic activities and interventions~~
202.25~~that will lead to goal attainment. The staff giving direction must also instruct the mental~~
202.26~~health behavioral aide about the client's diagnosis, functional status, and other characteristics~~
202.27~~that are likely to affect service delivery. Direction must also include determining that the~~
202.28~~mental health behavioral aide has the skills to interact with the client and the client's family~~
202.29~~in ways that convey personal and cultural respect and that the aide actively solicits~~
202.30~~information relevant to treatment from the family. The aide must be able to clearly explain~~
202.31~~or demonstrate the activities the aide is doing with the client and the activities' relationship~~
202.32~~to treatment goals. Direction is more didactic than is supervision and requires the staff~~
202.33~~providing it to continuously evaluate the mental health behavioral aide's ability to carry out~~
203.1~~the activities of the individual treatment plan and the individual behavior plan. When~~
203.2~~providing direction, the staff must:~~
203.3    ~~(i) review progress notes prepared by the mental health behavioral aide for accuracy and~~
203.4~~consistency with diagnostic assessment, treatment plan, and behavior goals and the staff~~
203.5~~must approve and sign the progress notes;~~
203.6    ~~(ii) identify changes in treatment strategies, revise the individual behavior plan, and~~
203.7~~communicate treatment instructions and methodologies as appropriate to ensure that treatment~~
203.8~~is implemented correctly;~~
203.9    ~~(iii) demonstrate family-friendly behaviors that support healthy collaboration among~~
203.10~~the child, the child's family, and providers as treatment is planned and implemented;~~
203.11    ~~(iv) ensure that the mental health behavioral aide is able to effectively communicate~~
203.12~~with the child, the child's family, and the provider;~~
203.13    ~~(v) record the results of any evaluation and corrective actions taken to modify the work~~
203.14~~of the mental health behavioral aide; and~~
203.15~~(vi) ensure~~ (4) requiring a mental health professional to determine the level of supervision
203.16for a behavioral health aide and to document and sign the supervision determination in the
203.17behavioral health aide's supervision plan;
203.18(5) ensuring the immediate accessibility of a mental health professional, clinical trainee,
203.19or mental health practitioner to the behavioral aide during service delivery;
203.20    ~~(8)~~ (6) providing service delivery that implements the individual treatment plan and
203.21meets the requirements under subdivision 9; and
203.22    ~~(9)~~ (7) individual treatment plan review. The review must determine the extent to which
203.23the services have met each of the goals and objectives in the treatment plan. The review
203.24must assess the client's progress and ensure that services and treatment goals continue to
203.25be necessary and appropriate to the client and the client's family or foster family.
203.26EFFECTIVE DATE.This section is effective January 1, 2023, or upon federal approval,
203.27whichever is later. The commissioner of human services shall notify the revisor of statutes
203.28when federal approval is obtained.

203.29    Sec. 13. Minnesota Statutes 2021 Supplement, section 256B.0943, subdivision 7, is
203.30amended to read:
203.31    Subd. 7. Qualifications of individual and team providers. (a) An individual or team
203.32provider working within the scope of the provider's practice or qualifications may provide
204.1service components of children's therapeutic services and supports that are identified as
204.2medically necessary in a client's individual treatment plan.
204.3(b) An individual provider must be qualified as a:
204.4(1) mental health professional;
204.5(2) clinical trainee;
204.6(3) mental health practitioner;
204.7(4) mental health certified family peer specialist; or
204.8(5) mental health behavioral aide.
204.9(c) A day treatment team must include ~~at least~~ one mental health professional or clinical
204.10trainee ~~and one mental health practitioner~~.
204.11EFFECTIVE DATE.This section is effective January 1, 2023, or upon federal approval,
204.12whichever is later. The commissioner of human services shall notify the revisor of statutes
204.13when federal approval is obtained.

204.14    Sec. 14. Minnesota Statutes 2021 Supplement, section 256B.0943, subdivision 9, is
204.15amended to read:
204.16    Subd. 9. Service delivery criteria. (a) In delivering services under this section, a certified
204.17provider entity must ensure that:
204.18    (1) the provider's caseload size should reasonably enable the provider to play an active
204.19role in service planning, monitoring, and delivering services to meet the client's and client's
204.20family's needs, as specified in each client's individual treatment plan;
204.21    (2) site-based programs, including day treatment programs, provide staffing and facilities
204.22to ensure the client's health, safety, and protection of rights, and that the programs are able
204.23to implement each client's individual treatment plan; and
204.24    (3) a day treatment program is provided to a group of clients by a team under the treatment
204.25supervision of a mental health professional. The day treatment program must be provided
204.26in and by: (i) an outpatient hospital accredited by the Joint Commission on Accreditation
204.27of Health Organizations and licensed under sections 144.50 to 144.55; (ii) a community
204.28mental health center under section 245.62; or (iii) an entity that is certified under subdivision
204.294 to operate a program that meets the requirements of section 245.4884, subdivision 2, and
204.30Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment program must stabilize
204.31the client's mental health status while developing and improving the client's independent
205.1living and socialization skills. The goal of the day treatment program must be to reduce or
205.2relieve the effects of mental illness and provide training to enable the client to live in the
205.3community. ~~The program must be available year-round at least three to five days per week,~~
205.4~~two or three hours per day, unless the normal five-day school week is shortened by a holiday,~~
205.5~~weather-related cancellation, or other districtwide reduction in a school week. A child~~
205.6~~transitioning into or out of day treatment must receive a minimum treatment of one day a~~
205.7~~week for a two-hour time block. The two-hour time block must include at least one hour of~~
205.8~~patient and/or family or group psychotherapy.~~ The remainder of the structured treatment
205.9program may include patient and/or family or group psychotherapy, and individual or group
205.10skills training, if included in the client's individual treatment plan. Day treatment programs
205.11are not part of inpatient or residential treatment services. When a day treatment group that
205.12meets the minimum group size requirement temporarily falls below the minimum group
205.13size because of a member's temporary absence, medical assistance covers a group session
205.14conducted for the group members in attendance. A day treatment program may provide
205.15fewer than the minimally required hours for a particular child during a billing period in
205.16which the child is transitioning into, or out of, the program.
205.17    (b) To be eligible for medical assistance payment, a provider entity must deliver the
205.18service components of children's therapeutic services and supports in compliance with the
205.19following requirements:
205.20    (1) psychotherapy to address the child's underlying mental health disorder must be
205.21documented as part of the child's ongoing treatment. A provider must deliver, or arrange
205.22for, medically necessary psychotherapy, unless the child's parent or caregiver chooses not
205.23to receive it or the provider determines that psychotherapy is no longer medically necessary.
205.24When a provider determines that psychotherapy is no longer medically necessary, the
205.25provider must update required documentation, including but not limited to the individual
205.26treatment plan, the child's medical record, or other authorizations, to include the
205.27determination. ~~When a provider delivering other services to a child under this section deems~~
205.28~~it not medically necessary to provide psychotherapy to the child for a period of 90 days or~~
205.29~~longer, the provider entity must document the medical reasons why psychotherapy is not~~
205.30~~necessary.~~ When a provider determines that a child needs psychotherapy but psychotherapy
205.31cannot be delivered due to a shortage of licensed mental health professionals in the child's
205.32community, the provider must document the lack of access in the child's medical record;
205.33    (2) individual, family, or group skills training is subject to the following requirements:
205.34(i) a mental health professional, clinical trainee, or mental health practitioner shall provide
205.35skills training;
206.1(ii) skills training delivered to a child or the child's family must be targeted to the specific
206.2deficits or maladaptations of the child's mental health disorder and must be prescribed in
206.3the child's individual treatment plan;
206.4~~(iii) the mental health professional delivering or supervising the delivery of skills training~~
206.5~~must document any underlying psychiatric condition and must document how skills training~~
206.6~~is being used in conjunction with psychotherapy to address the underlying condition;~~
206.7~~(iv) skills training delivered to the child's family must teach skills needed by parents to~~
206.8~~enhance the child's skill development, to help the child utilize daily life skills taught by a~~
206.9~~mental health professional, clinical trainee, or mental health practitioner, and to develop or~~
206.10~~maintain a home environment that supports the child's progressive use of skills;~~
206.11~~(v)~~ (iii) group skills training may be provided to multiple recipients who, because of the
206.12nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from
206.13interaction in a group setting, which must be staffed as follows:
206.14(A) one mental health professional, clinical trainee, or mental health practitioner must
206.15work with a group of three to eight clients; or
206.16(B) any combination of two mental health professionals, clinical trainees, or mental
206.17health practitioners must work with a group of nine to 12 clients;
206.18~~(vi)~~ (iv) a mental health professional, clinical trainee, or mental health practitioner must
206.19have taught the psychosocial skill before a mental health behavioral aide may practice that
206.20skill with the client; and
206.21~~(vii)~~ (v) for group skills training, when a skills group that meets the minimum group
206.22size requirement temporarily falls below the minimum group size because of a group
206.23member's temporary absence, the provider may conduct the session for the group members
206.24in attendance;
206.25    (3) crisis planning to a child and family must include development of a written plan that
206.26anticipates the particular factors specific to the child that may precipitate a psychiatric crisis
206.27for the child in the near future. The written plan must document actions that the family
206.28should be prepared to take to resolve or stabilize a crisis, such as advance arrangements for
206.29direct intervention and support services to the child and the child's family. Crisis planning
206.30must include preparing resources designed to address abrupt or substantial changes in the
206.31functioning of the child or the child's family when sudden change in behavior or a loss of
206.32usual coping mechanisms is observed, or the child begins to present a danger to self or
206.33others;
207.1    (4) mental health behavioral aide services must be medically necessary treatment services,
207.2identified in the child's individual treatment plan ~~and individual behavior plan, and which~~
207.3~~are designed to improve the functioning of the child in the progressive use of developmentally~~
207.4~~appropriate psychosocial skills. Activities involve working directly with the child, child-peer~~
207.5~~groupings, or child-family groupings to practice, repeat, reintroduce, and master the skills~~
207.6~~defined in subdivision 1, paragraph (t), as previously taught by a mental health professional,~~
207.7~~clinical trainee, or mental health practitioner including:~~.
207.8~~(i) providing cues or prompts in skill-building peer-to-peer or parent-child interactions~~
207.9~~so that the child progressively recognizes and responds to the cues independently;~~
207.10~~(ii) performing as a practice partner or role-play partner;~~
207.11~~(iii) reinforcing the child's accomplishments;~~
207.12~~(iv) generalizing skill-building activities in the child's multiple natural settings;~~
207.13~~(v) assigning further practice activities; and~~
207.14~~(vi) intervening as necessary to redirect the child's target behavior and to de-escalate~~
207.15~~behavior that puts the child or other person at risk of injury.~~
207.16To be eligible for medical assistance payment, mental health behavioral aide services must
207.17be delivered to a child who has been diagnosed with an emotional disturbance or a mental
207.18illness, as provided in subdivision 1, paragraph (a). ~~The mental health behavioral aide must~~
207.19~~implement treatment strategies in the individual treatment plan and the individual behavior~~
207.20~~plan as developed by the mental health professional, clinical trainee, or mental health~~
207.21~~practitioner providing direction for the mental health behavioral aide.~~ The mental health
207.22behavioral aide must document the delivery of services in written progress notes. Progress
207.23notes must reflect implementation of the treatment strategies, as performed by the mental
207.24health behavioral aide and the child's responses to the treatment strategies; and
207.25(5) mental health service plan development must be performed in consultation with the
207.26child's family and, when appropriate, with other key participants in the child's life by the
207.27child's treating mental health professional or clinical trainee or by a mental health practitioner
207.28and approved by the treating mental health professional. Treatment plan drafting consists
207.29of development, review, and revision by face-to-face or electronic communication. The
207.30provider must document events, including the time spent with the family and other key
207.31participants in the child's life to approve the individual treatment plan. Medical assistance
207.32covers service plan development before completion of the child's individual treatment plan.
207.33Service plan development is covered only if a treatment plan is completed for the child. If
208.1upon review it is determined that a treatment plan was not completed for the child, the
208.2commissioner shall recover the payment for the service plan development.
208.3EFFECTIVE DATE.This section is effective January 1, 2023, or upon federal approval,
208.4whichever is later. The commissioner of human services shall notify the revisor of statutes
208.5when federal approval is obtained.

208.6    Sec. 15. Minnesota Statutes 2021 Supplement, section 256B.0943, subdivision 11, is
208.7amended to read:
208.8    Subd. 11. Documentation and billing. (a) A provider entity must document the services
208.9it provides under this section. The provider entity must ensure that documentation complies
208.10with Minnesota Rules, parts 9505.2175 and 9505.2197. Services billed under this section
208.11that are not documented according to this subdivision shall be subject to monetary recovery
208.12by the commissioner. Billing for covered service components under subdivision 2, paragraph
208.13(b), must not include anything other than direct service time.
208.14    (b) Required documentation must be completed for each individual provider and service
208.15modality for each day a child receives a service under subdivision 2, paragraph (b).
208.16EFFECTIVE DATE.This section is effective January 1, 2023, or upon federal approval,
208.17whichever is later. The commissioner of human services shall notify the revisor of statutes
208.18when federal approval is obtained.

208.19    Sec. 16. Minnesota Statutes 2021 Supplement, section 256B.0947, subdivision 2, is
208.20amended to read:
208.21    Subd. 2. Definitions. For purposes of this section, the following terms have the meanings
208.22given them.
208.23(a) "Intensive nonresidential rehabilitative mental health services" means child
208.24rehabilitative mental health services as defined in section 256B.0943, except that these
208.25services are provided by a multidisciplinary staff using a total team approach consistent
208.26with assertive community treatment, as adapted for youth, and are directed to recipients
208.27who are eight years of age or older and under 26 21 years of age who require intensive
208.28services to prevent admission to an inpatient psychiatric hospital or placement in a residential
208.29treatment facility or who require intensive services to step down from inpatient or residential
208.30care to community-based care.
209.1(b) "Co-occurring mental illness and substance use disorder" means a dual diagnosis of
209.2at least one form of mental illness and at least one substance use disorder. Substance use
209.3disorders include alcohol or drug abuse or dependence, excluding nicotine use.
209.4(c) "Standard diagnostic assessment" means the assessment described in section 245I.10,
209.5subdivision 6.
209.6(d) "Medication education services" means services provided individually or in groups,
209.7which focus on:
209.8(1) educating the client and client's family or significant nonfamilial supporters about
209.9mental illness and symptoms;
209.10(2) the role and effects of medications in treating symptoms of mental illness; and
209.11(3) the side effects of medications.
209.12Medication education is coordinated with medication management services and does not
209.13duplicate it. Medication education services are provided by physicians, pharmacists, or
209.14registered nurses with certification in psychiatric and mental health care.
209.15(e) "Mental health professional" means a staff person who is qualified according to
209.16section 245I.04, subdivision 2.
209.17(f) "Provider agency" means a for-profit or nonprofit organization established to
209.18administer an assertive community treatment for youth team.
209.19(g) "Substance use disorders" means one or more of the disorders defined in the diagnostic
209.20and statistical manual of mental disorders, current edition.
209.21(h) "Transition services" means:
209.22(1) activities, materials, consultation, and coordination that ensures continuity of the
209.23client's care in advance of and in preparation for the client's move from one stage of care
209.24or life to another by maintaining contact with the client and assisting the client to establish
209.25provider relationships;
209.26(2) providing the client with knowledge and skills needed posttransition;
209.27(3) establishing communication between sending and receiving entities;
209.28(4) supporting a client's request for service authorization and enrollment; and
209.29(5) establishing and enforcing procedures and schedules.
209.30A youth's transition from the children's mental health system and services to the adult
209.31mental health system and services and return to the client's home and entry or re-entry into
210.1community-based mental health services following discharge from an out-of-home placement
210.2or inpatient hospital stay.
210.3(i) "Treatment team" means all staff who provide services to recipients under this section.
210.4(j) "Family peer specialist" means a staff person who is qualified under section
210.5256B.0616.

210.6    Sec. 17. Minnesota Statutes 2021 Supplement, section 256B.0947, subdivision 3, is
210.7amended to read:
210.8    Subd. 3. Client eligibility. An eligible recipient is an individual who:
210.9(1) is eight years of age or older and under 26 21 years of age;
210.10(2) is diagnosed with a serious mental illness or co-occurring mental illness and substance
210.11use disorder, for which intensive nonresidential rehabilitative mental health services are
210.12needed;
210.13(3) has received a level of care assessment as defined in section 245I.02, subdivision
210.1419, that indicates a need for intensive integrated intervention without 24-hour medical
210.15monitoring and a need for extensive collaboration among multiple providers;
210.16(4) has received a functional assessment as defined in section 245I.02, subdivision 17,
210.17that indicates functional impairment and a history of difficulty in functioning safely and
210.18successfully in the community, school, home, or job; or who is likely to need services from
210.19the adult mental health system during adulthood; and
210.20(5) has had a recent standard diagnostic assessment that documents that intensive
210.21nonresidential rehabilitative mental health services are medically necessary to ameliorate
210.22identified symptoms and functional impairments and to achieve individual transition goals.

210.23    Sec. 18. Minnesota Statutes 2021 Supplement, section 256B.0947, subdivision 5, is
210.24amended to read:
210.25    Subd. 5. Standards for intensive nonresidential rehabilitative providers. (a) Services
210.26must meet the standards in this section and chapter 245I as required in section 245I.011,
210.27subdivision 5.
210.28(b) The treatment team must have specialized training in providing services to the specific
210.29age group of youth that the team serves. An individual treatment team must serve youth
210.30who are: (1) at least eight years of age or older and under 16 years of age, or (2) at least 14
210.31years of age or older and under 26 21 years of age.
211.1(c) The treatment team for intensive nonresidential rehabilitative mental health services
211.2comprises both permanently employed core team members and client-specific team members
211.3as follows:
211.4(1) Based on professional qualifications and client needs, clinically qualified core team
211.5members are assigned on a rotating basis as the client's lead worker to coordinate a client's
211.6care. The core team must comprise at least four full-time equivalent direct care staff and
211.7must minimally include:
211.8(i) a mental health professional who serves as team leader to provide administrative
211.9direction and treatment supervision to the team;
211.10(ii) an advanced-practice registered nurse with certification in psychiatric or mental
211.11health care or a board-certified child and adolescent psychiatrist, either of which must be
211.12credentialed to prescribe medications;
211.13(iii) a licensed alcohol and drug counselor who is also trained in mental health
211.14interventions; and
211.15(iv) a mental health certified peer specialist who is qualified according to section 245I.04,
211.16subdivision 10, and is also a former children's mental health consumer.
211.17(2) The core team may also include any of the following:
211.18(i) additional mental health professionals;
211.19(ii) a vocational specialist;
211.20(iii) an educational specialist with knowledge and experience working with youth
211.21regarding special education requirements and goals, special education plans, and coordination
211.22of educational activities with health care activities;
211.23(iv) a child and adolescent psychiatrist who may be retained on a consultant basis;
211.24(v) a clinical trainee qualified according to section 245I.04, subdivision 6;
211.25(vi) a mental health practitioner qualified according to section 245I.04, subdivision 4;
211.26(vii) a case management service provider, as defined in section 245.4871, subdivision
211.274;
211.28(viii) a housing access specialist; and
211.29(ix) a family peer specialist as defined in subdivision 2, paragraph (j).
211.30(3) A treatment team may include, in addition to those in clause (1) or (2), ad hoc
211.31members not employed by the team who consult on a specific client and who must accept
212.1overall clinical direction from the treatment team for the duration of the client's placement
212.2with the treatment team and must be paid by the provider agency at the rate for a typical
212.3session by that provider with that client or at a rate negotiated with the client-specific
212.4member. Client-specific treatment team members may include:
212.5(i) the mental health professional treating the client prior to placement with the treatment
212.6team;
212.7(ii) the client's current substance use counselor, if applicable;
212.8(iii) a lead member of the client's individualized education program team or school-based
212.9mental health provider, if applicable;
212.10(iv) a representative from the client's health care home or primary care clinic, as needed
212.11to ensure integration of medical and behavioral health care;
212.12(v) the client's probation officer or other juvenile justice representative, if applicable;
212.13and
212.14(vi) the client's current vocational or employment counselor, if applicable.
212.15(d) The treatment supervisor shall be an active member of the treatment team and shall
212.16function as a practicing clinician at least on a part-time basis. The treatment team shall meet
212.17with the treatment supervisor at least weekly to discuss recipients' progress and make rapid
212.18adjustments to meet recipients' needs. The team meeting must include client-specific case
212.19reviews and general treatment discussions among team members. Client-specific case
212.20reviews and planning must be documented in the individual client's treatment record.
212.21(e) The staffing ratio must not exceed ten clients to one full-time equivalent treatment
212.22team position.
212.23(f) The treatment team shall serve no more than 80 clients at any one time. Should local
212.24demand exceed the team's capacity, an additional team must be established rather than
212.25exceed this limit.
212.26(g) Nonclinical staff shall have prompt access in person or by telephone to a mental
212.27health practitioner, clinical trainee, or mental health professional. The provider shall have
212.28the capacity to promptly and appropriately respond to emergent needs and make any
212.29necessary staffing adjustments to ensure the health and safety of clients.
212.30(h) The intensive nonresidential rehabilitative mental health services provider shall
212.31participate in evaluation of the assertive community treatment for youth (Youth ACT) model
213.1as conducted by the commissioner, including the collection and reporting of data and the
213.2reporting of performance measures as specified by contract with the commissioner.
213.3(i) A regional treatment team may serve multiple counties.

213.4    Sec. 19. Minnesota Statutes 2020, section 626.5571, subdivision 1, is amended to read:
213.5    Subdivision 1. Establishment of team. A county may establish a multidisciplinary adult
213.6protection team comprised of the director of the local welfare agency or designees, the
213.7county attorney or designees, the county sheriff or designees, and representatives of health
213.8care. In addition, representatives of mental health or other appropriate human service
213.9agencies, community corrections agencies, representatives from local tribal governments,
213.10local law enforcement agencies or designees thereof, and adult advocate groups may be
213.11added to the adult protection team.

213.12    Sec. 20. [626.8477] MENTAL HEALTH AND HEALTH RECORDS; WRITTEN
213.13POLICY REQUIRED.
213.14The chief officer of every state and local law enforcement agency that seeks or uses
213.15mental health data under section 13.46, subdivision 7, paragraph (c), or health records under
213.16section 144.294, subdivision 2, must establish and enforce a written policy governing its
213.17use. At a minimum, the written policy must incorporate the requirements of sections 13.46,
213.18subdivision 7, paragraph (c), and 144.294, subdivision 2, and access procedures, retention
213.19policies, and data security safeguards that, at a minimum, meet the requirements of chapter
213.2013 and any other applicable law.

213.21    Sec. 21. Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 33,
213.22is amended to read:

213.23
213.24

Subd. 33.Grant Programs; Chemical
Dependency Treatment Support Grants

`213.25`	Appropriations by Fund
`213.26`	General	4,273,000	4,274,000
`213.27`	Lottery Prize	1,733,000	1,733,000
`213.28` `213.29`	Opiate Epidemic Response	500,000	500,000

213.30(a) Problem Gambling. $225,000 in fiscal
213.31year 2022 and $225,000 in fiscal year 2023
213.32are from the lottery prize fund for a grant to
213.33the state affiliate recognized by the National
214.1Council on Problem Gambling. The affiliate
214.2must provide services to increase public
214.3awareness of problem gambling, education,
214.4training for individuals and organizations
214.5providing effective treatment services to
214.6problem gamblers and their families, and
214.7research related to problem gambling.
214.8(b) Recovery Community Organization
214.9Grants. $2,000,000 in fiscal year 2022 and
214.10$2,000,000 in fiscal year 2023 are from the
214.11general fund for grants to recovery community
214.12organizations, as defined in Minnesota
214.13Statutes, section 254B.01, subdivision 8, to
214.14provide for costs and community-based peer
214.15recovery support services that are not
214.16otherwise eligible for reimbursement under
214.17Minnesota Statutes, section 254B.05, as part
214.18of the continuum of care for substance use
214.19disorders. The general fund base for this
214.20appropriation is $2,000,000 in fiscal year 2024
214.21and $0 in fiscal year 2025
214.22(c) Grant to Anoka County for Enhanced
214.23Treatment Program. $125,000 in fiscal year
214.242023 is from the general fund for a grant to
214.25Anoka County for an enhanced treatment
214.26program for substance use disorder. This
214.27paragraph does not expire.
214.28(d) Base Level Adjustment. The general fund
214.29base is $4,636,000 in fiscal year 2024 and
214.30$2,636,000 in fiscal year 2025. The opiate
214.31epidemic response fund base is $500,000 in
214.32fiscal year 2024 and $0 in fiscal year 2025.

215.1    Sec. 22. Laws 2021, First Special Session chapter 7, article 17, section 1, subdivision 2,
215.2is amended to read:
215.3    Subd. 2. Eligibility. An individual is eligible for the transition to community initiative
215.4if the individual does not meet eligibility criteria for the medical assistance program under
215.5section 256B.056 or 256B.057, but who meets at least one of the following criteria:
215.6(1) the person otherwise meets the criteria under section 256B.092, subdivision 13, or
215.7256B.49, subdivision 24;
215.8(2) the person has met treatment objectives and no longer requires a hospital-level care
215.9or a secure treatment setting, but the person's discharge from the Anoka Metro Regional
215.10Treatment Center, the Minnesota Security Hospital, or a community behavioral health
215.11hospital would be substantially delayed without additional resources available through the
215.12transitions to community initiative;
215.13(3) the person is in a community hospital ~~and on the waiting list for the Anoka Metro~~
215.14~~Regional Treatment Center~~, but alternative community living options would be appropriate
215.15for the person, and the person has received approval from the commissioner; or
215.16(4)(i) the person is receiving customized living services reimbursed under section
215.17256B.4914, 24-hour customized living services reimbursed under section 256B.4914, or
215.18community residential services reimbursed under section 256B.4914; (ii) the person expresses
215.19a desire to move; and (iii) the person has received approval from the commissioner.

215.20    Sec. 23. REVIEW OF HUMAN SERVICES STRUCTURE; RECOMMENDATION
215.21FOR 2023 LEGISLATIVE SESSION.
215.22(a) No later than September 1, 2022, the addiction and recovery director must contract
215.23with a consultant to conduct an independent review of the structure of the Department of
215.24Human Services, with a focus on substance use disorder and mental health treatment access
215.25and service delivery. The review must be completed no later than December 31, 2022.
215.26(b) In addition to the duties prescribed by Minnesota Statutes, section 4.046, the Opioids,
215.27Substance Use, and Addiction Subcabinet must submit a recommendation to the legislature
215.28for the creation of a permanent Office of Opioid Use, Substance Use, and Addiction,
215.29including proposed statutory language that establishes the office and provides initial goals.
215.30This recommendation must be submitted to the chairs and ranking minority members of the
215.31legislative committees with jurisdiction over opioid and substance use disorder treatment
215.32and prevention no later than December 31, 2022.
215.33EFFECTIVE DATE.This section is effective the day following final enactment.

216.1    Sec. 24. IMPACT ON EXECUTIVE ORDER.
216.2Sections 1 and 23 supersede the requirements of Executive Order No. 22-07, filed April
216.37, 2022. To the extent a conflict exists between that executive order and this act, the
216.4provisions of this act prevail.
216.5EFFECTIVE DATE.This section is effective the day following final enactment.

216.6    Sec. 25. REVISOR INSTRUCTION.
216.7The revisor of statutes shall change the terms "medication-assisted treatment" and
216.8"medication-assisted therapy" or similar terms to "substance use disorder treatment with
216.9medications for opioid use disorder" whenever the terms appear in Minnesota Statutes and
216.10Minnesota Rules. The revisor may make technical and other necessary grammatical changes
216.11related to the term change.

216.12    Sec. 26. REPEALER.
216.13Minnesota Statutes 2020, section 256B.0943, subdivision 8a, is repealed.
216.14EFFECTIVE DATE.This section is effective July 1, 2022, or upon federal approval,
216.15whichever is later. The commissioner of human services shall notify the revisor of statutes
216.16when federal approval is obtained.

216.17ARTICLE 7

216.18CONTINUING CARE FOR OLDER ADULTS POLICY

216.19    Section 1. Minnesota Statutes 2020, section 245A.14, subdivision 14, is amended to read:
216.20    Subd. 14. Attendance records for publicly funded services. (a) A child care center
216.21licensed under this chapter and according to Minnesota Rules, chapter 9503, must maintain
216.22documentation of actual attendance for each child receiving care for which the license holder
216.23is reimbursed by a governmental program. The records must be accessible to the
216.24commissioner during the program's hours of operation, they must be completed on the actual
216.25day of attendance, and they must include:
216.26(1) the first and last name of the child;
216.27(2) the time of day that the child was dropped off; and
216.28(3) the time of day that the child was picked up.
216.29(b) A family child care provider licensed under this chapter and according to Minnesota
216.30Rules, chapter 9502, must maintain documentation of actual attendance for each child
217.1receiving care for which the license holder is reimbursed for the care of that child by a
217.2governmental program. The records must be accessible to the commissioner during the
217.3program's hours of operation, they must be completed on the actual day of attendance, and
217.4they must include:
217.5(1) the first and last name of the child;
217.6(2) the time of day that the child was dropped off; and
217.7(3) the time of day that the child was picked up.
217.8(c) An adult day services program licensed under this chapter and according to Minnesota
217.9Rules, parts 9555.5105 to 9555.6265, must maintain documentation of actual attendance
217.10for each adult day service recipient for which the license holder is reimbursed by a
217.11governmental program. The records must be accessible to the commissioner during the
217.12program's hours of operation, they must be completed on the actual day of attendance, and
217.13they must include:
217.14(1) the first, middle, and last name of the recipient;
217.15(2) the time of day that the recipient was dropped off; and
217.16(3) the time of day that the recipient was picked up.
217.17(d) ~~The commissioner shall not issue a correction for attendance record errors that occur~~
217.18~~before August 1, 2013.~~ Adult day services programs licensed under this chapter that are
217.19designated for remote adult day services must maintain documentation of actual participation
217.20for each adult day service recipient for whom the license holder is reimbursed by a
217.21governmental program. The records must be accessible to the commissioner during the
217.22program's hours of operation, must be completed on the actual day service is provided, and
217.23must include the:
217.24(1) first, middle, and last name of the recipient;
217.25(2) time of day the remote services started;
217.26(3) time of day that the remote services ended; and
217.27(4) means by which the remote services were provided, through audio remote services
217.28or through audio and video remote services.
217.29EFFECTIVE DATE.This section is effective January 1, 2023.

218.1    Sec. 2. [245A.70] REMOTE ADULT DAY SERVICES.
218.2(a) For the purposes of sections 245A.70 to 245A.75, the following terms have the
218.3meanings given.
218.4(b) "Adult day care" and "adult day services" have the meanings given in section 245A.02,
218.5subdivision 2a.
218.6(c) "Remote adult day services" means an individualized and coordinated set of services
218.7provided via live two-way communication by an adult day care or adult day services center.
218.8(d) "Live two-way communication" means real-time audio or audio and video
218.9transmission of information between a participant and an actively involved staff member.

218.10    Sec. 3. [245A.71] APPLICABILITY AND SCOPE.
218.11    Subdivision 1. Licensing requirements. Adult day care centers or adult day services
218.12centers that provide remote adult day services must be licensed under this chapter and
218.13comply with the requirements set forth in this section.
218.14    Subd. 2. Standards for licensure. License holders seeking to provide remote adult day
218.15services must submit a request in the manner prescribed by the commissioner. Remote adult
218.16day services must not be delivered until approved by the commissioner. The designation to
218.17provide remote services is voluntary for license holders. Upon approval, the designation of
218.18approval for remote adult day services must be printed on the center's license, and identified
218.19on the commissioner's public website.
218.20    Subd. 3. Federal requirements. Adult day care centers or adult day services centers
218.21that provide remote adult day services to participants receiving alternative care under section
218.22256B.0913, essential community supports under section 256B.0922, or home and
218.23community-based services waivers under chapter 256S or section 256B.092 or 256B.49
218.24must comply with federally approved waiver plans.
218.25    Subd. 4. Service limitations. Remote adult day services must be provided during the
218.26days and hours of in-person services specified on the license of the adult day care center or
218.27adult day services center.

218.28    Sec. 4. [245A.72] RECORD REQUIREMENTS.
218.29Adult day care centers and adult day services centers providing remote adult day services
218.30must comply with participant record requirements set forth in Minnesota Rules, part
219.19555.9660. The center must document how remote services will help a participant reach
219.2the short- and long-term objectives in the participant's plan of care.

219.3    Sec. 5. [245A.73] REMOTE ADULT DAY SERVICES STAFF.
219.4    Subdivision 1. Staff ratios. (a) A staff person who provides remote adult day services
219.5without two-way interactive video must only provide services to one participant at a time.
219.6(b) A staff person who provides remote adult day services through two-way interactive
219.7video must not provide services to more than eight participants at one time.
219.8    Subd. 2. Staff training. A center licensed under section 245A.71 must document training
219.9provided to each staff person regarding the provision of remote services in the staff person's
219.10record. The training must be provided prior to a staff person delivering remote adult day
219.11services without supervision. The training must include:
219.12(1) how to use the equipment, technology, and devices required to provide remote adult
219.13day services via live two-way communication;
219.14(2) orientation and training on each participant's plan of care as directly related to remote
219.15adult day services; and
219.16(3) direct observation by a manager or supervisor of the staff person while providing
219.17supervised remote service delivery sufficient to assess staff competency.

219.18    Sec. 6. [245A.74] INDIVIDUAL SERVICE PLANNING.
219.19    Subdivision 1. Eligibility. (a) A person must be eligible for and receiving in-person
219.20adult day services to receive remote adult day services from the same provider. The same
219.21provider must deliver both in-person adult day services and remote adult day services to a
219.22participant.
219.23(b) The license holder must update the participant's plan of care according to Minnesota
219.24Rules, part 9555.9700.
219.25(c) For a participant who chooses to receive remote adult day services, the license holder
219.26must document in the participant's plan of care the participant's proposed schedule and
219.27frequency for receiving both in-person and remote services. The license holder must also
219.28document in the participant's plan of care that remote services:
219.29(1) are chosen as a service delivery method by the participant or the participant's legal
219.30representative;
219.31(2) will meet the participant's assessed needs;
220.1(3) are provided within the scope of adult day services; and
220.2(4) will help the participant achieve identified short and long-term objectives specific
220.3to the provision of remote adult day services.
220.4    Subd. 2. Participant daily service limitations. In a 24-hour period, a participant may
220.5receive:
220.6(1) a combination of in-person adult day services and remote adult day services on the
220.7same day but not at the same time;
220.8(2) a combination of in-person and remote adult day services that does not exceed 12
220.9hours in total; and
220.10(3) up to six hours of remote adult day services.
220.11    Subd. 3. Minimum in-person requirement. A participant who receives remote services
220.12must receive services in-person as assigned in the participant's plan of care at least quarterly.

220.13    Sec. 7. [245A.75] SERVICE AND PROGRAM REQUIREMENTS.
220.14Remote adult day services must be in the scope of adult day services provided in
220.15Minnesota Rules, part 9555.9710, subparts 3 to 7.
220.16EFFECTIVE DATE.This section is effective January 1, 2023.

220.17    Sec. 8. Minnesota Statutes 2020, section 256R.02, subdivision 4, is amended to read:
220.18    Subd. 4. Administrative costs. "Administrative costs" means the identifiable costs for
220.19administering the overall activities of the nursing home. These costs include salaries and
220.20wages of the administrator, assistant administrator, business office employees, security
220.21guards, purchasing and inventory employees, and associated fringe benefits and payroll
220.22taxes, fees, contracts, or purchases related to business office functions, licenses, permits
220.23except as provided in the external fixed costs category, employee recognition, travel including
220.24meals and lodging, all training except as specified in subdivision 17, voice and data
220.25communication or transmission, office supplies, property and liability insurance and other
220.26forms of insurance except insurance that is a fringe benefit under subdivision 22, personnel
220.27recruitment, legal services, accounting services, management or business consultants, data
220.28processing, information technology, website, central or home office costs, business meetings
220.29and seminars, postage, fees for professional organizations, subscriptions, security services,
220.30nonpromotional advertising, board of directors fees, working capital interest expense, bad
220.31debts, bad debt collection fees, and costs incurred for travel and ~~housing~~ lodging for persons
221.1employed by a Minnesota-registered supplemental nursing services agency as defined in
221.2section 144A.70, subdivision 6.

221.3    Sec. 9. Minnesota Statutes 2020, section 256R.02, subdivision 17, is amended to read:
221.4    Subd. 17. Direct care costs. "Direct care costs" means costs for the wages of nursing
221.5administration, direct care registered nurses, licensed practical nurses, certified nursing
221.6assistants, trained medication aides, employees conducting training in resident care topics
221.7and associated fringe benefits and payroll taxes; services from a Minnesota-registered
221.8supplemental nursing services agency up to the maximum allowable charges under section
221.9144A.74, excluding associated lodging and travel costs; supplies that are stocked at nursing
221.10stations or on the floor and distributed or used individually, including, but not limited to:
221.11rubbing alcohol or alcohol swabs, applicators, cotton balls, incontinence pads, disposable
221.12ice bags, dressings, bandages, water pitchers, tongue depressors, disposable gloves, enemas,
221.13enema equipment, personal hygiene soap, medication cups, diapers, ~~plastic waste bags,~~
221.14sanitary products, disposable thermometers, hypodermic needles and syringes, ~~clinical~~
221.15~~reagents or similar diagnostic agents,~~ drugs ~~that are not paid~~ not payable on a separate fee
221.16schedule by the medical assistance program or any other payer, and ~~technology related~~
221.17clinical software costs specific to the provision of nursing care to residents, such as electronic
221.18charting systems; costs of materials used for resident care training, and training courses
221.19outside of the facility attended by direct care staff on resident care topics; and costs for
221.20nurse consultants, pharmacy consultants, and medical directors. Salaries and payroll taxes
221.21for nurse consultants who work out of a central office must be allocated proportionately by
221.22total resident days or by direct identification to the nursing facilities served by those
221.23consultants.

221.24    Sec. 10. Minnesota Statutes 2020, section 256R.02, subdivision 18, is amended to read:
221.25    Subd. 18. Employer health insurance costs. "Employer health insurance costs" means:
221.26(1) premium expenses for group coverage;
221.27(2) actual expenses incurred for self-insured plans, including ~~reinsurance;~~ actual claims
221.28paid, stop-loss premiums, and plan fees. Actual expenses incurred for self-insured plans
221.29does not include allowances for future funding unless the plan meets the Medicare
221.30requirements for reporting on a premium basis when the Medicare regulations define the
221.31actual costs; and
221.32(3) employer contributions to employer-sponsored individual coverage health
221.33reimbursement arrangements as provided by Code of Federal Regulations, title 45, section
222.1146.123, employee health reimbursement accounts, and health savings accounts. ~~Premium~~
222.2~~and expense costs and contributions are allowable for (1) all employees and (2) the spouse~~
222.3~~and dependents of those employees who are employed on average at least 30 hours per~~
222.4~~week.~~

222.5    Sec. 11. Minnesota Statutes 2020, section 256R.02, subdivision 22, is amended to read:
222.6    Subd. 22. Fringe benefit costs. "Fringe benefit costs" means the costs for group life,
222.7dental, workers' compensation, short- and long-term disability, long-term care insurance,
222.8accident insurance, supplemental insurance, legal assistance insurance, profit sharing, child
222.9care costs, health insurance costs not covered under subdivision 18, including costs associated
222.10with part-time employee family members or retirees, and pension and retirement plan
222.11contributions, except for the Public Employees Retirement Association costs.

222.12    Sec. 12. Minnesota Statutes 2020, section 256R.02, subdivision 29, is amended to read:
222.13    Subd. 29. Maintenance and plant operations costs. "Maintenance and plant operations
222.14costs" means the costs for the salaries and wages of the maintenance supervisor, engineers,
222.15heating-plant employees, and other maintenance employees and associated fringe benefits
222.16and payroll taxes. It also includes identifiable costs for maintenance and operation of the
222.17building and grounds, including, but not limited to, fuel, electricity, plastic waste bags,
222.18medical waste and garbage removal, water, sewer, supplies, tools, ~~and~~ repairs, and minor
222.19equipment not requiring capitalization under Medicare guidelines.

222.20    Sec. 13. Minnesota Statutes 2020, section 256R.02, is amended by adding a subdivision
222.21to read:
222.22    Subd. 32a. Minor equipment. "Minor equipment" means equipment that does not qualify
222.23as either fixed equipment or depreciable movable equipment as defined in section 256R.261.

222.24    Sec. 14. Minnesota Statutes 2020, section 256R.02, subdivision 42a, is amended to read:
222.25    Subd. 42a. Real estate taxes. "Real estate taxes" means the real estate tax liability shown
222.26on the annual property tax ~~statement~~ statements of the nursing facility for the reporting
222.27period. The term does not include personnel costs or fees for late payment.

222.28    Sec. 15. Minnesota Statutes 2020, section 256R.02, subdivision 48a, is amended to read:
222.29    Subd. 48a. Special assessments. "Special assessments" means the actual special
222.30assessments and related interest paid during the reporting period that are not voluntary costs.
223.1The term does not include personnel costs or, fees for late payment, or special assessments
223.2for projects that are reimbursed in the property rate.

223.3    Sec. 16. Minnesota Statutes 2020, section 256R.02, is amended by adding a subdivision
223.4to read:
223.5    Subd. 53. Vested. "Vested" means the existence of a legally fixed unconditional right
223.6to a present or future benefit.

223.7    Sec. 17. Minnesota Statutes 2020, section 256R.07, subdivision 1, is amended to read:
223.8    Subdivision 1. Criteria. A nursing facility ~~shall~~ must keep adequate documentation. In
223.9order to be adequate, documentation must:
223.10(1) be maintained in orderly, well-organized files;
223.11(2) not include documentation of more than one nursing facility in one set of files unless
223.12transactions may be traced by the commissioner to the nursing facility's annual cost report;
223.13(3) include a paid invoice or copy of a paid invoice with date of purchase, vendor name
223.14and address, purchaser name and delivery destination address, listing of items or services
223.15purchased, cost of items purchased, account number to which the cost is posted, and a
223.16breakdown of any allocation of costs between accounts or nursing facilities. If any of the
223.17information is not available, the nursing facility ~~shall~~ must document its good faith attempt
223.18to obtain the information;
223.19(4) include contracts, agreements, amortization schedules, mortgages, other debt
223.20instruments, and all other documents necessary to explain the nursing facility's costs or
223.21revenues; ~~and~~
223.22(5) include signed and dated position descriptions; and
223.23(6) be retained by the nursing facility to support the five most recent annual cost reports.
223.24The commissioner may extend the period of retention if the field audit was postponed
223.25because of inadequate record keeping or accounting practices as in section 256R.13,
223.26subdivisions 2 and 4, the records are necessary to resolve a pending appeal, or the records
223.27are required for the enforcement of sections 256R.04; 256R.05, subdivision 2; 256R.06,
223.28subdivisions 2, 6, and 7; 256R.08, subdivisions 1 to and 3; and 256R.09, subdivisions 3 and
223.294.

224.1    Sec. 18. Minnesota Statutes 2020, section 256R.07, subdivision 2, is amended to read:
224.2    Subd. 2. Documentation of compensation. Compensation for personal services,
224.3regardless of whether treated as identifiable costs or costs that are not identifiable, must be
224.4documented on payroll records. Payrolls must be supported by time and attendance or
224.5equivalent records for individual employees. Salaries and wages of employees which are
224.6allocated to more than one cost category must be supported by time distribution records.
224.7~~The method used must produce a proportional distribution of actual time spent, or an accurate~~
224.8~~estimate of time spent performing assigned duties. The nursing facility that chooses to~~
224.9~~estimate time spent must use a statistically valid method. The compensation must reflect~~
224.10~~an amount proportionate to a full-time basis if the services are rendered on less than a~~
224.11~~full-time basis.~~ Salary allocations are allowable using the Medicare-approved allocation
224.12basis and methodology only if the salary costs cannot be directly determined, including
224.13when employees provide shared services to noncovered operations.

224.14    Sec. 19. Minnesota Statutes 2020, section 256R.07, subdivision 3, is amended to read:
224.15    Subd. 3. Adequate documentation supporting nursing facility payrolls. Payroll
224.16records supporting compensation costs claimed by nursing facilities must be supported by
224.17affirmative time and attendance records prepared by each individual at intervals of not more
224.18than one month. The requirements of this subdivision are met when documentation is
224.19provided under either clause (1) or (2) ~~as follows~~:
224.20(1) the affirmative time and attendance record must identify the individual's name; the
224.21days worked during each pay period; the number of hours worked each day; and the number
224.22of hours taken each day by the individual for vacation, sick, and other leave. The affirmative
224.23time and attendance record must include a signed verification by the individual and the
224.24individual's supervisor, if any, that the entries reported on the record are correct; or
224.25(2) if the affirmative time and attendance records identifying the individual's name, the
224.26days worked each pay period, the number of hours worked each day, and the number of
224.27hours taken each day by the individual for vacation, sick, and other leave are ~~placed on~~
224.28~~microfilm~~ stored electronically, equipment must be made available for viewing and printing
224.29~~them, or if the records are stored as automated data, summary data must be available for~~
224.30~~viewing and printing~~ the records.

224.31    Sec. 20. Minnesota Statutes 2020, section 256R.08, subdivision 1, is amended to read:
224.32    Subdivision 1. Reporting of financial statements. (a) No later than February 1 of each
224.33year, a nursing facility ~~shall~~ must:
225.1(1) provide the state agency with a copy of its audited financial statements or its working
225.2trial balance;
225.3(2) provide the state agency with a statement of ownership for the facility;
225.4(3) provide the state agency with separate, audited financial statements or working trial
225.5balances for every other facility owned in whole or in part by an individual or entity that
225.6has an ownership interest in the facility;
225.7(4) upon request, provide the state agency with separate, audited financial statements or
225.8working trial balances for every organization with which the facility conducts business and
225.9which is owned in whole or in part by an individual or entity which has an ownership interest
225.10in the facility;
225.11(5) provide the state agency with copies of leases, purchase agreements, and other
225.12documents related to the lease or purchase of the nursing facility; and
225.13(6) upon request, provide the state agency with copies of leases, purchase agreements,
225.14and other documents related to the acquisition of equipment, goods, and services which are
225.15claimed as allowable costs.
225.16(b) Audited financial statements submitted under paragraph (a) must include a balance
225.17sheet, income statement, statement of the rate or rates charged to private paying residents,
225.18statement of retained earnings, statement of cash flows, notes to the financial statements,
225.19audited applicable supplemental information, and the public accountant's report. Public
225.20accountants must conduct audits in accordance with chapter 326A. The cost of an audit
225.21~~shall~~ must not be an allowable cost unless the nursing facility submits its audited financial
225.22statements in the manner otherwise specified in this subdivision. A nursing facility must
225.23permit access by the state agency to the public accountant's audit work papers that support
225.24the audited financial statements submitted under paragraph (a).
225.25(c) Documents or information provided to the state agency pursuant to this subdivision
225.26~~shall~~ must be public unless prohibited by the Health Insurance Portability and Accountability
225.27Act or any other federal or state regulation. Data, notes, and preliminary drafts of reports
225.28created, collected, and maintained by the audit offices of government entities, or persons
225.29performing audits for government entities, and relating to an audit or investigation are
225.30confidential data on individuals or protected nonpublic data until the final report has been
225.31published or the audit or investigation is no longer being pursued actively, except that the
225.32data must be disclosed as required to comply with section 6.67 or 609.456.
226.1(d) If the requirements of paragraphs (a) and (b) are not met, the reimbursement rate
226.2may be reduced to 80 percent of the rate in effect on the first day of the fourth calendar
226.3month after the close of the reporting period and the reduction ~~shall~~ must continue until the
226.4requirements are met.

226.5    Sec. 21. Minnesota Statutes 2020, section 256R.09, subdivision 2, is amended to read:
226.6    Subd. 2. Reporting of statistical and cost information. All nursing facilities ~~shall~~ must
226.7provide information annually to the commissioner on a form and in a manner determined
226.8by the commissioner. The commissioner may separately require facilities to submit in a
226.9manner specified by the commissioner documentation of statistical and cost information
226.10included in the report to ensure accuracy in establishing payment rates and to perform audit
226.11and appeal review functions under this chapter. The commissioner may also require nursing
226.12facilities to provide statistical and cost information for a subset of the items in the annual
226.13report on a semiannual basis. Nursing facilities ~~shall~~ must report only costs directly related
226.14to the operation of the nursing facility. The facility ~~shall~~ must not include costs which are
226.15separately reimbursed or reimbursable by residents, medical assistance, or other payors.
226.16Allocations of costs from central, affiliated, or corporate office and related organization
226.17transactions shall be reported according to sections 256R.07, subdivision 3, and 256R.12,
226.18subdivisions 1 to 7. The commissioner shall not grant facilities extensions to the filing
226.19deadline.

226.20    Sec. 22. Minnesota Statutes 2020, section 256R.09, subdivision 5, is amended to read:
226.21    Subd. 5. Method of accounting. (a) The accrual method of accounting in accordance
226.22with generally accepted accounting principles is the only method acceptable for purposes
226.23of satisfying the reporting requirements of this chapter. If a governmentally owned nursing
226.24facility demonstrates that the accrual method of accounting is not applicable to its accounts
226.25and that a cash or modified accrual method of accounting more accurately reports the nursing
226.26facility's financial operations, the commissioner shall permit the governmentally owned
226.27nursing facility to use a cash or modified accrual method of accounting.
226.28(b) For reimbursement purposes, a provider must pay an accrued nonpayroll expense
226.29within 180 days following the end of the reporting period. A provider must not report on a
226.30subsequent cost report an expense disallowed by the commissioner under this paragraph
226.31for nonpayment unless the commissioner grants a specific exception to the 180-day rule for
226.32a documented contractual arrangement such as receivership, property tax installment
226.33payments, or pension contributions.

227.1    Sec. 23. Minnesota Statutes 2020, section 256R.10, is amended by adding a subdivision
227.2to read:
227.3    Subd. 8. Employer health insurance costs. (a) Employer health insurance costs are
227.4allowable for (1) all employees and (2) the spouse and dependents of those employees who
227.5are employed on average at least 30 hours per week.
227.6(b) The commissioner must not treat employer contributions to employer-sponsored
227.7individual coverage health reimbursement arrangements as allowable costs if the facility
227.8does not provide the commissioner copies of the employer-sponsored individual coverage
227.9health reimbursement arrangement plan documents and documentation of any health
227.10insurance premiums and associated co-payments reimbursed under the arrangement.
227.11Documentation of reimbursements must denote any reimbursements for health insurance
227.12premiums or associated co-payments incurred by the spouses or dependents of employees
227.13who work on average less than 30 hours per week.

227.14    Sec. 24. Minnesota Statutes 2020, section 256R.13, subdivision 4, is amended to read:
227.15    Subd. 4. Extended record retention requirements. The commissioner shall extend the
227.16period for retention of records under section 256R.09, subdivision 3, for purposes of
227.17performing field audits as necessary to enforce sections 256R.04; 256R.05, subdivision 2;
227.18256R.06, subdivisions 2, 6, and 7; 256R.08, subdivisions 1 to and 3; and 256R.09,
227.19subdivisions 3 and 4, with written notice to the facility postmarked no later than 90 days
227.20prior to the expiration of the record retention requirement.

227.21    Sec. 25. Minnesota Statutes 2020, section 256R.16, subdivision 1, is amended to read:
227.22    Subdivision 1. Calculation of a quality score. (a) The commissioner shall determine
227.23a quality score for each nursing facility using quality measures established in section
227.24256B.439, according to methods determined by the commissioner in consultation with
227.25stakeholders and experts, and using the most recently available data as provided in the
227.26Minnesota Nursing Home Report Card. These methods ~~shall~~ must be exempt from the
227.27rulemaking requirements under chapter 14.
227.28(b) For each quality measure, a score ~~shall~~ must be determined with the number of points
227.29assigned as determined by the commissioner using the methodology established according
227.30to this subdivision. The determination of the quality measures to be used and the methods
227.31of calculating scores may be revised annually by the commissioner.
228.1(c) The quality score ~~shall~~ must include up to 50 points related to the Minnesota quality
228.2indicators score derived from the minimum data set, up to 40 points related to the resident
228.3quality of life score derived from the consumer survey conducted under section 256B.439,
228.4subdivision 3, and up to ten points related to the state inspection results score.
228.5(d) The commissioner, in cooperation with the commissioner of health, may adjust the
228.6formula in paragraph (c), or the methodology for computing the total quality score, ~~effective~~
228.7~~July 1 of any year,~~ with five months advance public notice. In changing the formula, the
228.8commissioner shall consider quality measure priorities registered by report card users, advice
228.9of stakeholders, and available research.

228.10    Sec. 26. Minnesota Statutes 2020, section 256R.17, subdivision 3, is amended to read:
228.11    Subd. 3. Resident assessment schedule. (a) Nursing facilities ~~shall~~ must conduct and
228.12submit case mix classification assessments according to the schedule established by the
228.13commissioner of health under section 144.0724, subdivisions 4 and 5.
228.14(b) The case mix classifications established under section 144.0724, subdivision 3a,
228.15~~shall be~~ are effective the day of admission for new admission assessments. The effective
228.16date for significant change assessments ~~shall be~~ is the assessment reference date. The
228.17effective date for annual and quarterly assessments ~~shall be~~ and significant corrections
228.18assessments is the first day of the month following assessment reference date.

228.19    Sec. 27. Minnesota Statutes 2020, section 256R.26, subdivision 1, is amended to read:
228.20    Subdivision 1. Determination of limited undepreciated replacement cost. A facility's
228.21limited URC is the lesser of:
228.22(1) the facility's recognized URC from the appraisal; or
228.23(2) the product of (i) the number of the facility's licensed beds three months prior to the
228.24beginning of the rate year, (ii) the construction cost per square foot value, and (iii) 1,000
228.25square feet.

228.26    Sec. 28. Minnesota Statutes 2020, section 256R.261, subdivision 13, is amended to read:
228.27    Subd. 13. Equipment allowance per bed value. The equipment allowance per bed
228.28value is $10,000 adjusted annually for rate years beginning on or after January 1, 2021, by
228.29the percentage change indicated by the urban consumer price index for Minneapolis-St.
228.30Paul, as published by the Bureau of Labor Statistics (series ~~1967=100~~ 1982-84=100) for
229.1the two previous Julys. The computation for this annual adjustment is based on the data that
229.2is publicly available on November 1 immediately preceding the start of the rate year.

229.3    Sec. 29. Minnesota Statutes 2020, section 256R.37, is amended to read:
229.4256R.37 SCHOLARSHIPS.
229.5~~(a) For the 27-month period beginning October 1, 2015, through December 31, 2017,~~
229.6~~the commissioner shall allow a scholarship per diem of up to 25 cents for each nursing~~
229.7~~facility with no scholarship per diem that is requesting a scholarship per diem to be added~~
229.8~~to the external fixed payment rate to be used:~~
229.9~~(1) for employee scholarships that satisfy the following requirements:~~
229.10~~(i) scholarships are available to all employees who work an average of at least ten hours~~
229.11~~per week at the facility except the administrator, and to reimburse student loan expenses~~
229.12~~for newly hired registered nurses and licensed practical nurses, and training expenses for~~
229.13~~nursing assistants as specified in section~~ ~~144A.611, subdivisions 2~~ ~~and 4, who are newly~~
229.14~~hired; and~~
229.15~~(ii) the course of study is expected to lead to career advancement with the facility or in~~
229.16~~long-term care, including medical care interpreter services and social work; and~~
229.17~~(2) to provide job-related training in English as a second language.~~
229.18~~(b) All facilities may annually request a rate adjustment under this section by submitting~~
229.19~~information to the commissioner on a schedule and in a form supplied by the commissioner.~~
229.20~~The commissioner shall allow a scholarship payment rate equal to the reported and allowable~~
229.21~~costs divided by resident days.~~
229.22~~(c) In calculating the per diem under paragraph (b), the commissioner shall allow costs~~
229.23~~related to tuition, direct educational expenses, and reasonable costs as defined by the~~
229.24~~commissioner for child care costs and transportation expenses related to direct educational~~
229.25~~expenses.~~
229.26~~(d) The rate increase under this section is an optional rate add-on that the facility must~~
229.27~~request from the commissioner in a manner prescribed by the commissioner. The rate~~
229.28~~increase must be used for scholarships as specified in this section.~~
229.29~~(e) For instances in which a rate adjustment will be 15 cents or greater, nursing facilities~~
229.30~~that close beds during a rate year may request to have their scholarship adjustment under~~
229.31~~paragraph (b) recalculated by the commissioner for the remainder of the rate year to reflect~~
229.32~~the reduction in resident days compared to the cost report year.~~
230.1(a) The commissioner shall provide a scholarship per diem rate calculated using the
230.2criteria in paragraphs (b) to (d). The per diem rate must be based on the allowable costs the
230.3facility paid for employee scholarships for any eligible employee, except the facility
230.4administrator, who works an average of at least ten hours per week in the licensed nursing
230.5facility building when the facility has paid expenses related to:
230.6(1) an employee's course of study that is expected to lead to career advancement with
230.7the facility or in the field of long-term care;
230.8(2) an employee's job-related training in English as a second language;
230.9(3) the reimbursement of student loan expenses for newly hired registered nurses and
230.10licensed practical nurses; and
230.11(4) the reimbursement of training, testing, and associated expenses for newly hired
230.12nursing assistants as specified in section 144A.611, subdivisions 2 and 4. The reimbursement
230.13of nursing assistant expenses under this clause is not subject to the ten-hour minimum work
230.14requirement under this paragraph.
230.15(b) Allowable scholarship costs include: tuition, student loan reimbursement, other direct
230.16educational expenses, and reasonable costs for child care and transportation expenses directly
230.17related to education, as defined by the commissioner.
230.18(c) The commissioner shall provide a scholarship per diem rate equal to the allowable
230.19scholarship costs divided by resident days. The commissioner shall compute the scholarship
230.20per diem rate annually and include the scholarship per diem rate in the external fixed costs
230.21payment rate.
230.22(d) When the resulting scholarship per diem rate is 15 cents or more, nursing facilities
230.23that close beds during a rate year may request to have the scholarship rate recalculated. This
230.24recalculation is effective from the date of the bed closure through the remainder of the rate
230.25year and reflects the estimated reduction in resident days compared to the previous cost
230.26report year.
230.27(e) Facilities seeking to have the facility's scholarship expenses recognized for the
230.28payment rate computation in section 256R.25 may apply annually by submitting information
230.29to the commissioner on a schedule and in a form supplied by the commissioner.

231.1    Sec. 30. Minnesota Statutes 2020, section 256R.39, is amended to read:
231.2256R.39 QUALITY IMPROVEMENT INCENTIVE PROGRAM.
231.3The commissioner shall develop a quality improvement incentive program in consultation
231.4with stakeholders. The annual funding pool available for quality improvement incentive
231.5payments ~~shall~~ must be equal to 0.8 percent of all operating payments, not including any
231.6rate components resulting from equitable cost-sharing for publicly owned nursing facility
231.7program participation under section 256R.48, critical access nursing facility program
231.8participation under section 256R.47, or performance-based incentive payment program
231.9participation under section 256R.38. ~~For the period from October 1, 2015, to December 31,~~
231.10~~2016, rate adjustments provided under this section shall be effective for 15 months. Beginning~~
231.11~~January 1, 2017,~~ An annual rate ~~adjustments~~ adjustment provided under this section ~~shall~~
231.12must be effective for one rate year.

231.13    Sec. 31. Minnesota Statutes 2021 Supplement, section 256S.205, is amended to read:
231.14256S.205 CUSTOMIZED LIVING SERVICES; DISPROPORTIONATE SHARE
231.15RATE ADJUSTMENTS.
231.16    Subdivision 1. Definitions. (a) For the purposes of this section, the terms in this
231.17subdivision have the meanings given.
231.18(b) "Application year" means a year in which a facility submits an application for
231.19designation as a disproportionate share facility.
231.20(c) ~~"Assisted living facility" or "facility" means an assisted living facility licensed under~~
231.21~~chapter 144G~~ "Customized living resident" means a resident of a facility who is receiving
231.22either 24-hour customized living services or customized living services authorized under
231.23the elderly waiver, the brain injury waiver, or the community access for disability inclusion
231.24waiver.
231.25(d) "Disproportionate share facility" means ~~an assisted living~~ a facility designated by
231.26the commissioner under subdivision 4.
231.27(e) "Facility" means either an assisted living facility licensed under chapter 144G or a
231.28setting that is exempt from assisted living licensure under section 144G.08, subdivision 7,
231.29clauses (10) to (13).
231.30(f) "Rate year" means January 1 to December 31 of the year following an application
231.31year.
232.1    Subd. 2. Rate adjustment application. ~~An assisted living~~ A facility may apply to the
232.2commissioner for designation as a disproportionate share facility. Applications must be
232.3submitted annually between ~~October~~ September 1 and ~~October 31~~ September 30. The
232.4applying facility must apply in a manner determined by the commissioner. The applying
232.5facility must document ~~as a percentage the census of elderly waiver participants~~ each of the
232.6following on the application:
232.7(1) the number of customized living residents in the facility on September 1 of the
232.8application year, broken out by specific waiver program; and
232.9(2) the total number of people residing in the facility on ~~October~~ September 1 of the
232.10application year.
232.11    Subd. 3. Rate adjustment eligibility criteria. Only facilities ~~with a census of at least~~
232.12~~80 percent elderly waiver participants~~ satisfying all of the following conditions on ~~October~~
232.13September 1 of the application year are eligible for designation as a disproportionate share
232.14facility:
232.15(1) at least 83.5 percent of the residents of the facility are customized living residents;
232.16and
232.17(2) at least 70 percent of the customized living residents are elderly waiver participants.
232.18    Subd. 4. Designation as a disproportionate share facility. (a) By ~~November~~ October
232.1915 of each application year, the commissioner must designate as a disproportionate share
232.20facility a facility that complies with the application requirements of subdivision 2 and meets
232.21the eligibility criteria of subdivision 3.
232.22(b) An annual designation is effective for one rate year.
232.23    Subd. 5. Rate adjustment; rate floor. (a) Notwithstanding the 24-hour customized
232.24living monthly service rate limits under section 256S.202, subdivision 2, and the component
232.25service rates established under section 256S.201, subdivision 4, the commissioner must
232.26establish a rate floor equal to $119 per resident per day for 24-hour customized living
232.27services provided to an elderly waiver participant in a designated disproportionate share
232.28facility ~~for the purpose of ensuring the minimal level of staffing required to meet the health~~
232.29~~and safety needs of elderly waiver participants~~.
232.30(b) The commissioner must apply the rate floor to the services described in paragraph
232.31(a) provided during the rate year.
232.32~~(b)~~ (c) The commissioner must adjust the rate floor ~~at least annually in the manner~~
232.33~~described under section~~ ~~256S.18, subdivisions 5~~ ~~and 6~~ by the same amount and at the same
233.1time as any adjustment to the 24-hour customized living monthly service rate limits under
233.2section 256S.202, subdivision 2.
233.3~~(c)~~ (d) The commissioner shall not implement the rate floor under this section if the
233.4customized living rates established under sections 256S.21 to 256S.215 will be implemented
233.5at 100 percent on January 1 of the year following an application year.
233.6    Subd. 6. Budget cap disregard. The value of the rate adjustment under this section
233.7must not be included in an elderly waiver client's monthly case mix budget cap.
233.8EFFECTIVE DATE.This section is effective September 1, 2022, or upon federal
233.9approval, whichever is later, and applies to services provided on or after January 1, 2023,
233.10or on or after the date upon which federal approval is obtained, whichever is later. The
233.11commissioner of human services shall notify the revisor of statutes when federal approval
233.12is obtained.

233.13    Sec. 32. REPEALER.
233.14Minnesota Statutes 2020, sections 245A.03, subdivision 5; and 256R.08, subdivision 2,
233.15and Minnesota Rules, part 9555.6255, are repealed.

233.16ARTICLE 8

233.17CHILD AND VULNERABLE ADULT PROTECTION

233.18    Section 1. Minnesota Statutes 2020, section 242.19, subdivision 2, is amended to read:
233.19    Subd. 2. Dispositions. When a child has been committed to the commissioner of
233.20corrections by a juvenile court, upon a finding of delinquency, the commissioner may for
233.21the purposes of treatment and rehabilitation:
233.22(1) order the child's confinement to the Minnesota Correctional Facility-Red Wing,
233.23which shall accept the child, or to a group foster home under the control of the commissioner
233.24of corrections, or to private facilities or facilities established by law or incorporated under
233.25the laws of this state that may care for delinquent children;
233.26(2) order the child's release on parole under such supervisions and conditions as the
233.27commissioner believes conducive to law-abiding conduct, treatment and rehabilitation;
233.28(3) order reconfinement or renewed parole as often as the commissioner believes to be
233.29desirable;
233.30(4) revoke or modify any order, except an order of discharge, as often as the commissioner
233.31believes to be desirable;
234.1(5) discharge the child when the commissioner is satisfied that the child has been
234.2rehabilitated and that such discharge is consistent with the protection of the public;
234.3(6) if the commissioner finds that the child is eligible for probation or parole and it
234.4appears from the commissioner's investigation that conditions in the child's or the guardian's
234.5home are not conducive to the child's treatment, rehabilitation, or law-abiding conduct, refer
234.6the child, together with the commissioner's findings, to a local social services agency or a
234.7licensed child-placing agency for placement in a foster care or, when appropriate, for
234.8initiation of child in need of protection or services proceedings as provided in sections
234.9260C.001 to 260C.421. The commissioner of corrections shall reimburse local social services
234.10agencies for foster care costs they incur for the child while on probation or parole to the
234.11extent that funds for this purpose are made available to the commissioner by the legislature.
234.12The juvenile court ~~shall~~ may order the parents of a child on probation or parole to pay the
234.13costs of foster care under section 260B.331, subdivision 1, if the local social services agency
234.14has determined that requiring reimbursement is in the child's best interests, according to
234.15their ability to pay, and to the extent that the commissioner of corrections has not reimbursed
234.16the local social services agency.

234.17    Sec. 2. Minnesota Statutes 2020, section 260.012, is amended to read:
234.18260.012 DUTY TO ENSURE PLACEMENT PREVENTION AND FAMILY
234.19REUNIFICATION; REASONABLE EFFORTS.
234.20    (a) Once a child alleged to be in need of protection or services is under the court's
234.21jurisdiction, the court shall ensure that reasonable efforts, including culturally appropriate
234.22services and practices, by the social services agency are made to prevent placement or to
234.23eliminate the need for removal and to reunite the child with the child's family at the earliest
234.24possible time, and the court must ensure that the responsible social services agency makes
234.25reasonable efforts to finalize an alternative permanent plan for the child as provided in
234.26paragraph (e). In determining reasonable efforts to be made with respect to a child and in
234.27making those reasonable efforts, the child's best interests, health, and safety must be of
234.28paramount concern. Reasonable efforts to prevent placement and for rehabilitation and
234.29reunification are always required except upon a determination by the court that a petition
234.30has been filed stating a prima facie case that:
234.31    (1) the parent has subjected a child to egregious harm as defined in section 260C.007,
234.32subdivision 14;
234.33    (2) the parental rights of the parent to another child have been terminated involuntarily;
235.1    (3) the child is an abandoned infant under section 260C.301, subdivision 2, paragraph
235.2(a), clause (2);
235.3    (4) the parent's custodial rights to another child have been involuntarily transferred to a
235.4relative under Minnesota Statutes 2010, section 260C.201, subdivision 11, paragraph (d),
235.5clause (1), section 260C.515, subdivision 4, or a similar law of another jurisdiction;
235.6(5) the parent has committed sexual abuse as defined in section 260E.03, against the
235.7child or another child of the parent;
235.8(6) the parent has committed an offense that requires registration as a predatory offender
235.9under section 243.166, subdivision 1b, paragraph (a) or (b); or
235.10    (7) the provision of services or further services for the purpose of reunification is futile
235.11and therefore unreasonable under the circumstances.
235.12    (b) When the court makes one of the prima facie determinations under paragraph (a),
235.13either permanency pleadings under section 260C.505, or a termination of parental rights
235.14petition under sections 260C.141 and 260C.301 must be filed. A permanency hearing under
235.15sections 260C.503 to 260C.521 must be held within 30 days of this determination.
235.16    (c) In the case of an Indian child, in proceedings under sections 260B.178, 260C.178,
235.17260C.201, 260C.202, 260C.204, 260C.301, or 260C.503 to 260C.521, the juvenile court
235.18must make findings and conclusions consistent with the Indian Child Welfare Act of 1978,
235.19United States Code, title 25, section 1901 et seq., as to the provision of active efforts. In
235.20cases governed by the Indian Child Welfare Act of 1978, United States Code, title 25, section
235.211901, the responsible social services agency must provide active efforts as required under
235.22United States Code, title 25, section 1911(d).
235.23    (d) "Reasonable efforts to prevent placement" means:
235.24    (1) the agency has made reasonable efforts to prevent the placement of the child in foster
235.25care by working with the family to develop and implement a safety plan that is individualized
235.26to the needs of the child and the child's family and may include support persons from the
235.27child's extended family, kin network, and community; or
235.28    (2) the agency has demonstrated to the court that, given the particular circumstances of
235.29the child and family at the time of the child's removal, there are no services or efforts
235.30available ~~which~~ that could allow the child to safely remain in the home.
235.31    (e) "Reasonable efforts to finalize a permanent plan for the child" means due diligence
235.32by the responsible social services agency to:
236.1    (1) reunify the child with the parent or guardian from whom the child was removed;
236.2    (2) assess a noncustodial parent's ability to provide day-to-day care for the child and,
236.3where appropriate, provide services necessary to enable the noncustodial parent to safely
236.4provide the care, as required by section 260C.219;
236.5    (3) conduct a relative search to identify and provide notice to adult relatives, and engage
236.6relatives in case planning and permanency planning, as required under section 260C.221;
236.7(4) consider placing the child with relatives in the order specified in section 260C.212,
236.8subdivision 2, paragraph (a);
236.9~~(4)~~ (5) place siblings removed from their home in the same home for foster care or
236.10adoption, or transfer permanent legal and physical custody to a relative. Visitation between
236.11siblings who are not in the same foster care, adoption, or custodial placement or facility
236.12shall be consistent with section 260C.212, subdivision 2; and
236.13    ~~(5)~~ (6) when the child cannot return to the parent or guardian from whom the child was
236.14removed, to plan for and finalize a safe and legally permanent alternative home for the child,
236.15and considers permanent alternative homes for the child inside or outside of the state,
236.16preferably with a relative in the order specified in section 260C.212, subdivision 2, paragraph
236.17(a), through adoption or transfer of permanent legal and physical custody of the child.
236.18    (f) Reasonable efforts are made upon the exercise of due diligence by the responsible
236.19social services agency to use culturally appropriate and available services to meet the
236.20individualized needs of the child and the child's family. Services may include those provided
236.21by the responsible social services agency and other culturally appropriate services available
236.22in the community. The responsible social services agency must select services for a child
236.23and the child's family by collaborating with the child's family and, if appropriate, the child.
236.24At each stage of the proceedings ~~where~~ when the court is required to review the
236.25appropriateness of the responsible social services agency's reasonable efforts as described
236.26in paragraphs (a), (d), and (e), the social services agency has the burden of demonstrating
236.27that:
236.28    (1) it the agency has made reasonable efforts to prevent placement of the child in foster
236.29care, including that the agency considered or established a safety plan according to paragraph
236.30(d), clause (1);
236.31    (2) it the agency has made reasonable efforts to eliminate the need for removal of the
236.32child from the child's home and to reunify the child with the child's family at the earliest
236.33possible time;
237.1(3) the agency has made reasonable efforts to finalize a permanent plan for the child
237.2pursuant to paragraph (e);
237.3    ~~(3) it~~ (4) the agency has made reasonable efforts to finalize an alternative permanent
237.4home for the child, and ~~considers~~ considered permanent alternative homes for the child
237.5~~inside or outside~~ in or out of the state, preferably with a relative in the order specified in
237.6section 260C.212, subdivision 2, paragraph (a); or
237.7    ~~(4)~~ (5) reasonable efforts to prevent placement and to reunify the child with the parent
237.8or guardian are not required. The agency may meet this burden by stating facts in a sworn
237.9petition filed under section 260C.141, by filing an affidavit summarizing the agency's
237.10reasonable efforts or facts that the agency believes demonstrate that there is no need for
237.11reasonable efforts to reunify the parent and child, or through testimony or a certified report
237.12required under juvenile court rules.
237.13    (g) Once the court determines that reasonable efforts for reunification are not required
237.14because the court has made one of the prima facie determinations under paragraph (a), the
237.15court may only require the agency to make reasonable efforts for reunification after a hearing
237.16according to section 260C.163, ~~where~~ if the court finds that there is not clear and convincing
237.17evidence of the facts upon which the court based ~~its~~ the court's prima facie determination.
237.18~~In this case when~~ If there is clear and convincing evidence that the child is in need of
237.19protection or services, the court may find the child in need of protection or services and
237.20order any of the dispositions available under section 260C.201, subdivision 1. Reunification
237.21of a child with a parent is not required if the parent has been convicted of:
237.22    (1) a violation of, or an attempt or conspiracy to commit a violation of, sections 609.185
237.23to 609.20; 609.222, subdivision 2; or 609.223 in regard to another child of the parent;
237.24    (2) a violation of section 609.222, subdivision 2; or 609.223, in regard to the child;
237.25    (3) a violation of, or an attempt or conspiracy to commit a violation of, United States
237.26Code, title 18, section 1111(a) or 1112(a), in regard to another child of the parent;
237.27(4) committing sexual abuse as defined in section 260E.03, against the child or another
237.28child of the parent; or
237.29(5) an offense that requires registration as a predatory offender under section 243.166,
237.30subdivision 1b, paragraph (a) or (b).
237.31    (h) The juvenile court, in proceedings under sections 260B.178, 260C.178, 260C.201,
237.32260C.202, 260C.204, 260C.301, or 260C.503 to 260C.521, shall make findings and
237.33conclusions as to the provision of reasonable efforts. When determining whether reasonable
238.1efforts have been made by the agency, the court shall consider whether services to the child
238.2and family were:
238.3(1) selected in collaboration with the child's family and, if appropriate, the child;
238.4(2) tailored to the individualized needs of the child and child's family;
238.5    ~~(1)~~ (3) relevant to the safety ~~and~~, protection, and well-being of the child;
238.6    ~~(2)~~ (4) adequate to meet the individualized needs of the child and family;
238.7    ~~(3)~~ (5) culturally appropriate;
238.8    ~~(4)~~ (6) available and accessible;
238.9    ~~(5)~~ (7) consistent and timely; and
238.10    ~~(6)~~ (8) realistic under the circumstances.
238.11In the alternative, the court may determine that the provision of services or further services
238.12for the purpose of rehabilitation is futile and therefore unreasonable under the circumstances
238.13or that reasonable efforts are not required as provided in paragraph (a).
238.14    (i) This section does not prevent out-of-home placement for the treatment of a child with
238.15a mental disability when it is determined to be medically necessary as a result of the child's
238.16diagnostic assessment or the child's individual treatment plan indicates that appropriate and
238.17necessary treatment cannot be effectively provided outside of a residential or inpatient
238.18treatment program and the level or intensity of supervision and treatment cannot be
238.19effectively and safely provided in the child's home or community and it is determined that
238.20a residential treatment setting is the least restrictive setting that is appropriate to the needs
238.21of the child.
238.22    (j) If continuation of reasonable efforts to prevent placement or reunify the child with
238.23the parent or guardian from whom the child was removed is determined by the court to be
238.24inconsistent with the permanent plan for the child or upon the court making one of the prima
238.25facie determinations under paragraph (a), reasonable efforts must be made to place the child
238.26in a timely manner in a safe and permanent home and to complete whatever steps are
238.27necessary to legally finalize the permanent placement of the child.
238.28    (k) Reasonable efforts to place a child for adoption or in another permanent placement
238.29may be made concurrently with reasonable efforts to prevent placement or to reunify the
238.30child with the parent or guardian from whom the child was removed. When the responsible
238.31social services agency decides to concurrently make reasonable efforts for both reunification
238.32and permanent placement away from the parent under paragraph (a), the agency shall disclose
239.1~~its~~ the agency's decision and both plans for concurrent reasonable efforts to all parties and
239.2the court. When the agency discloses ~~its~~ the agency's decision to proceed on with both plans
239.3for reunification and permanent placement away from the parent, the court's review of the
239.4agency's reasonable efforts shall include the agency's efforts under both plans.

239.5    Sec. 3. Minnesota Statutes 2020, section 260B.331, subdivision 1, is amended to read:
239.6    Subdivision 1. Care, examination, or treatment. (a)(1) Whenever legal custody of a
239.7child is transferred by the court to a local social services agency, or
239.8(2) whenever legal custody is transferred to a person other than the local social services
239.9agency, but under the supervision of the local social services agency, and
239.10(3) whenever a child is given physical or mental examinations or treatment under order
239.11of the court, and no provision is otherwise made by law for payment for the care,
239.12examination, or treatment of the child, these costs are a charge upon the welfare funds of
239.13the county in which proceedings are held upon certification of the judge of juvenile court.
239.14(b) The court ~~shall~~ may order, and the local social services agency ~~shall~~ may require,
239.15the parents or custodian of a child, while the child is under the age of 18, to use ~~the total~~
239.16income and resources attributable to the child for the period of care, examination, or
239.17treatment, except for clothing and personal needs allowance as provided in section 256B.35,
239.18to reimburse the county for the cost of care, examination, or treatment. Income and resources
239.19attributable to the child include, but are not limited to, Social Security benefits, Supplemental
239.20Security Income (SSI), veterans benefits, railroad retirement benefits and child support.
239.21When the child is over the age of 18, and continues to receive care, examination, or treatment,
239.22the court ~~shall~~ may order, and the local social services agency ~~shall~~ may require,
239.23reimbursement from the child for the cost of care, examination, or treatment from the income
239.24and resources attributable to the child less the clothing and personal needs allowance. The
239.25local social services agency shall determine whether requiring reimbursement, either through
239.26child support or parental fees, for the cost of care, examination, or treatment from income
239.27and resources attributable to the child is in the child's best interests. In determining whether
239.28to require reimbursement, the local social services agency shall consider:
239.29(1) whether requiring reimbursement would compromise a parent's ability to meet the
239.30child's treatment and rehabilitation needs before the child returns to the parent's home;
239.31(2) whether requiring reimbursement would compromise the parent's ability to meet the
239.32child's needs after the child returns home; and
240.1(3) whether redirecting existing child support payments or changing the representative
240.2payee of social security benefits to the local social services agency would limit the parent's
240.3ability to maintain financial stability for the child upon the child's return home.
240.4(c) If the income and resources attributable to the child are not enough to reimburse the
240.5county for the full cost of the care, examination, or treatment, the court ~~shall~~ may inquire
240.6into the ability of the parents to ~~support the child~~ reimburse the county for the cost of care,
240.7examination, or treatment and, after giving the parents a reasonable opportunity to be heard,
240.8the court ~~shall~~ may order, and the local social services agency ~~shall~~ may require, the parents
240.9to contribute to the cost of care, examination, or treatment of the child. ~~Except in delinquency~~
240.10~~cases where the victim is a member of the child's immediate family,~~ When determining the
240.11amount to be contributed by the parents, the court shall use a fee schedule based upon ability
240.12to pay that is established by the local social services agency and approved by the
240.13commissioner of human services. ~~In delinquency cases where the victim is a member of the~~
240.14~~child's immediate family,~~ The court shall ~~use the fee schedule but may also~~ take into account
240.15~~the seriousness of the offense and any expenses which the parents have incurred as a result~~
240.16~~of the offense~~ any expenses that the parents may have incurred as a result of the offense,
240.17including but not limited to co-payments for mental health treatment and attorney fees. The
240.18income of a stepparent who has not adopted a child shall be excluded in calculating the
240.19parental contribution under this section. The local social services agency shall determine
240.20whether requiring reimbursement from the parents, either through child support or parental
240.21fees, for the cost of care, examination, or treatment from income and resources attributable
240.22to the child is in the child's best interests. In determining whether to require reimbursement,
240.23the local social services agency shall consider:
240.24(1) whether requiring reimbursement would compromise a parent's ability to meet the
240.25child's treatment and rehabilitation needs before the child returns to the parent's home;
240.26(2) whether requiring reimbursement would compromise the parent's ability to meet the
240.27child's needs after the child returns home; and
240.28(3) whether requiring reimbursement would compromise the parent's ability to meet the
240.29needs of the family.
240.30(d) If the local social services agency determines that requiring reimbursement is in the
240.31child's best interests, the court shall order the amount of reimbursement attributable to the
240.32parents or custodian, or attributable to the child, or attributable to both sources, withheld
240.33under chapter 518A from the income of the parents or the custodian of the child. A parent
240.34or custodian who fails to pay without good reason may be proceeded against for contempt,
241.1or the court may inform the county attorney, who shall proceed to collect the unpaid sums,
241.2or both procedures may be used.
241.3(e) If the court orders a physical or mental examination for a child, the examination is
241.4a medically necessary service for purposes of determining whether the service is covered
241.5by a health insurance policy, health maintenance contract, or other health coverage plan.
241.6Court-ordered treatment shall be subject to policy, contract, or plan requirements for medical
241.7necessity. Nothing in this paragraph changes or eliminates benefit limits, conditions of
241.8coverage, co-payments or deductibles, provider restrictions, or other requirements in the
241.9policy, contract, or plan that relate to coverage of other medically necessary services.

241.10    Sec. 4. Minnesota Statutes 2020, section 260C.001, subdivision 3, is amended to read:
241.11    Subd. 3. Permanency, termination of parental rights, and adoption. The purpose of
241.12the laws relating to permanency, termination of parental rights, and children who come
241.13under the guardianship of the commissioner of human services is to ensure that:
241.14(1) when required and appropriate, reasonable efforts have been made by the social
241.15services agency to reunite the child with the child's parents in a home that is safe and
241.16permanent;
241.17(2) if placement with the parents is not reasonably foreseeable, to secure for the child a
241.18safe and permanent placement according to the requirements of section 260C.212, subdivision
241.192, preferably ~~with adoptive parents~~ with a relative through an adoption or a transfer of
241.20permanent legal and physical custody or, if that is not possible or in the best interests of the
241.21child, ~~a fit and willing relative through transfer of permanent legal and physical custody to~~
241.22~~that relative~~ with a nonrelative caregiver through adoption; and
241.23(3) when a child is under the guardianship of the commissioner of human services,
241.24reasonable efforts are made to finalize an adoptive home for the child in a timely manner.
241.25Nothing in this section requires reasonable efforts to prevent placement or to reunify
241.26the child with the parent or guardian to be made in circumstances where the court has
241.27determined that the child has been subjected to egregious harm, when the child is an
241.28abandoned infant, the parent has involuntarily lost custody of another child through a
241.29proceeding under section 260C.515, subdivision 4, or similar law of another state, the
241.30parental rights of the parent to a sibling have been involuntarily terminated, or the court has
241.31determined that reasonable efforts or further reasonable efforts to reunify the child with the
241.32parent or guardian would be futile.
242.1The paramount consideration in all proceedings for permanent placement of the child
242.2under sections 260C.503 to 260C.521, or the termination of parental rights is the best interests
242.3of the child. In proceedings involving an American Indian child, as defined in section
242.4260.755, subdivision 8, the best interests of the child must be determined consistent with
242.5the Indian Child Welfare Act of 1978, United States Code, title 25, section 1901, et seq.

242.6    Sec. 5. Minnesota Statutes 2020, section 260C.007, subdivision 27, is amended to read:
242.7    Subd. 27. Relative. "Relative" means a person related to the child by blood, marriage,
242.8or adoption; the legal parent, guardian, or custodian of the child's siblings; or an individual
242.9who is an important friend of the child or of the child's parent or custodian, including an
242.10individual with whom the child has resided or had significant contact or who has a significant
242.11relationship to the child or the child's parent or custodian.

242.12    Sec. 6. Minnesota Statutes 2020, section 260C.151, subdivision 6, is amended to read:
242.13    Subd. 6. Immediate custody. If the court makes individualized, explicit findings, based
242.14on the notarized petition or sworn affidavit, that there are reasonable grounds to believe
242.15that the child is in surroundings or conditions ~~which~~ that endanger the child's health, safety,
242.16or welfare that require that responsibility for the child's care and custody be immediately
242.17assumed by the responsible social services agency and that continuation of the child in the
242.18custody of the parent or guardian is contrary to the child's welfare, the court may order that
242.19the officer serving the summons take the child into immediate custody for placement of the
242.20child in foster care, preferably with a relative. In ordering that responsibility for the care,
242.21custody, and control of the child be assumed by the responsible social services agency, the
242.22court is ordering emergency protective care as that term is defined in the juvenile court
242.23rules.

242.24    Sec. 7. Minnesota Statutes 2020, section 260C.152, subdivision 5, is amended to read:
242.25    Subd. 5. Notice to foster parents and preadoptive parents and relatives. The foster
242.26parents, if any, of a child and any preadoptive parent or relative providing care for the child
242.27must be provided notice of and a right to be heard in any review or hearing to be held with
242.28respect to the child. Any other relative may also request, and must be granted, a notice and
242.29the ~~opportunity~~ right to be heard under this section. This subdivision does not require that
242.30a foster parent, preadoptive parent, or relative providing care for the child, or any other
242.31relative be made a party to a review or hearing solely on the basis of the notice and right to
242.32be heard.

243.1    Sec. 8. Minnesota Statutes 2020, section 260C.175, subdivision 2, is amended to read:
243.2    Subd. 2. Notice to parent or custodian and child; emergency placement with
243.3relative. ~~Whenever~~ (a) At the time that a peace officer takes a child into custody for relative
243.4placement or shelter care ~~or relative placement~~ pursuant to subdivision 1, section 260C.151,
243.5subdivision 5, or section 260C.154, the officer shall notify the child's parent or custodian
243.6and the child, if the child is ten years of age or older, that under section 260C.181, subdivision
243.72, the parent or custodian or the child may request ~~that~~ to place the child ~~be placed~~ with a
243.8relative ~~or a designated caregiver under chapter 257A~~ as defined in section 260C.007,
243.9subdivision 27, instead of in a shelter care facility.
243.10(b) When a child who is not alleged to be delinquent is taken into custody pursuant to
243.11subdivision 1, clause (1) or (2), item (ii), and placement with an identified relative is
243.12requested, the peace officer shall coordinate with the responsible social services agency to
243.13ensure the child's safety and well-being and comply with section 260C.181, subdivision 2.
243.14(c) The officer also shall give the parent or custodian of the child a list of names,
243.15addresses, and telephone numbers of social services agencies that offer child welfare services.
243.16If the parent or custodian was not present when the child was removed from the residence,
243.17the list shall be left with an adult on the premises or left in a conspicuous place on the
243.18premises if no adult is present. If the officer has reason to believe the parent or custodian
243.19is not able to read and understand English, the officer must provide a list that is written in
243.20the language of the parent or custodian. The list shall be prepared by the commissioner of
243.21human services. The commissioner shall prepare lists for each county and provide each
243.22county with copies of the list without charge. The list shall be reviewed annually by the
243.23commissioner and updated if it is no longer accurate. Neither the commissioner nor any
243.24peace officer or the officer's employer shall be liable to any person for mistakes or omissions
243.25in the list. The list does not constitute a promise that any agency listed will ~~in fact~~ assist the
243.26parent or custodian.

243.27    Sec. 9. Minnesota Statutes 2020, section 260C.176, subdivision 2, is amended to read:
243.28    Subd. 2. Reasons for detention. (a) If the child is not released as provided in subdivision
243.291, the person taking the child into custody shall notify the court as soon as possible of the
243.30detention of the child and the reasons for detention.
243.31(b) No child taken into custody and placed in a relative's home or shelter care facility
243.32~~or relative's home~~ by a peace officer pursuant to section 260C.175, subdivision 1, clause
243.33(1) or (2), item (ii), may be held in custody longer than 72 hours, excluding Saturdays,
243.34Sundays and holidays, unless a petition has been filed and the judge or referee determines
244.1pursuant to section 260C.178 that the child shall remain in custody or unless the court has
244.2made a finding of domestic abuse perpetrated by a minor after a hearing under Laws 1997,
244.3chapter 239, article 10, sections 2 to 26, in which case the court may extend the period of
244.4detention for an additional seven days, within which time the social services agency shall
244.5conduct an assessment and shall provide recommendations to the court regarding voluntary
244.6services or file a child in need of protection or services petition.

244.7    Sec. 10. Minnesota Statutes 2020, section 260C.178, subdivision 1, is amended to read:
244.8    Subdivision 1. Hearing and release requirements. (a) If a child was taken into custody
244.9under section 260C.175, subdivision 1, clause (1) or (2), item (ii), the court shall hold a
244.10hearing within 72 hours of the time that the child was taken into custody, excluding
244.11Saturdays, Sundays, and holidays, to determine whether the child should continue to be in
244.12custody.
244.13    (b) Unless there is reason to believe that the child would endanger self or others or not
244.14return for a court hearing, or that the child's health or welfare would be immediately
244.15endangered, the child shall be released to the custody of a parent, guardian, custodian, or
244.16other suitable person, subject to reasonable conditions of release including, but not limited
244.17to, a requirement that the child undergo a chemical use assessment as provided in section
244.18260C.157, subdivision 1.
244.19    (c) If the court determines that there is reason to believe that the child would endanger
244.20self or others or not return for a court hearing, or that the child's health or welfare would be
244.21immediately endangered if returned to the care of the parent or guardian who has custody
244.22and from whom the child was removed, the court shall order the child:
244.23    (1) into the care of the child's noncustodial parent and order the noncustodial parent to
244.24comply with any conditions that the court determines appropriate to ensure the safety and
244.25care of the child, including requiring the noncustodial parent to cooperate with paternity
244.26establishment proceedings if the noncustodial parent has not been adjudicated the child's
244.27father; or
244.28    (2) into foster care as defined in section 260C.007, subdivision 18, under the legal
244.29responsibility of the responsible social services agency or responsible probation or corrections
244.30agency for the purposes of protective care as that term is used in the juvenile court rules or
244.31~~into the home of a noncustodial parent and order the noncustodial parent to comply with~~
244.32~~any conditions the court determines to be appropriate to the safety and care of the child,~~
244.33~~including cooperating with paternity establishment proceedings in the case of a man who~~
244.34~~has not been adjudicated the child's father~~. The court shall not give the responsible social
245.1services legal custody and order a trial home visit at any time prior to adjudication and
245.2disposition under section 260C.201, subdivision 1, paragraph (a), clause (3), but may order
245.3the child returned to the care of the parent or guardian who has custody and from whom the
245.4child was removed and order the parent or guardian to comply with any conditions the court
245.5determines to be appropriate to meet the safety, health, and welfare of the child.
245.6    (d) In determining whether the child's health or welfare would be immediately
245.7endangered, the court shall consider whether the child would reside with a perpetrator of
245.8domestic child abuse.
245.9    (e) The court, before determining whether a child should be placed in or continue in
245.10foster care under the protective care of the responsible agency, shall also make a
245.11determination, consistent with section 260.012 as to whether reasonable efforts were made
245.12to prevent placement or whether reasonable efforts to prevent placement are not required.
245.13In the case of an Indian child, the court shall determine whether active efforts, according
245.14to section 260.762 and the Indian Child Welfare Act of 1978, United States Code, title 25,
245.15section 1912(d), were made to prevent placement. The court shall enter a finding that the
245.16responsible social services agency has made reasonable efforts to prevent placement when
245.17the agency establishes either:
245.18    (1) that it the agency has actually provided services or made efforts in an attempt to
245.19prevent the child's removal but that such services or efforts have not proven sufficient to
245.20permit the child to safely remain in the home; or
245.21    (2) that there are no services or other efforts that could be made at the time of the hearing
245.22that could safely permit the child to remain home or to return home. The court shall not
245.23make a reasonable efforts determination under this clause unless the court is satisfied that
245.24the agency has sufficiently demonstrated to the court that there were no services or other
245.25efforts that the agency was able to provide at the time of the hearing enabling the child to
245.26safely remain home or to safely return home. When reasonable efforts to prevent placement
245.27are required and there are services or other efforts that could be ordered ~~which~~ that would
245.28permit the child to safely return home, the court shall order the child returned to the care of
245.29the parent or guardian and the services or efforts put in place to ensure the child's safety.
245.30When the court makes a prima facie determination that one of the circumstances under
245.31paragraph (g) exists, the court shall determine that reasonable efforts to prevent placement
245.32and to return the child to the care of the parent or guardian are not required.
245.33    (f) If the court finds the social services agency's preventive or reunification efforts have
245.34not been reasonable but further preventive or reunification efforts could not permit the child
246.1to safely remain at home, the court may nevertheless authorize or continue the removal of
246.2the child.
246.3    ~~(f)~~ (g) The court may not order or continue the foster care placement of the child unless
246.4the court makes explicit, individualized findings that continued custody of the child by the
246.5parent or guardian would be contrary to the welfare of the child and that placement is in the
246.6best interest of the child.
246.7    ~~(g)~~ (h) At the emergency removal hearing, or at any time during the course of the
246.8proceeding, and upon notice and request of the county attorney, the court shall determine
246.9whether a petition has been filed stating a prima facie case that:
246.10    (1) the parent has subjected a child to egregious harm as defined in section 260C.007,
246.11subdivision 14;
246.12    (2) the parental rights of the parent to another child have been involuntarily terminated;
246.13    (3) the child is an abandoned infant under section 260C.301, subdivision 2, paragraph
246.14(a), clause (2);
246.15    (4) the parents' custodial rights to another child have been involuntarily transferred to a
246.16relative under Minnesota Statutes 2010, section 260C.201, subdivision 11, paragraph (e),
246.17clause (1); section 260C.515, subdivision 4; or a similar law of another jurisdiction;
246.18    (5) the parent has committed sexual abuse as defined in section 260E.03, against the
246.19child or another child of the parent;
246.20(6) the parent has committed an offense that requires registration as a predatory offender
246.21under section 243.166, subdivision 1b, paragraph (a) or (b); or
246.22(7) the provision of services or further services for the purpose of reunification is futile
246.23and therefore unreasonable.
246.24    ~~(h)~~ (i) When a petition to terminate parental rights is required under section 260C.301,
246.25subdivision 4, or 260C.503, subdivision 2, but the county attorney has determined not to
246.26proceed with a termination of parental rights petition, and has instead filed a petition to
246.27transfer permanent legal and physical custody to a relative under section 260C.507, the
246.28court shall schedule a permanency hearing within 30 days of the filing of the petition.
246.29    ~~(i)~~ (j) If the county attorney has filed a petition under section 260C.307, the court shall
246.30schedule a trial under section 260C.163 within 90 days of the filing of the petition except
246.31when the county attorney determines that the criminal case shall proceed to trial first under
246.32section 260C.503, subdivision 2, paragraph (c).
247.1    ~~(j)~~ (k) If the court determines the child should be ordered into foster care and the child's
247.2parent refuses to give information to the responsible social services agency regarding the
247.3child's father or relatives of the child, the court may order the parent to disclose the names,
247.4addresses, telephone numbers, and other identifying information to the responsible social
247.5services agency for the purpose of complying with sections 260C.150, 260C.151, 260C.212,
247.6260C.215, 260C.219, and 260C.221.
247.7    ~~(k)~~ (l) If a child ordered into foster care has siblings, whether full, half, or step, who are
247.8also ordered into foster care, the court shall inquire of the responsible social services agency
247.9of the efforts to place the children together as required by section 260C.212, subdivision 2,
247.10paragraph (d), if placement together is in each child's best interests, unless a child is in
247.11placement for treatment or a child is placed with a previously noncustodial parent who is
247.12not a parent to all siblings. If the children are not placed together at the time of the hearing,
247.13the court shall inquire at each subsequent hearing of the agency's reasonable efforts to place
247.14the siblings together, as required under section 260.012. If any sibling is not placed with
247.15another sibling or siblings, the agency must develop a plan to facilitate visitation or ongoing
247.16contact among the siblings as required under section 260C.212, subdivision 1, unless it is
247.17contrary to the safety or well-being of any of the siblings to do so.
247.18~~(l)~~ (m) When the court has ordered the child into the care of a noncustodial parent or in
247.19foster care ~~or into the home of a noncustodial parent~~, the court may order a chemical
247.20dependency evaluation, mental health evaluation, medical examination, and parenting
247.21assessment for the parent as necessary to support the development of a plan for reunification
247.22required under subdivision 7 and section 260C.212, subdivision 1, or the child protective
247.23services plan under section 260E.26, and Minnesota Rules, part 9560.0228.

247.24    Sec. 11. Minnesota Statutes 2020, section 260C.181, subdivision 2, is amended to read:
247.25    Subd. 2. Least restrictive setting. Notwithstanding the provisions of subdivision 1, if
247.26the child had been taken into custody pursuant to section 260C.175, subdivision 1, clause
247.27(1) or (2), item (ii), and is not alleged to be delinquent, the child shall be detained in the
247.28least restrictive setting consistent with the child's health and welfare and in closest proximity
247.29to the child's family as possible. Placement may be with a child's relative~~, a designated~~
247.30~~caregiver under chapter 257A,~~ or, if no placement is available with a relative, in a shelter
247.31care facility. The placing officer shall comply with this section and shall document why a
247.32less restrictive setting will or will not be in the best interests of the child for placement
247.33purposes.

248.1    Sec. 12. Minnesota Statutes 2020, section 260C.193, subdivision 3, is amended to read:
248.2    Subd. 3. Best interests of the child. (a) The policy of the state is to ensure that the best
248.3interests of children in foster care, who experience a transfer of permanent legal and physical
248.4custody to a relative under section 260C.515, subdivision 4, or adoption under this chapter,
248.5are met by:
248.6(1) considering placement of a child with relatives in the order specified in section
248.7260C.212, subdivision 2, paragraph (a); and
248.8(2) requiring individualized determinations under section 260C.212, subdivision 2,
248.9paragraph (b), of the needs of the child and of how the selected home will serve the needs
248.10of the child.
248.11(b) No later than three months after a child is ordered to be removed from th