Amendment sch4065a-2

sch4065a-2 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
4.6made radioactive by exposure to radiation created incident to the process of producing or
4.7utilizing 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
6.3with 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
8.19awarded 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
9.3131, 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
11.8progress toward improving the quality of care and patient outcomes for ST elevation
11.9myocardial 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,
19.24governmental 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
19.29of 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
20.2indirectly, 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,
20.27or 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
21.16employee 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
22.25employees 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
25.1corporation, association or a governmental unit or instrumentality shall be signed by at least
25.2two 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
25.15for 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
25.17relates 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
25.31employee official or the administrator:
26.1(i) two or more uncorrected violations or one or more repeated violations which created
26.2an 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
26.11person who makes any transfer of a beneficial interest in a nursing home shall notify the
26.12commissioner of health of the transfer within 14 days of its occurrence. The notification
26.13shall identify by name and address the transferor and transferee and shall specify the nature
26.14and amount of the transferred interest. On determining that the transferred beneficial interest
26.15exceeds ten percent of the total beneficial interest in the nursing home facility, the structure
26.16in which the facility is located, or the land upon which the structure is located, the
26.17commissioner may, and on determining that the transferred beneficial interest exceeds 50
26.18percent of the total beneficial interest in the facility, the structure in which the facility is
26.19located, or the land upon which the structure is located, the commissioner shall require that
26.20the license of the nursing home expire 90 days after the date of transfer. The commissioner
26.21of health shall notify the nursing home by certified mail of the expiration of the license at
26.22least 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
26.26the requirements for license renewal established by section 144A.05. A facility shall not be
26.27relicensed by the commissioner if at the time of transfer there are any uncorrected violations.
26.28The commissioner of health may temporarily waive correction of one or more violations if
26.29the commissioner determines that:
26.30(1) temporary noncorrection of the violation will not create an imminent risk of harm
26.31to 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
27.2violation, but the supplier or other contractor has failed to perform the terms of the contract
27.3and 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
30.25disease is not responsive to curative treatment. Control of pain, of other symptoms, and of
30.26psychological, 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
39.20care 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
39.30state 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
50.29appropriate, 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
56.6inadvisable 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
57.28contact 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
60.28subject of a background study is regulated by a health-related licensing board as defined in
60.29chapter 214, and the commissioner determines that the regulated individual is responsible
60.30for substantiated maltreatment under section 626.557 or chapter 260E, instead of the
60.31commissioner making a decision regarding disqualification, the board shall make a
60.32determination 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
61.22the commissioner would have disqualified the individual for the substantiated maltreatment
61.23if the individual were not regulated by the board.
61.24(c) The commissioner shall concurrently send the notice under this subdivision to the
61.25individual 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
72.3individual 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
80.5person, an institutionalized person's spouse, or any person, court, or administrative body
80.6with legal authority to act in place of, on behalf of, at the direction of, or upon the request
80.7of the institutionalized person or the institutionalized person's spouse, transfers to any
80.8annuity that exceeds the value of the benefit likely to be returned to the institutionalized
80.9person or institutionalized person's spouse while alive, based on estimated life expectancy
80.10as determined according to the current actuarial tables published by the Office of the Chief
80.11Actuary of the Social Security Administration. The commissioner may adopt rules reducing
80.12life expectancies based on the need for long-term care. This section applies to an annuity
80.13purchased on or after March 1, 2002, that:
80.14    (1) is not purchased from an insurance company or financial institution that is subject
80.15to licensing or regulation by the Minnesota Department of Commerce or a similar regulatory
80.16agency 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
82.20resulting 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
90.12of 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
90.28of 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
91.11of 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
92.2maintaining 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,
93.13one of whom must be a dentist practicing in the same specialty area, and the other from the
93.14director of each specialty program attended;
93.15(3) a licensed physician's statement attesting to the applicant's physical and mental
93.16condition;
93.17(4) a statement from a licensed ophthalmologist or optometrist attesting to the applicant's
93.18visual acuity;
93.19(5) (2) a nonrefundable fee; and
93.20(6) (3) a notarized, unmounted passport-type photograph, three inches by three inches,
93.21taken 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
94.21not 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,
95.21dental 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
97.10dental assistant licensee or registrant shall transmit to the executive secretary of the board,
97.11pertinent 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,
97.15dental hygienist, and dental assistant.
97.16    Subd. 3. Current address, change of address. Every dentist, dental therapist, dental
97.17hygienist, 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
97.21therapist, dental hygienist, and dental assistant licensee or registrant shall provide the board
97.22written 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
97.27and 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.
101.7The collaborative agreement must be signed and maintained by the dentist, the dental
101.8hygienist, and the facility, program, or organization; must be reviewed annually by the
101.9collaborating dentist and dental hygienist and must be made available to the board upon
101.10request.
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
103.18for 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;
105.20and
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
107.20Education. $585,000 in fiscal year 2022 and
107.21$585,000 in fiscal year 2023 are for regional
107.22emergency medical services programs, to be
107.23distributed equally to the eight emergency
107.24medical service regions under Minnesota
107.25Statutes, section 144E.52.
107.26(d) Regional Grants for Local and Regional
107.27Emergency 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
107.33emergency 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
108.7appropriation 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
113.21defined 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
125.8services under chapter 245D and residing in an unlicensed setting before May 1, 2017, and
125.9for which a license is required. This exception does not apply to people living in their own
125.10home. For purposes of this clause, there is a presumption that a foster care or community
125.11residential setting license is required for services provided to three or more people in a
125.12dwelling unit when the setting is controlled by the provider. A license holder subject to this
125.13exception may rebut the presumption that a license is required by seeking a reconsideration
125.14of the commissioner's determination. The commissioner's disposition of a request for
125.15reconsideration is final and not subject to appeal under chapter 14. The exception is available
125.16until 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
125.18service, service provider, and location of service, including in the person's home, to help
125.19the person make an informed choice; and
125.20(ii) the person's services provided in the licensed foster care or community residential
125.21setting are less than or equal to the cost of the person's services delivered in the unlicensed
125.22setting 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
147.12in 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
151.8on an individual treatment plan, the provider may document the client's verbal approval or
151.9electronic written approval of the treatment plan or change in the treatment plan in lieu of
151.10the 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
151.13use 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
151.285, 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
153.26adults. 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
161.2agency case manager both agree that there is no change in the person's condition, there is
161.3no 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,
163.29subpart 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.
165.14A youth's transition from the children's mental health system and services to the adult
165.15mental health system and services and return to the client's home and entry or re-entry into
165.16community-based mental health services following discharge from an out-of-home placement
165.17or 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
166.20and revised to document treatment progress or, if progress is not documented, to document
166.21changes 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
169.25details 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
172.29must 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
174.19county 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
192.16for funding are received by the commissioner which meet the specifications contained in
192.17requests 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
193.14prospective 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
193.31each 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
194.5established CCBHCs with a similar scope of services. If no comparable CCBHC exists, the
194.6commissioner shall establish a clinic-specific rate using audited historical cost report data
194.7adjusted for the estimated cost of delivering CCBHC services, including the estimated cost
194.8of providing the full scope of services and the projected change in visits resulting from the
194.9change 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
197.30for a child written by a mental health professional or a clinical trainee or mental health
197.31practitioner under the treatment supervision of a mental health professional, to guide the
197.32work of the mental health behavioral aide. The individual behavioral plan may be
198.1incorporated into the child's individual treatment plan so long as the behavioral plan is
198.2separately 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
198.20involvement of the client or client's parents, primary caregiver, or other person authorized
198.21to consent to mental health services for the client, and including arrangement of treatment
198.22and 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
201.25to be provided by the mental health behavioral aide. The individual behavior plan must
201.26include:
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
201.32plan;
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
202.7percent of the time in a provider's standard working week during which the supervisee is
202.8providing a mental health service; and
202.9    (ii) every 30 days, the treatment supervisor must review and sign the record indicating
202.10the 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
202.12provided under CTSS:
202.13    (i) the mental health professional is required to be present at the site of service delivery
202.14for observation as clinically appropriate when the clinical trainee, mental health practitioner,
202.15or 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
202.17documented in the child's record and signed by the mental health professional who accepts
202.18full professional responsibility;
202.19    (7) providing direction to a mental health behavioral aide. For entities that employ mental
202.20health behavioral aides, the treatment supervisor must be employed by the provider entity
202.21or other provider certified to provide mental health behavioral aide services to ensure
202.22necessary and appropriate oversight for the client's treatment and continuity of care. The
202.23staff giving direction must begin with the goals on the individual treatment plan, and instruct
202.24the mental health behavioral aide on how to implement therapeutic activities and interventions
202.25that will lead to goal attainment. The staff giving direction must also instruct the mental
202.26health behavioral aide about the client's diagnosis, functional status, and other characteristics
202.27that are likely to affect service delivery. Direction must also include determining that the
202.28mental health behavioral aide has the skills to interact with the client and the client's family
202.29in ways that convey personal and cultural respect and that the aide actively solicits
202.30information relevant to treatment from the family. The aide must be able to clearly explain
202.31or demonstrate the activities the aide is doing with the client and the activities' relationship
202.32to treatment goals. Direction is more didactic than is supervision and requires the staff
202.33providing it to continuously evaluate the mental health behavioral aide's ability to carry out
203.1the activities of the individual treatment plan and the individual behavior plan. When
203.2providing direction, the staff must:
203.3    (i) review progress notes prepared by the mental health behavioral aide for accuracy and
203.4consistency with diagnostic assessment, treatment plan, and behavior goals and the staff
203.5must approve and sign the progress notes;
203.6    (ii) identify changes in treatment strategies, revise the individual behavior plan, and
203.7communicate treatment instructions and methodologies as appropriate to ensure that treatment
203.8is implemented correctly;
203.9    (iii) demonstrate family-friendly behaviors that support healthy collaboration among
203.10the 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
203.12with 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
203.14of 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,
205.4two or three hours per day, unless the normal five-day school week is shortened by a holiday,
205.5weather-related cancellation, or other districtwide reduction in a school week. A child
205.6transitioning into or out of day treatment must receive a minimum treatment of one day a
205.7week for a two-hour time block. The two-hour time block must include at least one hour of
205.8patient 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
205.28it not medically necessary to provide psychotherapy to the child for a period of 90 days or
205.29longer, the provider entity must document the medical reasons why psychotherapy is not
205.30necessary. 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
206.5must document any underlying psychiatric condition and must document how skills training
206.6is 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
206.8enhance the child's skill development, to help the child utilize daily life skills taught by a
206.9mental health professional, clinical trainee, or mental health practitioner, and to develop or
206.10maintain 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
207.3are designed to improve the functioning of the child in the progressive use of developmentally
207.4appropriate psychosocial skills. Activities involve working directly with the child, child-peer
207.5groupings, or child-family groupings to practice, repeat, reintroduce, and master the skills
207.6defined in subdivision 1, paragraph (t), as previously taught by a mental health professional,
207.7clinical trainee, or mental health practitioner including:.
207.8(i) providing cues or prompts in skill-building peer-to-peer or parent-child interactions
207.9so 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
207.15behavior 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
207.19implement treatment strategies in the individual treatment plan and the individual behavior
207.20plan as developed by the mental health professional, clinical trainee, or mental health
207.21practitioner 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
215.14Regional 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
217.18before 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
221.15reagents 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
222.2and expense costs and contributions are allowable for (1) all employees and (2) the spouse
222.3and dependents of those employees who are employed on average at least 30 hours per
222.4week.

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.
224.7The method used must produce a proportional distribution of actual time spent, or an accurate
224.8estimate of time spent performing assigned duties. The nursing facility that chooses to
224.9estimate time spent must use a statistically valid method. The compensation must reflect
224.10an amount proportionate to a full-time basis if the services are rendered on less than a
224.11full-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
224.28microfilm stored electronically, equipment must be made available for viewing and printing
224.29them, or if the records are stored as automated data, summary data must be available for
224.30viewing 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
225.21shall 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
225.26shall 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
228.7July 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,
228.15shall 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,
229.6the commissioner shall allow a scholarship per diem of up to 25 cents for each nursing
229.7facility with no scholarship per diem that is requesting a scholarship per diem to be added
229.8to 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
229.11per week at the facility except the administrator, and to reimburse student loan expenses
229.12for newly hired registered nurses and licensed practical nurses, and training expenses for
229.13nursing assistants as specified in section 144A.611, subdivisions 2 and 4, who are newly
229.14hired; and
229.15(ii) the course of study is expected to lead to career advancement with the facility or in
229.16long-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
229.19information to the commissioner on a schedule and in a form supplied by the commissioner.
229.20The commissioner shall allow a scholarship payment rate equal to the reported and allowable
229.21costs divided by resident days.
229.22(c) In calculating the per diem under paragraph (b), the commissioner shall allow costs
229.23related to tuition, direct educational expenses, and reasonable costs as defined by the
229.24commissioner for child care costs and transportation expenses related to direct educational
229.25expenses.
229.26(d) The rate increase under this section is an optional rate add-on that the facility must
229.27request from the commissioner in a manner prescribed by the commissioner. The rate
229.28increase 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
229.30that close beds during a rate year may request to have their scholarship adjustment under
229.31paragraph (b) recalculated by the commissioner for the remainder of the rate year to reflect
229.32the 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,
231.102016, rate adjustments provided under this section shall be effective for 15 months. Beginning
231.11January 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
231.21chapter 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
232.1280 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
232.29and 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
232.33described 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
237.5inside 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.
237.18In 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
239.1its 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
240.10cases 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
240.14child's immediate family, The court shall use the fee schedule but may also take into account
240.15the seriousness of the offense and any expenses which the parents have incurred as a result
240.16of 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
241.22that 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
243.32or 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
244.31into the home of a noncustodial parent and order the noncustodial parent to comply with
244.32any conditions the court determines to be appropriate to the safety and care of the child,
244.33including cooperating with paternity establishment proceedings in the case of a man who
244.34has 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
247.30caregiver 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 the care of a
248.12parent in the hearing required under section 260C.202, the court shall review and enter
248.13findings regarding whether the responsible social services agency made:
248.14(1) diligent efforts exercised due diligence to identify and, search for, notify, and engage
248.15relatives as required under section 260C.221; and
248.16(2) made a placement consistent with section 260C.212, subdivision 2, that is based on
248.17an individualized determination as required under section 260C.212, subdivision 2, of the
248.18child's needs to select a home that meets the needs of the child.
248.19(c) If the court finds that the agency has not made efforts exercised due diligence as
248.20required under section 260C.221, and the court shall order the agency to make reasonable
248.21efforts. If there is a relative who qualifies to be licensed to provide family foster care under
248.22chapter 245A, the court may order the child to be placed with the relative consistent with
248.23the child's best interests.
248.24(d) If the agency's efforts under section 260C.221 are found by the court to be sufficient,
248.25the court shall order the agency to continue to appropriately engage relatives who responded
248.26to the notice under section 260C.221 in placement and case planning decisions and to
248.27appropriately engage relatives who subsequently come to the agency's attention. A court's
248.28finding that the agency has made reasonable efforts under this paragraph does not relieve
248.29the agency of the duty to continue notifying relatives who come to the agency's attention
248.30and engaging and considering relatives who respond to the notice under section 260C.221
248.31in child placement and case planning decisions.
248.32(e) If the child's birth parent or parents explicitly request requests that a specific relative
248.33or important friend not be considered for placement of the child, the court shall honor that
249.1request if it is consistent with the best interests of the child and consistent with the
249.2requirements of section 260C.221. The court shall not waive relative search, notice, and
249.3consideration requirements, unless section 260C.139 applies. If the child's birth parent or
249.4parents express expresses a preference for placing the child in a foster or adoptive home of
249.5the same or a similar religious background to as that of the birth parent or parents, the court
249.6shall order placement of the child with an individual who meets the birth parent's religious
249.7preference.
249.8(f) Placement of a child cannot must not be delayed or denied based on race, color, or
249.9national origin of the foster parent or the child.
249.10(g) Whenever possible, siblings requiring foster care placement should shall be placed
249.11together unless it is determined not to be in the best interests of one or more of the siblings
249.12after weighing the benefits of separate placement against the benefits of sibling connections
249.13for each sibling. The agency shall consider section 260C.008 when making this determination.
249.14If siblings were not placed together according to section 260C.212, subdivision 2, paragraph
249.15(d), the responsible social services agency shall report to the court the efforts made to place
249.16the siblings together and why the efforts were not successful. If the court is not satisfied
249.17that the agency has made reasonable efforts to place siblings together, the court must order
249.18the agency to make further reasonable efforts. If siblings are not placed together, the court
249.19shall order the responsible social services agency to implement the plan for visitation among
249.20siblings required as part of the out-of-home placement plan under section 260C.212.
249.21(h) This subdivision does not affect the Indian Child Welfare Act, United States Code,
249.22title 25, sections 1901 to 1923, and the Minnesota Indian Family Preservation Act, sections
249.23260.751 to 260.835.

249.24    Sec. 13. Minnesota Statutes 2020, section 260C.201, subdivision 1, is amended to read:
249.25    Subdivision 1. Dispositions. (a) If the court finds that the child is in need of protection
249.26or services or neglected and in foster care, it the court shall enter an order making any of
249.27the following dispositions of the case:
249.28(1) place the child under the protective supervision of the responsible social services
249.29agency or child-placing agency in the home of a parent of the child under conditions
249.30prescribed by the court directed to the correction of the child's need for protection or services:
249.31(i) the court may order the child into the home of a parent who does not otherwise have
249.32legal custody of the child, however, an order under this section does not confer legal custody
249.33on that parent;
250.1(ii) if the court orders the child into the home of a father who is not adjudicated, the
250.2father must cooperate with paternity establishment proceedings regarding the child in the
250.3appropriate jurisdiction as one of the conditions prescribed by the court for the child to
250.4continue in the father's home; and
250.5(iii) the court may order the child into the home of a noncustodial parent with conditions
250.6and may also order both the noncustodial and the custodial parent to comply with the
250.7requirements of a case plan under subdivision 2; or
250.8(2) transfer legal custody to one of the following:
250.9(i) a child-placing agency; or
250.10(ii) the responsible social services agency. In making a foster care placement for of a
250.11child whose custody has been transferred under this subdivision, the agency shall make an
250.12individualized determination of how the placement is in the child's best interests using the
250.13placement consideration order for relatives, and the best interest factors in section 260C.212,
250.14subdivision 2, paragraph (b), and may include a child colocated with a parent in a licensed
250.15residential family-based substance use disorder treatment program under section 260C.190;
250.16or
250.17(3) order a trial home visit without modifying the transfer of legal custody to the
250.18responsible social services agency under clause (2). Trial home visit means the child is
250.19returned to the care of the parent or guardian from whom the child was removed for a period
250.20not to exceed six months. During the period of the trial home visit, the responsible social
250.21services agency:
250.22(i) shall continue to have legal custody of the child, which means that the agency may
250.23see the child in the parent's home, at school, in a child care facility, or other setting as the
250.24agency deems necessary and appropriate;
250.25(ii) shall continue to have the ability to access information under section 260C.208;
250.26(iii) shall continue to provide appropriate services to both the parent and the child during
250.27the period of the trial home visit;
250.28(iv) without previous court order or authorization, may terminate the trial home visit in
250.29order to protect the child's health, safety, or welfare and may remove the child to foster care;
250.30(v) shall advise the court and parties within three days of the termination of the trial
250.31home visit when a visit is terminated by the responsible social services agency without a
250.32court order; and
251.1(vi) shall prepare a report for the court when the trial home visit is terminated whether
251.2by the agency or court order which that describes the child's circumstances during the trial
251.3home visit and recommends appropriate orders, if any, for the court to enter to provide for
251.4the child's safety and stability. In the event a trial home visit is terminated by the agency
251.5by removing the child to foster care without prior court order or authorization, the court
251.6shall conduct a hearing within ten days of receiving notice of the termination of the trial
251.7home visit by the agency and shall order disposition under this subdivision or commence
251.8permanency proceedings under sections 260C.503 to 260C.515. The time period for the
251.9hearing may be extended by the court for good cause shown and if it is in the best interests
251.10of the child as long as the total time the child spends in foster care without a permanency
251.11hearing does not exceed 12 months;
251.12(4) if the child has been adjudicated as a child in need of protection or services because
251.13the child is in need of special services or care to treat or ameliorate a physical or mental
251.14disability or emotional disturbance as defined in section 245.4871, subdivision 15, the court
251.15may order the child's parent, guardian, or custodian to provide it. The court may order the
251.16child's health plan company to provide mental health services to the child. Section 62Q.535
251.17applies to an order for mental health services directed to the child's health plan company.
251.18If the health plan, parent, guardian, or custodian fails or is unable to provide this treatment
251.19or care, the court may order it provided. Absent specific written findings by the court that
251.20the child's disability is the result of abuse or neglect by the child's parent or guardian, the
251.21court shall not transfer legal custody of the child for the purpose of obtaining special
251.22treatment or care solely because the parent is unable to provide the treatment or care. If the
251.23court's order for mental health treatment is based on a diagnosis made by a treatment
251.24professional, the court may order that the diagnosing professional not provide the treatment
251.25to the child if it finds that such an order is in the child's best interests; or
251.26(5) if the court believes that the child has sufficient maturity and judgment and that it is
251.27in the best interests of the child, the court may order a child 16 years old or older to be
251.28allowed to live independently, either alone or with others as approved by the court under
251.29supervision the court considers appropriate, if the county board, after consultation with the
251.30court, has specifically authorized this dispositional alternative for a child.
251.31(b) If the child was adjudicated in need of protection or services because the child is a
251.32runaway or habitual truant, the court may order any of the following dispositions in addition
251.33to or as alternatives to the dispositions authorized under paragraph (a):
251.34(1) counsel the child or the child's parents, guardian, or custodian;
252.1(2) place the child under the supervision of a probation officer or other suitable person
252.2in the child's own home under conditions prescribed by the court, including reasonable rules
252.3for the child's conduct and the conduct of the parents, guardian, or custodian, designed for
252.4the physical, mental, and moral well-being and behavior of the child;
252.5(3) subject to the court's supervision, transfer legal custody of the child to one of the
252.6following:
252.7(i) a reputable person of good moral character. No person may receive custody of two
252.8or more unrelated children unless licensed to operate a residential program under sections
252.9245A.01 to 245A.16; or
252.10(ii) a county probation officer for placement in a group foster home established under
252.11the direction of the juvenile court and licensed pursuant to section 241.021;
252.12(4) require the child to pay a fine of up to $100. The court shall order payment of the
252.13fine in a manner that will not impose undue financial hardship upon the child;
252.14(5) require the child to participate in a community service project;
252.15(6) order the child to undergo a chemical dependency evaluation and, if warranted by
252.16the evaluation, order participation by the child in a drug awareness program or an inpatient
252.17or outpatient chemical dependency treatment program;
252.18(7) if the court believes that it is in the best interests of the child or of public safety that
252.19the child's driver's license or instruction permit be canceled, the court may order the
252.20commissioner of public safety to cancel the child's license or permit for any period up to
252.21the child's 18th birthday. If the child does not have a driver's license or permit, the court
252.22may order a denial of driving privileges for any period up to the child's 18th birthday. The
252.23court shall forward an order issued under this clause to the commissioner, who shall cancel
252.24the license or permit or deny driving privileges without a hearing for the period specified
252.25by the court. At any time before the expiration of the period of cancellation or denial, the
252.26court may, for good cause, order the commissioner of public safety to allow the child to
252.27apply for a license or permit, and the commissioner shall so authorize;
252.28(8) order that the child's parent or legal guardian deliver the child to school at the
252.29beginning of each school day for a period of time specified by the court; or
252.30(9) require the child to perform any other activities or participate in any other treatment
252.31programs deemed appropriate by the court.
252.32To the extent practicable, the court shall enter a disposition order the same day it makes
252.33a finding that a child is in need of protection or services or neglected and in foster care, but
253.1in no event more than 15 days after the finding unless the court finds that the best interests
253.2of the child will be served by granting a delay. If the child was under eight years of age at
253.3the time the petition was filed, the disposition order must be entered within ten days of the
253.4finding and the court may not grant a delay unless good cause is shown and the court finds
253.5the best interests of the child will be served by the delay.
253.6(c) If a child who is 14 years of age or older is adjudicated in need of protection or
253.7services because the child is a habitual truant and truancy procedures involving the child
253.8were previously dealt with by a school attendance review board or county attorney mediation
253.9program under section 260A.06 or 260A.07, the court shall order a cancellation or denial
253.10of driving privileges under paragraph (b), clause (7), for any period up to the child's 18th
253.11birthday.
253.12(d) In the case of a child adjudicated in need of protection or services because the child
253.13has committed domestic abuse and been ordered excluded from the child's parent's home,
253.14the court shall dismiss jurisdiction if the court, at any time, finds the parent is able or willing
253.15to provide an alternative safe living arrangement for the child, as defined in Laws 1997,
253.16chapter 239, article 10, section 2.
253.17(e) When a parent has complied with a case plan ordered under subdivision 6 and the
253.18child is in the care of the parent, the court may order the responsible social services agency
253.19to monitor the parent's continued ability to maintain the child safely in the home under such
253.20terms and conditions as the court determines appropriate under the circumstances.

253.21    Sec. 14. Minnesota Statutes 2020, section 260C.201, subdivision 2, is amended to read:
253.22    Subd. 2. Written findings. (a) Any order for a disposition authorized under this section
253.23shall contain written findings of fact to support the disposition and case plan ordered and
253.24shall also set forth in writing the following information:
253.25(1) why the best interests and safety of the child are served by the disposition and case
253.26plan ordered;
253.27(2) what alternative dispositions or services under the case plan were considered by the
253.28court and why such dispositions or services were not appropriate in the instant case;
253.29(3) when legal custody of the child is transferred, the appropriateness of the particular
253.30placement made or to be made by the placing agency using the relative and sibling placement
253.31considerations and best interest factors in section 260C.212, subdivision 2, paragraph (b),
253.32or the appropriateness of a child colocated with a parent in a licensed residential family-based
253.33substance use disorder treatment program under section 260C.190;
254.1(4) whether reasonable efforts to finalize the permanent plan for the child consistent
254.2with section 260.012 were made including reasonable efforts:
254.3(i) to prevent the child's placement and to reunify the child with the parent or guardian
254.4from whom the child was removed at the earliest time consistent with the child's safety.
254.5The court's findings must include a brief description of what preventive and reunification
254.6efforts were made and why further efforts could not have prevented or eliminated the
254.7necessity of removal or that reasonable efforts were not required under section 260.012 or
254.8260C.178, subdivision 1;
254.9(ii) to identify and locate any noncustodial or nonresident parent of the child and to
254.10assess such parent's ability to provide day-to-day care of the child, and, where appropriate,
254.11provide services necessary to enable the noncustodial or nonresident parent to safely provide
254.12day-to-day care of the child as required under section 260C.219, unless such services are
254.13not required under section 260.012 or 260C.178, subdivision 1;. The court's findings must
254.14include a description of the agency's efforts to:
254.15(A) identify and locate the child's noncustodial or nonresident parent;
254.16(B) assess the noncustodial or nonresident parent's ability to provide day-to-day care of
254.17the child; and
254.18(C) if appropriate, provide services necessary to enable the noncustodial or nonresident
254.19parent to safely provide the child's day-to-day care, including efforts to engage the
254.20noncustodial or nonresident parent in assuming care and responsibility of the child;
254.21(iii) to make the diligent search for relatives and provide the notices required under
254.22section 260C.221; a finding made pursuant to a hearing under section 260C.202 that the
254.23agency has made diligent efforts to conduct a relative search and has appropriately engaged
254.24relatives who responded to the notice under section 260C.221 and other relatives, who came
254.25to the attention of the agency after notice under section 260C.221 was sent, in placement
254.26and case planning decisions fulfills the requirement of this item;
254.27(iv) to identify and make a foster care placement of the child, considering the order in
254.28section 260C.212, subdivision 2, paragraph (a), in the home of an unlicensed relative,
254.29according to the requirements of section 245A.035, a licensed relative, or other licensed
254.30foster care provider, who will commit to being the permanent legal parent or custodian for
254.31the child in the event reunification cannot occur, but who will actively support the
254.32reunification plan for the child. If the court finds that the agency has not appropriately
254.33considered relatives for placement of the child, the court shall order the agency to comply
254.34with section 260C.212, subdivision 2, paragraph (a). The court may order the agency to
255.1continue considering relatives for placement of the child regardless of the child's current
255.2placement setting; and
255.3(v) to place siblings together in the same home or to ensure visitation is occurring when
255.4siblings are separated in foster care placement and visitation is in the siblings' best interests
255.5under section 260C.212, subdivision 2, paragraph (d); and
255.6(5) if the child has been adjudicated as a child in need of protection or services because
255.7the child is in need of special services or care to treat or ameliorate a mental disability or
255.8emotional disturbance as defined in section 245.4871, subdivision 15, the written findings
255.9shall also set forth:
255.10(i) whether the child has mental health needs that must be addressed by the case plan;
255.11(ii) what consideration was given to the diagnostic and functional assessments performed
255.12by the child's mental health professional and to health and mental health care professionals'
255.13treatment recommendations;
255.14(iii) what consideration was given to the requests or preferences of the child's parent or
255.15guardian with regard to the child's interventions, services, or treatment; and
255.16(iv) what consideration was given to the cultural appropriateness of the child's treatment
255.17or services.
255.18(b) If the court finds that the social services agency's preventive or reunification efforts
255.19have not been reasonable but that further preventive or reunification efforts could not permit
255.20the child to safely remain at home, the court may nevertheless authorize or continue the
255.21removal of the child.
255.22(c) If the child has been identified by the responsible social services agency as the subject
255.23of concurrent permanency planning, the court shall review the reasonable efforts of the
255.24agency to develop a permanency plan for the child that includes a primary plan which that
255.25is for reunification with the child's parent or guardian and a secondary plan which that is
255.26for an alternative, legally permanent home for the child in the event reunification cannot
255.27be achieved in a timely manner.

255.28    Sec. 15. Minnesota Statutes 2020, section 260C.202, is amended to read:
255.29260C.202 COURT REVIEW OF FOSTER CARE.
255.30    (a) If the court orders a child placed in foster care, the court shall review the out-of-home
255.31placement plan and the child's placement at least every 90 days as required in juvenile court
255.32rules to determine whether continued out-of-home placement is necessary and appropriate
256.1or whether the child should be returned home. This review is not required if the court has
256.2returned the child home, ordered the child permanently placed away from the parent under
256.3sections 260C.503 to 260C.521, or terminated rights under section 260C.301. Court review
256.4for a child permanently placed away from a parent, including where the child is under
256.5guardianship of the commissioner, shall be governed by section 260C.607. When a child
256.6is placed in a qualified residential treatment program setting as defined in section 260C.007,
256.7subdivision 26d, the responsible social services agency must submit evidence to the court
256.8as specified in section 260C.712.
256.9(b) No later than three months after the child's placement in foster care, the court shall
256.10review agency efforts to search for and notify relatives pursuant to section 260C.221, and
256.11order that the agency's efforts begin immediately, or continue, if the agency has failed to
256.12perform, or has not adequately performed, the duties under that section. The court must
256.13order the agency to continue to appropriately engage relatives who responded to the notice
256.14under section 260C.221 in placement and case planning decisions and to consider relatives
256.15for foster care placement consistent with section 260C.221. Notwithstanding a court's finding
256.16that the agency has made reasonable efforts to search for and notify relatives under section
256.17260C.221, the court may order the agency to continue making reasonable efforts to search
256.18for, notify, engage other, and consider relatives who came to the agency's attention after
256.19sending the initial notice under section 260C.221 was sent.
256.20(c) The court shall review the out-of-home placement plan and may modify the plan as
256.21provided under section 260C.201, subdivisions 6 and 7.
256.22(d) When the court orders transfer of transfers the custody of a child to a responsible
256.23social services agency resulting in foster care or protective supervision with a noncustodial
256.24parent under subdivision 1, the court shall notify the parents of the provisions of sections
256.25260C.204 and 260C.503 to 260C.521, as required under juvenile court rules.
256.26(e) When a child remains in or returns to foster care pursuant to section 260C.451 and
256.27the court has jurisdiction pursuant to section 260C.193, subdivision 6, paragraph (c), the
256.28court shall at least annually conduct the review required under section 260C.203.

256.29    Sec. 16. Minnesota Statutes 2020, section 260C.203, is amended to read:
256.30260C.203 ADMINISTRATIVE OR COURT REVIEW OF PLACEMENTS.
256.31(a) Unless the court is conducting the reviews required under section 260C.202, there
256.32shall be an administrative review of the out-of-home placement plan of each child placed
256.33in foster care no later than 180 days after the initial placement of the child in foster care
257.1and at least every six months thereafter if the child is not returned to the home of the parent
257.2or parents within that time. The out-of-home placement plan must be monitored and updated
257.3by the responsible social services agency at each administrative review. The administrative
257.4review shall be conducted by the responsible social services agency using a panel of
257.5appropriate persons at least one of whom is not responsible for the case management of, or
257.6the delivery of services to, either the child or the parents who are the subject of the review.
257.7The administrative review shall be open to participation by the parent or guardian of the
257.8child and the child, as appropriate.
257.9(b) As an alternative to the administrative review required in paragraph (a), the court
257.10may, as part of any hearing required under the Minnesota Rules of Juvenile Protection
257.11Procedure, conduct a hearing to monitor and update the out-of-home placement plan pursuant
257.12to the procedure and standard in section 260C.201, subdivision 6, paragraph (d). The party
257.13requesting review of the out-of-home placement plan shall give parties to the proceeding
257.14notice of the request to review and update the out-of-home placement plan. A court review
257.15conducted pursuant to section 260C.141, subdivision 2; 260C.193; 260C.201, subdivision
257.161; 260C.202; 260C.204; 260C.317; or 260D.06 shall satisfy the requirement for the review
257.17so long as the other requirements of this section are met.
257.18(c) As appropriate to the stage of the proceedings and relevant court orders, the
257.19responsible social services agency or the court shall review:
257.20(1) the safety, permanency needs, and well-being of the child;
257.21(2) the continuing necessity for and appropriateness of the placement, including whether
257.22the placement is consistent with the child's best interests and other placement considerations,
257.23including relative and sibling placement considerations under section 260C.212, subdivision
257.242;
257.25(3) the extent of compliance with the out-of-home placement plan required under section
257.26260C.212, subdivisions 1 and 1a, including services and resources that the agency has
257.27provided to the child and child's parents, services and resources that other agencies and
257.28individuals have provided to the child and child's parents, and whether the out-of-home
257.29placement plan is individualized to the needs of the child and child's parents;
257.30(4) the extent of progress that has been made toward alleviating or mitigating the causes
257.31necessitating placement in foster care;
257.32(5) the projected date by which the child may be returned to and safely maintained in
257.33the home or placed permanently away from the care of the parent or parents or guardian;
257.34and
258.1(6) the appropriateness of the services provided to the child.
258.2(d) When a child is age 14 or older:
258.3(1) in addition to any administrative review conducted by the responsible social services
258.4agency, at the in-court review required under section 260C.317, subdivision 3, clause (3),
258.5or 260C.515, subdivision 5 or 6, the court shall review the independent living plan required
258.6under section 260C.212, subdivision 1, paragraph (c), clause (12), and the provision of
258.7services to the child related to the well-being of the child as the child prepares to leave foster
258.8care. The review shall include the actual plans related to each item in the plan necessary to
258.9the child's future safety and well-being when the child is no longer in foster care; and
258.10(2) consistent with the requirements of the independent living plan, the court shall review
258.11progress toward or accomplishment of the following goals:
258.12(i) the child has obtained a high school diploma or its equivalent;
258.13(ii) the child has completed a driver's education course or has demonstrated the ability
258.14to use public transportation in the child's community;
258.15(iii) the child is employed or enrolled in postsecondary education;
258.16(iv) the child has applied for and obtained postsecondary education financial aid for
258.17which the child is eligible;
258.18(v) the child has health care coverage and health care providers to meet the child's
258.19physical and mental health needs;
258.20(vi) the child has applied for and obtained disability income assistance for which the
258.21child is eligible;
258.22(vii) the child has obtained affordable housing with necessary supports, which does not
258.23include a homeless shelter;
258.24(viii) the child has saved sufficient funds to pay for the first month's rent and a damage
258.25deposit;
258.26(ix) the child has an alternative affordable housing plan, which does not include a
258.27homeless shelter, if the original housing plan is unworkable;
258.28(x) the child, if male, has registered for the Selective Service; and
258.29(xi) the child has a permanent connection to a caring adult.

259.1    Sec. 17. Minnesota Statutes 2020, section 260C.204, is amended to read:
259.2260C.204 PERMANENCY PROGRESS REVIEW FOR CHILDREN IN FOSTER
259.3CARE FOR SIX MONTHS.
259.4(a) When a child continues in placement out of the home of the parent or guardian from
259.5whom the child was removed, no later than six months after the child's placement the court
259.6shall conduct a permanency progress hearing to review:
259.7(1) the progress of the case, the parent's progress on the case plan or out-of-home
259.8placement plan, whichever is applicable;
259.9(2) the agency's reasonable, or in the case of an Indian child, active efforts for
259.10reunification and its provision of services;
259.11(3) the agency's reasonable efforts to finalize the permanent plan for the child under
259.12section 260.012, paragraph (e), and to make a placement as required under section 260C.212,
259.13subdivision 2, in a home that will commit to being the legally permanent family for the
259.14child in the event the child cannot return home according to the timelines in this section;
259.15and
259.16(4) in the case of an Indian child, active efforts to prevent the breakup of the Indian
259.17family and to make a placement according to the placement preferences under United States
259.18Code, title 25, chapter 21, section 1915.
259.19(b) When a child is placed in a qualified residential treatment program setting as defined
259.20in section 260C.007, subdivision 26d, the responsible social services agency must submit
259.21evidence to the court as specified in section 260C.712.
259.22(c) The court shall ensure that notice of the hearing is sent to any relative who:
259.23(1) responded to the agency's notice provided under section 260C.221, indicating an
259.24interest in participating in planning for the child or being a permanency resource for the
259.25child and who has kept the court apprised of the relative's address; or
259.26(2) asked to be notified of court proceedings regarding the child as is permitted in section
259.27260C.152, subdivision 5.
259.28(d)(1) If the parent or guardian has maintained contact with the child and is complying
259.29with the court-ordered out-of-home placement plan, and if the child would benefit from
259.30reunification with the parent, the court may either:
260.1(i) return the child home, if the conditions which that led to the out-of-home placement
260.2have been sufficiently mitigated that it is safe and in the child's best interests to return home;
260.3or
260.4(ii) continue the matter up to a total of six additional months. If the child has not returned
260.5home by the end of the additional six months, the court must conduct a hearing according
260.6to sections 260C.503 to 260C.521.
260.7(2) If the court determines that the parent or guardian is not complying, is not making
260.8progress with or engaging with services in the out-of-home placement plan, or is not
260.9maintaining regular contact with the child as outlined in the visitation plan required as part
260.10of the out-of-home placement plan under section 260C.212, the court may order the
260.11responsible social services agency:
260.12(i) to develop a plan for legally permanent placement of the child away from the parent;
260.13(ii) to consider, identify, recruit, and support one or more permanency resources from
260.14the child's relatives and foster parent, consistent with section 260C.212, subdivision 2,
260.15paragraph (a), to be the legally permanent home in the event the child cannot be returned
260.16to the parent. Any relative or the child's foster parent may ask the court to order the agency
260.17to consider them for permanent placement of the child in the event the child cannot be
260.18returned to the parent. A relative or foster parent who wants to be considered under this
260.19item shall cooperate with the background study required under section 245C.08, if the
260.20individual has not already done so, and with the home study process required under chapter
260.21245A for providing child foster care and for adoption under section 259.41. The home study
260.22referred to in this item shall be a single-home study in the form required by the commissioner
260.23of human services or similar study required by the individual's state of residence when the
260.24subject of the study is not a resident of Minnesota. The court may order the responsible
260.25social services agency to make a referral under the Interstate Compact on the Placement of
260.26Children when necessary to obtain a home study for an individual who wants to be considered
260.27for transfer of permanent legal and physical custody or adoption of the child; and
260.28(iii) to file a petition to support an order for the legally permanent placement plan.
260.29(e) Following the review under this section:
260.30(1) if the court has either returned the child home or continued the matter up to a total
260.31of six additional months, the agency shall continue to provide services to support the child's
260.32return home or to make reasonable efforts to achieve reunification of the child and the parent
260.33as ordered by the court under an approved case plan;
261.1(2) if the court orders the agency to develop a plan for the transfer of permanent legal
261.2and physical custody of the child to a relative, a petition supporting the plan shall be filed
261.3in juvenile court within 30 days of the hearing required under this section and a trial on the
261.4petition held within 60 days of the filing of the pleadings; or
261.5(3) if the court orders the agency to file a termination of parental rights, unless the county
261.6attorney can show cause why a termination of parental rights petition should not be filed,
261.7a petition for termination of parental rights shall be filed in juvenile court within 30 days
261.8of the hearing required under this section and a trial on the petition held within 60 days of
261.9the filing of the petition.

261.10    Sec. 18. Minnesota Statutes 2021 Supplement, section 260C.212, subdivision 1, is amended
261.11to read:
261.12    Subdivision 1. Out-of-home placement; plan. (a) An out-of-home placement plan shall
261.13be prepared within 30 days after any child is placed in foster care by court order or a
261.14voluntary placement agreement between the responsible social services agency and the
261.15child's parent pursuant to section 260C.227 or chapter 260D.
261.16    (b) An out-of-home placement plan means a written document which individualized to
261.17the needs of the child and the child's parents or guardians that is prepared by the responsible
261.18social services agency jointly with the parent or parents or guardian of the child the child's
261.19parents or guardians and in consultation with the child's guardian ad litem,; the child's tribe,
261.20if the child is an Indian child,; the child's foster parent or representative of the foster care
261.21facility,; and, where when appropriate, the child. When a child is age 14 or older, the child
261.22may include two other individuals on the team preparing the child's out-of-home placement
261.23plan. The child may select one member of the case planning team to be designated as the
261.24child's advisor and to advocate with respect to the application of the reasonable and prudent
261.25parenting standards. The responsible social services agency may reject an individual selected
261.26by the child if the agency has good cause to believe that the individual would not act in the
261.27best interest of the child. For a child in voluntary foster care for treatment under chapter
261.28260D, preparation of the out-of-home placement plan shall additionally include the child's
261.29mental health treatment provider. For a child 18 years of age or older, the responsible social
261.30services agency shall involve the child and the child's parents as appropriate. As appropriate,
261.31the plan shall be:
261.32    (1) submitted to the court for approval under section 260C.178, subdivision 7;
261.33    (2) ordered by the court, either as presented or modified after hearing, under section
261.34260C.178, subdivision 7, or 260C.201, subdivision 6; and
262.1    (3) signed by the parent or parents or guardian of the child, the child's guardian ad litem,
262.2a representative of the child's tribe, the responsible social services agency, and, if possible,
262.3the child.
262.4    (c) The out-of-home placement plan shall be explained by the responsible social services
262.5agency to all persons involved in its the plan's implementation, including the child who has
262.6signed the plan, and shall set forth:
262.7    (1) a description of the foster care home or facility selected, including how the
262.8out-of-home placement plan is designed to achieve a safe placement for the child in the
262.9least restrictive, most family-like, setting available which that is in close proximity to the
262.10home of the parent or child's parents or guardian of the child guardians when the case plan
262.11goal is reunification,; and how the placement is consistent with the best interests and special
262.12needs of the child according to the factors under subdivision 2, paragraph (b);
262.13    (2) the specific reasons for the placement of the child in foster care, and when
262.14reunification is the plan, a description of the problems or conditions in the home of the
262.15parent or parents which that necessitated removal of the child from home and the changes
262.16the parent or parents must make for the child to safely return home;
262.17    (3) a description of the services offered and provided to prevent removal of the child
262.18from the home and to reunify the family including:
262.19    (i) the specific actions to be taken by the parent or parents of the child to eliminate or
262.20correct the problems or conditions identified in clause (2), and the time period during which
262.21the actions are to be taken; and
262.22    (ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made to
262.23achieve a safe and stable home for the child including social and other supportive services
262.24to be provided or offered to the parent or parents or guardian of the child, the child, and the
262.25residential facility during the period the child is in the residential facility;
262.26    (4) a description of any services or resources that were requested by the child or the
262.27child's parent, guardian, foster parent, or custodian since the date of the child's placement
262.28in the residential facility, and whether those services or resources were provided and if not,
262.29the basis for the denial of the services or resources;
262.30    (5) the visitation plan for the parent or parents or guardian, other relatives as defined in
262.31section 260C.007, subdivision 26b or 27, and siblings of the child if the siblings are not
262.32placed together in foster care, and whether visitation is consistent with the best interest of
262.33the child, during the period the child is in foster care;
263.1    (6) when a child cannot return to or be in the care of either parent, documentation of
263.2steps to finalize adoption as the permanency plan for the child through reasonable efforts
263.3to place the child for adoption pursuant to section 260C.605. At a minimum, the
263.4documentation must include consideration of whether adoption is in the best interests of
263.5the child, and child-specific recruitment efforts such as a relative search, consideration of
263.6relatives for adoptive placement, and the use of state, regional, and national adoption
263.7exchanges to facilitate orderly and timely placements in and outside of the state. A copy of
263.8this documentation shall be provided to the court in the review required under section
263.9260C.317, subdivision 3, paragraph (b);
263.10    (7) when a child cannot return to or be in the care of either parent, documentation of
263.11steps to finalize the transfer of permanent legal and physical custody to a relative as the
263.12permanency plan for the child. This documentation must support the requirements of the
263.13kinship placement agreement under section 256N.22 and must include the reasonable efforts
263.14used to determine that it is not appropriate for the child to return home or be adopted, and
263.15reasons why permanent placement with a relative through a Northstar kinship assistance
263.16arrangement is in the child's best interest; how the child meets the eligibility requirements
263.17for Northstar kinship assistance payments; agency efforts to discuss adoption with the child's
263.18relative foster parent and reasons why the relative foster parent chose not to pursue adoption,
263.19if applicable; and agency efforts to discuss with the child's parent or parents the permanent
263.20transfer of permanent legal and physical custody or the reasons why these efforts were not
263.21made;
263.22    (8) efforts to ensure the child's educational stability while in foster care for a child who
263.23attained the minimum age for compulsory school attendance under state law and is enrolled
263.24full time in elementary or secondary school, or instructed in elementary or secondary
263.25education at home, or instructed in an independent study elementary or secondary program,
263.26or incapable of attending school on a full-time basis due to a medical condition that is
263.27documented and supported by regularly updated information in the child's case plan.
263.28Educational stability efforts include:
263.29(i) efforts to ensure that the child remains in the same school in which the child was
263.30enrolled prior to placement or upon the child's move from one placement to another, including
263.31efforts to work with the local education authorities to ensure the child's educational stability
263.32and attendance; or
263.33(ii) if it is not in the child's best interest to remain in the same school that the child was
263.34enrolled in prior to placement or move from one placement to another, efforts to ensure
263.35immediate and appropriate enrollment for the child in a new school;
264.1(9) the educational records of the child including the most recent information available
264.2regarding:
264.3    (i) the names and addresses of the child's educational providers;
264.4    (ii) the child's grade level performance;
264.5    (iii) the child's school record;
264.6    (iv) a statement about how the child's placement in foster care takes into account
264.7proximity to the school in which the child is enrolled at the time of placement; and
264.8(v) any other relevant educational information;
264.9    (10) the efforts by the responsible social services agency to ensure the oversight and
264.10continuity of health care services for the foster child, including:
264.11(i) the plan to schedule the child's initial health screens;
264.12(ii) how the child's known medical problems and identified needs from the screens,
264.13including any known communicable diseases, as defined in section 144.4172, subdivision
264.142, shall be monitored and treated while the child is in foster care;
264.15(iii) how the child's medical information shall be updated and shared, including the
264.16child's immunizations;
264.17(iv) who is responsible to coordinate and respond to the child's health care needs,
264.18including the role of the parent, the agency, and the foster parent;
264.19(v) who is responsible for oversight of the child's prescription medications;
264.20(vi) how physicians or other appropriate medical and nonmedical professionals shall be
264.21consulted and involved in assessing the health and well-being of the child and determine
264.22the appropriate medical treatment for the child; and
264.23(vii) the responsibility to ensure that the child has access to medical care through either
264.24medical insurance or medical assistance;
264.25(11) the health records of the child including information available regarding:
264.26(i) the names and addresses of the child's health care and dental care providers;
264.27(ii) a record of the child's immunizations;
264.28(iii) the child's known medical problems, including any known communicable diseases
264.29as defined in section 144.4172, subdivision 2;
264.30(iv) the child's medications; and
265.1(v) any other relevant health care information such as the child's eligibility for medical
265.2insurance or medical assistance;
265.3(12) an independent living plan for a child 14 years of age or older, developed in
265.4consultation with the child. The child may select one member of the case planning team to
265.5be designated as the child's advisor and to advocate with respect to the application of the
265.6reasonable and prudent parenting standards in subdivision 14. The plan should include, but
265.7not be limited to, the following objectives:
265.8    (i) educational, vocational, or employment planning;
265.9    (ii) health care planning and medical coverage;
265.10    (iii) transportation including, where appropriate, assisting the child in obtaining a driver's
265.11license;
265.12    (iv) money management, including the responsibility of the responsible social services
265.13agency to ensure that the child annually receives, at no cost to the child, a consumer report
265.14as defined under section 13C.001 and assistance in interpreting and resolving any inaccuracies
265.15in the report;
265.16    (v) planning for housing;
265.17    (vi) social and recreational skills;
265.18    (vii) establishing and maintaining connections with the child's family and community;
265.19and
265.20    (viii) regular opportunities to engage in age-appropriate or developmentally appropriate
265.21activities typical for the child's age group, taking into consideration the capacities of the
265.22individual child;
265.23    (13) for a child in voluntary foster care for treatment under chapter 260D, diagnostic
265.24and assessment information, specific services relating to meeting the mental health care
265.25needs of the child, and treatment outcomes;
265.26(14) for a child 14 years of age or older, a signed acknowledgment that describes the
265.27child's rights regarding education, health care, visitation, safety and protection from
265.28exploitation, and court participation; receipt of the documents identified in section 260C.452;
265.29and receipt of an annual credit report. The acknowledgment shall state that the rights were
265.30explained in an age-appropriate manner to the child; and
265.31(15) for a child placed in a qualified residential treatment program, the plan must include
265.32the requirements in section 260C.708.
266.1    (d) The parent or parents or guardian and the child each shall have the right to legal
266.2counsel in the preparation of the case plan and shall be informed of the right at the time of
266.3placement of the child. The child shall also have the right to a guardian ad litem. If unable
266.4to employ counsel from their own resources, the court shall appoint counsel upon the request
266.5of the parent or parents or the child or the child's legal guardian. The parent or parents may
266.6also receive assistance from any person or social services agency in preparation of the case
266.7plan.
266.8    (e) After the plan has been agreed upon by the parties involved or approved or ordered
266.9by the court, the foster parents shall be fully informed of the provisions of the case plan and
266.10shall be provided a copy of the plan.
266.11    (f) Upon the child's discharge from foster care, the responsible social services agency
266.12must provide the child's parent, adoptive parent, or permanent legal and physical custodian,
266.13and the child, if the child is 14 years of age or older, with a current copy of the child's health
266.14and education record. If a child meets the conditions in subdivision 15, paragraph (b), the
266.15agency must also provide the child with the child's social and medical history. The responsible
266.16social services agency may give a copy of the child's health and education record and social
266.17and medical history to a child who is younger than 14 years of age, if it is appropriate and
266.18if subdivision 15, paragraph (b), applies.

266.19    Sec. 19. Minnesota Statutes 2021 Supplement, section 260C.212, subdivision 2, is amended
266.20to read:
266.21    Subd. 2. Placement decisions based on best interests of the child. (a) The policy of
266.22the state of Minnesota is to ensure that the child's best interests are met by requiring an
266.23individualized determination of the needs of the child in consideration of paragraphs (a) to
266.24(f), and of how the selected placement will serve the current and future needs of the child
266.25being placed. The authorized child-placing agency shall place a child, released by court
266.26order or by voluntary release by the parent or parents, in a family foster home selected by
266.27considering placement with relatives and important friends in the following order:
266.28    (1) with an individual who is related to the child by blood, marriage, or adoption,
266.29including the legal parent, guardian, or custodian of the child's siblings sibling; or
266.30(2) with an individual who is an important friend of the child or of the child's parent or
266.31custodian, including an individual with whom the child has resided or had significant contact
266.32or who has a significant relationship to the child or the child's parent or custodian.
267.1    (2) with an individual who is an important friend with whom the child has resided or
267.2had significant contact.
267.3For an Indian child, the agency shall follow the order of placement preferences in the Indian
267.4Child Welfare Act of 1978, United States Code, title 25, section 1915.
267.5    (b) Among the factors the agency shall consider in determining the current and future
267.6needs of the child are the following:
267.7    (1) the child's current functioning and behaviors;
267.8    (2) the medical needs of the child;
267.9(3) the educational needs of the child;
267.10(4) the developmental needs of the child;
267.11    (5) the child's history and past experience;
267.12    (6) the child's religious and cultural needs;
267.13    (7) the child's connection with a community, school, and faith community;
267.14    (8) the child's interests and talents;
267.15    (9) the child's relationship to current caretakers, current and long-term needs regarding
267.16relationships with parents, siblings, and relatives, and other caretakers;
267.17    (10) the reasonable preference of the child, if the court, or the child-placing agency in
267.18the case of a voluntary placement, deems the child to be of sufficient age to express
267.19preferences; and
267.20    (11) for an Indian child, the best interests of an Indian child as defined in section 260.755,
267.21subdivision 2a.
267.22When placing a child in foster care or in a permanent placement based on an individualized
267.23determination of the child's needs, the agency must not use one factor in this paragraph to
267.24the exclusion of all others, and the agency shall consider that the factors in paragraph (b)
267.25may be interrelated.
267.26    (c) Placement of a child cannot be delayed or denied based on race, color, or national
267.27origin of the foster parent or the child.
267.28    (d) Siblings should be placed together for foster care and adoption at the earliest possible
267.29time unless it is documented that a joint placement would be contrary to the safety or
267.30well-being of any of the siblings or unless it is not possible after reasonable efforts by the
267.31responsible social services agency. In cases where siblings cannot be placed together, the
268.1agency is required to provide frequent visitation or other ongoing interaction between
268.2siblings unless the agency documents that the interaction would be contrary to the safety
268.3or well-being of any of the siblings.
268.4    (e) Except for emergency placement as provided for in section 245A.035, the following
268.5requirements must be satisfied before the approval of a foster or adoptive placement in a
268.6related or unrelated home: (1) a completed background study under section 245C.08; and
268.7(2) a completed review of the written home study required under section 260C.215,
268.8subdivision 4, clause (5), or 260C.611, to assess the capacity of the prospective foster or
268.9adoptive parent to ensure the placement will meet the needs of the individual child.
268.10(f) The agency must determine whether colocation with a parent who is receiving services
268.11in a licensed residential family-based substance use disorder treatment program is in the
268.12child's best interests according to paragraph (b) and include that determination in the child's
268.13case plan under subdivision 1. The agency may consider additional factors not identified
268.14in paragraph (b). The agency's determination must be documented in the child's case plan
268.15before the child is colocated with a parent.
268.16(g) The agency must establish a juvenile treatment screening team under section 260C.157
268.17to determine whether it is necessary and appropriate to recommend placing a child in a
268.18qualified residential treatment program, as defined in section 260C.007, subdivision 26d.

268.19    Sec. 20. Minnesota Statutes 2020, section 260C.212, subdivision 4a, is amended to read:
268.20    Subd. 4a. Monthly caseworker visits. (a) Every child in foster care or on a trial home
268.21visit shall be visited by the child's caseworker or another person who has responsibility for
268.22visitation of the child on a monthly basis, with the majority of visits occurring in the child's
268.23residence. The responsible social services agency may designate another person responsible
268.24for monthly case visits. For the purposes of this section, the following definitions apply:
268.25    (1) "visit" is defined as a face-to-face contact between a child and the child's caseworker;
268.26    (2) "visited on a monthly basis" is defined as at least one visit per calendar month;
268.27    (3) "the child's caseworker" is defined as the person who has responsibility for managing
268.28the child's foster care placement case as assigned by the responsible social services agency;
268.29    (4) "another person" means the professional staff whom the responsible social services
268.30agency has assigned in the out-of-home placement plan or case plan. Another person must
268.31be professionally trained to assess the child's safety, permanency, well-being, and case
268.32progress. The agency may not designate the guardian ad litem, the child foster care provider,
269.1residential facility staff, or a qualified individual as defined in section 260C.007,
269.2subdivision26b, as another person; and
269.3    (5) "the child's residence" is defined as the home where the child is residing, and can
269.4include the foster home, child care institution, or the home from which the child was removed
269.5if the child is on a trial home visit.
269.6    (b) Caseworker visits shall be of sufficient substance and duration to address issues
269.7pertinent to case planning and service delivery to ensure the safety, permanency, and
269.8well-being of the child, including whether the child is enrolled and attending school as
269.9required by law.
269.10    (c) Every effort shall be made by the responsible social services agency and professional
269.11staff to have the monthly visit with the child outside the presence of the child's parents,
269.12foster parents, or facility staff. There may be situations related to the child's needs when a
269.13caseworker visit cannot occur with the child alone. The reason the caseworker visit occurred
269.14in the presence of others must be documented in the case record and may include:
269.15    (1) that the child exhibits intense emotion or behavior indicating that visiting without
269.16the presence of the parent, foster parent, or facility staff would be traumatic for the child;
269.17    (2) that despite a caseworker's efforts, the child declines to visit with the caseworker
269.18outside the presence of the parent, foster parent, or facility staff; and
269.19    (3) that the child has a specific developmental delay, physical limitation, incapacity,
269.20medical device, or significant medical need, such that the parent, foster parent, or facility
269.21staff is required to be present with the child during the visit.

269.22    Sec. 21. Minnesota Statutes 2020, section 260C.221, is amended to read:
269.23260C.221 RELATIVE SEARCH AND ENGAGEMENT; PLACEMENT
269.24CONSIDERATION.
269.25    Subdivision 1. Relative search requirements. (a) The responsible social services agency
269.26shall exercise due diligence to identify and notify adult relatives and current caregivers of
269.27a child's sibling, prior to placement or within 30 days after the child's removal from the
269.28parent, regardless of whether a child is placed in a relative's home, as required under
269.29subdivision 2. The county agency shall consider placement with a relative under this section
269.30without delay and whenever the child must move from or be returned to foster care. The
269.31relative search required by this section shall be comprehensive in scope. After a finding
269.32that the agency has made reasonable efforts to conduct the relative search under this
269.33paragraph, the agency has the continuing responsibility to appropriately involve relatives,
270.1who have responded to the notice required under this paragraph, in planning for the child
270.2and to continue to consider relatives according to the requirements of section 260C.212,
270.3subdivision 2. At any time during the course of juvenile protection proceedings, the court
270.4may order the agency to reopen its search for relatives when it is in the child's best interest
270.5to do so.
270.6(b) The relative search required by this section shall include both maternal and paternal
270.7adult relatives of the child; all adult grandparents; all legal parents, guardians, or custodians
270.8of the child's siblings; and any other adult relatives suggested by the child's parents, subject
270.9to the exceptions due to family violence in subdivision 5, paragraph (c) (b). The search shall
270.10also include getting information from the child in an age-appropriate manner about who the
270.11child considers to be family members and important friends with whom the child has resided
270.12or had significant contact. The relative search required under this section must fulfill the
270.13agency's duties under the Indian Child Welfare Act regarding active efforts to prevent the
270.14breakup of the Indian family under United States Code, title 25, section 1912(d), and to
270.15meet placement preferences under United States Code, title 25, section 1915.
270.16(c) The responsible social services agency has a continuing responsibility to search for
270.17and identify relatives of a child and send the notice to relatives that is required under
270.18subdivision 2, unless the court has relieved the agency of this duty under subdivision 5,
270.19paragraph (e).
270.20    Subd. 2. Relative notice requirements. (a) The agency may provide oral or written
270.21notice to a child's relatives. In the child's case record, the agency must document providing
270.22the required notice to each of the child's relatives. The responsible social services agency
270.23must notify relatives must be notified:
270.24(1) of the need for a foster home for the child, the option to become a placement resource
270.25for the child, the order of placement that the agency will consider under section 260C.212,
270.26subdivision 2, paragraph (a), and the possibility of the need for a permanent placement for
270.27the child;
270.28(2) of their responsibility to keep the responsible social services agency and the court
270.29informed of their current address in order to receive notice in the event that a permanent
270.30placement is sought for the child and to receive notice of the permanency progress review
270.31hearing under section 260C.204. A relative who fails to provide a current address to the
270.32responsible social services agency and the court forfeits the right to receive notice of the
270.33possibility of permanent placement and of the permanency progress review hearing under
270.34section 260C.204, until the relative provides a current address to the responsible social
271.1services agency and the court. A decision by a relative not to be identified as a potential
271.2permanent placement resource or participate in planning for the child at the beginning of
271.3the case shall not affect whether the relative is considered for placement of, or as a
271.4permanency resource for, the child with that relative later at any time in the case, and shall
271.5not be the sole basis for the court to rule out the relative as the child's placement or
271.6permanency resource;
271.7(3) that the relative may participate in the care and planning for the child, as specified
271.8in subdivision 3, including that the opportunity for such participation may be lost by failing
271.9to respond to the notice sent under this subdivision. "Participate in the care and planning"
271.10includes, but is not limited to, participation in case planning for the parent and child,
271.11identifying the strengths and needs of the parent and child, supervising visits, providing
271.12respite and vacation visits for the child, providing transportation to appointments, suggesting
271.13other relatives who might be able to help support the case plan, and to the extent possible,
271.14helping to maintain the child's familiar and regular activities and contact with friends and
271.15relatives;
271.16(4) of the family foster care licensing and adoption home study requirements, including
271.17how to complete an application and how to request a variance from licensing standards that
271.18do not present a safety or health risk to the child in the home under section 245A.04 and
271.19supports that are available for relatives and children who reside in a family foster home;
271.20and
271.21    (5) of the relatives' right to ask to be notified of any court proceedings regarding the
271.22child, to attend the hearings, and of a relative's right or opportunity to be heard by the court
271.23as required under section 260C.152, subdivision 5.;
271.24(6) that regardless of the relative's response to the notice sent under this subdivision, the
271.25agency is required to establish permanency for a child, including planning for alternative
271.26permanency options if the agency's reunification efforts fail or are not required; and
271.27(7) that by responding to the notice, a relative may receive information about participating
271.28in a child's family and permanency team if the child is placed in a qualified residential
271.29treatment program as defined in section 260C.007, subdivision 26d.
271.30(b) The responsible social services agency shall send the notice required under paragraph
271.31(a) to relatives who become known to the responsible social services agency, except for
271.32relatives that the agency does not contact due to safety reasons under subdivision 5, paragraph
271.33(b). The responsible social services agency shall continue to send notice to relatives
272.1notwithstanding a court's finding that the agency has made reasonable efforts to conduct a
272.2relative search.
272.3(c) The responsible social services agency is not required to send the notice under
272.4paragraph (a) to a relative who becomes known to the agency after an adoption placement
272.5agreement has been fully executed under section 260C.613, subdivision 1. If the relative
272.6wishes to be considered for adoptive placement of the child, the agency shall inform the
272.7relative of the relative's ability to file a motion for an order for adoptive placement under
272.8section 260C.607, subdivision 6.
272.9    Subd. 3. Relative engagement requirements. (a) A relative who responds to the notice
272.10under subdivision 2 has the opportunity to participate in care and planning for a child, which
272.11must not be limited based solely on the relative's prior inconsistent participation or
272.12nonparticipation in care and planning for the child. Care and planning for a child may include
272.13but is not limited to:
272.14(1) participating in case planning for the child and child's parent, including identifying
272.15services and resources that meet the individualized needs of the child and child's parent. A
272.16relative's participation in case planning may be in person, via phone call, or by electronic
272.17means;
272.18(2) identifying the strengths and needs of the child and child's parent;
272.19(3) asking the responsible social services agency to consider the relative for placement
272.20of the child according to subdivision 4;
272.21(4) acting as a support person for the child, the child's parents, and the child's current
272.22caregiver;
272.23(5) supervising visits;
272.24(6) providing respite care for the child and having vacation visits with the child;
272.25(7) providing transportation;
272.26(8) suggesting other relatives who may be able to participate in the case plan or that the
272.27agency may consider for placement of the child. The agency shall send a notice to each
272.28relative identified by other relatives according to subdivision 2, paragraph (b), unless a
272.29relative received this notice earlier in the case;
272.30(9) helping to maintain the child's familiar and regular activities and contact with the
272.31child's friends and relatives, including providing supervision of the child at family gatherings
272.32and events; and
273.1(10) participating in the child's family and permanency team if the child is placed in a
273.2qualified residential treatment program as defined in section 260C.007, subdivision 26d.
273.3(b) The responsible social services agency shall make reasonable efforts to contact and
273.4engage relatives who respond to the notice required under this section. Upon a request by
273.5a relative or party to the proceeding, the court may conduct a review of the agency's
273.6reasonable efforts to contact and engage relatives who respond to the notice. If the court
273.7finds that the agency did not make reasonable efforts to contact and engage relatives who
273.8respond to the notice, the court may order the agency to make reasonable efforts to contact
273.9and engage relatives who respond to the notice in care and planning for the child.
273.10    Subd. 4. Placement considerations. (a) The responsible social services agency shall
273.11consider placing a child with a relative under this section without delay and when the child:
273.12(1) enters foster care;
273.13(2) must be moved from the child's current foster setting;
273.14(3) must be permanently placed away from the child's parent; or
273.15(4) returns to foster care after permanency has been achieved for the child.
273.16(b) The agency shall consider placing a child with relatives:
273.17(1) in the order specified in section 260C.212, subdivision 2, paragraph (a); and
273.18(2) based on the child's best interests using the factors in section 260C.212, subdivision
273.192.
273.20    (c) The agency shall document how the agency considered relatives in the child's case
273.21record.
273.22(d) Any relative who requests to be a placement option for a child in foster care has the
273.23right to be considered for placement of the child according to section 260C.212, subdivision
273.242, paragraph (a), unless the court finds that placing the child with a specific relative would
273.25endanger the child, sibling, parent, guardian, or any other family member under subdivision
273.265, paragraph (b).
273.27(e) When adoption is the responsible social services agency's permanency goal for the
273.28child, the agency shall consider adoptive placement of the child with a relative in the order
273.29specified under section 260C.212, subdivision 2, paragraph (a).
273.30    Subd. 5. Data disclosure; court review. (c) (a) A responsible social services agency
273.31may disclose private data, as defined in section 13.02 and chapter 260E, to relatives of the
273.32child for the purpose of locating and assessing a suitable placement and may use any
274.1reasonable means of identifying and locating relatives including the Internet or other
274.2electronic means of conducting a search. The agency shall disclose data that is necessary
274.3to facilitate possible placement with relatives and to ensure that the relative is informed of
274.4the needs of the child so the relative can participate in planning for the child and be supportive
274.5of services to the child and family.
274.6(b) If the child's parent refuses to give the responsible social services agency information
274.7sufficient to identify the maternal and paternal relatives of the child, the agency shall ask
274.8the juvenile court to order the parent to provide the necessary information and shall use
274.9other resources to identify the child's maternal and paternal relatives. If a parent makes an
274.10explicit request that a specific relative not be contacted or considered for placement due to
274.11safety reasons, including past family or domestic violence, the agency shall bring the parent's
274.12request to the attention of the court to determine whether the parent's request is consistent
274.13with the best interests of the child and. The agency shall not contact the specific relative
274.14when the juvenile court finds that contacting or placing the child with the specific relative
274.15would endanger the parent, guardian, child, sibling, or any family member. Unless section
274.16260C.139 applies to the child's case, a court shall not waive or relieve the responsible social
274.17services agency of reasonable efforts to:
274.18(1) conduct a relative search;
274.19(2) notify relatives;
274.20(3) contact and engage relatives in case planning; and
274.21(4) consider relatives for placement of the child.
274.22(c) Notwithstanding chapter 13, the agency shall disclose data to the court about particular
274.23relatives that the agency has identified, contacted, or considered for the child's placement
274.24for the court to review the agency's due diligence.
274.25(d) At a regularly scheduled hearing not later than three months after the child's placement
274.26in foster care and as required in section sections 260C.193 and 260C.202, the agency shall
274.27report to the court:
274.28(1) its the agency's efforts to identify maternal and paternal relatives of the child and to
274.29engage the relatives in providing support for the child and family, and document that the
274.30relatives have been provided the notice required under paragraph (a) subdivision 2; and
274.31(2) its the agency's decision regarding placing the child with a relative as required under
274.32section 260C.212, subdivision 2, and to ask. If the responsible social services agency decides
275.1that relative placement is not in the child's best interests at the time of the hearing, the agency
275.2shall inform the court of the agency's decision, including:
275.3(i) why the agency decided against relative placement of the child; and
275.4(ii) the agency's efforts to engage relatives to visit or maintain contact with the child in
275.5order as required under subdivision 3 to support family connections for the child, when
275.6placement with a relative is not possible or appropriate.
275.7(e) Notwithstanding chapter 13, the agency shall disclose data about particular relatives
275.8identified, searched for, and contacted for the purposes of the court's review of the agency's
275.9due diligence.
275.10(f) (e) When the court is satisfied that the agency has exercised due diligence to identify
275.11relatives and provide the notice required in paragraph (a) subdivision 2, the court may find
275.12that the agency made reasonable efforts have been made to conduct a relative search to
275.13identify and provide notice to adult relatives as required under section 260.012, paragraph
275.14(e), clause (3). A finding under this paragraph does not relieve the responsible social services
275.15agency of the ongoing duty to contact, engage, and consider relatives under this section nor
275.16is it a basis for the court to rule out any relative from being a foster care or permanent
275.17placement option for the child. The agency has the continuing responsibility to:
275.18(1) involve relatives who respond to the notice in planning for the child; and
275.19(2) continue considering relatives for the child's placement while taking the child's short-
275.20and long-term permanency goals into consideration, according to the requirements of section
275.21260C.212, subdivision 2.
275.22    (f) At any time during the course of juvenile protection proceedings, the court may order
275.23the agency to reopen the search for relatives when it is in the child's best interests.
275.24(g) If the court is not satisfied that the agency has exercised due diligence to identify
275.25relatives and provide the notice required in paragraph (a) subdivision 2, the court may order
275.26the agency to continue its search and notice efforts and to report back to the court.
275.27(g) When the placing agency determines that permanent placement proceedings are
275.28necessary because there is a likelihood that the child will not return to a parent's care, the
275.29agency must send the notice provided in paragraph (h), may ask the court to modify the
275.30duty of the agency to send the notice required in paragraph (h), or may ask the court to
275.31completely relieve the agency of the requirements of paragraph (h). The relative notification
275.32requirements of paragraph (h) do not apply when the child is placed with an appropriate
275.33relative or a foster home that has committed to adopting the child or taking permanent legal
276.1and physical custody of the child and the agency approves of that foster home for permanent
276.2placement of the child. The actions ordered by the court under this section must be consistent
276.3with the best interests, safety, permanency, and welfare of the child.
276.4(h) Unless required under the Indian Child Welfare Act or relieved of this duty by the
276.5court under paragraph (f), When the agency determines that it is necessary to prepare for
276.6permanent placement determination proceedings, or in anticipation of filing a termination
276.7of parental rights petition, the agency shall send notice to the relatives who responded to a
276.8notice under this section sent at any time during the case, any adult with whom the child is
276.9currently residing, any adult with whom the child has resided for one year or longer in the
276.10past, and any adults who have maintained a relationship or exercised visitation with the
276.11child as identified in the agency case plan. The notice must state that a permanent home is
276.12sought for the child and that the individuals receiving the notice may indicate to the agency
276.13their interest in providing a permanent home. The notice must state that within 30 days of
276.14receipt of the notice an individual receiving the notice must indicate to the agency the
276.15individual's interest in providing a permanent home for the child or that the individual may
276.16lose the opportunity to be considered for a permanent placement. A relative's failure to
276.17respond or timely respond to the notice is not a basis for ruling out the relative from being
276.18a permanent placement option for the child, should the relative request to be considered for
276.19permanent placement at a later date.

276.20    Sec. 22. Minnesota Statutes 2020, section 260C.331, subdivision 1, is amended to read:
276.21    Subdivision 1. Care, examination, or treatment. (a) Except where parental rights are
276.22terminated,
276.23    (1) whenever legal custody of a child is transferred by the court to a responsible social
276.24services agency,
276.25    (2) whenever legal custody is transferred to a person other than the responsible social
276.26services agency, but under the supervision of the responsible social services agency, or
276.27    (3) whenever a child is given physical or mental examinations or treatment under order
276.28of the court, and no provision is otherwise made by law for payment for the care,
276.29examination, or treatment of the child, these costs are a charge upon the welfare funds of
276.30the county in which proceedings are held upon certification of the judge of juvenile court.
276.31    (b) The court shall may order, and the responsible social services agency shall may
276.32require, the parents or custodian of a child, while the child is under the age of 18, to use the
276.33total income and resources attributable to the child for the period of care, examination, or
277.1treatment, except for clothing and personal needs allowance as provided in section 256B.35,
277.2to reimburse the county for the cost of care, examination, or treatment. Income and resources
277.3attributable to the child include, but are not limited to, Social Security benefits, Supplemental
277.4Security Income (SSI), veterans benefits, railroad retirement benefits and child support.
277.5When the child is over the age of 18, and continues to receive care, examination, or treatment,
277.6the court shall may order, and the responsible social services agency shall may require,
277.7reimbursement from the child for the cost of care, examination, or treatment from the income
277.8and resources attributable to the child less the clothing and personal needs allowance. Income
277.9does not include earnings from a child over the age of 18 who is working as part of a plan
277.10under section 260C.212, subdivision 1, paragraph (c), clause (12), to transition from foster
277.11care, or the income and resources from sources other than Supplemental Security Income
277.12and child support that are needed to complete the requirements listed in section 260C.203.
277.13The responsible social services agency shall determine whether requiring reimbursement,
277.14either through child support or parental fees, for the cost of care, examination, or treatment
277.15from the parents or custodian of a child is in the child's best interests. In determining whether
277.16to require reimbursement, the responsible social services agency shall consider:
277.17(1) whether requiring reimbursement would compromise the parent's ability to meet the
277.18requirements of the reunification plan;
277.19(2) whether requiring reimbursement would compromise the parent's ability to meet the
277.20child's needs after reunification; and
277.21(3) whether redirecting existing child support payments or changing the representative
277.22payee of social security benefits to the responsible social services agency would limit the
277.23parent's ability to maintain financial stability for the child.
277.24    (c) If the income and resources attributable to the child are not enough to reimburse the
277.25county for the full cost of the care, examination, or treatment, the court shall may inquire
277.26into the ability of the parents to support the child reimburse the county for the cost of care,
277.27examination, or treatment and, after giving the parents a reasonable opportunity to be heard,
277.28the court shall may order, and the responsible social services agency shall may require, the
277.29parents to contribute to the cost of care, examination, or treatment of the child. When
277.30determining the amount to be contributed by the parents, the court shall use a fee schedule
277.31based upon ability to pay that is established by the responsible social services agency and
277.32approved by the commissioner of human services. The income of a stepparent who has not
277.33adopted a child shall be excluded in calculating the parental contribution under this section.
277.34In determining whether to require reimbursement, the responsible social services agency
277.35shall consider:
278.1(1) whether requiring reimbursement would compromise the parent's ability to meet the
278.2requirements of the reunification plan;
278.3(2) whether requiring reimbursement would compromise the parent's ability to meet the
278.4child's needs after reunification; and
278.5(3) whether requiring reimbursement would compromise the parent's ability to meet the
278.6needs of the family.
278.7    (d) If the responsible social services agency determines that reimbursement is in the
278.8child's best interest, the court shall order the amount of reimbursement attributable to the
278.9parents or custodian, or attributable to the child, or attributable to both sources, withheld
278.10under chapter 518A from the income of the parents or the custodian of the child. A parent
278.11or custodian who fails to pay without good reason may be proceeded against for contempt,
278.12or the court may inform the county attorney, who shall proceed to collect the unpaid sums,
278.13or both procedures may be used.
278.14    (e) If the court orders a physical or mental examination for a child, the examination is
278.15a medically necessary service for purposes of determining whether the service is covered
278.16by a health insurance policy, health maintenance contract, or other health coverage plan.
278.17Court-ordered treatment shall be subject to policy, contract, or plan requirements for medical
278.18necessity. Nothing in this paragraph changes or eliminates benefit limits, conditions of
278.19coverage, co-payments or deductibles, provider restrictions, or other requirements in the
278.20policy, contract, or plan that relate to coverage of other medically necessary services.
278.21(f) Notwithstanding paragraph (b), (c), or (d), a parent, custodian, or guardian of the
278.22child is not required to use income and resources attributable to the child to reimburse the
278.23county for costs of care and is not required to contribute to the cost of care of the child
278.24during any period of time when the child is returned to the home of that parent, custodian,
278.25or guardian pursuant to a trial home visit under section 260C.201, subdivision 1, paragraph
278.26(a).

278.27    Sec. 23. Minnesota Statutes 2020, section 260C.513, is amended to read:
278.28260C.513 PERMANENCY DISPOSITIONS WHEN CHILD CANNOT RETURN
278.29HOME.
278.30(a) Termination of parental rights and adoption, or guardianship to the commissioner of
278.31human services through a consent to adopt, are preferred permanency options for a child
278.32who cannot return home. If the court finds that termination of parental rights and guardianship
278.33to the commissioner is not in the child's best interests, the court may transfer permanent
279.1legal and physical custody of the child to a relative when that order is in the child's best
279.2interests. For a child who cannot return home, a permanency placement with a relative is
279.3preferred. A permanency placement with a relative includes termination of parental rights
279.4and adoption by a relative, guardianship to the commissioner of human services through a
279.5consent to adopt with a relative, or a transfer of permanent legal and physical custody to a
279.6relative. The court must consider the best interests of the child and section 260C.212,
279.7subdivision 2, paragraph (a), when making a permanency determination.
279.8(b) When the court has determined that permanent placement of the child away from
279.9the parent is necessary, the court shall consider permanent alternative homes that are available
279.10both inside and outside the state.

279.11    Sec. 24. Minnesota Statutes 2021 Supplement, section 260C.605, subdivision 1, is amended
279.12to read:
279.13    Subdivision 1. Requirements. (a) Reasonable efforts to finalize the adoption of a child
279.14under the guardianship of the commissioner shall be made by the responsible social services
279.15agency responsible for permanency planning for the child.
279.16(b) Reasonable efforts to make a placement in a home according to the placement
279.17considerations under section 260C.212, subdivision 2, with a relative or foster parent who
279.18will commit to being the permanent resource for the child in the event the child cannot be
279.19reunified with a parent are required under section 260.012 and may be made concurrently
279.20with reasonable, or if the child is an Indian child, active efforts to reunify the child with the
279.21parent.
279.22(c) Reasonable efforts under paragraph (b) must begin as soon as possible when the
279.23child is in foster care under this chapter, but not later than the hearing required under section
279.24260C.204.
279.25(d) Reasonable efforts to finalize the adoption of the child include:
279.26(1) considering the child's preference for an adoptive family;
279.27(1) (2) using age-appropriate engagement strategies to plan for adoption with the child;
279.28(2) (3) identifying an appropriate prospective adoptive parent for the child by updating
279.29the child's identified needs using the factors in section 260C.212, subdivision 2;
279.30(3) (4) making an adoptive placement that meets the child's needs by:
279.31(i) completing or updating the relative search required under section 260C.221 and giving
279.32notice of the need for an adoptive home for the child to:
280.1(A) relatives who have kept the agency or the court apprised of their whereabouts and
280.2who have indicated an interest in adopting the child; or
280.3(B) relatives of the child who are located in an updated search;
280.4(ii) an updated search is required whenever:
280.5(A) there is no identified prospective adoptive placement for the child notwithstanding
280.6a finding by the court that the agency made diligent efforts under section 260C.221, in a
280.7hearing required under section 260C.202;
280.8(B) the child is removed from the home of an adopting parent; or
280.9(C) the court determines that a relative search by the agency is in the best interests of
280.10the child;
280.11(iii) engaging the child's relatives or current or former foster parent and the child's
280.12relatives identified as an adoptive resource during the search conducted under section
280.13260C.221, parents to commit to being the prospective adoptive parent of the child, and
280.14considering the child's relatives for adoptive placement of the child in the order specified
280.15under section 260C.212, subdivision 2, paragraph (a); or
280.16(iv) when there is no identified prospective adoptive parent:
280.17(A) registering the child on the state adoption exchange as required in section 259.75
280.18unless the agency documents to the court an exception to placing the child on the state
280.19adoption exchange reported to the commissioner;
280.20(B) reviewing all families with approved adoption home studies associated with the
280.21responsible social services agency;
280.22(C) presenting the child to adoption agencies and adoption personnel who may assist
280.23with finding an adoptive home for the child;
280.24(D) using newspapers and other media to promote the particular child;
280.25(E) using a private agency under grant contract with the commissioner to provide adoption
280.26services for intensive child-specific recruitment efforts; and
280.27(F) making any other efforts or using any other resources reasonably calculated to identify
280.28a prospective adoption parent for the child;
280.29(4) (5) updating and completing the social and medical history required under sections
280.30260C.212, subdivision 15, and 260C.609;
281.1(5) (6) making, and keeping updated, appropriate referrals required by section 260.851,
281.2the Interstate Compact on the Placement of Children;
281.3(6) (7) giving notice regarding the responsibilities of an adoptive parent to any prospective
281.4adoptive parent as required under section 259.35;
281.5(7) (8) offering the adopting parent the opportunity to apply for or decline adoption
281.6assistance under chapter 256N;
281.7(8) (9) certifying the child for adoption assistance, assessing the amount of adoption
281.8assistance, and ascertaining the status of the commissioner's decision on the level of payment
281.9if the adopting parent has applied for adoption assistance;
281.10(9) (10) placing the child with siblings. If the child is not placed with siblings, the agency
281.11must document reasonable efforts to place the siblings together, as well as the reason for
281.12separation. The agency may not cease reasonable efforts to place siblings together for final
281.13adoption until the court finds further reasonable efforts would be futile or that placement
281.14together for purposes of adoption is not in the best interests of one of the siblings; and
281.15(10) (11) working with the adopting parent to file a petition to adopt the child and with
281.16the court administrator to obtain a timely hearing to finalize the adoption.

281.17    Sec. 25. Minnesota Statutes 2020, section 260C.607, subdivision 2, is amended to read:
281.18    Subd. 2. Notice. Notice of review hearings shall be given by the court to:
281.19(1) the responsible social services agency;
281.20(2) the child, if the child is age ten and older;
281.21(3) the child's guardian ad litem;
281.22(4) counsel appointed for the child pursuant to section 260C.163, subdivision 3;
281.23(5) relatives of the child who have kept the court informed of their whereabouts as
281.24required in section 260C.221 and who have responded to the agency's notice under section
281.25260C.221, indicating a willingness to provide an adoptive home for the child unless the
281.26relative has been previously ruled out by the court as a suitable foster parent or permanency
281.27resource for the child;
281.28(6) the current foster or adopting parent of the child;
281.29(7) any foster or adopting parents of siblings of the child; and
281.30(8) the Indian child's tribe.

282.1    Sec. 26. Minnesota Statutes 2020, section 260C.607, subdivision 5, is amended to read:
282.2    Subd. 5. Required placement by responsible social services agency. (a) No petition
282.3for adoption shall be filed for a child under the guardianship of the commissioner unless
282.4the child sought to be adopted has been placed for adoption with the adopting parent by the
282.5responsible social services agency as required under section 260C.613, subdivision 1. The
282.6court may order the agency to make an adoptive placement using standards and procedures
282.7under subdivision 6.
282.8(b) Any relative or the child's foster parent who believes the responsible agency has not
282.9reasonably considered the relative's or foster parent's request to be considered for adoptive
282.10placement as required under section 260C.212, subdivision 2, and who wants to be considered
282.11for adoptive placement of the child shall bring a request for consideration to the attention
282.12of the court during a review required under this section. The child's guardian ad litem and
282.13the child may also bring a request for a relative or the child's foster parent to be considered
282.14for adoptive placement. After hearing from the agency, the court may order the agency to
282.15take appropriate action regarding the relative's or foster parent's request for consideration
282.16under section 260C.212, subdivision 2, paragraph (b).

282.17    Sec. 27. Minnesota Statutes 2021 Supplement, section 260C.607, subdivision 6, is amended
282.18to read:
282.19    Subd. 6. Motion and hearing to order adoptive placement. (a) At any time after the
282.20district court orders the child under the guardianship of the commissioner of human services,
282.21but not later than 30 days after receiving notice required under section 260C.613, subdivision
282.221, paragraph (c), that the agency has made an adoptive placement, a relative or the child's
282.23foster parent may file a motion for an order for adoptive placement of a child who is under
282.24the guardianship of the commissioner if the relative or the child's foster parent:
282.25(1) has an adoption home study under section 259.41 or 260C.611 approving the relative
282.26or foster parent for adoption and has. If the relative or foster parent does not have an adoption
282.27home study, an affidavit attesting to efforts to complete an adoption home study may be
282.28filed with the motion instead. The affidavit must be signed by the relative or foster parent
282.29and the responsible social services agency or licensed child-placing agency completing the
282.30adoption home study. The relative or foster parent must also have been a resident of
282.31Minnesota for at least six months before filing the motion; the court may waive the residency
282.32requirement for the moving party if there is a reasonable basis to do so; or
282.33(2) is not a resident of Minnesota, but has an approved adoption home study by an agency
282.34licensed or approved to complete an adoption home study in the state of the individual's
283.1residence and the study is filed with the motion for adoptive placement. If the relative or
283.2foster parent does not have an adoption home study in the relative or foster parent's state
283.3of residence, an affidavit attesting to efforts to complete an adoption home study may be
283.4filed with the motion instead. The affidavit must be signed by the relative or foster parent
283.5and the agency completing the adoption home study.
283.6(b) The motion shall be filed with the court conducting reviews of the child's progress
283.7toward adoption under this section. The motion and supporting documents must make a
283.8prima facie showing that the agency has been unreasonable in failing to make the requested
283.9adoptive placement. The motion must be served according to the requirements for motions
283.10under the Minnesota Rules of Juvenile Protection Procedure and shall be made on all
283.11individuals and entities listed in subdivision 2.
283.12(c) If the motion and supporting documents do not make a prima facie showing for the
283.13court to determine whether the agency has been unreasonable in failing to make the requested
283.14adoptive placement, the court shall dismiss the motion. If the court determines a prima facie
283.15basis is made, the court shall set the matter for evidentiary hearing.
283.16(d) At the evidentiary hearing, the responsible social services agency shall proceed first
283.17with evidence about the reason for not making the adoptive placement proposed by the
283.18moving party. When the agency presents evidence regarding the child's current relationship
283.19with the identified adoptive placement resource, the court must consider the agency's efforts
283.20to support the child's relationship with the moving party consistent with section 260C.221.
283.21The moving party then has the burden of proving by a preponderance of the evidence that
283.22the agency has been unreasonable in failing to make the adoptive placement.
283.23(e) The court shall review and enter findings regarding whether the agency, in making
283.24an adoptive placement decision for the child:
283.25(1) considered relatives for adoptive placement in the order specified under section
283.26260C.212, subdivision 2, paragraph (a); and
283.27(2) assessed how the identified adoptive placement resource and the moving party are
283.28each able to meet the child's current and future needs, based on an individualized
283.29determination of the child's needs, as required under sections 260C.212, subdivision 2, and
283.30260C.613, subdivision 1, paragraph (b).
283.31(e) (f) At the conclusion of the evidentiary hearing, if the court finds that the agency has
283.32been unreasonable in failing to make the adoptive placement and that the relative or the
283.33child's foster parent moving party is the most suitable adoptive home to meet the child's
283.34needs using the factors in section 260C.212, subdivision 2, paragraph (b), the court may:
284.1(1) order the responsible social services agency to make an adoptive placement in the
284.2home of the relative or the child's foster parent. moving party if the moving party has an
284.3approved adoption home study; or
284.4(2) order the responsible social services agency to place the child in the home of the
284.5moving party upon approval of an adoption home study. The agency must promote and
284.6support the child's ongoing visitation and contact with the moving party until the child is
284.7placed in the moving party's home. The agency must provide an update to the court after
284.890 days, including progress and any barriers encountered. If the moving party does not have
284.9an approved adoption home study within 180 days, the moving party and the agency must
284.10inform the court of any barriers to obtaining the approved adoption home study during a
284.11review hearing under this section. If the court finds that the moving party is unable to obtain
284.12an approved adoption home study, the court must dismiss the order for adoptive placement
284.13under this subdivision and order the agency to continue making reasonable efforts to finalize
284.14the adoption of the child as required under section 260C.605.
284.15    (f) (g) If, in order to ensure that a timely adoption may occur, the court orders the
284.16responsible social services agency to make an adoptive placement under this subdivision,
284.17the agency shall:
284.18    (1) make reasonable efforts to obtain a fully executed adoption placement agreement,
284.19including assisting the moving party with the adoption home study process;
284.20    (2) work with the moving party regarding eligibility for adoption assistance as required
284.21under chapter 256N; and
284.22    (3) if the moving party is not a resident of Minnesota, timely refer the matter for approval
284.23of the adoptive placement through the Interstate Compact on the Placement of Children.
284.24(g) (h) Denial or granting of a motion for an order for adoptive placement after an
284.25evidentiary hearing is an order which may be appealed by the responsible social services
284.26agency, the moving party, the child, when age ten or over, the child's guardian ad litem,
284.27and any individual who had a fully executed adoption placement agreement regarding the
284.28child at the time the motion was filed if the court's order has the effect of terminating the
284.29adoption placement agreement. An appeal shall be conducted according to the requirements
284.30of the Rules of Juvenile Protection Procedure.

284.31    Sec. 28. Minnesota Statutes 2020, section 260C.613, subdivision 1, is amended to read:
284.32    Subdivision 1. Adoptive placement decisions. (a) The responsible social services agency
284.33has exclusive authority to make an adoptive placement of a child under the guardianship of
285.1the commissioner. The child shall be considered placed for adoption when the adopting
285.2parent, the agency, and the commissioner have fully executed an adoption placement
285.3agreement on the form prescribed by the commissioner.
285.4(b) The responsible social services agency shall use an individualized determination of
285.5the child's current and future needs, pursuant to section 260C.212, subdivision 2, paragraph
285.6(b), to determine the most suitable adopting parent for the child in the child's best interests.
285.7The responsible social services agency must consider adoptive placement of the child with
285.8relatives in the order specified in section 260C.212, subdivision 2, paragraph (a).
285.9(c) The responsible social services agency shall notify the court and parties entitled to
285.10notice under section 260C.607, subdivision 2, when there is a fully executed adoption
285.11placement agreement for the child.
285.12(d) In the event an adoption placement agreement terminates, the responsible social
285.13services agency shall notify the court, the parties entitled to notice under section 260C.607,
285.14subdivision 2, and the commissioner that the agreement and the adoptive placement have
285.15terminated.

285.16    Sec. 29. Minnesota Statutes 2020, section 260C.613, subdivision 5, is amended to read:
285.17    Subd. 5. Required record keeping. The responsible social services agency shall
285.18document, in the records required to be kept under section 259.79, the reasons for the
285.19adoptive placement decision regarding the child, including the individualized determination
285.20of the child's needs based on the factors in section 260C.212, subdivision 2, paragraph (b),;
285.21the agency's consideration of relatives in the order specified in section 260C.212, subdivision
285.222, paragraph (a); and the assessment of how the selected adoptive placement meets the
285.23identified needs of the child. The responsible social services agency shall retain in the
285.24records required to be kept under section 259.79, copies of all out-of-home placement plans
285.25made since the child was ordered under guardianship of the commissioner and all court
285.26orders from reviews conducted pursuant to section 260C.607.

285.27    Sec. 30. Minnesota Statutes 2021 Supplement, section 260E.20, subdivision 2, is amended
285.28to read:
285.29    Subd. 2. Face-to-face contact. (a) Upon receipt of a screened in report, the local welfare
285.30agency shall conduct a face-to-face contact with the child reported to be maltreated and
285.31with the child's primary caregiver sufficient to complete a safety assessment and ensure the
285.32immediate safety of the child. When it is possible and the report alleges substantial child
285.33endangerment or sexual abuse, the local welfare agency is not required to provide notice
286.1before conducting the initial face-to-face contact with the child and the child's primary
286.2caregiver.
286.3(b) The face-to-face contact with the child and primary caregiver shall occur immediately
286.4if sexual abuse or substantial child endangerment is alleged and within five calendar days
286.5for all other reports. If the alleged offender was not already interviewed as the primary
286.6caregiver, the local welfare agency shall also conduct a face-to-face interview with the
286.7alleged offender in the early stages of the assessment or investigation. Face-to-face contact
286.8with the child and primary caregiver in response to a report alleging sexual abuse or
286.9substantial child endangerment may be postponed for no more than five calendar days if
286.10the child is residing in a location that is confirmed to restrict contact with the alleged offender
286.11as established in guidelines issued by the commissioner, or if the local welfare agency is
286.12pursuing a court order for the child's caregiver to produce the child for questioning under
286.13section 260E.22, subdivision 5.
286.14(c) At the initial contact with the alleged offender, the local welfare agency or the agency
286.15responsible for assessing or investigating the report must inform the alleged offender of the
286.16complaints or allegations made against the individual in a manner consistent with laws
286.17protecting the rights of the person who made the report. The interview with the alleged
286.18offender may be postponed if it would jeopardize an active law enforcement investigation.
286.19(d) The local welfare agency or the agency responsible for assessing or investigating
286.20the report must provide the alleged offender with an opportunity to make a statement. The
286.21alleged offender may submit supporting documentation relevant to the assessment or
286.22investigation.

286.23    Sec. 31. Minnesota Statutes 2020, section 260E.22, subdivision 2, is amended to read:
286.24    Subd. 2. Child interview procedure. (a) The interview may take place at school or at
286.25any facility or other place where the alleged victim or other children might be found or the
286.26child may be transported to, and the interview may be conducted at a place appropriate for
286.27the interview of a child designated by the local welfare agency or law enforcement agency.
286.28(b) When it is possible and the report alleges substantial child endangerment or sexual
286.29abuse, the interview may take place outside the presence of the alleged offender or parent,
286.30legal custodian, guardian, or school official. and may take place prior to any interviews of
286.31the alleged offender.
287.1(c) For a family assessment, it is the preferred practice to request a parent or guardian's
287.2permission to interview the child before conducting the child interview, unless doing so
287.3would compromise the safety assessment.

287.4    Sec. 32. Minnesota Statutes 2020, section 260E.24, subdivision 2, is amended to read:
287.5    Subd. 2. Determination after family assessment. After conducting a family assessment,
287.6the local welfare agency shall determine whether child protective services are needed to
287.7address the safety of the child and other family members and the risk of subsequent
287.8maltreatment. The local welfare agency must document the information collected under
287.9section 260E.20, subdivision 3, related to the completed family assessment in the child's or
287.10family's case notes.

287.11    Sec. 33. Minnesota Statutes 2020, section 477A.0126, is amended by adding a subdivision
287.12to read:
287.13    Subd. 3a. Transfer of withheld aid amounts. (a) For aid payable in 2023 and later, the
287.14commissioner must transfer the total amount of the aid reductions under subdivision 3,
287.15paragraph (d), for that year to the Board of Regents of the University of Minnesota for the
287.16Tribal and Training Certification Partnership in the College of Education and Human Service
287.17Professions at the University of Minnesota, Duluth.
287.18(b) In order to support consistent training and county compliance with the Indian Child
287.19Welfare Act and the Minnesota Indian Family Preservation Act, the Tribal Training and
287.20Certification Partnership must use funds transferred under this subdivision to (1) enhance
287.21training on the Indian Child Welfare Act and Minnesota Indian Family Preservation Act
287.22for county workers and state guardians ad litem, and (2) build indigenous child welfare
287.23training for the Tribal child welfare workforce.
287.24EFFECTIVE DATE.This section is effective for aid payable in 2023 and later.

287.25    Sec. 34. Minnesota Statutes 2020, section 477A.0126, subdivision 7, is amended to read:
287.26    Subd. 7. Appropriation. (a) $5,000,000 is annually appropriated to the commissioner
287.27of revenue from the general fund to pay aid and make transfers required under this section.
287.28(b) $390,000 is appropriated annually from the general fund to the commissioner of
287.29human services to implement subdivision 6.
287.30EFFECTIVE DATE.This section is effective for aid payable in 2023 and later.

288.1    Sec. 35. Minnesota Statutes 2020, section 518.17, subdivision 1, is amended to read:
288.2    Subdivision 1. Best interests of the child. (a) In evaluating the best interests of the child
288.3for purposes of determining issues of custody and parenting time, the court must consider
288.4and evaluate all relevant factors, including:
288.5(1) a child's physical, emotional, cultural, spiritual, and other needs, and the effect of
288.6the proposed arrangements on the child's needs and development;
288.7(2) any special medical, mental health, developmental disability, or educational needs
288.8that the child may have that may require special parenting arrangements or access to
288.9recommended services;
288.10(3) the reasonable preference of the child, if the court deems the child to be of sufficient
288.11ability, age, and maturity to express an independent, reliable preference;
288.12(4) whether domestic abuse, as defined in section 518B.01, has occurred in the parents'
288.13or either parent's household or relationship; the nature and context of the domestic abuse;
288.14and the implications of the domestic abuse for parenting and for the child's safety, well-being,
288.15and developmental needs;
288.16(5) any physical, mental, or chemical health issue of a parent that affects the child's
288.17safety or developmental needs;
288.18(6) the history and nature of each parent's participation in providing care for the child;
288.19(7) the willingness and ability of each parent to provide ongoing care for the child; to
288.20meet the child's ongoing developmental, emotional, spiritual, and cultural needs; and to
288.21maintain consistency and follow through with parenting time;
288.22(8) the effect on the child's well-being and development of changes to home, school,
288.23and community;
288.24(9) the effect of the proposed arrangements on the ongoing relationships between the
288.25child and each parent, siblings, and other significant persons in the child's life;
288.26(10) the benefit to the child in maximizing parenting time with both parents and the
288.27detriment to the child in limiting parenting time with either parent;
288.28(11) except in cases in which domestic abuse as described in clause (4) has occurred,
288.29the disposition of each parent to support the child's relationship with the other parent and
288.30to encourage and permit frequent and continuing contact between the child and the other
288.31parent; and
289.1(12) the willingness and ability of parents to cooperate in the rearing of their child; to
289.2maximize sharing information and minimize exposure of the child to parental conflict; and
289.3to utilize methods for resolving disputes regarding any major decision concerning the life
289.4of the child.
289.5(b) Clauses (1) to (9) govern the application of the best interests of the child factors by
289.6the court:
289.7(1) The court must make detailed findings on each of the factors in paragraph (a) based
289.8on the evidence presented and explain how each factor led to its conclusions and to the
289.9determination of custody and parenting time. The court may not use one factor to the
289.10exclusion of all others, and the court shall consider that the factors may be interrelated.
289.11(2) The court shall consider that it is in the best interests of the child to promote the
289.12child's healthy growth and development through safe, stable, nurturing relationships between
289.13a child and both parents.
289.14(3) The court shall consider both parents as having the capacity to develop and sustain
289.15nurturing relationships with their children unless there are substantial reasons to believe
289.16otherwise. In assessing whether parents are capable of sustaining nurturing relationships
289.17with their children, the court shall recognize that there are many ways that parents can
289.18respond to a child's needs with sensitivity and provide the child love and guidance, and
289.19these may differ between parents and among cultures.
289.20(4) The court shall not consider conduct of a party that does not affect the party's
289.21relationship with the child.
289.22(5) Disability alone, as defined in section 363A.03, of a proposed custodian or the child
289.23shall not be determinative of the custody of the child.
289.24(6) The court shall consider evidence of a violation of section 609.507 in determining
289.25the best interests of the child.
289.26(7) There is no presumption for or against joint physical custody, except as provided in
289.27clause (9).
289.28(8) Joint physical custody does not require an absolutely equal division of time.
289.29(9) The court shall use a rebuttable presumption that upon request of either or both
289.30parties, joint legal custody is in the best interests of the child. However, the court shall use
289.31a rebuttable presumption that joint legal custody or joint physical custody is not in the best
289.32interests of the child if domestic abuse, as defined in section 518B.01, has occurred between
289.33the parents. In determining whether the presumption is rebutted, the court shall consider
290.1the nature and context of the domestic abuse and the implications of the domestic abuse for
290.2parenting and for the child's safety, well-being, and developmental needs. Disagreement
290.3alone over whether to grant sole or joint custody does not constitute an inability of parents
290.4to cooperate in the rearing of their children as referenced in paragraph (a), clause (12).
290.5(c) In a proceeding involving the custodial responsibility of a service member's child, a
290.6court may not consider only a parent's past deployment or possible future deployment in
290.7determining the best interests of the child. For purposes of this paragraph, "custodial
290.8responsibility" has the meaning given in section 518E.102, paragraph (f).
290.9EFFECTIVE DATE.This section is effective the day following final enactment.

290.10    Sec. 36. Minnesota Statutes 2020, section 518A.43, subdivision 1, is amended to read:
290.11    Subdivision 1. General factors. Among other reasons, deviation from the presumptive
290.12child support obligation computed under section 518A.34 is intended to encourage prompt
290.13and regular payments of child support and to prevent either parent or the joint children from
290.14living in poverty. In addition to the child support guidelines and other factors used to calculate
290.15the child support obligation under section 518A.34, the court must take into consideration
290.16the following factors in setting or modifying child support or in determining whether to
290.17deviate upward or downward from the presumptive child support obligation:
290.18    (1) all earnings, income, circumstances, and resources of each parent, including real and
290.19personal property, but excluding income from excess employment of the obligor or obligee
290.20that meets the criteria of section 518A.29, paragraph (b);
290.21    (2) the extraordinary financial needs and resources, physical and emotional condition,
290.22and educational needs of the child to be supported;
290.23    (3) the standard of living the child would enjoy if the parents were currently living
290.24together, but recognizing that the parents now have separate households;
290.25    (4) whether the child resides in a foreign country for more than one year that has a
290.26substantially higher or lower cost of living than this country;
290.27    (5) which parent receives the income taxation dependency exemption and the financial
290.28benefit the parent receives from it;
290.29    (6) the parents' debts as provided in subdivision 2; and
290.30    (7) the obligor's total payments for court-ordered child support exceed the limitations
290.31set forth in section 571.922.; and
291.1(8) in cases involving court-ordered out-of-home placement, whether ordering and
291.2redirecting a child support obligation to reimburse the county for the cost of care,
291.3examination, or treatment would compromise the parent's ability to meet the requirements
291.4of a reunification plan or the parent's ability to meet the child's needs after reunification.

291.5    Sec. 37. Minnesota Statutes 2020, section 626.557, subdivision 4, is amended to read:
291.6    Subd. 4. Reporting. (a) Except as provided in paragraph (b), a mandated reporter shall
291.7immediately make an oral a report to the common entry point. The common entry point
291.8may accept electronic reports submitted through a web-based reporting system established
291.9by the commissioner. Use of a telecommunications device for the deaf or other similar
291.10device shall be considered an oral report. The common entry point may not require written
291.11reports. To the extent possible, the report must be of sufficient content to identify the
291.12vulnerable adult, the caregiver, the nature and extent of the suspected maltreatment, any
291.13evidence of previous maltreatment, the name and address of the reporter, the time, date,
291.14and location of the incident, and any other information that the reporter believes might be
291.15helpful in investigating the suspected maltreatment. A mandated reporter may disclose not
291.16public data, as defined in section 13.02, and medical records under sections 144.291 to
291.17144.298, to the extent necessary to comply with this subdivision.
291.18(b) A boarding care home that is licensed under sections 144.50 to 144.58 and certified
291.19under Title 19 of the Social Security Act, a nursing home that is licensed under section
291.20144A.02 and certified under Title 18 or Title 19 of the Social Security Act, or a hospital
291.21that is licensed under sections 144.50 to 144.58 and has swing beds certified under Code
291.22of Federal Regulations, title 42, section 482.66, may submit a report electronically to the
291.23common entry point instead of submitting an oral report. The report may be a duplicate of
291.24the initial report the facility submits electronically to the commissioner of health to comply
291.25with the reporting requirements under Code of Federal Regulations, title 42, section 483.12.
291.26The commissioner of health may modify these reporting requirements to include items
291.27required under paragraph (a) that are not currently included in the electronic reporting form.

291.28    Sec. 38. Minnesota Statutes 2020, section 626.557, subdivision 9, is amended to read:
291.29    Subd. 9. Common entry point designation. (a) Each county board shall designate a
291.30common entry point for reports of suspected maltreatment, for use until the commissioner
291.31of human services establishes a common entry point. Two or more county boards may
291.32jointly designate a single common entry point. The commissioner of human services shall
292.1establish a common entry point effective July 1, 2015. The common entry point is the unit
292.2responsible for receiving the report of suspected maltreatment under this section.
292.3(b) The common entry point must be available 24 hours per day to take calls from
292.4reporters of suspected maltreatment. The common entry point shall use a standard intake
292.5form that includes:
292.6(1) the time and date of the report;
292.7(2) the name, relationship, and identifying and contact information for the person believed
292.8to be a vulnerable adult and the individual or facility alleged responsible for maltreatment;
292.9(3) the name, address, and telephone number of the person reporting; relationship, and
292.10contact information for the:
292.11(i) reporter;
292.12(ii) initial reporter, witnesses, and persons who may have knowledge about the
292.13maltreatment; and
292.14(iii) legal surrogate and persons who may provide support to the vulnerable adult;
292.15(4) the basis of vulnerability for the vulnerable adult;
292.16(3) (5) the time, date, and location of the incident;
292.17(4) the names of the persons involved, including but not limited to, perpetrators, alleged
292.18victims, and witnesses;
292.19(5) whether there was a risk of imminent danger to the alleged victim;
292.20(6) the immediate safety risk to the vulnerable adult;
292.21(6) (7) a description of the suspected maltreatment;
292.22(7) the disability, if any, of the alleged victim;
292.23(8) the relationship of the alleged perpetrator to the alleged victim;
292.24(8) the impact of the suspected maltreatment on the vulnerable adult;
292.25(9) whether a facility was involved and, if so, which agency licenses the facility;
292.26(10) any action taken by the common entry point;
292.27(11) whether law enforcement has been notified;
292.28(10) the actions taken to protect the vulnerable adult;
292.29(11) the required notifications and referrals made by the common entry point; and
293.1(12) whether the reporter wishes to receive notification of the initial and final reports;
293.2and disposition.
293.3(13) if the report is from a facility with an internal reporting procedure, the name, mailing
293.4address, and telephone number of the person who initiated the report internally.
293.5(c) The common entry point is not required to complete each item on the form prior to
293.6dispatching the report to the appropriate lead investigative agency.
293.7(d) The common entry point shall immediately report to a law enforcement agency any
293.8incident in which there is reason to believe a crime has been committed.
293.9(e) If a report is initially made to a law enforcement agency or a lead investigative agency,
293.10those agencies shall take the report on the appropriate common entry point intake forms
293.11and immediately forward a copy to the common entry point.
293.12(f) The common entry point staff must receive training on how to screen and dispatch
293.13reports efficiently and in accordance with this section.
293.14(g) The commissioner of human services shall maintain a centralized database for the
293.15collection of common entry point data, lead investigative agency data including maltreatment
293.16report disposition, and appeals data. The common entry point shall have access to the
293.17centralized database and must log the reports into the database and immediately identify
293.18and locate prior reports of abuse, neglect, or exploitation.
293.19(h) When appropriate, the common entry point staff must refer calls that do not allege
293.20the abuse, neglect, or exploitation of a vulnerable adult to other organizations that might
293.21resolve the reporter's concerns.
293.22(i) A common entry point must be operated in a manner that enables the commissioner
293.23of human services to:
293.24(1) track critical steps in the reporting, evaluation, referral, response, disposition, and
293.25investigative process to ensure compliance with all requirements for all reports;
293.26(2) maintain data to facilitate the production of aggregate statistical reports for monitoring
293.27patterns of abuse, neglect, or exploitation;
293.28(3) serve as a resource for the evaluation, management, and planning of preventative
293.29and remedial services for vulnerable adults who have been subject to abuse, neglect, or
293.30exploitation;
293.31(4) set standards, priorities, and policies to maximize the efficiency and effectiveness
293.32of the common entry point; and
294.1(5) track and manage consumer complaints related to the common entry point.
294.2(j) The commissioners of human services and health shall collaborate on the creation of
294.3a system for referring reports to the lead investigative agencies. This system shall enable
294.4the commissioner of human services to track critical steps in the reporting, evaluation,
294.5referral, response, disposition, investigation, notification, determination, and appeal processes.

294.6    Sec. 39. Minnesota Statutes 2020, section 626.557, subdivision 9b, is amended to read:
294.7    Subd. 9b. Response to reports. Law enforcement is the primary agency to conduct
294.8investigations of any incident in which there is reason to believe a crime has been committed.
294.9Law enforcement shall initiate a response immediately. If the common entry point notified
294.10a county agency for emergency adult protective services, law enforcement shall cooperate
294.11with that county agency when both agencies are involved and shall exchange data to the
294.12extent authorized in subdivision 12b, paragraph (g). County adult protection shall initiate
294.13a response immediately. Each lead investigative agency shall complete the investigative
294.14process for reports within its jurisdiction. A lead investigative agency, county, adult protective
294.15agency, licensed facility, or law enforcement agency shall cooperate with other agencies in
294.16the provision of protective services, coordinating its investigations, and assisting another
294.17agency within the limits of its resources and expertise and shall exchange data to the extent
294.18authorized in subdivision 12b, paragraph (g). The lead investigative agency shall obtain the
294.19results of any investigation conducted by law enforcement officials. The lead investigative
294.20agency has the right to enter facilities and inspect and copy records as part of investigations.
294.21The lead investigative agency has access to not public data, as defined in section 13.02, and
294.22medical records under sections 144.291 to 144.298, that are maintained by facilities to the
294.23extent necessary to conduct its investigation. Each lead investigative agency shall develop
294.24guidelines for prioritizing reports for investigation. When a county acts as a lead investigative
294.25agency, the county shall make guidelines available to the public regarding which reports
294.26the county prioritizes for investigation and adult protective services.

294.27    Sec. 40. Minnesota Statutes 2020, section 626.557, subdivision 9c, is amended to read:
294.28    Subd. 9c. Lead investigative agency; notifications, dispositions, determinations. (a)
294.29Upon request of the reporter, the lead investigative agency shall notify the reporter that it
294.30has received the report, and provide information on the initial disposition of the report within
294.31five business days of receipt of the report, provided that the notification will not endanger
294.32the vulnerable adult or hamper the investigation.
295.1    (b) In making the initial disposition of a report alleging maltreatment of a vulnerable
295.2adult, the lead investigative agency may consider previous reports of suspected maltreatment
295.3and may request and consider public information, records maintained by a lead investigative
295.4agency or licensed providers, and information from any person who may have knowledge
295.5regarding the alleged maltreatment and the basis for the adult's vulnerability.
295.6(c) When the county social service agency does not accept a report for adult protective
295.7services or investigation, the agency may offer assistance to the reporter or the person who
295.8was the subject of the report.
295.9    (d) While investigating reports and providing adult protective services, the lead
295.10investigative agency may coordinate with entities identified under subdivision 12b, paragraph
295.11(g), and may coordinate with support persons to safeguard the welfare of the vulnerable
295.12adult and prevent further maltreatment of the vulnerable adult.
295.13    (b) (e) Upon conclusion of every investigation it conducts, the lead investigative agency
295.14shall make a final disposition as defined in section 626.5572, subdivision 8.
295.15    (c) (f) When determining whether the facility or individual is the responsible party for
295.16substantiated maltreatment or whether both the facility and the individual are responsible
295.17for substantiated maltreatment, the lead investigative agency shall consider at least the
295.18following mitigating factors:
295.19    (1) whether the actions of the facility or the individual caregivers were in accordance
295.20with, and followed the terms of, an erroneous physician order, prescription, resident care
295.21plan, or directive. This is not a mitigating factor when the facility or caregiver is responsible
295.22for the issuance of the erroneous order, prescription, plan, or directive or knows or should
295.23have known of the errors and took no reasonable measures to correct the defect before
295.24administering care;
295.25    (2) the comparative responsibility between the facility, other caregivers, and requirements
295.26placed upon the employee, including but not limited to, the facility's compliance with related
295.27regulatory standards and factors such as the adequacy of facility policies and procedures,
295.28the adequacy of facility training, the adequacy of an individual's participation in the training,
295.29the adequacy of caregiver supervision, the adequacy of facility staffing levels, and a
295.30consideration of the scope of the individual employee's authority; and
295.31    (3) whether the facility or individual followed professional standards in exercising
295.32professional judgment.
296.1    (d) (g) When substantiated maltreatment is determined to have been committed by an
296.2individual who is also the facility license holder, both the individual and the facility must
296.3be determined responsible for the maltreatment, and both the background study
296.4disqualification standards under section 245C.15, subdivision 4, and the licensing actions
296.5under section 245A.06 or 245A.07 apply.
296.6(e) (h) The lead investigative agency shall complete its final disposition within 60
296.7calendar days. If the lead investigative agency is unable to complete its final disposition
296.8within 60 calendar days, the lead investigative agency shall notify the following persons
296.9provided that the notification will not endanger the vulnerable adult or hamper the
296.10investigation: (1) the vulnerable adult or the vulnerable adult's guardian or health care agent,
296.11when known, if the lead investigative agency knows them to be aware of the investigation;
296.12and (2) the facility, where applicable. The notice shall contain the reason for the delay and
296.13the projected completion date. If the lead investigative agency is unable to complete its final
296.14disposition by a subsequent projected completion date, the lead investigative agency shall
296.15again notify the vulnerable adult or the vulnerable adult's guardian or health care agent,
296.16when known if the lead investigative agency knows them to be aware of the investigation,
296.17and the facility, where applicable, of the reason for the delay and the revised projected
296.18completion date provided that the notification will not endanger the vulnerable adult or
296.19hamper the investigation. The lead investigative agency must notify the health care agent
296.20of the vulnerable adult only if the health care agent's authority to make health care decisions
296.21for the vulnerable adult is currently effective under section 145C.06 and not suspended
296.22under section 524.5-310 and the investigation relates to a duty assigned to the health care
296.23agent by the principal. A lead investigative agency's inability to complete the final disposition
296.24within 60 calendar days or by any projected completion date does not invalidate the final
296.25disposition.
296.26    (f) Within ten calendar days of completing the final disposition (i) When the lead
296.27investigative agency is the Department of Health or the Department of Human Services,
296.28the lead investigative agency shall provide a copy of the public investigation memorandum
296.29under subdivision 12b, paragraph (b), clause (1), when required to be completed under this
296.30section, within ten calendar days of completing the final disposition to the following persons:
296.31    (1) the vulnerable adult, or the vulnerable adult's guardian or health care agent, if known,
296.32unless the lead investigative agency knows that the notification would endanger the
296.33well-being of the vulnerable adult;
296.34    (2) the reporter, if the reporter requested notification when making the report, provided
296.35this notification would not endanger the well-being of the vulnerable adult;
297.1    (3) the alleged perpetrator person or facility alleged responsible for maltreatment, if
297.2known;
297.3    (4) the facility; and
297.4    (5) the ombudsman for long-term care, or the ombudsman for mental health and
297.5developmental disabilities, as appropriate.
297.6    (j) When the lead investigative agency is a county agency, within ten calendar days of
297.7completing the final disposition, the lead investigative agency shall provide notification of
297.8the final disposition to the following persons:
297.9    (1) the vulnerable adult, or the vulnerable adult's guardian or health care agent, if known,
297.10when the allegation is applicable to the authority of the vulnerable adult's guardian or health
297.11care agent, unless the agency knows that the notification would endanger the well-being of
297.12the vulnerable adult;
297.13    (2) the individual determined responsible for maltreatment, if known; and
297.14    (3) when the alleged incident involves a personal care assistant or provider agency, the
297.15personal care provider organization under section 256B.0659. Upon implementation of
297.16Community First Services and Supports (CFSS), this notification requirement applies to
297.17the CFSS support worker or CFSS agency under section 256B.85.
297.18(g) (k) If, as a result of a reconsideration, review, or hearing, the lead investigative
297.19agency changes the final disposition, or if a final disposition is changed on appeal, the lead
297.20investigative agency shall notify the parties specified in paragraph (f) (k).
297.21    (h) (l) The lead investigative agency shall notify the vulnerable adult who is the subject
297.22of the report or the vulnerable adult's guardian or health care agent, if known, and any person
297.23or facility determined to have maltreated a vulnerable adult, of their appeal or review rights
297.24under this section or section 256.021.
297.25    (i) (m) The lead investigative agency shall routinely provide investigation memoranda
297.26for substantiated reports to the appropriate licensing boards. These reports must include the
297.27names of substantiated perpetrators. The lead investigative agency may not provide
297.28investigative memoranda for inconclusive or false reports to the appropriate licensing boards
297.29unless the lead investigative agency's investigation gives reason to believe that there may
297.30have been a violation of the applicable professional practice laws. If the investigation
297.31memorandum is provided to a licensing board, the subject of the investigation memorandum
297.32shall be notified and receive a summary of the investigative findings.
298.1    (j) (n) In order to avoid duplication, licensing boards shall consider the findings of the
298.2lead investigative agency in their investigations if they choose to investigate. This does not
298.3preclude licensing boards from considering other information.
298.4    (k) (o) The lead investigative agency must provide to the commissioner of human services
298.5its final dispositions, including the names of all substantiated perpetrators. The commissioner
298.6of human services shall establish records to retain the names of substantiated perpetrators.

298.7    Sec. 41. Minnesota Statutes 2020, section 626.557, subdivision 9d, is amended to read:
298.8    Subd. 9d. Administrative reconsideration; review panel. (a) Except as provided under
298.9paragraph (e), any individual or facility which a lead investigative agency determines has
298.10maltreated a vulnerable adult, or the vulnerable adult or an interested person acting on behalf
298.11of the vulnerable adult, regardless of the lead investigative agency's determination, who
298.12contests the lead investigative agency's final disposition of an allegation of maltreatment,
298.13may request the lead investigative agency to reconsider its final disposition. The request
298.14for reconsideration must be submitted in writing to the lead investigative agency within 15
298.15calendar days after receipt of notice of final disposition or, if the request is made by an
298.16interested person who is not entitled to notice, within 15 days after receipt of the notice by
298.17the vulnerable adult or the vulnerable adult's guardian or health care agent. If mailed, the
298.18request for reconsideration must be postmarked and sent to the lead investigative agency
298.19within 15 calendar days of the individual's or facility's receipt of the final disposition. If the
298.20request for reconsideration is made by personal service, it must be received by the lead
298.21investigative agency within 15 calendar days of the individual's or facility's receipt of the
298.22final disposition. An individual who was determined to have maltreated a vulnerable adult
298.23under this section and who was disqualified on the basis of serious or recurring maltreatment
298.24under sections 245C.14 and 245C.15, may request reconsideration of the maltreatment
298.25determination and the disqualification. The request for reconsideration of the maltreatment
298.26determination and the disqualification must be submitted in writing within 30 calendar days
298.27of the individual's receipt of the notice of disqualification under sections 245C.16 and
298.28245C.17. If mailed, the request for reconsideration of the maltreatment determination and
298.29the disqualification must be postmarked and sent to the lead investigative agency within 30
298.30calendar days of the individual's receipt of the notice of disqualification. If the request for
298.31reconsideration is made by personal service, it must be received by the lead investigative
298.32agency within 30 calendar days after the individual's receipt of the notice of disqualification.
298.33    (b) Except as provided under paragraphs (e) and (f), if the lead investigative agency
298.34denies the request or fails to act upon the request within 15 working days after receiving
299.1the request for reconsideration, the person or facility entitled to a fair hearing under section
299.2256.045, may submit to the commissioner of human services a written request for a hearing
299.3under that statute. The vulnerable adult, or an interested person acting on behalf of the
299.4vulnerable adult, may request a review by the Vulnerable Adult Maltreatment Review Panel
299.5under section 256.021 if the lead investigative agency denies the request or fails to act upon
299.6the request, or if the vulnerable adult or interested person contests a reconsidered disposition.
299.7The Vulnerable Adult Maltreatment Review Panel shall not conduct a review if the interested
299.8person making the request on behalf of the vulnerable adult is also the individual or facility
299.9alleged responsible for the maltreatment of the vulnerable adult. The lead investigative
299.10agency shall notify persons who request reconsideration of their rights under this paragraph.
299.11The request must be submitted in writing to the review panel and a copy sent to the lead
299.12investigative agency within 30 calendar days of receipt of notice of a denial of a request for
299.13reconsideration or of a reconsidered disposition. The request must specifically identify the
299.14aspects of the lead investigative agency determination with which the person is dissatisfied.
299.15    (c) If, as a result of a reconsideration or review, the lead investigative agency changes
299.16the final disposition, it shall notify the parties specified in subdivision 9c, paragraph (f) (i).
299.17    (d) For purposes of this subdivision, "interested person acting on behalf of the vulnerable
299.18adult" means a person designated in writing by the vulnerable adult to act on behalf of the
299.19vulnerable adult, or a legal guardian or conservator or other legal representative, a proxy
299.20or health care agent appointed under chapter 145B or 145C, or an individual who is related
299.21to the vulnerable adult, as defined in section 245A.02, subdivision 13.
299.22    (e) If an individual was disqualified under sections 245C.14 and 245C.15, on the basis
299.23of a determination of maltreatment, which was serious or recurring, and the individual has
299.24requested reconsideration of the maltreatment determination under paragraph (a) and
299.25reconsideration of the disqualification under sections 245C.21 to 245C.27, reconsideration
299.26of the maltreatment determination and requested reconsideration of the disqualification
299.27shall be consolidated into a single reconsideration. If reconsideration of the maltreatment
299.28determination is denied and the individual remains disqualified following a reconsideration
299.29decision, the individual may request a fair hearing under section 256.045. If an individual
299.30requests a fair hearing on the maltreatment determination and the disqualification, the scope
299.31of the fair hearing shall include both the maltreatment determination and the disqualification.
299.32    (f) If a maltreatment determination or a disqualification based on serious or recurring
299.33maltreatment is the basis for a denial of a license under section 245A.05 or a licensing
299.34sanction under section 245A.07, the license holder has the right to a contested case hearing
299.35under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. As provided for
300.1under section 245A.08, the scope of the contested case hearing must include the maltreatment
300.2determination, disqualification, and licensing sanction or denial of a license. In such cases,
300.3a fair hearing must not be conducted under section 256.045. Except for family child care
300.4and child foster care, reconsideration of a maltreatment determination under this subdivision,
300.5and reconsideration of a disqualification under section 245C.22, must not be conducted
300.6when:
300.7    (1) a denial of a license under section 245A.05, or a licensing sanction under section
300.8245A.07, is based on a determination that the license holder is responsible for maltreatment
300.9or the disqualification of a license holder based on serious or recurring maltreatment;
300.10    (2) the denial of a license or licensing sanction is issued at the same time as the
300.11maltreatment determination or disqualification; and
300.12    (3) the license holder appeals the maltreatment determination or disqualification, and
300.13denial of a license or licensing sanction.
300.14    Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment
300.15determination or disqualification, but does not appeal the denial of a license or a licensing
300.16sanction, reconsideration of the maltreatment determination shall be conducted under sections
300.17260E.33 and 626.557, subdivision 9d, and reconsideration of the disqualification shall be
300.18conducted under section 245C.22. In such cases, a fair hearing shall also be conducted as
300.19provided under sections 245C.27, 260E.33, and 626.557, subdivision 9d.
300.20    If the disqualified subject is an individual other than the license holder and upon whom
300.21a background study must be conducted under chapter 245C, the hearings of all parties may
300.22be consolidated into a single contested case hearing upon consent of all parties and the
300.23administrative law judge.
300.24    (g) Until August 1, 2002, an individual or facility that was determined by the
300.25commissioner of human services or the commissioner of health to be responsible for neglect
300.26under section 626.5572, subdivision 17, after October 1, 1995, and before August 1, 2001,
300.27that believes that the finding of neglect does not meet an amended definition of neglect may
300.28request a reconsideration of the determination of neglect. The commissioner of human
300.29services or the commissioner of health shall mail a notice to the last known address of
300.30individuals who are eligible to seek this reconsideration. The request for reconsideration
300.31must state how the established findings no longer meet the elements of the definition of
300.32neglect. The commissioner shall review the request for reconsideration and make a
300.33determination within 15 calendar days. The commissioner's decision on this reconsideration
300.34is the final agency action.
301.1    (1) For purposes of compliance with the data destruction schedule under subdivision
301.212b, paragraph (d), when a finding of substantiated maltreatment has been changed as a
301.3result of a reconsideration under this paragraph, the date of the original finding of a
301.4substantiated maltreatment must be used to calculate the destruction date.
301.5    (2) For purposes of any background studies under chapter 245C, when a determination
301.6of substantiated maltreatment has been changed as a result of a reconsideration under this
301.7paragraph, any prior disqualification of the individual under chapter 245C that was based
301.8on this determination of maltreatment shall be rescinded, and for future background studies
301.9under chapter 245C the commissioner must not use the previous determination of
301.10substantiated maltreatment as a basis for disqualification or as a basis for referring the
301.11individual's maltreatment history to a health-related licensing board under section 245C.31.

301.12    Sec. 42. Minnesota Statutes 2020, section 626.557, subdivision 10, is amended to read:
301.13    Subd. 10. Duties of county social service agency. (a) When the common entry point
301.14refers a report to the county social service agency as the lead investigative agency or makes
301.15a referral to the county social service agency for emergency adult protective services, or
301.16when another lead investigative agency requests assistance from the county social service
301.17agency for adult protective services, the county social service agency shall immediately
301.18assess and offer emergency and continuing protective social services for purposes of
301.19preventing further maltreatment and for safeguarding the welfare of the maltreated vulnerable
301.20adult. The county shall use a standardized tool tools and the data system made available by
301.21the commissioner. The information entered by the county into the standardized tool must
301.22be accessible to the Department of Human Services. In cases of suspected sexual abuse, the
301.23county social service agency shall immediately arrange for and make available to the
301.24vulnerable adult appropriate medical examination and treatment. When necessary in order
301.25to protect the vulnerable adult from further harm, the county social service agency shall
301.26seek authority to remove the vulnerable adult from the situation in which the maltreatment
301.27occurred. The county social service agency may also investigate to determine whether the
301.28conditions which resulted in the reported maltreatment place other vulnerable adults in
301.29jeopardy of being maltreated and offer protective social services that are called for by its
301.30determination.
301.31(b) Within five business days of receipt of a report screened in by the county social
301.32service agency for investigation, the county social service agency shall determine whether,
301.33in addition to an assessment and services for the vulnerable adult, to also conduct an
302.1investigation for final disposition of the individual or facility alleged to have maltreated the
302.2vulnerable adult.
302.3(c) The county social service agency must investigate for a final disposition the individual
302.4or facility alleged to have maltreated a vulnerable adult for each report accepted as lead
302.5investigative agency involving an allegation of abuse, caregiver neglect that resulted in
302.6harm to the vulnerable adult, financial exploitation that may be criminal, or an allegation
302.7against a caregiver under chapter 256B.
302.8(d) An investigating county social service agency must make a final disposition for any
302.9allegation when the county social service agency determines that a final disposition may
302.10safeguard a vulnerable adult or may prevent further maltreatment.
302.11(e) If the county social service agency learns of an allegation listed in paragraph (c) after
302.12the determination in paragraph (a), the county social service agency must change the initial
302.13determination and conduct an investigation for final disposition of the individual or facility
302.14alleged to have maltreated the vulnerable adult.
302.15(b) (f) County social service agencies may enter facilities and inspect and copy records
302.16as part of an investigation. The county social service agency has access to not public data,
302.17as defined in section 13.02, and medical records under sections 144.291 to 144.298, that
302.18are maintained by facilities to the extent necessary to conduct its investigation. The inquiry
302.19is not limited to the written records of the facility, but may include every other available
302.20source of information.
302.21(c) (g) When necessary in order to protect a vulnerable adult from serious harm, the
302.22county social service agency shall immediately intervene on behalf of that adult to help the
302.23family, vulnerable adult, or other interested person by seeking any of the following:
302.24(1) a restraining order or a court order for removal of the perpetrator from the residence
302.25of the vulnerable adult pursuant to section 518B.01;
302.26(2) the appointment of a guardian or conservator pursuant to sections 524.5-101 to
302.27524.5-502, or guardianship or conservatorship pursuant to chapter 252A;
302.28(3) replacement of a guardian or conservator suspected of maltreatment and appointment
302.29of a suitable person as guardian or conservator, pursuant to sections 524.5-101 to 524.5-502;
302.30or
302.31(4) a referral to the prosecuting attorney for possible criminal prosecution of the
302.32perpetrator under chapter 609.
303.1The expenses of legal intervention must be paid by the county in the case of indigent
303.2persons, under section 524.5-502 and chapter 563.
303.3In proceedings under sections 524.5-101 to 524.5-502, if a suitable relative or other
303.4person is not available to petition for guardianship or conservatorship, a county employee
303.5shall present the petition with representation by the county attorney. The county shall contract
303.6with or arrange for a suitable person or organization to provide ongoing guardianship
303.7services. If the county presents evidence to the court exercising probate jurisdiction that it
303.8has made a diligent effort and no other suitable person can be found, a county employee
303.9may serve as guardian or conservator. The county shall not retaliate against the employee
303.10for any action taken on behalf of the ward or protected person subject to guardianship or
303.11conservatorship, even if the action is adverse to the county's interest. Any person retaliated
303.12against in violation of this subdivision shall have a cause of action against the county and
303.13shall be entitled to reasonable attorney fees and costs of the action if the action is upheld
303.14by the court.

303.15    Sec. 43. Minnesota Statutes 2020, section 626.557, subdivision 10b, is amended to read:
303.16    Subd. 10b. Investigations; guidelines. (a) Each lead investigative agency shall develop
303.17guidelines for prioritizing reports for investigation.
303.18(b) When investigating a report, the lead investigative agency shall conduct the following
303.19activities, as appropriate:
303.20(1) interview of the alleged victim vulnerable adult;
303.21(2) interview of the reporter and others who may have relevant information;
303.22(3) interview of the alleged perpetrator individual or facility alleged responsible for
303.23maltreatment; and
303.24(4) examination of the environment surrounding the alleged incident;
303.25(5) (4) review of records and pertinent documentation of the alleged incident; and.
303.26(6) consultation with professionals.
303.27(c) The lead investigative agency shall conduct the following activities as appropriate
303.28to further the investigation, to prevent further maltreatment, or to safeguard the vulnerable
303.29adult:
303.30(1) examining the environment surrounding the alleged incident;
303.31(2) consulting with professionals; and
304.1(3) communicating with state, federal, tribal, and other agencies including:
304.2(i) service providers;
304.3(ii) case managers;
304.4(iii) ombudsmen; and
304.5(iv) support persons for the vulnerable adult.
304.6(d) The lead investigative agency may decide not to conduct an interview of a vulnerable
304.7adult, reporter, or witness under paragraph (b) if:
304.8(1) the vulnerable adult, reporter, or witness declines to have an interview with the
304.9agency or is unable to be contacted despite the agency's diligent attempts;
304.10(2) an interview of the vulnerable adult or reporter was conducted by law enforcement
304.11or a professional trained in forensic interview and an additional interview will not further
304.12the investigation;
304.13(3) an interview of the witness will not further the investigation; or
304.14(4) the agency has a reason to believe that the interview will endanger the vulnerable
304.15adult.

304.16    Sec. 44. Minnesota Statutes 2020, section 626.557, subdivision 12b, is amended to read:
304.17    Subd. 12b. Data management. (a) In performing any of the duties of this section as a
304.18lead investigative agency, the county social service agency shall maintain appropriate
304.19records. Data collected by the county social service agency under this section while providing
304.20adult protective services are welfare data under section 13.46. Investigative data collected
304.21under this section are confidential data on individuals or protected nonpublic data as defined
304.22under section 13.02. Notwithstanding section 13.46, subdivision 1, paragraph (a), data under
304.23this paragraph that are inactive investigative data on an individual who is a vendor of services
304.24are private data on individuals, as defined in section 13.02. The identity of the reporter may
304.25only be disclosed as provided in paragraph (c).
304.26Data maintained by the common entry point are confidential data on individuals or
304.27protected nonpublic data as defined in section 13.02. Notwithstanding section 138.163, the
304.28common entry point shall maintain data for three calendar years after date of receipt and
304.29then destroy the data unless otherwise directed by federal requirements.
304.30(b) The commissioners of health and human services shall prepare an investigation
304.31memorandum for each report alleging maltreatment investigated under this section. County
305.1social service agencies must maintain private data on individuals but are not required to
305.2prepare an investigation memorandum. During an investigation by the commissioner of
305.3health or the commissioner of human services, data collected under this section are
305.4confidential data on individuals or protected nonpublic data as defined in section 13.02.
305.5Upon completion of the investigation, the data are classified as provided in clauses (1) to
305.6(3) and paragraph (c).
305.7(1) The investigation memorandum must contain the following data, which are public:
305.8(i) the name of the facility investigated;
305.9(ii) a statement of the nature of the alleged maltreatment;
305.10(iii) pertinent information obtained from medical or other records reviewed;
305.11(iv) the identity of the investigator;
305.12(v) a summary of the investigation's findings;
305.13(vi) statement of whether the report was found to be substantiated, inconclusive, false,
305.14or that no determination will be made;
305.15(vii) a statement of any action taken by the facility;
305.16(viii) a statement of any action taken by the lead investigative agency; and
305.17(ix) when a lead investigative agency's determination has substantiated maltreatment, a
305.18statement of whether an individual, individuals, or a facility were responsible for the
305.19substantiated maltreatment, if known.
305.20The investigation memorandum must be written in a manner which protects the identity
305.21of the reporter and of the vulnerable adult and may not contain the names or, to the extent
305.22possible, data on individuals or private data listed in clause (2).
305.23(2) Data on individuals collected and maintained in the investigation memorandum are
305.24private data, including:
305.25(i) the name of the vulnerable adult;
305.26(ii) the identity of the individual alleged to be the perpetrator;
305.27(iii) the identity of the individual substantiated as the perpetrator; and
305.28(iv) the identity of all individuals interviewed as part of the investigation.
305.29(3) Other data on individuals maintained as part of an investigation under this section
305.30are private data on individuals upon completion of the investigation.
306.1(c) After the assessment or investigation is completed, The name of the reporter must
306.2be confidential. The subject of the report may compel disclosure of the name of the reporter
306.3only with the consent of the reporter or upon a written finding by a court that the report was
306.4false and there is evidence that the report was made in bad faith. This subdivision does not
306.5alter disclosure responsibilities or obligations under the Rules of Criminal Procedure, except
306.6that where the identity of the reporter is relevant to a criminal prosecution, the district court
306.7shall do an in-camera review prior to determining whether to order disclosure of the identity
306.8of the reporter.
306.9(d) Notwithstanding section 138.163, data maintained under this section by the
306.10commissioners of health and human services must be maintained under the following
306.11schedule and then destroyed unless otherwise directed by federal requirements:
306.12(1) data from reports determined to be false, maintained for three years after the finding
306.13was made;
306.14(2) data from reports determined to be inconclusive, maintained for four years after the
306.15finding was made;
306.16(3) data from reports determined to be substantiated, maintained for seven years after
306.17the finding was made; and
306.18(4) data from reports which were not investigated by a lead investigative agency and for
306.19which there is no final disposition, maintained for three years from the date of the report.
306.20(e) The commissioners of health and human services shall annually publish on their
306.21websites the number and type of reports of alleged maltreatment involving licensed facilities
306.22reported under this section, the number of those requiring investigation under this section,
306.23and the resolution of those investigations. On a biennial basis, the commissioners of health
306.24and human services shall jointly report the following information to the legislature and the
306.25governor:
306.26(1) the number and type of reports of alleged maltreatment involving licensed facilities
306.27reported under this section, the number of those requiring investigations under this section,
306.28the resolution of those investigations, and which of the two lead agencies was responsible;
306.29(2) trends about types of substantiated maltreatment found in the reporting period;
306.30(3) if there are upward trends for types of maltreatment substantiated, recommendations
306.31for addressing and responding to them;
306.32(4) efforts undertaken or recommended to improve the protection of vulnerable adults;
307.1(5) whether and where backlogs of cases result in a failure to conform with statutory
307.2time frames and recommendations for reducing backlogs if applicable;
307.3(6) recommended changes to statutes affecting the protection of vulnerable adults; and
307.4(7) any other information that is relevant to the report trends and findings.
307.5(f) Each lead investigative agency must have a record retention policy.
307.6(g) Lead investigative agencies, county agencies responsible for adult protective services,
307.7prosecuting authorities, and law enforcement agencies may exchange not public data, as
307.8defined in section 13.02, with a tribal agency, facility, service provider, vulnerable adult,
307.9primary support person for a vulnerable adult, state licensing board, federal or state agency,
307.10the ombudsman for long-term care, or the ombudsman for mental health and developmental
307.11disabilities, if the agency or authority requesting providing the data determines that the data
307.12are pertinent and necessary to the requesting agency in initiating, furthering, or completing
307.13to prevent further maltreatment of a vulnerable adult, to safeguard a vulnerable adult, or for
307.14an investigation under this section. Data collected under this section must be made available
307.15to prosecuting authorities and law enforcement officials, local county agencies, and licensing
307.16agencies investigating the alleged maltreatment under this section. The lead investigative
307.17agency shall exchange not public data with the vulnerable adult maltreatment review panel
307.18established in section 256.021 if the data are pertinent and necessary for a review requested
307.19under that section. Notwithstanding section 138.17, upon completion of the review, not
307.20public data received by the review panel must be destroyed.
307.21(h) Each lead investigative agency shall keep records of the length of time it takes to
307.22complete its investigations.
307.23(i) A lead investigative agency may notify other affected parties and their authorized
307.24representative if the lead investigative agency has reason to believe maltreatment has occurred
307.25and determines the information will safeguard the well-being of the affected parties or dispel
307.26widespread rumor or unrest in the affected facility.
307.27(j) Under any notification provision of this section, where federal law specifically
307.28prohibits the disclosure of patient identifying information, a lead investigative agency may
307.29not provide any notice unless the vulnerable adult has consented to disclosure in a manner
307.30which conforms to federal requirements.

307.31    Sec. 45. Minnesota Statutes 2020, section 626.5571, subdivision 1, is amended to read:
307.32    Subdivision 1. Establishment of team. A county may establish a multidisciplinary adult
307.33protection team comprised of the director of the local welfare agency or designees, the
308.1county attorney or designees, the county sheriff or designees, and representatives of health
308.2care. In addition, representatives of mental health or other appropriate human service
308.3agencies, representatives from local tribal governments, and adult advocate groups, and any
308.4other organization with relevant expertise may be added to the adult protection team.

308.5    Sec. 46. Minnesota Statutes 2020, section 626.5571, subdivision 2, is amended to read:
308.6    Subd. 2. Duties of team. A multidisciplinary adult protection team may provide public
308.7and professional education, develop resources for prevention, intervention, and treatment,
308.8and provide case consultation to the local welfare agency to better enable the agency to
308.9carry out its adult protection functions under section 626.557 and to meet the community's
308.10needs for adult protection services. Case consultation may be performed by a committee of
308.11the team composed of the team members representing social services, law enforcement, the
308.12county attorney, health care, and persons directly involved in an individual case as determined
308.13by the case consultation committee. Case consultation is includes a case review process that
308.14results in recommendations about services to be provided to the identified adult and family.

308.15    Sec. 47. Minnesota Statutes 2020, section 626.5572, subdivision 2, is amended to read:
308.16    Subd. 2. Abuse. "Abuse" means:
308.17(a) An act against a vulnerable adult that constitutes a violation of, an attempt to violate,
308.18or aiding and abetting a violation of:
308.19(1) assault in the first through fifth degrees as defined in sections 609.221 to 609.224;
308.20(2) the use of drugs to injure or facilitate crime as defined in section 609.235;
308.21(3) the solicitation, inducement, and promotion of prostitution as defined in section
308.22609.322; and
308.23(4) criminal sexual conduct in the first through fifth degrees as defined in sections
308.24609.342 to 609.3451.
308.25A violation includes any action that meets the elements of the crime, regardless of
308.26whether there is a criminal proceeding or conviction.
308.27(b) Conduct which is not an accident or therapeutic conduct as defined in this section,
308.28which produces or could reasonably be expected to produce physical pain or injury or
308.29emotional distress including, but not limited to, the following:
308.30(1) hitting, slapping, kicking, pinching, biting, or corporal punishment of a vulnerable
308.31adult;
309.1(2) use of repeated or malicious oral, written, or gestured language toward a vulnerable
309.2adult or the treatment of a vulnerable adult which would be considered by a reasonable
309.3person to be disparaging, derogatory, humiliating, harassing, or threatening; or
309.4(3) use of any aversive or deprivation procedure, unreasonable confinement, or
309.5involuntary seclusion, including the forced separation of the vulnerable adult from other
309.6persons against the will of the vulnerable adult or the legal representative of the vulnerable
309.7adult; and unless authorized under applicable licensing requirements or Minnesota Rules,
309.8chapter 9544.
309.9(4) use of any aversive or deprivation procedures for persons with developmental
309.10disabilities or related conditions not authorized under section 245.825.
309.11(c) Any sexual contact or penetration as defined in section 609.341, between a facility
309.12staff person or a person providing services in the facility and a resident, patient, or client
309.13of that facility.
309.14(d) The act of forcing, compelling, coercing, or enticing a vulnerable adult against the
309.15vulnerable adult's will to perform services for the advantage of another.
309.16(e) For purposes of this section, a vulnerable adult is not abused for the sole reason that
309.17the vulnerable adult or a person with authority to make health care decisions for the
309.18vulnerable adult under sections 144.651, 144A.44, chapter 145B, 145C or 252A, or section
309.19253B.03 or 524.5-313, refuses consent or withdraws consent, consistent with that authority
309.20and within the boundary of reasonable medical practice, to any therapeutic conduct, including
309.21any care, service, or procedure to diagnose, maintain, or treat the physical or mental condition
309.22of the vulnerable adult or, where permitted under law, to provide nutrition and hydration
309.23parenterally or through intubation. This paragraph does not enlarge or diminish rights
309.24otherwise held under law by:
309.25(1) a vulnerable adult or a person acting on behalf of a vulnerable adult, including an
309.26involved family member, to consent to or refuse consent for therapeutic conduct; or
309.27(2) a caregiver to offer or provide or refuse to offer or provide therapeutic conduct.
309.28(f) For purposes of this section, a vulnerable adult is not abused for the sole reason that
309.29the vulnerable adult, a person with authority to make health care decisions for the vulnerable
309.30adult, or a caregiver in good faith selects and depends upon spiritual means or prayer for
309.31treatment or care of disease or remedial care of the vulnerable adult in lieu of medical care,
309.32provided that this is consistent with the prior practice or belief of the vulnerable adult or
309.33with the expressed intentions of the vulnerable adult.
310.1(g) For purposes of this section, a vulnerable adult is not abused for the sole reason that
310.2the vulnerable adult, who is not impaired in judgment or capacity by mental or emotional
310.3dysfunction or undue influence, engages in consensual sexual contact with:
310.4(1) a person, including a facility staff person, when a consensual sexual personal
310.5relationship existed prior to the caregiving relationship; or
310.6(2) a personal care attendant, regardless of whether the consensual sexual personal
310.7relationship existed prior to the caregiving relationship.

310.8    Sec. 48. Minnesota Statutes 2020, section 626.5572, subdivision 4, is amended to read:
310.9    Subd. 4. Caregiver. "Caregiver" means an individual or facility who has responsibility
310.10for all or a portion of the care of a vulnerable adult as a result of a family relationship, or
310.11who has assumed responsibility for all or a portion of the care of a vulnerable adult
310.12voluntarily, by contract, or by agreement. Caregiver does not include an unpaid caregiver
310.13who provides incidental care.

310.14    Sec. 49. Minnesota Statutes 2020, section 626.5572, subdivision 17, is amended to read:
310.15    Subd. 17. Neglect. "Neglect" means: Neglect means neglect by a caregiver or self-neglect.
310.16    (a) "Caregiver neglect" means the failure or omission by a caregiver to supply a vulnerable
310.17adult with care or services, including but not limited to, food, clothing, shelter, health care,
310.18or supervision which is:
310.19    (1) reasonable and necessary to obtain or maintain the vulnerable adult's physical or
310.20mental health or safety, considering the physical and mental capacity or dysfunction of the
310.21vulnerable adult; and
310.22    (2) which is not the result of an accident or therapeutic conduct.
310.23    (b) The absence or likelihood of absence of care or services, including but not limited
310.24to, food, clothing, shelter, health care, or supervision necessary to maintain the physical
310.25and mental health of the vulnerable adult "Self-neglect" means neglect by a vulnerable adult
310.26of the vulnerable adult's own food, clothing, shelter, health care, or other services that are
310.27not the responsibility of a caregiver which a reasonable person would deem essential to
310.28obtain or maintain the vulnerable adult's health, safety, or comfort considering the physical
310.29or mental capacity or dysfunction of the vulnerable adult.
310.30    (c) For purposes of this section, a vulnerable adult is not neglected for the sole reason
310.31that:
311.1    (1) the vulnerable adult or a person with authority to make health care decisions for the
311.2vulnerable adult under sections 144.651, 144A.44, chapter 145B, 145C, or 252A, or sections
311.3253B.03 or 524.5-101 to 524.5-502, refuses consent or withdraws consent, consistent with
311.4that authority and within the boundary of reasonable medical practice, to any therapeutic
311.5conduct, including any care, service, or procedure to diagnose, maintain, or treat the physical
311.6or mental condition of the vulnerable adult, or, where permitted under law, to provide
311.7nutrition and hydration parenterally or through intubation; this paragraph does not enlarge
311.8or diminish rights otherwise held under law by:
311.9    (i) a vulnerable adult or a person acting on behalf of a vulnerable adult, including an
311.10involved family member, to consent to or refuse consent for therapeutic conduct; or
311.11    (ii) a caregiver to offer or provide or refuse to offer or provide therapeutic conduct; or
311.12    (2) the vulnerable adult, a person with authority to make health care decisions for the
311.13vulnerable adult, or a caregiver in good faith selects and depends upon spiritual means or
311.14prayer for treatment or care of disease or remedial care of the vulnerable adult in lieu of
311.15medical care, provided that this is consistent with the prior practice or belief of the vulnerable
311.16adult or with the expressed intentions of the vulnerable adult;
311.17    (3) the vulnerable adult, who is not impaired in judgment or capacity by mental or
311.18emotional dysfunction or undue influence, engages in consensual sexual contact with:
311.19    (i) a person including a facility staff person when a consensual sexual personal
311.20relationship existed prior to the caregiving relationship; or
311.21    (ii) a personal care attendant, regardless of whether the consensual sexual personal
311.22relationship existed prior to the caregiving relationship; or
311.23    (4) an individual makes an error in the provision of therapeutic conduct to a vulnerable
311.24adult which does not result in injury or harm which reasonably requires medical or mental
311.25health care; or
311.26    (5) an individual makes an error in the provision of therapeutic conduct to a vulnerable
311.27adult that results in injury or harm, which reasonably requires the care of a physician, and:
311.28    (i) the necessary care is provided in a timely fashion as dictated by the condition of the
311.29vulnerable adult;
311.30    (ii) if after receiving care, the health status of the vulnerable adult can be reasonably
311.31expected, as determined by the attending physician, to be restored to the vulnerable adult's
311.32preexisting condition;
312.1    (iii) the error is not part of a pattern of errors by the individual;
312.2    (iv) if in a facility, the error is immediately reported as required under section 626.557,
312.3and recorded internally in the facility;
312.4    (v) if in a facility, the facility identifies and takes corrective action and implements
312.5measures designed to reduce the risk of further occurrence of this error and similar errors;
312.6and
312.7    (vi) if in a facility, the actions required under items (iv) and (v) are sufficiently
312.8documented for review and evaluation by the facility and any applicable licensing,
312.9certification, and ombudsman agency.
312.10    (d) Nothing in this definition requires a caregiver, if regulated, to provide services in
312.11excess of those required by the caregiver's license, certification, registration, or other
312.12regulation.
312.13    (e) If the findings of an investigation by a lead investigative agency result in a
312.14determination of substantiated maltreatment for the sole reason that the actions required of
312.15a facility under paragraph (c), clause (5), item (iv), (v), or (vi), were not taken, then the
312.16facility is subject to a correction order. An individual will not be found to have neglected
312.17or maltreated the vulnerable adult based solely on the facility's not having taken the actions
312.18required under paragraph (c), clause (5), item (iv), (v), or (vi). This must not alter the lead
312.19investigative agency's determination of mitigating factors under section 626.557, subdivision
312.209c, paragraph (c) (f).

312.21    Sec. 50. Laws 2021, First Special Session chapter 7, article 10, section 1, the effective
312.22date, is amended to read:
312.23EFFECTIVE DATE.This section is effective June 1, 2022 2023.

312.24    Sec. 51. Laws 2021, First Special Session chapter 7, article 10, section 3, is amended to
312.25read:
312.26    Sec. 3. LEGISLATIVE TASK FORCE; CHILD PROTECTION.
312.27(a) A legislative task force is created to:
312.28(1) review the efforts being made to implement the recommendations of the Governor's
312.29Task Force on the Protection of Children;
312.30(2) expand the efforts into related areas of the child welfare system;
313.1(3) work with the commissioner of human services and community partners to establish
313.2and evaluate child protection grants to address disparities in child welfare pursuant to
313.3Minnesota Statutes, section 256E.28;
313.4(4) review and recommend alternatives to law enforcement responding to a maltreatment
313.5report by removing the child and evaluate situations in which it may be appropriate for a
313.6social worker or other child protection worker to remove the child from the home;
313.7(5) evaluate current statutes governing mandatory reporters, consider the modification
313.8of mandatory reporting requirements for private or public youth recreation programs, and,
313.9if necessary, introduce legislation by February 15, 2022, to implement appropriate
313.10modifications;
313.11(6) evaluate and consider the intersection of educational neglect and the child protection
313.12system; and
313.13(7) identify additional areas within the child welfare system that need to be addressed
313.14by the legislature.
313.15(b) Members of the legislative task force shall include:
313.16(1) six members from the house of representatives appointed by the speaker of the house,
313.17including three from the majority party and three from the minority party; and
313.18(2) six members from the senate, including three members appointed by the senate
313.19majority leader and three members appointed by the senate minority leader.
313.20(c) Members of the task force shall serve a term that expires on December 31 of the
313.21even-numbered odd-numbered year following the year they are appointed. The speaker of
313.22the house and the majority leader of the senate shall each appoint a chair and vice-chair
313.23from the membership of the task force. The chair shall rotate after each meeting. The task
313.24force must meet at least quarterly.
313.25(d) Initial appointments to the task force shall be made by July 15, 2021 2022. The chair
313.26shall convene the first meeting of the task force by August 15, 2021 2022.
313.27(e) The task force may provide oversight and monitoring of:
313.28(1) the efforts by the Department of Human Services, counties, and Tribes to implement
313.29laws related to child protection;
313.30(2) efforts by the Department of Human Services, counties, and Tribes to implement the
313.31recommendations of the Governor's Task Force on the Protection of Children;
314.1(3) efforts by agencies including but not limited to the Department of Education, the
314.2Housing Finance Agency, the Department of Corrections, and the Department of Public
314.3Safety, to work with the Department of Human Services to assure safety and well-being for
314.4children at risk of harm or children in the child welfare system; and
314.5(4) efforts by the Department of Human Services, other agencies, counties, and Tribes
314.6to implement best practices to ensure every child is protected from maltreatment and neglect
314.7and to ensure every child has the opportunity for healthy development.
314.8(f) The task force, in cooperation with the commissioner of human services, shall issue
314.9a report to the legislature and governor by February 1, 2024. The report must contain
314.10information on the progress toward implementation of changes to the child protection system,
314.11recommendations for additional legislative changes and procedures affecting child protection
314.12and child welfare, and funding needs to implement recommended changes.
314.13(g) (f) This section expires December 31, 2024 2025.

314.14ARTICLE 9
314.15ECONOMIC ASSISTANCE

314.16    Section 1. Minnesota Statutes 2020, section 256D.0515, is amended to read:
314.17256D.0515 ASSET LIMITATIONS FOR SUPPLEMENTAL NUTRITION
314.18ASSISTANCE PROGRAM HOUSEHOLDS.
314.19All Supplemental Nutrition Assistance Program (SNAP) households must be determined
314.20eligible for the benefit discussed under section 256.029. SNAP households must demonstrate
314.21that their gross income is equal to or less than 165 200 percent of the federal poverty
314.22guidelines for the same family size.
314.23EFFECTIVE DATE.This section is effective September 1, 2022.

314.24    Sec. 2. Minnesota Statutes 2020, section 256E.36, subdivision 1, is amended to read:
314.25    Subdivision 1. Definitions. (a) The definitions in this subdivision apply to this section.
314.26(b) "Commissioner" means the commissioner of human services.
314.27(c) "Eligible organization" means a local governmental unit, federally recognized Tribal
314.28Nation, or nonprofit organization providing or seeking to provide emergency services for
314.29homeless persons.
314.30(d) "Emergency services" means:
315.1(1) providing emergency shelter for homeless persons; and
315.2(2) assisting homeless persons in obtaining essential services, including:
315.3(i) access to permanent housing;
315.4(ii) medical and psychological help;
315.5(iii) employment counseling and job placement;
315.6(iv) substance abuse treatment;
315.7(v) financial assistance available from other programs;
315.8(vi) emergency child care;
315.9(vii) transportation; and
315.10(viii) other services needed to stabilize housing.
315.11EFFECTIVE DATE.This section is effective July 1, 2022.

315.12    Sec. 3. Minnesota Statutes 2020, section 256P.04, subdivision 11, is amended to read:
315.13    Subd. 11. Participant's completion of household report form. (a) When a participant
315.14is required to complete a household report form, the following paragraphs apply.
315.15(b) If the agency receives an incomplete household report form, the agency must
315.16immediately return the incomplete form and clearly state what the participant must do for
315.17the form to be complete contact the participant by phone or in writing to acquire the necessary
315.18information to complete the form.
315.19(c) The automated eligibility system must send a notice of proposed termination of
315.20assistance to the participant if a complete household report form is not received by the
315.21agency. The automated notice must be mailed to the participant by approximately the 16th
315.22of the month. When a participant submits an incomplete form on or after the date a notice
315.23of proposed termination has been sent, the termination is valid unless the participant submits
315.24a complete form before the end of the month.
315.25(d) The submission of a household report form is considered to have continued the
315.26participant's application for assistance if a complete household report form is received within
315.27a calendar month after the month in which the form was due. Assistance shall be paid for
315.28the period beginning with the first day of that calendar month.
315.29(e) An agency must allow good cause exemptions for a participant required to complete
315.30a household report form when any of the following factors cause a participant to fail to
316.1submit a completed household report form before the end of the month in which the form
316.2is due:
316.3(1) an employer delays completion of employment verification;
316.4(2) the agency does not help a participant complete the household report form when the
316.5participant asks for help;
316.6(3) a participant does not receive a household report form due to a mistake on the part
316.7of the department or the agency or a reported change in address;
316.8(4) a participant is ill or physically or mentally incapacitated; or
316.9(5) some other circumstance occurs that a participant could not avoid with reasonable
316.10care which prevents the participant from providing a completed household report form
316.11before the end of the month in which the form is due.

316.12    Sec. 4. Minnesota Statutes 2021 Supplement, section 256P.06, subdivision 3, is amended
316.13to read:
316.14    Subd. 3. Income inclusions. The following must be included in determining the income
316.15of an assistance unit:
316.16(1) earned income; and
316.17(2) unearned income, which includes:
316.18(i) interest and dividends from investments and savings;
316.19(ii) capital gains as defined by the Internal Revenue Service from any sale of real property;
316.20(iii) proceeds from rent and contract for deed payments in excess of the principal and
316.21interest portion owed on property;
316.22(iv) income from trusts, excluding special needs and supplemental needs trusts;
316.23(v) interest income from loans made by the participant or household;
316.24(vi) cash prizes and winnings;
316.25(vii) unemployment insurance income that is received by an adult member of the
316.26assistance unit unless the individual receiving unemployment insurance income is:
316.27(A) 18 years of age and enrolled in a secondary school; or
316.28(B) 18 or 19 years of age, a caregiver, and is enrolled in school at least half-time;
316.29(viii) retirement, survivors, and disability insurance payments;
317.1(ix) nonrecurring income over $60 per quarter unless the nonrecurring income is: (A)
317.2from tax refunds, tax rebates, or tax credits; (B) a reimbursement, rebate, award, grant, or
317.3refund of personal or real property or costs or losses incurred when these payments are
317.4made by: a public agency; a court; solicitations through public appeal; a federal, state, or
317.5local unit of government; or a disaster assistance organization; (C) provided as an in-kind
317.6benefit; or (D) earmarked and used for the purpose for which it was intended, subject to
317.7verification requirements under section 256P.04;
317.8(x) retirement benefits;
317.9(xi) cash assistance benefits, as defined by each program in chapters 119B, 256D, 256I,
317.10and 256J;
317.11(xii) Tribal per capita payments unless excluded by federal and state law;
317.12(xiii) income and payments from service and rehabilitation programs that meet or exceed
317.13the state's minimum wage rate;
317.14(xiv) (xiii) income from members of the United States armed forces unless excluded
317.15from income taxes according to federal or state law;
317.16(xv) (xiv) all child support payments for programs under chapters 119B, 256D, and 256I;
317.17(xvi) (xv) the amount of child support received that exceeds $100 for assistance units
317.18with one child and $200 for assistance units with two or more children for programs under
317.19chapter 256J;
317.20(xvii) (xvi) spousal support; and
317.21(xviii) (xvii) workers' compensation.
317.22EFFECTIVE DATE.This section is effective November 1, 2022.

317.23    Sec. 5. Minnesota Statutes 2020, section 268.19, subdivision 1, is amended to read:
317.24    Subdivision 1. Use of data. (a) Except as provided by this section, data gathered from
317.25any person under the administration of the Minnesota Unemployment Insurance Law are
317.26private data on individuals or nonpublic data not on individuals as defined in section 13.02,
317.27subdivisions 9 and 12, and may not be disclosed except according to a district court order
317.28or section 13.05. A subpoena is not considered a district court order. These data may be
317.29disseminated to and used by the following agencies without the consent of the subject of
317.30the data:
318.1(1) state and federal agencies specifically authorized access to the data by state or federal
318.2law;
318.3(2) any agency of any other state or any federal agency charged with the administration
318.4of an unemployment insurance program;
318.5(3) any agency responsible for the maintenance of a system of public employment offices
318.6for the purpose of assisting individuals in obtaining employment;
318.7(4) the public authority responsible for child support in Minnesota or any other state in
318.8accordance with section 256.978;
318.9(5) human rights agencies within Minnesota that have enforcement powers;
318.10(6) the Department of Revenue to the extent necessary for its duties under Minnesota
318.11laws;
318.12(7) public and private agencies responsible for administering publicly financed assistance
318.13programs for the purpose of monitoring the eligibility of the program's recipients;
318.14(8) the Department of Labor and Industry and the Commerce Fraud Bureau in the
318.15Department of Commerce for uses consistent with the administration of their duties under
318.16Minnesota law;
318.17(9) the Department of Human Services and the Office of Inspector General and its agents
318.18within the Department of Human Services, including county fraud investigators, for
318.19investigations related to recipient or provider fraud and employees of providers when the
318.20provider is suspected of committing public assistance fraud;
318.21(10) local and state welfare agencies for monitoring the eligibility of the data subject
318.22for assistance programs, or for any employment or training program administered by those
318.23agencies, whether alone, in combination with another welfare agency, or in conjunction
318.24with the department or to monitor and evaluate the statewide Minnesota family investment
318.25program and other cash assistance programs, the Supplemental Nutrition Assistance Program,
318.26and the Supplemental Nutrition Assistance Program Employment and Training program by
318.27providing data on recipients and former recipients of Supplemental Nutrition Assistance
318.28Program (SNAP) benefits, cash assistance under chapter 256, 256D, 256J, or 256K, child
318.29care assistance under chapter 119B, or medical programs under chapter 256B or 256L or
318.30formerly codified under chapter 256D;
318.31(11) local and state welfare agencies for the purpose of identifying employment, wages,
318.32and other information to assist in the collection of an overpayment debt in an assistance
318.33program;
319.1(12) local, state, and federal law enforcement agencies for the purpose of ascertaining
319.2the last known address and employment location of an individual who is the subject of a
319.3criminal investigation;
319.4(13) the United States Immigration and Customs Enforcement has access to data on
319.5specific individuals and specific employers provided the specific individual or specific
319.6employer is the subject of an investigation by that agency;
319.7(14) the Department of Health for the purposes of epidemiologic investigations;
319.8(15) the Department of Corrections for the purposes of case planning and internal research
319.9for preprobation, probation, and postprobation employment tracking of offenders sentenced
319.10to probation and preconfinement and postconfinement employment tracking of committed
319.11offenders;
319.12(16) the state auditor to the extent necessary to conduct audits of job opportunity building
319.13zones as required under section 469.3201; and
319.14(17) the Office of Higher Education for purposes of supporting program improvement,
319.15system evaluation, and research initiatives including the Statewide Longitudinal Education
319.16Data System.
319.17(b) Data on individuals and employers that are collected, maintained, or used by the
319.18department in an investigation under section 268.182 are confidential as to data on individuals
319.19and protected nonpublic data not on individuals as defined in section 13.02, subdivisions 3
319.20and 13, and must not be disclosed except under statute or district court order or to a party
319.21named in a criminal proceeding, administrative or judicial, for preparation of a defense.
319.22(c) Data gathered by the department in the administration of the Minnesota unemployment
319.23insurance program must not be made the subject or the basis for any suit in any civil
319.24proceedings, administrative or judicial, unless the action is initiated by the department.

319.25    Sec. 6. DIRECTION TO COMMISSIONER; SNAP VERIFICATION OF FEDERAL
319.26WORK REQUIREMENTS.
319.27No later than December 1, 2022, the commissioner of human services shall issue guidance
319.28to local agencies that administer the Supplemental Nutrition Assistance Program (SNAP)
319.29regarding local agency responsibilities for verification of federal work requirements for
319.30SNAP recipients.

320.1    Sec. 7. REVISOR INSTRUCTION.
320.2The revisor of statutes shall renumber each section of Minnesota Statutes listed in column
320.3A with the number listed in column B. The revisor shall also make necessary grammatical
320.4and cross-reference changes consistent with the renumbering.
320.5
 Column A
 Column B
320.6
 256D.051, subdivision 20
 256D.60, subdivision 1
320.7
 256D.051, subdivision 21
 256D.60, subdivision 2
320.8
 256D.051, subdivision 22
 256D.60, subdivision 3
320.9
 256D.051, subdivision 23
 256D.60, subdivision 4
320.10
 256D.051, subdivision 24
 256D.60, subdivision 5
320.11
 256D.0512
 256D.61
320.12
 256D.0515
 256D.62
320.13
 256D.0516
 256D.63
320.14
 256D.053
 256D.64

320.15    Sec. 8. REPEALER.
320.16Minnesota Statutes 2020, section 256D.055, is repealed.

320.17ARTICLE 10
320.18DIRECT CARE AND TREATMENT POLICY

320.19    Section 1. Minnesota Statutes 2020, section 253B.18, subdivision 6, is amended to read:
320.20    Subd. 6. Transfer. (a) A patient who is a person who has a mental illness and is
320.21dangerous to the public shall not be transferred out of a secure treatment facility unless it
320.22appears to the satisfaction of the commissioner, after a hearing and favorable recommendation
320.23by a majority of the special review board, that the transfer is appropriate. Transfer may be
320.24to another state-operated treatment program. In those instances where a commitment also
320.25exists to the Department of Corrections, transfer may be to a facility designated by the
320.26commissioner of corrections.
320.27(b) The following factors must be considered in determining whether a transfer is
320.28appropriate:
320.29(1) the person's clinical progress and present treatment needs;
320.30(2) the need for security to accomplish continuing treatment;
320.31(3) the need for continued institutionalization;
321.1(4) which facility can best meet the person's needs; and
321.2(5) whether transfer can be accomplished with a reasonable degree of safety for the
321.3public.
321.4(c) If a committed person has been transferred out of a secure treatment facility pursuant
321.5to this subdivision, that committed person may voluntarily return to a secure treatment
321.6facility for a period of up to 60 days with the consent of the head of the treatment facility.
321.7(d) If the committed person is not returned to the original, nonsecure transfer facility
321.8within 60 days of being readmitted to a secure treatment facility, the transfer is revoked and
321.9the committed person must remain in a secure treatment facility. The committed person
321.10must immediately be notified in writing of the revocation.
321.11(e) Within 15 days of receiving notice of the revocation, the committed person may
321.12petition the special review board for a review of the revocation. The special review board
321.13shall review the circumstances of the revocation and shall recommend to the commissioner
321.14whether or not the revocation should be upheld. The special review board may also
321.15recommend a new transfer at the time of the revocation hearing.
321.16(f) No action by the special review board is required if the transfer has not been revoked
321.17and the committed person is returned to the original, nonsecure transfer facility with no
321.18substantive change to the conditions of the transfer ordered under this subdivision.
321.19(g) The head of the treatment facility may revoke a transfer made under this subdivision
321.20and require a committed person to return to a secure treatment facility if:
321.21(1) remaining in a nonsecure setting does not provide a reasonable degree of safety to
321.22the committed person or others; or
321.23(2) the committed person has regressed clinically and the facility to which the committed
321.24person was transferred does not meet the committed person's needs.
321.25(h) Upon the revocation of the transfer, the committed person must be immediately
321.26returned to a secure treatment facility. A report documenting the reasons for revocation
321.27must be issued by the head of the treatment facility within seven days after the committed
321.28person is returned to the secure treatment facility. Advance notice to the committed person
321.29of the revocation is not required.
321.30(i) The committed person must be provided a copy of the revocation report and informed,
321.31orally and in writing, of the rights of a committed person under this section. The revocation
321.32report must be served upon the committed person, the committed person's counsel, and the
322.1designated agency. The report must outline the specific reasons for the revocation, including
322.2but not limited to the specific facts upon which the revocation is based.
322.3(j) If a committed person's transfer is revoked, the committed person may re-petition for
322.4transfer according to subdivision 5.
322.5(k) A committed person aggrieved by a transfer revocation decision may petition the
322.6special review board within seven business days after receipt of the revocation report for a
322.7review of the revocation. The matter must be scheduled within 30 days. The special review
322.8board shall review the circumstances leading to the revocation and, after considering the
322.9factors in paragraph (b), shall recommend to the commissioner whether or not the revocation
322.10shall be upheld. The special review board may also recommend a new transfer out of a
322.11secure treatment facility at the time of the revocation hearing.

322.12    Sec. 2. Minnesota Statutes 2021 Supplement, section 256.01, subdivision 42, is amended
322.13to read:
322.14    Subd. 42. Expiration of report mandates. (a) If the submission of a report by the
322.15commissioner of human services to the legislature is mandated by statute and the enabling
322.16legislation does not include a date for the submission of a final report or an expiration date,
322.17the mandate to submit the report shall expire in accordance with this section.
322.18(b) If the mandate requires the submission of an annual or more frequent report and the
322.19mandate was enacted before January 1, 2021, the mandate shall expire on January 1, 2023.
322.20If the mandate requires the submission of a biennial or less frequent report and the mandate
322.21was enacted before January 1, 2021, the mandate shall expire on January 1, 2024.
322.22(c) Any reporting mandate enacted on or after January 1, 2021, shall expire three years
322.23after the date of enactment if the mandate requires the submission of an annual or more
322.24frequent report and shall expire five years after the date of enactment if the mandate requires
322.25the submission of a biennial or less frequent report unless the enacting legislation provides
322.26for a different expiration date.
322.27(d) By January 15 of each year, the commissioner shall submit a list to the chairs and
322.28ranking minority members of the legislative committees with jurisdiction over human
322.29services by February 15 of each year, beginning February 15, 2022, of all reports set to
322.30expire during the following calendar year in accordance with this section to the chairs and
322.31ranking minority members of the legislative committees with jurisdiction over human
322.32services. Notwithstanding paragraph (c), this paragraph does not expire.

323.1    Sec. 3. Laws 2009, chapter 79, article 13, section 3, subdivision 10, as amended by Laws
323.22009, chapter 173, article 2, section 1, subdivision 10, is amended to read:
323.3
 Subd. 10.State-Operated Services
323.4The amounts that may be spent from the
323.5appropriation for each purpose are as follows:
323.6Transfer Authority Related to
323.7State-Operated Services. Money
323.8appropriated to finance state-operated services
323.9may be transferred between the fiscal years of
323.10the biennium with the approval of the
323.11commissioner of finance.
323.12County Past Due Receivables. The
323.13commissioner is authorized to withhold county
323.14federal administrative reimbursement when
323.15the county of financial responsibility for
323.16cost-of-care payments due the state under
323.17Minnesota Statutes, section 246.54 or
323.18253B.045, is 90 days past due. The
323.19commissioner shall deposit the withheld
323.20federal administrative earnings for the county
323.21into the general fund to settle the claims with
323.22the county of financial responsibility. The
323.23process for withholding funds is governed by
323.24Minnesota Statutes, section 256.017.
323.25Forecast and Census Data. The
323.26commissioner shall include census data and
323.27fiscal projections for state-operated services
323.28and Minnesota sex offender services with the
323.29November and February budget forecasts.
323.30Notwithstanding any contrary provision in this
323.31article, this paragraph shall not expire.
323.32
 (a) Adult Mental Health Services
 106,702,000
 107,201,000
323.33Appropriation Limitation. No part of the
323.34appropriation in this article to the
324.1commissioner for mental health treatment
324.2services provided by state-operated services
324.3shall be used for the Minnesota sex offender
324.4program.
324.5Community Behavioral Health Hospitals.
324.6Under Minnesota Statutes, section 246.51,
324.7subdivision 1, a determination order for the
324.8clients served in a community behavioral
324.9health hospital operated by the commissioner
324.10of human services is only required when a
324.11client's third-party coverage has been
324.12exhausted.
324.13Base Adjustment. The general fund base is
324.14decreased by $500,000 for fiscal year 2012
324.15and by $500,000 for fiscal year 2013.
324.16
 (b) Minnesota Sex Offender Services
324.17
 Appropriations by Fund
324.18
 General
 38,348,000
 67,503,000
324.19
 Federal Fund
 26,495,000
 0
324.20Use of Federal Stabilization Funds. Of this
324.21appropriation, $26,495,000 in fiscal year 2010
324.22is from the fiscal stabilization account in the
324.23federal fund to the commissioner. This
324.24appropriation must not be used for any activity
324.25or service for which federal reimbursement is
324.26claimed. This is a onetime appropriation.
324.27
324.28
 (c) Minnesota Security Hospital and METO
Services
324.29
 Appropriations by Fund
324.30
 General
 230,000
 83,735,000
324.31
 Federal Fund
 83,505,000
 0
324.32Minnesota Security Hospital. For the
324.33purposes of enhancing the safety of the public,
324.34improving supervision, and enhancing
325.1community-based mental health treatment,
325.2state-operated services may establish
325.3additional community capacity for providing
325.4treatment and supervision of clients who have
325.5been ordered into a less restrictive alternative
325.6of care from the state-operated services
325.7transitional services program consistent with
325.8Minnesota Statutes, section 246.014.
325.9Use of Federal Stabilization Funds.
325.10$83,505,000 in fiscal year 2010 is appropriated
325.11from the fiscal stabilization account in the
325.12federal fund to the commissioner. This
325.13appropriation must not be used for any activity
325.14or service for which federal reimbursement is
325.15claimed. This is a onetime appropriation.

325.16    Sec. 4. REPEALER.
325.17Minnesota Statutes 2020, sections 246.0136; 252.025, subdivision 7; and 252.035, are
325.18repealed.

325.19ARTICLE 11
325.20PREVENTING HOMELESSNESS

325.21    Section 1. Minnesota Statutes 2020, section 256E.33, subdivision 1, is amended to read:
325.22    Subdivision 1. Definitions. (a) The definitions in this subdivision apply to this section.
325.23(b) "Transitional housing" means housing designed for independent living and provided
325.24to a homeless person or family at a rental rate of at least 25 percent of the family income
325.25for a period of up to 24 36 months. If a transitional housing program is associated with a
325.26licensed facility or shelter, it must be located in a separate facility or a specified section of
325.27the main facility where residents can be responsible for their own meals and other daily
325.28needs.
325.29(c) "Support services" means an assessment service that identifies the needs of individuals
325.30for independent living and arranges or provides for the appropriate educational, social, legal,
325.31advocacy, child care, employment, financial, health care, or information and referral services
325.32to meet these needs.

326.1    Sec. 2. Minnesota Statutes 2020, section 256E.33, subdivision 2, is amended to read:
326.2    Subd. 2. Establishment and administration. A transitional housing program is
326.3established to be administered by the commissioner. The commissioner may make grants
326.4to eligible recipients or enter into agreements with community action agencies or other
326.5public or private nonprofit agencies to make grants to eligible recipients to initiate, maintain,
326.6or expand programs to provide transitional housing and support services for persons in need
326.7of transitional housing, which may include up to six months of follow-up support services
326.8for persons who complete transitional housing as they stabilize in permanent housing. The
326.9commissioner must ensure that money appropriated to implement this section is distributed
326.10as soon as practicable. The commissioner may make grants directly to eligible recipients.
326.11The commissioner may extend use up to ten percent of the appropriation available for of
326.12this program for persons needing assistance longer than 24 36 months.

326.13    Sec. 3. Minnesota Statutes 2020, section 256K.45, subdivision 6, is amended to read:
326.14    Subd. 6. Funding. Funds appropriated for this section may be expended on programs
326.15described under subdivisions 3 to 5 and 7, technical assistance, and capacity building to
326.16meet the greatest need on a statewide basis. The commissioner will provide outreach,
326.17technical assistance, and program development support to increase capacity to new and
326.18existing service providers to better meet needs statewide, particularly in areas where services
326.19for homeless youth have not been established, especially in greater Minnesota.

326.20    Sec. 4. Minnesota Statutes 2020, section 256K.45, is amended by adding a subdivision to
326.21read:
326.22    Subd. 7. Provider repair or improvement grants. (a) Providers that serve homeless
326.23youth under this section may apply for a grant of up to $200,000 under this subdivision to
326.24make minor or mechanical repairs or improvements to a facility providing services to
326.25homeless youth or youth at risk of homelessness.
326.26(b) Grant applications under this subdivision must include a description of the repairs
326.27or improvements and the estimated cost of the repairs or improvements.
326.28(c) Grantees under this subdivision cannot receive grant funds under this subdivision
326.29for two consecutive years.

327.1    Sec. 5. Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 24,
327.2is amended to read:
327.3
327.4
 Subd. 24.Grant Programs; Children and
Economic Support Grants
 29,740,000
 29,740,000
327.5(a) Minnesota Food Assistance Program.
327.6Unexpended funds for the Minnesota food
327.7assistance program for fiscal year 2022 do not
327.8cancel but are available in fiscal year 2023.
327.9(b) Base Level Adjustment; Provider Repair
327.10Grants. The general fund base includes
327.11$1,000,000 in fiscal year 2024 and $1,000,000
327.12in fiscal year 2025 for provider repair or
327.13improvement grants under Minnesota Statutes,
327.14section 256K.45, subdivision 7.

327.15    Sec. 6. Laws 2021, First Special Session chapter 8, article 6, section 1, subdivision 7, is
327.16amended to read:
327.17    Subd. 7. Report. (a) No later than February 1, 2022, the task force shall submit an initial
327.18report to the chairs and ranking minority members of the house of representatives and senate
327.19committees and divisions with jurisdiction over housing and preventing homelessness on
327.20its findings and recommendations.
327.21(b) No later than August 31 December 15, 2022, the task force shall submit a final report
327.22to the chairs and ranking minority members of the house of representatives and senate
327.23committees and divisions with jurisdiction over housing and preventing homelessness on
327.24its findings and recommendations.

327.25ARTICLE 12
327.26DEPARTMENT OF HUMAN SERVICES
327.27LICENSING AND OPERATIONS POLICY

327.28    Section 1. Minnesota Statutes 2020, section 245A.02, subdivision 5a, is amended to read:
327.29    Subd. 5a. Controlling individual. (a) "Controlling individual" means an owner of a
327.30program or service provider licensed under this chapter and the following individuals, if
327.31applicable:
328.1(1) each officer of the organization, including the chief executive officer and chief
328.2financial officer;
328.3(2) the individual designated as the authorized agent under section 245A.04, subdivision
328.41, paragraph (b);
328.5(3) the individual designated as the compliance officer under section 256B.04, subdivision
328.621, paragraph (g); and
328.7(4) each managerial official whose responsibilities include the direction of the
328.8management or policies of a program.; and
328.9(5) the individual designated as the primary provider of care for a special family child
328.10care program under section 245A.14, subdivision 4, paragraph (i).
328.11(b) Controlling individual does not include:
328.12    (1) a bank, savings bank, trust company, savings association, credit union, industrial
328.13loan and thrift company, investment banking firm, or insurance company unless the entity
328.14operates a program directly or through a subsidiary;
328.15    (2) an individual who is a state or federal official, or state or federal employee, or a
328.16member or employee of the governing body of a political subdivision of the state or federal
328.17government that operates one or more programs, unless the individual is also an officer,
328.18owner, or managerial official of the program, receives remuneration from the program, or
328.19owns any of the beneficial interests not excluded in this subdivision;
328.20    (3) an individual who owns less than five percent of the outstanding common shares of
328.21a corporation:
328.22    (i) whose securities are exempt under section 80A.45, clause (6); or
328.23    (ii) whose transactions are exempt under section 80A.46, clause (2);
328.24    (4) an individual who is a member of an organization exempt from taxation under section
328.25290.05, unless the individual is also an officer, owner, or managerial official of the program
328.26or owns any of the beneficial interests not excluded in this subdivision. This clause does
328.27not exclude from the definition of controlling individual an organization that is exempt from
328.28taxation; or
328.29(5) an employee stock ownership plan trust, or a participant or board member of an
328.30employee stock ownership plan, unless the participant or board member is a controlling
328.31individual according to paragraph (a).
329.1(c) For purposes of this subdivision, "managerial official" means an individual who has
329.2the decision-making authority related to the operation of the program, and the responsibility
329.3for the ongoing management of or direction of the policies, services, or employees of the
329.4program. A site director who has no ownership interest in the program is not considered to
329.5be a managerial official for purposes of this definition.
329.6EFFECTIVE DATE.This section is effective July 1, 2022.

329.7    Sec. 2. Minnesota Statutes 2021 Supplement, section 245A.14, subdivision 4, is amended
329.8to read:
329.9    Subd. 4. Special family child care homes. Nonresidential child care programs serving
329.1014 or fewer children that are conducted at a location other than the license holder's own
329.11residence shall be licensed under this section and the rules governing family child care or
329.12group family child care if:
329.13(a) the license holder is the primary provider of care and the nonresidential child care
329.14program is conducted in a dwelling that is located on a residential lot;
329.15(b) the license holder is an employer who may or may not be the primary provider of
329.16care, and the purpose for the child care program is to provide child care services to children
329.17of the license holder's employees;
329.18(c) the license holder is a church or religious organization;
329.19(d) the license holder is a community collaborative child care provider. For purposes of
329.20this subdivision, a community collaborative child care provider is a provider participating
329.21in a cooperative agreement with a community action agency as defined in section 256E.31;
329.22(e) the license holder is a not-for-profit agency that provides child care in a dwelling
329.23located on a residential lot and the license holder maintains two or more contracts with
329.24community employers or other community organizations to provide child care services.
329.25The county licensing agency may grant a capacity variance to a license holder licensed
329.26under this paragraph to exceed the licensed capacity of 14 children by no more than five
329.27children during transition periods related to the work schedules of parents, if the license
329.28holder meets the following requirements:
329.29(1) the program does not exceed a capacity of 14 children more than a cumulative total
329.30of four hours per day;
329.31(2) the program meets a one to seven staff-to-child ratio during the variance period;
330.1(3) all employees receive at least an extra four hours of training per year than required
330.2in the rules governing family child care each year;
330.3(4) the facility has square footage required per child under Minnesota Rules, part
330.49502.0425;
330.5(5) the program is in compliance with local zoning regulations;
330.6(6) the program is in compliance with the applicable fire code as follows:
330.7(i) if the program serves more than five children older than 2-1/2 years of age, but no
330.8more than five children 2-1/2 years of age or less, the applicable fire code is educational
330.9occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code 2015,
330.10Section 202; or
330.11(ii) if the program serves more than five children 2-1/2 years of age or less, the applicable
330.12fire code is Group I-4 Occupancies, as provided in the Minnesota State Fire Code 2015,
330.13Section 202, unless the rooms in which the children are cared for are located on a level of
330.14exit discharge and each of these child care rooms has an exit door directly to the exterior,
330.15then the applicable fire code is Group E occupancies, as provided in the Minnesota State
330.16Fire Code 2015, Section 202; and
330.17(7) any age and capacity limitations required by the fire code inspection and square
330.18footage determinations shall be printed on the license; or
330.19(f) the license holder is the primary provider of care and has located the licensed child
330.20care program in a commercial space, if the license holder meets the following requirements:
330.21(1) the program is in compliance with local zoning regulations;
330.22(2) the program is in compliance with the applicable fire code as follows:
330.23(i) if the program serves more than five children older than 2-1/2 years of age, but no
330.24more than five children 2-1/2 years of age or less, the applicable fire code is educational
330.25occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code 2015,
330.26Section 202; or
330.27(ii) if the program serves more than five children 2-1/2 years of age or less, the applicable
330.28fire code is Group I-4 Occupancies, as provided under the Minnesota State Fire Code 2015,
330.29Section 202;
330.30(3) any age and capacity limitations required by the fire code inspection and square
330.31footage determinations are printed on the license; and
331.1(4) the license holder prominently displays the license issued by the commissioner which
331.2contains the statement "This special family child care provider is not licensed as a child
331.3care center."
331.4(g) Notwithstanding Minnesota Rules, part 9502.0335, subpart 12, the commissioner
331.5may issue up to four licenses to an organization licensed under paragraph (b), (c), or (e).
331.6Each license must have its own primary provider of care as required under paragraph (i).
331.7Each license must operate as a distinct and separate program in compliance with all applicable
331.8laws and regulations.
331.9(h) For licenses issued under paragraph (b), (c), (d), (e), or (f), the commissioner may
331.10approve up to four licenses at the same location or under one contiguous roof if each license
331.11holder is able to demonstrate compliance with all applicable rules and laws. Each licensed
331.12program must operate as a distinct program and within the capacity, age, and ratio
331.13distributions of each license.
331.14(i) For a license issued under paragraph (b), (c), or (e), the license holder must designate
331.15a person to be the primary provider of care at the licensed location on a form and in a manner
331.16prescribed by the commissioner. The license holder shall notify the commissioner in writing
331.17before there is a change of the person designated to be the primary provider of care. The
331.18primary provider of care:
331.19(1) must be the person who will be the provider of care at the program and present during
331.20the hours of operation;
331.21(2) must operate the program in compliance with applicable laws and regulations under
331.22chapter 245A and Minnesota Rules, chapter 9502;
331.23(3) is considered a child care background study subject as defined in section 245C.02,
331.24subdivision 6a, and must comply with background study requirements in chapter 245C; and
331.25(4) must complete the training that is required of license holders in section 245A.50.;
331.26and
331.27(5) is authorized to communicate with the county licensing agency and the department
331.28on matters related to licensing.
331.29(j) For any license issued under this subdivision, the license holder must ensure that any
331.30other caregiver, substitute, or helper who assists in the care of children meets the training
331.31requirements in section 245A.50 and background study requirements under chapter 245C.
331.32EFFECTIVE DATE.This section is effective July 1, 2022.

332.1    Sec. 3. Minnesota Statutes 2020, section 245A.1443, is amended to read:
332.2245A.1443 CHEMICAL DEPENDENCY SUBSTANCE USE DISORDER
332.3TREATMENT LICENSED PROGRAMS THAT SERVE PARENTS WITH THEIR
332.4CHILDREN.
332.5    Subdivision 1. Application. This section applies to chemical dependency residential
332.6substance use disorder treatment facilities that are licensed under this chapter and Minnesota
332.7Rules, chapter 9530, 245G and that provide services in accordance with section 245G.19.
332.8    Subd. 2. Requirements for providing education. (a) On or before the date of a child's
332.9initial physical presence at the facility, the license holder must provide education to the
332.10child's parent related to safe bathing and reducing the risk of sudden unexpected infant death
332.11and abusive head trauma from shaking infants and young children. The license holder must
332.12use the educational material developed by the commissioner to comply with this requirement.
332.13At a minimum, the education must address:
332.14(1) instruction that a child or infant should never be left unattended around water, a tub
332.15should be filled with only two to four inches of water for infants, and an infant should never
332.16be put into a tub when the water is running; and
332.17(2) the risk factors related to sudden unexpected infant death and abusive head trauma
332.18from shaking infants and young children, and means of reducing the risks, including the
332.19safety precautions identified in section 245A.1435 and the dangers risks of co-sleeping.
332.20(b) The license holder must document the parent's receipt of the education and keep the
332.21documentation in the parent's file. The documentation must indicate whether the parent
332.22agrees to comply with the safeguards. If the parent refuses to comply, program staff must
332.23provide additional education to the parent at appropriate intervals, at least weekly as described
332.24in the parental supervision plan. The parental supervision plan must include the intervention,
332.25frequency, and staff responsible for the duration of the parent's participation in the program
332.26or until the parent agrees to comply with the safeguards.
332.27    Subd. 3. Parental supervision of children. (a) On or before the date of a child's initial
332.28physical presence at the facility, the license holder must complete and document an
332.29assessment of the parent's capacity to meet the health and safety needs of the child while
332.30on the facility premises, including identifying circumstances when the parent may be unable
332.31to adequately care for their child due to considering the following factors:
332.32(1) the parent's physical or and mental health;
332.33(2) the parent being under the influence of drugs, alcohol, medications, or other chemicals;
333.1(3) the parent being unable to provide appropriate supervision for the child; or
333.2(3) the child's physical and mental health; and
333.3(4) any other information available to the license holder that indicates the parent may
333.4not be able to adequately care for the child.
333.5(b) The license holder must have written procedures specifying the actions to be taken
333.6by staff if a parent is or becomes unable to adequately care for the parent's child.
333.7(c) If the parent refuses to comply with the safeguards described in subdivision 2 or is
333.8unable to adequately care for the child, the license holder must develop a parental supervision
333.9plan in conjunction with the client. The plan must account for any factors in paragraph (a)
333.10that contribute to the parent's inability to adequately care for the child. The plan must be
333.11dated and signed by the staff person who completed the plan.
333.12    Subd. 4. Alternative supervision arrangements. The license holder must have written
333.13procedures addressing whether the program permits a parent to arrange for supervision of
333.14the parent's child by another client in the program. If permitted, the facility must have a
333.15procedure that requires staff approval of the supervision arrangement before the supervision
333.16by the nonparental client occurs. The procedure for approval must include an assessment
333.17of the nonparental client's capacity to assume the supervisory responsibilities using the
333.18criteria in subdivision 3. The license holder must document the license holder's approval of
333.19the supervisory arrangement and the assessment of the nonparental client's capacity to
333.20supervise the child, and must keep this documentation in the file of the parent of the child
333.21being supervised.
333.22EFFECTIVE DATE.This section is effective January 1, 2023.

333.23    Sec. 4. Minnesota Statutes 2020, section 245F.15, subdivision 1, is amended to read:
333.24    Subdivision 1. Qualifications for all staff who have direct patient contact. (a) All
333.25staff who have direct patient contact must be at least 18 years of age and must, at the time
333.26of hiring, document that they meet the requirements in paragraph (b), (c), or (d).
333.27(b) Program directors, supervisors, nurses, and alcohol and drug counselors must be free
333.28of substance use problems for at least two years immediately preceding their hiring and
333.29must sign a statement attesting to that fact.
333.30(c) Recovery peers must be free of substance use problems for at least one year
333.31immediately preceding their hiring and must sign a statement attesting to that fact.
334.1(d) Technicians and other support staff must be free of substance use problems for at
334.2least six months immediately preceding their hiring and must sign a statement attesting to
334.3that fact.
334.4EFFECTIVE DATE.This section is effective January 1, 2023.

334.5    Sec. 5. Minnesota Statutes 2020, section 245F.16, subdivision 1, is amended to read:
334.6    Subdivision 1. Policy requirements. A license holder must have written personnel
334.7policies and must make them available to staff members at all times. The personnel policies
334.8must:
334.9(1) ensure that a staff member's retention, promotion, job assignment, or pay are not
334.10affected by a good-faith communication between the staff member and the Department of
334.11Human Services, Department of Health, Ombudsman for Mental Health and Developmental
334.12Disabilities, law enforcement, or local agencies that investigate complaints regarding patient
334.13rights, health, or safety;
334.14(2) include a job description for each position that specifies job responsibilities, degree
334.15of authority to execute job responsibilities, standards of job performance related to specified
334.16job responsibilities, and qualifications;
334.17(3) provide for written job performance evaluations for staff members of the license
334.18holder at least annually;
334.19(4) describe behavior that constitutes grounds the process for disciplinary action,
334.20suspension, or dismissal, including policies that address substance use problems and meet
334.21the requirements of section 245F.15, subdivisions 1 and 2. The policies and procedures
334.22must list behaviors or incidents that are considered substance use problems. The list must
334.23include: of a staff person for violating the drug and alcohol policy described in section
334.24245A.04, subdivision 1, paragraph (c);
334.25(i) receiving treatment for substance use disorder within the period specified for the
334.26position in the staff qualification requirements;
334.27(ii) substance use that has a negative impact on the staff member's job performance;
334.28(iii) substance use that affects the credibility of treatment services with patients, referral
334.29sources, or other members of the community; and
334.30(iv) symptoms of intoxication or withdrawal on the job;
335.1(5) include policies prohibiting personal involvement with patients and policies
335.2prohibiting patient maltreatment as specified under sections 245A.65, 626.557, and 626.5572
335.3and chapters 260E and 604;
335.4(6) include a chart or description of organizational structure indicating the lines of
335.5authority and responsibilities;
335.6(7) include a written plan for new staff member orientation that, at a minimum, includes
335.7training related to the specific job functions for which the staff member was hired, program
335.8policies and procedures, patient needs, and the areas identified in subdivision 2, paragraphs
335.9(b) to (e); and
335.10(8) include a policy on the confidentiality of patient information.
335.11EFFECTIVE DATE.This section is effective January 1, 2023.

335.12    Sec. 6. Minnesota Statutes 2020, section 245G.01, subdivision 4, is amended to read:
335.13    Subd. 4. Alcohol and drug counselor. "Alcohol and drug counselor" has the meaning
335.14given in section 148F.01, subdivision 5 means a person who is qualified according to section
335.15245G.11, subdivision 5.
335.16EFFECTIVE DATE.This section is effective the day following final enactment.

335.17    Sec. 7. Minnesota Statutes 2020, section 245G.01, subdivision 17, is amended to read:
335.18    Subd. 17. Licensed professional in private practice. (a) "Licensed professional in
335.19private practice" means an individual who:
335.20(1) is licensed under chapter 148F, or is exempt from licensure under that chapter but
335.21is otherwise licensed to provide alcohol and drug counseling services;
335.22(2) practices solely within the permissible scope of the individual's license as defined
335.23in the law authorizing licensure; and
335.24(3) does not affiliate with other licensed or unlicensed professionals to provide alcohol
335.25and drug counseling services. Affiliation does not include conferring with another
335.26professional or making a client referral.
335.27(b) For purposes of this subdivision, affiliate includes but is not limited to:
335.28(1) using the same electronic record system as another professional, except when the
335.29system prohibits each professional from accessing the records of another professional;
335.30(2) advertising the services of more than one professional together;
336.1(3) accepting client referrals made to a group of professionals;
336.2(4) providing services to another professional's clients when that professional is absent;
336.3or
336.4(5) appearing in any way to be a group practice or program.
336.5(c) For purposes of this subdivision, affiliate does not include:
336.6(1) conferring with another professional;
336.7(2) making a client referral to another professional;
336.8(3) contracting with the same agency as another professional for billing services;
336.9(4) using the same waiting area for clients in an office as another professional; or
336.10(5) using the same receptionist as another professional if the receptionist supports each
336.11professional independently.
336.12EFFECTIVE DATE.This section is effective the day following final enactment.

336.13    Sec. 8. Minnesota Statutes 2020, section 245G.06, is amended by adding a subdivision to
336.14read:
336.15    Subd. 2a. Documentation of treatment services. The license holder must ensure that
336.16the staff member who provides the treatment service documents in the client record the
336.17date, type, and amount of each treatment service provided to a client and the client's response
336.18to each treatment service within seven days of providing the treatment service.
336.19EFFECTIVE DATE.This section is effective August 1, 2022.

336.20    Sec. 9. Minnesota Statutes 2020, section 245G.06, is amended by adding a subdivision to
336.21read:
336.22    Subd. 2b. Client record documentation requirements. (a) The license holder must
336.23document in the client record any significant event that occurs at the program on the day
336.24the event occurs. A significant event is an event that impacts the client's relationship with
336.25other clients, staff, or the client's family, or the client's treatment plan.
336.26(b) A residential treatment program must document in the client record the following
336.27items on the day that each occurs:
336.28(1) medical and other appointments the client attended;
337.1(2) concerns related to medications that are not documented in the medication
337.2administration record; and
337.3(3) concerns related to attendance for treatment services, including the reason for any
337.4client absence from a treatment service.
337.5(c) Each entry in a client's record must be accurate, legible, signed, dated, and include
337.6the job title or position of the staff person that made the entry. A late entry must be clearly
337.7labeled "late entry." A correction to an entry must be made in a way in which the original
337.8entry can still be read.
337.9EFFECTIVE DATE.This section is effective August 1, 2022.

337.10    Sec. 10. Minnesota Statutes 2020, section 245G.06, subdivision 3, is amended to read:
337.11    Subd. 3. Documentation of treatment services; Treatment plan review. (a) A review
337.12of all treatment services must be documented weekly and include a review of:
337.13(1) care coordination activities;
337.14(2) medical and other appointments the client attended;
337.15(3) issues related to medications that are not documented in the medication administration
337.16record; and
337.17(4) issues related to attendance for treatment services, including the reason for any client
337.18absence from a treatment service.
337.19(b) A note must be entered immediately following any significant event. A significant
337.20event is an event that impacts the client's relationship with other clients, staff, the client's
337.21family, or the client's treatment plan.
337.22(c) A treatment plan review must be entered in a client's file weekly or after each treatment
337.23service, whichever is less frequent, by the staff member providing the service alcohol and
337.24drug counselor responsible for the client's treatment plan. The review must indicate the span
337.25of time covered by the review and each of the six dimensions listed in section 245G.05,
337.26subdivision 2, paragraph (c). The review must:
337.27(1) indicate the date, type, and amount of each treatment service provided and the client's
337.28response to each service;
337.29(2) (1) address each goal in the treatment plan and whether the methods to address the
337.30goals are effective;
337.31(3) (2) include monitoring of any physical and mental health problems;
338.1(4) (3) document the participation of others;
338.2(5) (4) document staff recommendations for changes in the methods identified in the
338.3treatment plan and whether the client agrees with the change; and
338.4(6) (5) include a review and evaluation of the individual abuse prevention plan according
338.5to section 245A.65.
338.6(d) Each entry in a client's record must be accurate, legible, signed, and dated. A late
338.7entry must be clearly labeled "late entry." A correction to an entry must be made in a way
338.8in which the original entry can still be read.
338.9EFFECTIVE DATE.This section is effective August 1, 2022.

338.10    Sec. 11. Minnesota Statutes 2020, section 245G.08, subdivision 5, is amended to read:
338.11    Subd. 5. Administration of medication and assistance with self-medication. (a) A
338.12license holder must meet the requirements in this subdivision if a service provided includes
338.13the administration of medication.
338.14(b) A staff member, other than a licensed practitioner or nurse, who is delegated by a
338.15licensed practitioner or a registered nurse the task of administration of medication or assisting
338.16with self-medication, must:
338.17(1) successfully complete a medication administration training program for unlicensed
338.18personnel through an accredited Minnesota postsecondary educational institution. A staff
338.19member's completion of the course must be documented in writing and placed in the staff
338.20member's personnel file;
338.21(2) be trained according to a formalized training program that is taught by a registered
338.22nurse and offered by the license holder. The training must include the process for
338.23administration of naloxone, if naloxone is kept on site. A staff member's completion of the
338.24training must be documented in writing and placed in the staff member's personnel records;
338.25or
338.26(3) demonstrate to a registered nurse competency to perform the delegated activity. A
338.27registered nurse must be employed or contracted to develop the policies and procedures for
338.28administration of medication or assisting with self-administration of medication, or both.
338.29(c) A registered nurse must provide supervision as defined in section 148.171, subdivision
338.3023. The registered nurse's supervision must include, at a minimum, monthly on-site
338.31supervision or more often if warranted by a client's health needs. The policies and procedures
338.32must include:
339.1(1) a provision that a delegation of administration of medication is limited to a method
339.2a staff member has been trained to administer and limited to the administration of:
339.3(i) a medication that is administered orally, topically, or as a suppository, an eye drop,
339.4an ear drop, or an inhalant, or an intranasal; and
339.5(ii) an intramuscular injection of naloxone or epinephrine;
339.6(2) a provision that each client's file must include documentation indicating whether
339.7staff must conduct the administration of medication or the client must self-administer
339.8medication, or both;
339.9(3) a provision that a client may carry emergency medication such as nitroglycerin as
339.10instructed by the client's physician or advanced practice registered nurse;
339.11(4) a provision for the client to self-administer medication when a client is scheduled to
339.12be away from the facility;
339.13(5) a provision that if a client self-administers medication when the client is present in
339.14the facility, the client must self-administer medication under the observation of a trained
339.15staff member;
339.16(6) a provision that when a license holder serves a client who is a parent with a child,
339.17the parent may only administer medication to the child under a staff member's supervision;
339.18(7) requirements for recording the client's use of medication, including staff signatures
339.19with date and time;
339.20(8) guidelines for when to inform a nurse of problems with self-administration of
339.21medication, including a client's failure to administer, refusal of a medication, adverse
339.22reaction, or error; and
339.23(9) procedures for acceptance, documentation, and implementation of a prescription,
339.24whether written, verbal, telephonic, or electronic.
339.25EFFECTIVE DATE.This section is effective the day following final enactment.

339.26    Sec. 12. Minnesota Statutes 2020, section 245G.09, subdivision 3, is amended to read:
339.27    Subd. 3. Contents. Client records must contain the following:
339.28(1) documentation that the client was given information on client rights and
339.29responsibilities, grievance procedures, tuberculosis, and HIV, and that the client was provided
339.30an orientation to the program abuse prevention plan required under section 245A.65,
339.31subdivision 2, paragraph (a), clause (4). If the client has an opioid use disorder, the record
340.1must contain documentation that the client was provided educational information according
340.2to section 245G.05, subdivision 1, paragraph (b);
340.3(2) an initial services plan completed according to section 245G.04;
340.4(3) a comprehensive assessment completed according to section 245G.05;
340.5(4) an assessment summary completed according to section 245G.05, subdivision 2;
340.6(5) an individual abuse prevention plan according to sections 245A.65, subdivision 2,
340.7and 626.557, subdivision 14, when applicable;
340.8(6) an individual treatment plan according to section 245G.06, subdivisions 1 and 2;
340.9(7) documentation of treatment services, significant events, appointments, concerns, and
340.10treatment plan review reviews according to section 245G.06, subdivision subdivisions 2a,
340.112b, and 3; and
340.12(8) a summary at the time of service termination according to section 245G.06,
340.13subdivision 4.
340.14EFFECTIVE DATE.This section is effective August 1, 2022.

340.15    Sec. 13. Minnesota Statutes 2020, section 245G.11, subdivision 1, is amended to read:
340.16    Subdivision 1. General qualifications. (a) All staff members who have direct contact
340.17must be 18 years of age or older. At the time of employment, each staff member must meet
340.18the qualifications in this subdivision. For purposes of this subdivision, "problematic substance
340.19use" means a behavior or incident listed by the license holder in the personnel policies and
340.20procedures according to section 245G.13, subdivision 1, clause (5).
340.21(b) A treatment director, supervisor, nurse, counselor, student intern, or other professional
340.22must be free of problematic substance use for at least the two years immediately preceding
340.23employment and must sign a statement attesting to that fact.
340.24(c) A paraprofessional, recovery peer, or any other staff member with direct contact
340.25must be free of problematic substance use for at least one year immediately preceding
340.26employment and must sign a statement attesting to that fact.
340.27EFFECTIVE DATE.This section is effective January 1, 2023.

340.28    Sec. 14. Minnesota Statutes 2020, section 245G.11, subdivision 10, is amended to read:
340.29    Subd. 10. Student interns. A qualified staff member must supervise and be responsible
340.30for a treatment service performed by a student intern and must review and sign each
341.1assessment, progress note, and individual treatment plan, and treatment plan review prepared
341.2by a student intern. A student intern must receive the orientation and training required in
341.3section 245G.13, subdivisions 1, clause (7), and 2. No more than 50 percent of the treatment
341.4staff may be students or licensing candidates with time documented to be directly related
341.5to the provision of treatment services for which the staff are authorized.
341.6EFFECTIVE DATE.This section is effective January 1, 2023.

341.7    Sec. 15. Minnesota Statutes 2020, section 245G.13, subdivision 1, is amended to read:
341.8    Subdivision 1. Personnel policy requirements. A license holder must have written
341.9personnel policies that are available to each staff member. The personnel policies must:
341.10(1) ensure that staff member retention, promotion, job assignment, or pay are not affected
341.11by a good faith communication between a staff member and the department, the Department
341.12of Health, the ombudsman for mental health and developmental disabilities, law enforcement,
341.13or a local agency for the investigation of a complaint regarding a client's rights, health, or
341.14safety;
341.15(2) contain a job description for each staff member position specifying responsibilities,
341.16degree of authority to execute job responsibilities, and qualification requirements;
341.17(3) provide for a job performance evaluation based on standards of job performance
341.18conducted on a regular and continuing basis, including a written annual review;
341.19(4) describe behavior that constitutes grounds for disciplinary action, suspension, or
341.20dismissal, including policies that address staff member problematic substance use and the
341.21requirements of section 245G.11, subdivision 1, policies prohibiting personal involvement
341.22with a client in violation of chapter 604, and policies prohibiting client abuse described in
341.23sections 245A.65, 626.557, and 626.5572, and chapter 260E;
341.24(5) identify how the program will identify whether behaviors or incidents are problematic
341.25substance use, including a description of how the facility must address:
341.26(i) receiving treatment for substance use within the period specified for the position in
341.27the staff qualification requirements, including medication-assisted treatment;
341.28(ii) substance use that negatively impacts the staff member's job performance;
341.29(iii) substance use that affects the credibility of treatment services with a client, referral
341.30source, or other member of the community;
341.31(iv) symptoms of intoxication or withdrawal on the job; and
342.1(v) the circumstances under which an individual who participates in monitoring by the
342.2health professional services program for a substance use or mental health disorder is able
342.3to provide services to the program's clients;
342.4(5) describe the process for disciplinary action, suspension, or dismissal of a staff person
342.5for violating the drug and alcohol policy described in section 245A.04, subdivision 1,
342.6paragraph (c);
342.7(6) include a chart or description of the organizational structure indicating lines of
342.8authority and responsibilities;
342.9(7) include orientation within 24 working hours of starting for each new staff member
342.10based on a written plan that, at a minimum, must provide training related to the staff member's
342.11specific job responsibilities, policies and procedures, client confidentiality, HIV minimum
342.12standards, and client needs; and
342.13(8) include policies outlining the license holder's response to a staff member with a
342.14behavior problem that interferes with the provision of treatment service.
342.15EFFECTIVE DATE.This section is effective January 1, 2023.

342.16    Sec. 16. Minnesota Statutes 2020, section 245G.20, is amended to read:
342.17245G.20 LICENSE HOLDERS SERVING PERSONS WITH CO-OCCURRING
342.18DISORDERS.
342.19A license holder specializing in the treatment of a person with co-occurring disorders
342.20must:
342.21(1) demonstrate that staff levels are appropriate for treating a client with a co-occurring
342.22disorder, and that there are adequate staff members with mental health training;
342.23(2) have continuing access to a medical provider with appropriate expertise in prescribing
342.24psychotropic medication;
342.25(3) have a mental health professional available for staff member supervision and
342.26consultation;
342.27(4) determine group size, structure, and content considering the special needs of a client
342.28with a co-occurring disorder;
342.29(5) have documentation of active interventions to stabilize mental health symptoms
342.30present in the individual treatment plans and progress notes treatment plan reviews;
343.1(6) have continuing documentation of collaboration with continuing care mental health
343.2providers, and involvement of the providers in treatment planning meetings;
343.3(7) have available program materials adapted to a client with a mental health problem;
343.4(8) have policies that provide flexibility for a client who may lapse in treatment or may
343.5have difficulty adhering to established treatment rules as a result of a mental illness, with
343.6the goal of helping a client successfully complete treatment; and
343.7(9) have individual psychotherapy and case management available during treatment
343.8service.
343.9EFFECTIVE DATE.This section is effective January 1, 2023.

343.10    Sec. 17. Minnesota Statutes 2020, section 245G.22, subdivision 7, is amended to read:
343.11    Subd. 7. Restrictions for unsupervised use of methadone hydrochloride. (a) If a
343.12medical director or prescribing practitioner assesses and determines that a client meets the
343.13criteria in subdivision 6 and may be dispensed a medication used for the treatment of opioid
343.14addiction, the restrictions in this subdivision must be followed when the medication to be
343.15dispensed is methadone hydrochloride. The results of the assessment must be contained in
343.16the client file. The number of unsupervised use medication doses per week in paragraphs
343.17(b) to (d) is in addition to the number of unsupervised use medication doses a client may
343.18receive for days the clinic is closed for business as allowed by subdivision 6, paragraph (a).
343.19(b) During the first 90 days of treatment, the unsupervised use medication supply must
343.20be limited to a maximum of a single dose each week and the client shall ingest all other
343.21doses under direct supervision.
343.22(c) In the second 90 days of treatment, the unsupervised use medication supply must be
343.23limited to two doses per week.
343.24(d) In the third 90 days of treatment, the unsupervised use medication supply must not
343.25exceed three doses per week.
343.26(e) In the remaining months of the first year, a client may be given a maximum six-day
343.27unsupervised use medication supply.
343.28(f) After one year of continuous treatment, a client may be given a maximum two-week
343.29unsupervised use medication supply.
343.30(g) After two years of continuous treatment, a client may be given a maximum one-month
343.31unsupervised use medication supply, but must make monthly visits to the program.
344.1EFFECTIVE DATE.This section is effective the day following final enactment.

344.2    Sec. 18. Laws 2020, First Special Session chapter 7, section 1, subdivision 5, as amended
344.3by Laws 2021, First Special Session chapter 7, article 2, section 73, is amended to read:
344.4    Subd. 5. Waivers and modifications; extension for 365 days. (a) When the peacetime
344.5emergency declared by the governor in response to the COVID-19 outbreak expires, is
344.6terminated, or is rescinded by the proper authority, waiver CV23: modifying background
344.7study requirements, issued by the commissioner of human services pursuant to Executive
344.8Orders 20-11 and 20-12, including any amendments to the modification issued before the
344.9peacetime emergency expires, shall remain in effect for 365 days after the peacetime
344.10emergency ends until January 1, 2023.
344.11(b) Under the extension of the waiver in paragraph (a), mandatory direct contact
344.12supervision requirements are waived to allow the commissioner to permit an individual to
344.13work without supervision while that individual's background study is being processed, on
344.14a case-by-case basis and as permitted under federal law and regulation, while providers
344.15transition from name and date of birth background studies of only Minnesota records to
344.16fingerprint-based background studies.
344.17(c) The commissioner shall conduct a name and date of birth background study of only
344.18Minnesota records for an individual who has direct contact with persons served in any
344.19program licensed by the commissioner that is not authorized to conduct fingerprint-based
344.20national criminal history record checks, until federal approval is obtained for
344.21fingerprint-based national criminal history record checks and necessary NETStudy 2.0
344.22system changes following federal approval have been completed. A name and date of birth
344.23background study of only Minnesota records conducted under this paragraph shall remain
344.24valid until three months after the commissioner begins conducting fingerprint-based national
344.25criminal history record checks.
344.26EFFECTIVE DATE.This section is effective the day following final enactment.

344.27    Sec. 19. CHILD CARE REGULATION MODERNIZATION; PILOT PROJECTS.
344.28The commissioner of human services may conduct and administer pilot projects to test
344.29methods and procedures for the projects to modernize regulation of child care centers and
344.30family child care allowed under Laws 2021, First Special Session chapter 7, article 2, sections
344.3175 and 81. To carry out the pilot projects, the commissioner of human services may, by
344.32issuing a commissioner's order, waive enforcement of existing specific statutory program
344.33requirements, rules, and standards in one or more counties. The commissioner's order
345.1establishing the waiver must provide alternative methods and procedures of administration
345.2and must not be in conflict with the basic purposes, coverage, or benefits provided by law.
345.3Pilot projects must comply with the requirements of the child care and development fund
345.4plan.
345.5EFFECTIVE DATE.This section is effective the day following final enactment.

345.6    Sec. 20. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; AMENDING
345.7CHILDREN'S RESIDENTIAL FACILITY AND DETOXIFICATION PROGRAM
345.8RULES.
345.9(a) The commissioner of human services must amend Minnesota Rules, part 2960.0460,
345.10to remove all references to repealed Minnesota Rules, part 2960.0460, subpart 2.
345.11(b) The commissioner must amend Minnesota Rules, part 2960.0470, to require license
345.12holders to have written personnel policies that describe the process for disciplinary action,
345.13suspension, or dismissal of a staff person for violating the drug and alcohol policy described
345.14in Minnesota Statutes, section 245A.04, subdivision 1, paragraph (c), and Minnesota Rules,
345.15part 2960.0030, subpart 9.
345.16(c) The commissioner must amend Minnesota Rules, part 9530.6565, subpart 1, to
345.17remove items A and B and the documentation requirement that references these items.
345.18(d) The commissioner must amend Minnesota Rules, part 9530.6570, subpart 1, item
345.19D, to remove the existing language and insert language to require license holders to have
345.20written personnel policies that describe the process for disciplinary action, suspension, or
345.21dismissal of a staff person for violating the drug and alcohol policy described in Minnesota
345.22Statutes, section 245A.04, subdivision 1, paragraph (c).
345.23(e) For purposes of this section, the commissioner may use the good cause exempt
345.24process under Minnesota Statutes, section 14.388, subdivision 1, clause (3), and Minnesota
345.25Statutes, section 14.386, does not apply.
345.26EFFECTIVE DATE.This section is effective the day following final enactment.

345.27    Sec. 21. REPEALER.
345.28(a) Minnesota Statutes 2020, sections 245F.15, subdivision 2; and 245G.11, subdivision
345.292, are repealed.
345.30(b) Minnesota Rules, parts 2960.0460, subpart 2; and 9530.6565, subpart 2, are repealed.
345.31EFFECTIVE DATE.This section is effective January 1, 2023.

346.1ARTICLE 13
346.2MISCELLANEOUS

346.3    Section 1. Minnesota Statutes 2020, section 34A.01, subdivision 4, is amended to read:
346.4    Subd. 4. Food. "Food" means every ingredient used for, entering into the consumption
346.5of, or used or intended for use in the preparation of food, drink, confectionery, or condiment
346.6for humans or other animals, whether simple, mixed, or compound; and articles used as
346.7components of these ingredients, except that edible cannabinoid products, as defined in
346.8section 151.72, subdivision 1, paragraph (c), are not food.

346.9    Sec. 2. Minnesota Statutes 2020, section 137.68, is amended to read:
346.10137.68 MINNESOTA RARE DISEASE ADVISORY COUNCIL ON RARE
346.11DISEASES.
346.12    Subdivision 1. Establishment. The University of Minnesota is requested to establish
346.13There is established an advisory council on rare diseases to provide advice on policies,
346.14access, equity, research, diagnosis, treatment, and education related to rare diseases. The
346.15advisory council is established in honor of Chloe Barnes and her experiences in the health
346.16care system. For purposes of this section, "rare disease" has the meaning given in United
346.17States Code, title 21, section 360bb. The council shall be called the Chloe Barnes Advisory
346.18Council on Rare Diseases Minnesota Rare Disease Advisory Council. The Council on
346.19Disability shall provide meeting and office space and administrative support to the advisory
346.20council but does not have authority over the work of the advisory council.
346.21    Subd. 2. Membership. (a) The advisory council may shall consist of at least 17 public
346.22members who reflect statewide representation. Except for initial members, members are
346.23appointed by the Board of Regents or a designee the governor according to paragraph (b)
346.24and. Four members of the legislature are appointed according to paragraph (c).
346.25(b) The Board of Regents or a designee is requested to The governor shall appoint at
346.26least the following public members according to section 15.0597:
346.27(1) three physicians licensed and practicing in the state with experience researching,
346.28diagnosing, or treating rare diseases, including one specializing in pediatrics;
346.29(2) one registered nurse or advanced practice registered nurse licensed and practicing
346.30in the state with experience treating rare diseases;
346.31(3) at least two hospital administrators, or their designees, from hospitals in the state
346.32that provide care to persons diagnosed with a rare disease. One administrator or designee
347.1appointed under this clause must represent a hospital in which the scope of service focuses
347.2on rare diseases of pediatric patients;
347.3(4) three persons age 18 or older who either have a rare disease or are a caregiver of a
347.4person with a rare disease. One person appointed under this clause must reside in rural
347.5Minnesota;
347.6(5) a representative of a rare disease patient organization that operates in the state;
347.7(6) a social worker with experience providing services to persons diagnosed with a rare
347.8disease;
347.9(7) a pharmacist with experience with drugs used to treat rare diseases;
347.10(8) a dentist licensed and practicing in the state with experience treating rare diseases;
347.11(9) a representative of the biotechnology industry;
347.12(10) a representative of health plan companies;
347.13(11) a medical researcher with experience conducting research on rare diseases; and
347.14(12) a genetic counselor with experience providing services to persons diagnosed with
347.15a rare disease or caregivers of those persons.; and
347.16(13) representatives with other areas of expertise as identified by the advisory council.
347.17(c) The advisory council shall include two members of the senate, one appointed by the
347.18majority leader and one appointed by the minority leader; and two members of the house
347.19of representatives, one appointed by the speaker of the house and one appointed by the
347.20minority leader. Members appointed under this paragraph serve until their successors are
347.21appointed.
347.22(d) The commissioner of health or a designee, a representative of Mayo Medical School,
347.23and a representative of the University of Minnesota Medical School shall serve as ex officio,
347.24nonvoting members of the advisory council.
347.25(e) Initial appointments to the advisory council shall be made no later than September
347.261, 2019. Members appointed according to paragraph (b) shall serve for a term of three years,
347.27except that the initial members appointed according to paragraph (b) shall have an initial
347.28term of two, three, or four years determined by lot by the chairperson. Members appointed
347.29according to paragraph (b) shall serve until their successors have been appointed.
347.30(f) Members may be reappointed for up to two full additional terms according to the
347.31advisory council's operating procedures.
348.1(g) Members may be removed as provided in section 15.059, subdivision 4.
348.2(h) Public members serve without compensation, but may have expenses reimbursed as
348.3provided in section 15.059, subdivision 3. Legislative members may receive per diem
348.4according to the rules of their respective bodies.
348.5    Subd. 3. Meetings. The Board of Regents or a designee is requested to convene the first
348.6meeting of the advisory council no later than October 1, 2019. The advisory council shall
348.7meet at the call of the chairperson or at the request of a majority of advisory council members.
348.8Meetings of the advisory council are subject to section 13D.01, and notice of its meetings
348.9is governed by section 13D.04.
348.10    Subd. 3a. Chairperson; executive director; staff; executive committee. (a) The
348.11advisory council shall elect a chairperson and other officers as it deems necessary and in
348.12accordance with the advisory council's operating procedures.
348.13(b) The advisory council shall be governed by an executive committee elected by the
348.14members of the advisory council. One member of the executive committee must be the
348.15advisory council chairperson.
348.16(c) The advisory council shall appoint an executive director. The executive director
348.17serves as an ex officio nonvoting member of the executive committee. The advisory council
348.18may delegate to the executive director any powers and duties under this section that do not
348.19require advisory council approval. The executive director serves in the unclassified service
348.20and may be removed at any time by a majority vote of the advisory council. The executive
348.21director may employ and direct staff necessary to carry out advisory council mandates,
348.22policies, activities, and objectives.
348.23(d) The executive committee may appoint additional subcommittees and work groups
348.24as necessary to fulfill the duties of the advisory council.
348.25    Subd. 4. Duties. (a) The advisory council's duties may include, but are not limited to:
348.26(1) in conjunction with the state's medical schools, the state's schools of public health,
348.27and hospitals in the state that provide care to persons diagnosed with a rare disease,
348.28developing resources or recommendations relating to quality of and access to treatment and
348.29services in the state for persons with a rare disease, including but not limited to:
348.30(i) a list of existing, publicly accessible resources on research, diagnosis, treatment, and
348.31education relating to rare diseases;
349.1(ii) identifying best practices for rare disease care implemented in other states, at the
349.2national level, and at the international level that will improve rare disease care in the state
349.3and seeking opportunities to partner with similar organizations in other states and countries;
349.4(iii) identifying and addressing problems faced by patients with a rare disease when
349.5changing health plans, including recommendations on how to remove obstacles faced by
349.6these patients to finding a new health plan and how to improve the ease and speed of finding
349.7a new health plan that meets the needs of patients with a rare disease; and
349.8(iv) identifying and addressing barriers faced by patients with a rare disease to obtaining
349.9care, caused by prior authorization requirements in private and public health plans; and
349.10(iv) (v) identifying, recommending, and implementing best practices to ensure health
349.11care providers are adequately informed of the most effective strategies for recognizing and
349.12treating rare diseases; and
349.13(2) advising, consulting, and cooperating with the Department of Health, including the
349.14Advisory Committee on Heritable and Congenital Disorders,; the Department of Human
349.15Services, including the Drug Utilization Review Board and the Drug Formulary Committee;
349.16and other agencies of state government in developing recommendations, information, and
349.17programs for the public and the health care community relating to diagnosis, treatment, and
349.18awareness of rare diseases.;
349.19(3) advising on policy issues and advancing policy initiatives at the state and federal
349.20levels; and
349.21(4) receiving funds and issuing grants.
349.22(b) The advisory council shall collect additional topic areas for study and evaluation
349.23from the general public. In order for the advisory council to study and evaluate a topic, the
349.24topic must be approved for study and evaluation by the advisory council.
349.25(c) Legislative members may not deliberate about or vote on decisions related to the
349.26issuance of grants of state money.
349.27    Subd. 5. Conflict of interest. Advisory council members are subject to the Board of
349.28Regents policy on conflicts advisory council's conflict of interest policy as outlined in the
349.29advisory council's operating procedures.
349.30    Subd. 6. Annual report. By January 1 of each year, beginning January 1, 2020, the
349.31advisory council shall report to the chairs and ranking minority members of the legislative
349.32committees with jurisdiction over higher education and health care policy on the advisory
350.1council's activities under subdivision 4 and other issues on which the advisory council may
350.2choose to report.
350.3EFFECTIVE DATE.This section is effective July 1, 2022.

350.4    Sec. 3. Minnesota Statutes 2020, section 151.72, subdivision 1, is amended to read:
350.5    Subdivision 1. Definitions. (a) For the purposes of this section, the following terms have
350.6the meanings given.
350.7(b) "Certified hemp" means hemp plants that have been tested and found to meet the
350.8requirements of chapter 18K and the rules adopted thereunder.
350.9(c) "Edible cannabinoid product" means any product that is intended to be eaten or
350.10consumed as a beverage by humans, contains a cannabinoid in combination with food
350.11ingredients, and is not a drug.
350.12(b) (d) "Hemp" has the meaning given to "industrial hemp" in section 18K.02, subdivision
350.133.
350.14(e) "Label" has the meaning given in section 151.01, subdivision 18.
350.15(c) (f) "Labeling" means all labels and other written, printed, or graphic matter that are:
350.16(1) affixed to the immediate container in which a product regulated under this section
350.17is sold; or
350.18(2) provided, in any manner, with the immediate container, including but not limited to
350.19outer containers, wrappers, package inserts, brochures, or pamphlets.; or
350.20(3) provided on that portion of a manufacturer's website that is linked by a scannable
350.21barcode or matrix barcode.
350.22(g) "Matrix barcode" means a code that stores data in a two-dimensional array of
350.23geometrically shaped dark and light cells capable of being read by the camera on a
350.24smartphone or other mobile device.
350.25(h) "Nonintoxicating cannabinoid" means substances extracted from certified hemp
350.26plants that do not produce intoxicating effects when consumed by any route of administration.

350.27    Sec. 4. Minnesota Statutes 2020, section 151.72, subdivision 2, is amended to read:
350.28    Subd. 2. Scope. (a) This section applies to the sale of any product that contains
350.29nonintoxicating cannabinoids extracted from hemp other than food and that is an edible
351.1cannabinoid product or is intended for human or animal consumption by any route of
351.2administration.
351.3(b) This section does not apply to any product dispensed by a registered medical cannabis
351.4manufacturer pursuant to sections 152.22 to 152.37.
351.5(c) The board must have no authority over food products, as defined in section 34A.01,
351.6subdivision 4, that do not contain cannabinoids extracted or derived from hemp.

351.7    Sec. 5. Minnesota Statutes 2020, section 151.72, subdivision 3, is amended to read:
351.8    Subd. 3. Sale of cannabinoids derived from hemp. (a) Notwithstanding any other
351.9section of this chapter, a product containing nonintoxicating cannabinoids, including an
351.10edible cannabinoid product, may be sold for human or animal consumption only if all of
351.11the requirements of this section are met, provided that a product sold for human or animal
351.12consumption does not contain more than 0.3 percent of any tetrahydrocannabinol and an
351.13edible cannabinoid product does not contain an amount of any tetrahydrocannabinol that
351.14exceeds the limits established in subdivision 5a, paragraph (f).
351.15(b) No other substance extracted or otherwise derived from hemp may be sold for human
351.16consumption if the substance is intended:
351.17(1) for external or internal use in the diagnosis, cure, mitigation, treatment, or prevention
351.18of disease in humans or other animals; or
351.19(2) to affect the structure or any function of the bodies of humans or other animals.
351.20(c) No product containing any cannabinoid or tetrahydrocannabinol extracted or otherwise
351.21derived from hemp may be sold to any individual who is under the age of 21.
351.22(d) Products that meet the requirements of this section are not controlled substances
351.23under section 152.02.

351.24    Sec. 6. Minnesota Statutes 2020, section 151.72, subdivision 4, is amended to read:
351.25    Subd. 4. Testing requirements. (a) A manufacturer of a product regulated under this
351.26section must submit representative samples of the product to an independent, accredited
351.27laboratory in order to certify that the product complies with the standards adopted by the
351.28board. Testing must be consistent with generally accepted industry standards for herbal and
351.29botanical substances, and, at a minimum, the testing must confirm that the product:
351.30(1) contains the amount or percentage of cannabinoids that is stated on the label of the
351.31product;
352.1(2) does not contain more than trace amounts of any mold, residual solvents, pesticides,
352.2fertilizers, or heavy metals; and
352.3(3) does not contain a delta-9 tetrahydrocannabinol concentration that exceeds the
352.4concentration permitted for industrial hemp as defined in section 18K.02, subdivision 3
352.5more than 0.3 percent of any tetrahydrocannabinol.
352.6(b) Upon the request of the board, the manufacturer of the product must provide the
352.7board with the results of the testing required in this section.
352.8(c) Testing of the hemp from which the nonintoxicating cannabinoid was derived, or
352.9possession of a certificate of analysis for such hemp, does not meet the testing requirements
352.10of this section.

352.11    Sec. 7. Minnesota Statutes 2021 Supplement, section 151.72, subdivision 5, is amended
352.12to read:
352.13    Subd. 5. Labeling requirements. (a) A product regulated under this section must bear
352.14a label that contains, at a minimum:
352.15(1) the name, location, contact phone number, and website of the manufacturer of the
352.16product;
352.17(2) the name and address of the independent, accredited laboratory used by the
352.18manufacturer to test the product; and
352.19(3) an accurate statement of the amount or percentage of cannabinoids found in each
352.20unit of the product meant to be consumed; or.
352.21(4) instead of the information required in clauses (1) to (3), a scannable bar code or QR
352.22code that links to the manufacturer's website.
352.23(b) The information in paragraph (a) may be provided on an outer package if the
352.24immediate container that holds the product is too small to contain all of the information.
352.25(c) The information required in paragraph (a) may be provided through the use of a
352.26scannable barcode or matrix barcode that links to a page on the manufacturer's website if
352.27that page contains all of the information required by this subdivision.
352.28    (d) The label must also include a statement stating that this the product does not claim
352.29to diagnose, treat, cure, or prevent any disease and has not been evaluated or approved by
352.30the United States Food and Drug Administration (FDA) unless the product has been so
352.31approved.
353.1(b) (e) The information required to be on the label by this subdivision must be prominently
353.2and conspicuously placed and on the label or displayed on the website in terms that can be
353.3easily read and understood by the consumer.
353.4(c) (f) The label labeling must not contain any claim that the product may be used or is
353.5effective for the prevention, treatment, or cure of a disease or that it may be used to alter
353.6the structure or function of human or animal bodies, unless the claim has been approved by
353.7the FDA.

353.8    Sec. 8. Minnesota Statutes 2020, section 151.72, is amended by adding a subdivision to
353.9read:
353.10    Subd. 5a. Additional requirements for edible cannabinoid products. (a) In addition
353.11to the testing and labeling requirements under subdivisions 4 and 5, an edible cannabinoid
353.12must meet the requirements of this subdivision.
353.13(b) An edible cannabinoid product must not:
353.14(1) bear the likeness or contain cartoon-like characteristics of a real or fictional person,
353.15animal, or fruit that appeals to children;
353.16(2) be modeled after a brand of products primarily consumed by or marketed to children;
353.17(3) be made by applying an extracted or concentrated hemp-derived cannabinoid to a
353.18commercially available candy or snack food item;
353.19(4) contain an ingredient, other than a hemp-derived cannabinoid, that is not approved
353.20by the United States Food and Drug Administration for use in food;
353.21(5) be packaged in a way that resembles the trademarked, characteristic, or
353.22product-specialized packaging of any commercially available food product; or
353.23(6) be packaged in a container that includes a statement, artwork, or design that could
353.24reasonably mislead any person to believe that the package contains anything other than an
353.25edible cannabinoid product.
353.26(c) An edible cannabinoid product must be prepackaged in packaging or a container that
353.27is child-resistant, tamper-evident, and opaque or placed in packaging or a container that is
353.28child-resistant, tamper-evident, and opaque at the final point of sale to a customer. The
353.29requirement that packaging be child-resistant does not apply to an edible cannabinoid product
353.30that is intended to be consumed as a beverage and which contains no more than a trace
353.31amount of any tetrahydrocannabinol.
354.1(d) If an edible cannabinoid product is intended for more than a single use or contains
354.2multiple servings, each serving must be indicated by scoring, wrapping, or other indicators
354.3designating the individual serving size.
354.4(e) A label containing at least the following information must be affixed to the packaging
354.5or container of all edible cannabinoid products sold to consumers:
354.6(1) the serving size;
354.7(2) the cannabinoid profile per serving and in total;
354.8(3) a list of ingredients, including identification of any major food allergens declared
354.9by name; and
354.10(4) the following statement: "Keep this product out of reach of children."
354.11(f) An edible cannabinoid product must not contain more than five milligrams of any
354.12tetrahydrocannabinol in a single serving, or more than a total of 50 milligrams of any
354.13tetrahydrocannabinol per package.

354.14    Sec. 9. Minnesota Statutes 2020, section 151.72, subdivision 6, is amended to read:
354.15    Subd. 6. Enforcement. (a) A product sold regulated under this section, including an
354.16edible cannabinoid product, shall be considered an adulterated drug if:
354.17(1) it consists, in whole or in part, of any filthy, putrid, or decomposed substance;
354.18(2) it has been produced, prepared, packed, or held under unsanitary conditions where
354.19it may have been rendered injurious to health, or where it may have been contaminated with
354.20filth;
354.21(3) its container is composed, in whole or in part, of any poisonous or deleterious
354.22substance that may render the contents injurious to health;
354.23(4) it contains any food additives, color additives, or excipients that have been found by
354.24the FDA to be unsafe for human or animal consumption; or
354.25(5) it contains an amount or percentage of nonintoxicating cannabinoids that is different
354.26than the amount or percentage stated on the label.;
354.27(6) it contains more than 0.3 percent of any tetrahydrocannabinol or, if the product is
354.28an edible cannabinoid product, an amount of tetrahydrocannabinol that exceeds the limits
354.29established in subdivision 5a, paragraph (f); or
354.30(7) it contains more than trace amounts of mold, residual solvents, pesticides, fertilizers,
354.31or heavy metals.
355.1(b) A product sold regulated under this section shall be considered a misbranded drug
355.2if the product's labeling is false or misleading in any manner or in violation of the
355.3requirements of this section.
355.4(c) The board's authority to issue cease and desist orders under section 151.06; to embargo
355.5adulterated and misbranded drugs under section 151.38; and to seek injunctive relief under
355.6section 214.11, extends to any violation of this section.

355.7    Sec. 10. Minnesota Statutes 2020, section 152.02, subdivision 2, is amended to read:
355.8    Subd. 2. Schedule I. (a) Schedule I consists of the substances listed in this subdivision.
355.9(b) Opiates. Unless specifically excepted or unless listed in another schedule, any of the
355.10following substances, including their analogs, isomers, esters, ethers, salts, and salts of
355.11isomers, esters, and ethers, whenever the existence of the analogs, isomers, esters, ethers,
355.12and salts is possible:
355.13(1) acetylmethadol;
355.14(2) allylprodine;
355.15(3) alphacetylmethadol (except levo-alphacetylmethadol, also known as levomethadyl
355.16acetate);
355.17(4) alphameprodine;
355.18(5) alphamethadol;
355.19(6) alpha-methylfentanyl benzethidine;
355.20(7) betacetylmethadol;
355.21(8) betameprodine;
355.22(9) betamethadol;
355.23(10) betaprodine;
355.24(11) clonitazene;
355.25(12) dextromoramide;
355.26(13) diampromide;
355.27(14) diethyliambutene;
355.28(15) difenoxin;
355.29(16) dimenoxadol;
356.1(17) dimepheptanol;
356.2(18) dimethyliambutene;
356.3(19) dioxaphetyl butyrate;
356.4(20) dipipanone;
356.5(21) ethylmethylthiambutene;
356.6(22) etonitazene;
356.7(23) etoxeridine;
356.8(24) furethidine;
356.9(25) hydroxypethidine;
356.10(26) ketobemidone;
356.11(27) levomoramide;
356.12(28) levophenacylmorphan;
356.13(29) 3-methylfentanyl;
356.14(30) acetyl-alpha-methylfentanyl;
356.15(31) alpha-methylthiofentanyl;
356.16(32) benzylfentanyl beta-hydroxyfentanyl;
356.17(33) beta-hydroxy-3-methylfentanyl;
356.18(34) 3-methylthiofentanyl;
356.19(35) thenylfentanyl;
356.20(36) thiofentanyl;
356.21(37) para-fluorofentanyl;
356.22(38) morpheridine;
356.23(39) 1-methyl-4-phenyl-4-propionoxypiperidine;
356.24(40) noracymethadol;
356.25(41) norlevorphanol;
356.26(42) normethadone;
356.27(43) norpipanone;
357.1(44) 1-(2-phenylethyl)-4-phenyl-4-acetoxypiperidine (PEPAP);
357.2(45) phenadoxone;
357.3(46) phenampromide;
357.4(47) phenomorphan;
357.5(48) phenoperidine;
357.6(49) piritramide;
357.7(50) proheptazine;
357.8(51) properidine;
357.9(52) propiram;
357.10(53) racemoramide;
357.11(54) tilidine;
357.12(55) trimeperidine;
357.13(56) N-(1-Phenethylpiperidin-4-yl)-N-phenylacetamide (acetyl fentanyl);
357.14(57) 3,4-dichloro-N-[(1R,2R)-2-(dimethylamino)cyclohexyl]-N-
357.15methylbenzamide(U47700);
357.16(58) N-phenyl-N-[1-(2-phenylethyl)piperidin-4-yl]furan-2-carboxamide(furanylfentanyl);
357.17(59) 4-(4-bromophenyl)-4-dimethylamino-1-phenethylcyclohexanol (bromadol);
357.18(60) N-(1-phenethylpiperidin-4-yl)-N-phenylcyclopropanecarboxamide (Cyclopropryl
357.19fentanyl);
357.20(61) N-(1-phenethylpiperidin-4-yl)-N-phenylbutanamide) (butyryl fentanyl);
357.21(62) 1-cyclohexyl-4-(1,2-diphenylethyl)piperazine) (MT-45);
357.22(63) N-(1-phenethylpiperidin-4-yl)-N-phenylcyclopentanecarboxamide (cyclopentyl
357.23fentanyl);
357.24(64) N-(1-phenethylpiperidin-4-yl)-N-phenylisobutyramide (isobutyryl fentanyl);
357.25(65) N-(1-phenethylpiperidin-4-yl)-N-phenylpentanamide (valeryl fentanyl);
357.26(66) N-(4-chlorophenyl)-N-(1-phenethylpiperidin-4-yl)isobutyramide
357.27(para-chloroisobutyryl fentanyl);
358.1(67) N-(4-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)butyramide (para-fluorobutyryl
358.2fentanyl);
358.3(68) N-(4-methoxyphenyl)-N-(1-phenethylpiperidin-4-yl)butyramide
358.4(para-methoxybutyryl fentanyl);
358.5(69) N-(2-fluorophenyl)-2-methoxy-N-(1-phenethylpiperidin-4-yl)acetamide (ocfentanil);
358.6(70) N-(4-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)isobutyramide (4-fluoroisobutyryl
358.7fentanyl or para-fluoroisobutyryl fentanyl);
358.8(71) N-(1-phenethylpiperidin-4-yl)-N-phenylacrylamide (acryl fentanyl or
358.9acryloylfentanyl);
358.10(72) 2-methoxy-N-(1-phenethylpiperidin-4-yl)-N-phenylacetamide (methoxyacetyl
358.11fentanyl);
358.12(73) N-(2-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)propionamide (ortho-fluorofentanyl
358.13or 2-fluorofentanyl);
358.14(74) N-(1-phenethylpiperidin-4-yl)-N-phenyltetrahydrofuran-2-carboxamide
358.15(tetrahydrofuranyl fentanyl); and
358.16(75) Fentanyl-related substances, their isomers, esters, ethers, salts and salts of isomers,
358.17esters and ethers, meaning any substance not otherwise listed under another federal
358.18Administration Controlled Substance Code Number or not otherwise listed in this section,
358.19and for which no exemption or approval is in effect under section 505 of the Federal Food,
358.20Drug, and Cosmetic Act, United States Code , title 21, section 355, that is structurally related
358.21to fentanyl by one or more of the following modifications:
358.22(i) replacement of the phenyl portion of the phenethyl group by any monocycle, whether
358.23or not further substituted in or on the monocycle;
358.24(ii) substitution in or on the phenethyl group with alkyl, alkenyl, alkoxyl, hydroxyl, halo,
358.25haloalkyl, amino, or nitro groups;
358.26(iii) substitution in or on the piperidine ring with alkyl, alkenyl, alkoxyl, ester, ether,
358.27hydroxyl, halo, haloalkyl, amino, or nitro groups;
358.28(iv) replacement of the aniline ring with any aromatic monocycle whether or not further
358.29substituted in or on the aromatic monocycle; or
358.30(v) replacement of the N-propionyl group by another acyl group.
359.1(c) Opium derivatives. Any of the following substances, their analogs, salts, isomers,
359.2and salts of isomers, unless specifically excepted or unless listed in another schedule,
359.3whenever the existence of the analogs, salts, isomers, and salts of isomers is possible:
359.4(1) acetorphine;
359.5(2) acetyldihydrocodeine;
359.6(3) benzylmorphine;
359.7(4) codeine methylbromide;
359.8(5) codeine-n-oxide;
359.9(6) cyprenorphine;
359.10(7) desomorphine;
359.11(8) dihydromorphine;
359.12(9) drotebanol;
359.13(10) etorphine;
359.14(11) heroin;
359.15(12) hydromorphinol;
359.16(13) methyldesorphine;
359.17(14) methyldihydromorphine;
359.18(15) morphine methylbromide;
359.19(16) morphine methylsulfonate;
359.20(17) morphine-n-oxide;
359.21(18) myrophine;
359.22(19) nicocodeine;
359.23(20) nicomorphine;
359.24(21) normorphine;
359.25(22) pholcodine; and
359.26(23) thebacon.
359.27(d) Hallucinogens. Any material, compound, mixture or preparation which contains any
359.28quantity of the following substances, their analogs, salts, isomers (whether optical, positional,
360.1or geometric), and salts of isomers, unless specifically excepted or unless listed in another
360.2schedule, whenever the existence of the analogs, salts, isomers, and salts of isomers is
360.3possible:
360.4(1) methylenedioxy amphetamine;
360.5(2) methylenedioxymethamphetamine;
360.6(3) methylenedioxy-N-ethylamphetamine (MDEA);
360.7(4) n-hydroxy-methylenedioxyamphetamine;
360.8(5) 4-bromo-2,5-dimethoxyamphetamine (DOB);
360.9(6) 2,5-dimethoxyamphetamine (2,5-DMA);
360.10(7) 4-methoxyamphetamine;
360.11(8) 5-methoxy-3, 4-methylenedioxyamphetamine;
360.12(9) alpha-ethyltryptamine;
360.13(10) bufotenine;
360.14(11) diethyltryptamine;
360.15(12) dimethyltryptamine;
360.16(13) 3,4,5-trimethoxyamphetamine;
360.17(14) 4-methyl-2, 5-dimethoxyamphetamine (DOM);
360.18(15) ibogaine;
360.19(16) lysergic acid diethylamide (LSD);
360.20(17) mescaline;
360.21(18) parahexyl;
360.22(19) N-ethyl-3-piperidyl benzilate;
360.23(20) N-methyl-3-piperidyl benzilate;
360.24(21) psilocybin;
360.25(22) psilocyn;
360.26(23) tenocyclidine (TPCP or TCP);
360.27(24) N-ethyl-1-phenyl-cyclohexylamine (PCE);
360.28(25) 1-(1-phenylcyclohexyl) pyrrolidine (PCPy);
361.1(26) 1-[1-(2-thienyl)cyclohexyl]-pyrrolidine (TCPy);
361.2(27) 4-chloro-2,5-dimethoxyamphetamine (DOC);
361.3(28) 4-ethyl-2,5-dimethoxyamphetamine (DOET);
361.4(29) 4-iodo-2,5-dimethoxyamphetamine (DOI);
361.5(30) 4-bromo-2,5-dimethoxyphenethylamine (2C-B);
361.6(31) 4-chloro-2,5-dimethoxyphenethylamine (2C-C);
361.7(32) 4-methyl-2,5-dimethoxyphenethylamine (2C-D);
361.8(33) 4-ethyl-2,5-dimethoxyphenethylamine (2C-E);
361.9(34) 4-iodo-2,5-dimethoxyphenethylamine (2C-I);
361.10(35) 4-propyl-2,5-dimethoxyphenethylamine (2C-P);
361.11(36) 4-isopropylthio-2,5-dimethoxyphenethylamine (2C-T-4);
361.12(37) 4-propylthio-2,5-dimethoxyphenethylamine (2C-T-7);
361.13(38) 2-(8-bromo-2,3,6,7-tetrahydrofuro [2,3-f][1]benzofuran-4-yl)ethanamine
361.14(2-CB-FLY);
361.15(39) bromo-benzodifuranyl-isopropylamine (Bromo-DragonFLY);
361.16(40) alpha-methyltryptamine (AMT);
361.17(41) N,N-diisopropyltryptamine (DiPT);
361.18(42) 4-acetoxy-N,N-dimethyltryptamine (4-AcO-DMT);
361.19(43) 4-acetoxy-N,N-diethyltryptamine (4-AcO-DET);
361.20(44) 4-hydroxy-N-methyl-N-propyltryptamine (4-HO-MPT);
361.21(45) 4-hydroxy-N,N-dipropyltryptamine (4-HO-DPT);
361.22(46) 4-hydroxy-N,N-diallyltryptamine (4-HO-DALT);
361.23(47) 4-hydroxy-N,N-diisopropyltryptamine (4-HO-DiPT);
361.24(48) 5-methoxy-N,N-diisopropyltryptamine (5-MeO-DiPT);
361.25(49) 5-methoxy-α-methyltryptamine (5-MeO-AMT);
361.26(50) 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT);
361.27(51) 5-methylthio-N,N-dimethyltryptamine (5-MeS-DMT);
362.1(52) 5-methoxy-N-methyl-N-isopropyltryptamine (5-MeO-MiPT);
362.2(53) 5-methoxy-α-ethyltryptamine (5-MeO-AET);
362.3(54) 5-methoxy-N,N-dipropyltryptamine (5-MeO-DPT);
362.4(55) 5-methoxy-N,N-diethyltryptamine (5-MeO-DET);
362.5(56) 5-methoxy-N,N-diallyltryptamine (5-MeO-DALT);
362.6(57) methoxetamine (MXE);
362.7(58) 5-iodo-2-aminoindane (5-IAI);
362.8(59) 5,6-methylenedioxy-2-aminoindane (MDAI);
362.9(60) 2-(4-bromo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25B-NBOMe);
362.10(61) 2-(4-chloro-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25C-NBOMe);
362.11(62) 2-(4-iodo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25I-NBOMe);
362.12(63) 2-(2,5-Dimethoxyphenyl)ethanamine (2C-H);
362.13(64) 2-(4-Ethylthio-2,5-dimethoxyphenyl)ethanamine (2C-T-2);
362.14(65) N,N-Dipropyltryptamine (DPT);
362.15(66) 3-[1-(Piperidin-1-yl)cyclohexyl]phenol (3-HO-PCP);
362.16(67) N-ethyl-1-(3-methoxyphenyl)cyclohexanamine (3-MeO-PCE);
362.17(68) 4-[1-(3-methoxyphenyl)cyclohexyl]morpholine (3-MeO-PCMo);
362.18(69) 1-[1-(4-methoxyphenyl)cyclohexyl]-piperidine (methoxydine, 4-MeO-PCP);
362.19(70) 2-(2-Chlorophenyl)-2-(ethylamino)cyclohexan-1-one (N-Ethylnorketamine,
362.20ethketamine, NENK);
362.21(71) methylenedioxy-N,N-dimethylamphetamine (MDDMA);
362.22(72) 3-(2-Ethyl(methyl)aminoethyl)-1H-indol-4-yl (4-AcO-MET); and
362.23(73) 2-Phenyl-2-(methylamino)cyclohexanone (deschloroketamine).
362.24(e) Peyote. All parts of the plant presently classified botanically as Lophophora williamsii
362.25Lemaire, whether growing or not, the seeds thereof, any extract from any part of the plant,
362.26and every compound, manufacture, salts, derivative, mixture, or preparation of the plant,
362.27its seeds or extracts. The listing of peyote as a controlled substance in Schedule I does not
362.28apply to the nondrug use of peyote in bona fide religious ceremonies of the American Indian
362.29Church, and members of the American Indian Church are exempt from registration. Any
363.1person who manufactures peyote for or distributes peyote to the American Indian Church,
363.2however, is required to obtain federal registration annually and to comply with all other
363.3requirements of law.
363.4(f) Central nervous system depressants. Unless specifically excepted or unless listed in
363.5another schedule, any material compound, mixture, or preparation which contains any
363.6quantity of the following substances, their analogs, salts, isomers, and salts of isomers
363.7whenever the existence of the analogs, salts, isomers, and salts of isomers is possible:
363.8(1) mecloqualone;
363.9(2) methaqualone;
363.10(3) gamma-hydroxybutyric acid (GHB), including its esters and ethers;
363.11(4) flunitrazepam;
363.12(5) 2-(2-Methoxyphenyl)-2-(methylamino)cyclohexanone (2-MeO-2-deschloroketamine,
363.13methoxyketamine);
363.14(6) tianeptine;
363.15(7) clonazolam;
363.16(8) etizolam;
363.17(9) flubromazolam; and
363.18(10) flubromazepam.
363.19(g) Stimulants. Unless specifically excepted or unless listed in another schedule, any
363.20material compound, mixture, or preparation which contains any quantity of the following
363.21substances, their analogs, salts, isomers, and salts of isomers whenever the existence of the
363.22analogs, salts, isomers, and salts of isomers is possible:
363.23    (1) aminorex;
363.24(2) cathinone;
363.25(3) fenethylline;
363.26    (4) methcathinone;
363.27(5) methylaminorex;
363.28(6) N,N-dimethylamphetamine;
363.29(7) N-benzylpiperazine (BZP);
364.1(8) methylmethcathinone (mephedrone);
364.2(9) 3,4-methylenedioxy-N-methylcathinone (methylone);
364.3(10) methoxymethcathinone (methedrone);
364.4(11) methylenedioxypyrovalerone (MDPV);
364.5(12) 3-fluoro-N-methylcathinone (3-FMC);
364.6(13) methylethcathinone (MEC);
364.7(14) 1-benzofuran-6-ylpropan-2-amine (6-APB);
364.8(15) dimethylmethcathinone (DMMC);
364.9(16) fluoroamphetamine;
364.10(17) fluoromethamphetamine;
364.11(18) α-methylaminobutyrophenone (MABP or buphedrone);
364.12(19) 1-(1,3-benzodioxol-5-yl)-2-(methylamino)butan-1-one (butylone);
364.13(20) 2-(methylamino)-1-(4-methylphenyl)butan-1-one (4-MEMABP or BZ-6378);
364.14(21) 1-(naphthalen-2-yl)-2-(pyrrolidin-1-yl) pentan-1-one (naphthylpyrovalerone or
364.15naphyrone);
364.16(22) (alpha-pyrrolidinopentiophenone (alpha-PVP);
364.17(23) (RS)-1-(4-methylphenyl)-2-(1-pyrrolidinyl)-1-hexanone (4-Me-PHP or MPHP);
364.18(24) 2-(1-pyrrolidinyl)-hexanophenone (Alpha-PHP);
364.19(25) 4-methyl-N-ethylcathinone (4-MEC);
364.20(26) 4-methyl-alpha-pyrrolidinopropiophenone (4-MePPP);
364.21(27) 2-(methylamino)-1-phenylpentan-1-one (pentedrone);
364.22(28) 1-(1,3-benzodioxol-5-yl)-2-(methylamino)pentan-1-one (pentylone);
364.23(29) 4-fluoro-N-methylcathinone (4-FMC);
364.24(30) 3,4-methylenedioxy-N-ethylcathinone (ethylone);
364.25(31) alpha-pyrrolidinobutiophenone (α-PBP);
364.26(32) 5-(2-Aminopropyl)-2,3-dihydrobenzofuran (5-APDB);
364.27(33) 1-phenyl-2-(1-pyrrolidinyl)-1-heptanone (PV8);
365.1(34) 6-(2-Aminopropyl)-2,3-dihydrobenzofuran (6-APDB);
365.2(35) 4-methyl-alpha-ethylaminopentiophenone (4-MEAPP);
365.3(36) 4'-chloro-alpha-pyrrolidinopropiophenone (4'-chloro-PPP);
365.4(37) 1-(1,3-Benzodioxol-5-yl)-2-(dimethylamino)butan-1-one (dibutylone, bk-DMBDB);
365.5(38) 1-(3-chlorophenyl) piperazine (meta-chlorophenylpiperazine or mCPP);
365.6(39) 1-(1,3-benzodioxol-5-yl)-2-(ethylamino)-pentan-1-one (N-ethylpentylone, ephylone);
365.7and
365.8(40) any other substance, except bupropion or compounds listed under a different
365.9schedule, that is structurally derived from 2-aminopropan-1-one by substitution at the
365.101-position with either phenyl, naphthyl, or thiophene ring systems, whether or not the
365.11compound is further modified in any of the following ways:
365.12(i) by substitution in the ring system to any extent with alkyl, alkylenedioxy, alkoxy,
365.13haloalkyl, hydroxyl, or halide substituents, whether or not further substituted in the ring
365.14system by one or more other univalent substituents;
365.15(ii) by substitution at the 3-position with an acyclic alkyl substituent;
365.16(iii) by substitution at the 2-amino nitrogen atom with alkyl, dialkyl, benzyl, or
365.17methoxybenzyl groups; or
365.18(iv) by inclusion of the 2-amino nitrogen atom in a cyclic structure.
365.19(h) Marijuana, tetrahydrocannabinols, and synthetic cannabinoids. Unless specifically
365.20excepted or unless listed in another schedule, any natural or synthetic material, compound,
365.21mixture, or preparation that contains any quantity of the following substances, their analogs,
365.22isomers, esters, ethers, salts, and salts of isomers, esters, and ethers, whenever the existence
365.23of the isomers, esters, ethers, or salts is possible:
365.24(1) marijuana;
365.25(2) tetrahydrocannabinols naturally contained in a plant of the genus Cannabis, except
365.26that tetrahydrocannabinols do not include any material, compound, mixture, or preparation
365.27that qualifies as industrial hemp as defined in section 18K.02, subdivision 3; synthetic
365.28equivalents of the substances contained in the cannabis plant or in the resinous extractives
365.29of the plant,; or synthetic substances with similar chemical structure and pharmacological
365.30activity to those substances contained in the plant or resinous extract, including, but not
365.31limited to, 1 cis or trans tetrahydrocannabinol, 6 cis or trans tetrahydrocannabinol, and 3,4
365.32cis or trans tetrahydrocannabinol;
366.1(3) synthetic cannabinoids, including the following substances:
366.2(i) Naphthoylindoles, which are any compounds containing a 3-(1-napthoyl)indole
366.3structure with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl,
366.4alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or
366.52-(4-morpholinyl)ethyl group, whether or not further substituted in the indole ring to any
366.6extent and whether or not substituted in the naphthyl ring to any extent. Examples of
366.7naphthoylindoles include, but are not limited to:
366.8(A) 1-Pentyl-3-(1-naphthoyl)indole (JWH-018 and AM-678);
366.9(B) 1-Butyl-3-(1-naphthoyl)indole (JWH-073);
366.10(C) 1-Pentyl-3-(4-methoxy-1-naphthoyl)indole (JWH-081);
366.11(D) 1-[2-(4-morpholinyl)ethyl]-3-(1-naphthoyl)indole (JWH-200);
366.12(E) 1-Propyl-2-methyl-3-(1-naphthoyl)indole (JWH-015);
366.13(F) 1-Hexyl-3-(1-naphthoyl)indole (JWH-019);
366.14(G) 1-Pentyl-3-(4-methyl-1-naphthoyl)indole (JWH-122);
366.15(H) 1-Pentyl-3-(4-ethyl-1-naphthoyl)indole (JWH-210);
366.16(I) 1-Pentyl-3-(4-chloro-1-naphthoyl)indole (JWH-398);
366.17(J) 1-(5-fluoropentyl)-3-(1-naphthoyl)indole (AM-2201).
366.18(ii) Napthylmethylindoles, which are any compounds containing a
366.191H-indol-3-yl-(1-naphthyl)methane structure with substitution at the nitrogen atom of the
366.20indole ring by an alkyl, haloalkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl,
366.211-(N-methyl-2-piperidinyl)methyl or 2-(4-morpholinyl)ethyl group, whether or not further
366.22substituted in the indole ring to any extent and whether or not substituted in the naphthyl
366.23ring to any extent. Examples of naphthylmethylindoles include, but are not limited to:
366.24(A) 1-Pentyl-1H-indol-3-yl-(1-naphthyl)methane (JWH-175);
366.25(B) 1-Pentyl-1H-indol-3-yl-(4-methyl-1-naphthyl)methane (JWH-184).
366.26(iii) Naphthoylpyrroles, which are any compounds containing a 3-(1-naphthoyl)pyrrole
366.27structure with substitution at the nitrogen atom of the pyrrole ring by an alkyl, haloalkyl,
366.28alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or
366.292-(4-morpholinyl)ethyl group whether or not further substituted in the pyrrole ring to any
366.30extent, whether or not substituted in the naphthyl ring to any extent. Examples of
367.1naphthoylpyrroles include, but are not limited to,
367.2(5-(2-fluorophenyl)-1-pentylpyrrol-3-yl)-naphthalen-1-ylmethanone (JWH-307).
367.3(iv) Naphthylmethylindenes, which are any compounds containing a naphthylideneindene
367.4structure with substitution at the 3-position of the indene ring by an alkyl, haloalkyl, alkenyl,
367.5cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or
367.62-(4-morpholinyl)ethyl group whether or not further substituted in the indene ring to any
367.7extent, whether or not substituted in the naphthyl ring to any extent. Examples of
367.8naphthylemethylindenes include, but are not limited to,
367.9E-1-[1-(1-naphthalenylmethylene)-1H-inden-3-yl]pentane (JWH-176).
367.10(v) Phenylacetylindoles, which are any compounds containing a 3-phenylacetylindole
367.11structure with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl,
367.12alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or
367.132-(4-morpholinyl)ethyl group whether or not further substituted in the indole ring to any
367.14extent, whether or not substituted in the phenyl ring to any extent. Examples of
367.15phenylacetylindoles include, but are not limited to:
367.16(A) 1-(2-cyclohexylethyl)-3-(2-methoxyphenylacetyl)indole (RCS-8);
367.17(B) 1-pentyl-3-(2-methoxyphenylacetyl)indole (JWH-250);
367.18(C) 1-pentyl-3-(2-methylphenylacetyl)indole (JWH-251);
367.19(D) 1-pentyl-3-(2-chlorophenylacetyl)indole (JWH-203).
367.20(vi) Cyclohexylphenols, which are compounds containing a
367.212-(3-hydroxycyclohexyl)phenol structure with substitution at the 5-position of the phenolic
367.22ring by an alkyl, haloalkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl,
367.231-(N-methyl-2-piperidinyl)methyl or 2-(4-morpholinyl)ethyl group whether or not substituted
367.24in the cyclohexyl ring to any extent. Examples of cyclohexylphenols include, but are not
367.25limited to:
367.26(A) 5-(1,1-dimethylheptyl)-2-[(1R,3S)-3-hydroxycyclohexyl]-phenol (CP 47,497);
367.27(B) 5-(1,1-dimethyloctyl)-2-[(1R,3S)-3-hydroxycyclohexyl]-phenol
367.28(Cannabicyclohexanol or CP 47,497 C8 homologue);
367.29(C) 5-(1,1-dimethylheptyl)-2-[(1R,2R)-5-hydroxy-2-(3-hydroxypropyl)cyclohexyl]
367.30-phenol (CP 55,940).
367.31(vii) Benzoylindoles, which are any compounds containing a 3-(benzoyl)indole structure
367.32with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl, alkenyl,
368.1cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or
368.22-(4-morpholinyl)ethyl group whether or not further substituted in the indole ring to any
368.3extent and whether or not substituted in the phenyl ring to any extent. Examples of
368.4benzoylindoles include, but are not limited to:
368.5(A) 1-Pentyl-3-(4-methoxybenzoyl)indole (RCS-4);
368.6(B) 1-(5-fluoropentyl)-3-(2-iodobenzoyl)indole (AM-694);
368.7(C) (4-methoxyphenyl-[2-methyl-1-(2-(4-morpholinyl)ethyl)indol-3-yl]methanone (WIN
368.848,098 or Pravadoline).
368.9(viii) Others specifically named:
368.10(A) (6aR,10aR)-9-(hydroxymethyl)-6,6-dimethyl-3-(2-methyloctan-2-yl)
368.11-6a,7,10,10a-tetrahydrobenzo[c]chromen-1-ol (HU-210);
368.12(B) (6aS,10aS)-9-(hydroxymethyl)-6,6-dimethyl-3-(2-methyloctan-2-yl)
368.13-6a,7,10,10a-tetrahydrobenzo[c]chromen-1-ol (Dexanabinol or HU-211);
368.14(C) 2,3-dihydro-5-methyl-3-(4-morpholinylmethyl)pyrrolo[1,2,3-de]
368.15-1,4-benzoxazin-6-yl-1-naphthalenylmethanone (WIN 55,212-2);
368.16(D) (1-pentylindol-3-yl)-(2,2,3,3-tetramethylcyclopropyl)methanone (UR-144);
368.17(E) (1-(5-fluoropentyl)-1H-indol-3-yl)(2,2,3,3-tetramethylcyclopropyl)methanone
368.18(XLR-11);
368.19(F) 1-pentyl-N-tricyclo[3.3.1.13,7]dec-1-yl-1H-indazole-3-carboxamide
368.20(AKB-48(APINACA));
368.21(G) N-((3s,5s,7s)-adamantan-1-yl)-1-(5-fluoropentyl)-1H-indazole-3-carboxamide
368.22(5-Fluoro-AKB-48);
368.23(H) 1-pentyl-8-quinolinyl ester-1H-indole-3-carboxylic acid (PB-22);
368.24(I) 8-quinolinyl ester-1-(5-fluoropentyl)-1H-indole-3-carboxylic acid (5-Fluoro PB-22);
368.25(J) N-[(1S)-1-(aminocarbonyl)-2-methylpropyl]-1-pentyl-1H-indazole- 3-carboxamide
368.26(AB-PINACA);
368.27(K) N-[(1S)-1-(aminocarbonyl)-2-methylpropyl]-1-[(4-fluorophenyl)methyl]-
368.281H-indazole-3-carboxamide (AB-FUBINACA);
368.29(L) N-[(1S)-1-(aminocarbonyl)-2-methylpropyl]-1-(cyclohexylmethyl)-1H-
368.30indazole-3-carboxamide(AB-CHMINACA);
369.1(M) (S)-methyl 2-(1-(5-fluoropentyl)-1H-indazole-3-carboxamido)-3- methylbutanoate
369.2(5-fluoro-AMB);
369.3(N) [1-(5-fluoropentyl)-1H-indazol-3-yl](naphthalen-1-yl) methanone (THJ-2201);
369.4(O) (1-(5-fluoropentyl)-1H-benzo[d]imidazol-2-yl)(naphthalen-1-yl)methanone)
369.5(FUBIMINA);
369.6(P) (7-methoxy-1-(2-morpholinoethyl)-N-((1S,2S,4R)-1,3,3-trimethylbicyclo
369.7[2.2.1]heptan-2-yl)-1H-indole-3-carboxamide (MN-25 or UR-12);
369.8(Q) (S)-N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-(5-fluoropentyl)
369.9-1H-indole-3-carboxamide (5-fluoro-ABICA);
369.10(R) N-(1-amino-3-phenyl-1-oxopropan-2-yl)-1-(5-fluoropentyl)
369.11-1H-indole-3-carboxamide;
369.12(S) N-(1-amino-3-phenyl-1-oxopropan-2-yl)-1-(5-fluoropentyl)
369.13-1H-indazole-3-carboxamide;
369.14(T) methyl 2-(1-(cyclohexylmethyl)-1H-indole-3-carboxamido) -3,3-dimethylbutanoate;
369.15(U) N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1(cyclohexylmethyl)-1
369.16H-indazole-3-carboxamide (MAB-CHMINACA);
369.17(V) N-(1-Amino-3,3-dimethyl-1-oxo-2-butanyl)-1-pentyl-1H-indazole-3-carboxamide
369.18(ADB-PINACA);
369.19(W) methyl (1-(4-fluorobenzyl)-1H-indazole-3-carbonyl)-L-valinate (FUB-AMB);
369.20(X) N-[(1S)-2-amino-2-oxo-1-(phenylmethyl)ethyl]-1-(cyclohexylmethyl)-1H-Indazole-
369.213-carboxamide. (APP-CHMINACA);
369.22(Y) quinolin-8-yl 1-(4-fluorobenzyl)-1H-indole-3-carboxylate (FUB-PB-22); and
369.23(Z) methyl N-[1-(cyclohexylmethyl)-1H-indole-3-carbonyl]valinate (MMB-CHMICA).
369.24(ix) Additional substances specifically named:
369.25(A) 1-(5-fluoropentyl)-N-(2-phenylpropan-2-yl)-1
369.26H-pyrrolo[2,3-B]pyridine-3-carboxamide (5F-CUMYL-P7AICA);
369.27(B) 1-(4-cyanobutyl)-N-(2- phenylpropan-2-yl)-1 H-indazole-3-carboxamide
369.28(4-CN-Cumyl-Butinaca);
369.29(C) naphthalen-1-yl-1-(5-fluoropentyl)-1-H-indole-3-carboxylate (NM2201; CBL2201);
370.1(D) N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-(5-fluoropentyl)-1
370.2H-indazole-3-carboxamide (5F-ABPINACA);
370.3(E) methyl-2-(1-(cyclohexylmethyl)-1H-indole-3-carboxamido)-3,3-dimethylbutanoate
370.4(MDMB CHMICA);
370.5(F) methyl 2-(1-(5-fluoropentyl)-1H-indazole-3-carboxamido)-3,3-dimethylbutanoate
370.6(5F-ADB; 5F-MDMB-PINACA); and
370.7(G) N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1-(4-fluorobenzyl)
370.81H-indazole-3-carboxamide (ADB-FUBINACA).
370.9(i) A controlled substance analog, to the extent that it is implicitly or explicitly intended
370.10for human consumption.
370.11EFFECTIVE DATE.This section is effective August 1, 2022, and applies to crimes
370.12committed on or after that date.

370.13    Sec. 11. Minnesota Statutes 2021 Supplement, section 363A.50, is amended to read:
370.14363A.50 NONDISCRIMINATION IN ACCESS TO TRANSPLANTS.
370.15    Subdivision 1. Definitions. (a) For purposes of this section, the following terms have
370.16the meanings given unless the context clearly requires otherwise.
370.17(b) "Anatomical gift" has the meaning given in section 525A.02, subdivision 4.
370.18(c) "Auxiliary aids and services" include, but are not limited to:
370.19(1) qualified interpreters or other effective methods of making aurally delivered materials
370.20available to individuals with hearing impairments and to non-English-speaking individuals;
370.21(2) qualified readers, taped texts, texts in accessible electronic format, or other effective
370.22methods of making visually delivered materials available to individuals with visual
370.23impairments;
370.24(3) the provision of information in a format that is accessible for individuals with
370.25cognitive, neurological, developmental, intellectual, or physical disabilities;
370.26(4) the provision of supported decision-making services; and
370.27(5) the acquisition or modification of equipment or devices.
370.28(d) "Covered entity" means:
370.29(1) any licensed provider of health care services, including licensed health care
370.30practitioners, hospitals, nursing facilities, laboratories, intermediate care facilities, psychiatric
371.1residential treatment facilities, institutions for individuals with intellectual or developmental
371.2disabilities, and prison health centers; or
371.3(2) any entity responsible for matching anatomical gift donors to potential recipients.
371.4(e) "Disability" has the meaning given in section 363A.03, subdivision 12.
371.5(f) "Organ transplant" means the transplantation or infusion of a part of a human body
371.6into the body of another for the purpose of treating or curing a medical condition.
371.7(g) "Qualified individual" means an individual who, with or without available support
371.8networks, the provision of auxiliary aids and services, or reasonable modifications to policies
371.9or practices, meets the essential eligibility requirements for the receipt of an anatomical
371.10gift.
371.11(h) "Reasonable modifications" include, but are not limited to:
371.12(1) communication with individuals responsible for supporting an individual with
371.13postsurgical and post-transplantation care, including medication; and
371.14(2) consideration of support networks available to the individual, including family,
371.15friends, and home and community-based services, including home and community-based
371.16services funded through Medicaid, Medicare, another health plan in which the individual
371.17is enrolled, or any program or source of funding available to the individual, in determining
371.18whether the individual is able to comply with post-transplant medical requirements.
371.19(i) "Supported decision making" has the meaning given in section 524.5-102, subdivision
371.2016a.
371.21    Subd. 2. Prohibition of discrimination. (a) A covered entity may not, on the basis of
371.22a qualified individual's race, ethnicity, mental disability, or physical disability:
371.23(1) deem an individual ineligible to receive an anatomical gift or organ transplant;
371.24(2) deny medical or related organ transplantation services, including evaluation, surgery,
371.25counseling, and postoperative treatment and care;
371.26(3) refuse to refer the individual to a transplant center or other related specialist for the
371.27purpose of evaluation or receipt of an anatomical gift or organ transplant;
371.28(4) refuse to place an individual on an organ transplant waiting list or place the individual
371.29at a lower-priority position on the list than the position at which the individual would have
371.30been placed if not for the individual's race, ethnicity, or disability; or
372.1(5) decline insurance coverage for any procedure associated with the receipt of the
372.2anatomical gift or organ transplant, including post-transplantation and postinfusion care.
372.3(b) Notwithstanding paragraph (a), a covered entity may take an individual's disability
372.4into account when making treatment or coverage recommendations or decisions, solely to
372.5the extent that the physical or mental disability has been found by a physician, following
372.6an individualized evaluation of the potential recipient to be medically significant to the
372.7provision of the anatomical gift or organ transplant. The provisions of this section may not
372.8be deemed to require referrals or recommendations for, or the performance of, organ
372.9transplants that are not medically appropriate given the individual's overall health condition.
372.10(c) If an individual has the necessary support system to assist the individual in complying
372.11with post-transplant medical requirements, an individual's inability to independently comply
372.12with those requirements may not be deemed to be medically significant for the purposes of
372.13paragraph (b).
372.14(d) A covered entity must make reasonable modifications to policies, practices, or
372.15procedures, when such modifications are necessary to make services such as
372.16transplantation-related counseling, information, coverage, or treatment available to qualified
372.17individuals with disabilities, unless the entity can demonstrate that making such modifications
372.18would fundamentally alter the nature of such services.
372.19(e) A covered entity must take such steps as may be necessary to ensure that no qualified
372.20individual with a disability is denied services such as transplantation-related counseling,
372.21information, coverage, or treatment because of the absence of auxiliary aids and services,
372.22unless the entity can demonstrate that taking such steps would fundamentally alter the nature
372.23of the services being offered or result in an undue burden. A covered entity is not required
372.24to provide supported decision-making services.
372.25(f) A covered entity must otherwise comply with the requirements of Titles II and III of
372.26the Americans with Disabilities Act of 1990, the Americans with Disabilities Act
372.27Amendments Act of 2008, and the Minnesota Human Rights Act.
372.28(g) The provisions of this section apply to each part of the organ transplant process.
372.29    Subd. 3. Remedies. In addition to all other remedies available under this chapter, any
372.30individual who has been subjected to discrimination in violation of this section may initiate
372.31a civil action in a court of competent jurisdiction to enjoin violations of this section.

373.1    Sec. 12. INITIAL MEMBERS AND FIRST MEETING; MINNESOTA RARE
373.2DISEASE ADVISORY COUNCIL.
373.3Public members serving on the University of Minnesota's Advisory Council on Rare
373.4Diseases on June 30, 2022, are the initial public members of the Minnesota Rare Disease
373.5Advisory Council. The terms of the members begin on July 1, 2022. The governor must
373.6designate six members to serve a two-year term; six members to serve a three-year term;
373.7and five members to serve a four-year term. The governor may appoint additional members
373.8under Minnesota Statutes, section 137.68, subdivision 2, paragraph (b), clause (13), and
373.9must set their terms so that roughly one-third of the members' terms expire after two years,
373.10one-third after three years, and one-third after four years. Legislative members of the
373.11University of Minnesota's Advisory Council on Rare Disease serve on the Minnesota Rare
373.12Disease Advisory Council until appointing authorities appoint successors. The person serving
373.13as chair of the executive subcommittee of the University of Minnesota's Advisory Council
373.14on Rare Diseases shall convene the first meeting of the Minnesota Rare Disease Advisory
373.15Council by September 1, 2022.

373.16    Sec. 13. APPROPRIATIONS.
373.17In accordance with Minnesota Statutes, section 15.039, subdivision 6, the unexpended
373.18balance of money appropriated from the general fund to the Board of Regents of the
373.19University of Minnesota for purposes of the advisory council on rare diseases under
373.20Minnesota Statutes, section 137.68, shall be under the control of the Minnesota Rare Disease
373.21Advisory Council and the Council on Disability.
373.22EFFECTIVE DATE.This section is effective July 1, 2022.

373.23    Sec. 14. REVISOR INSTRUCTION.
373.24The revisor of statutes shall renumber as Minnesota Statutes, section 256.4835, the
373.25Minnesota Rare Disease Advisory Council that is currently coded as Minnesota Statutes,
373.26section 137.68. The revisor shall also make necessary cross-reference changes consistent
373.27with the renumbering.
373.28EFFECTIVE DATE.This section is effective July 1, 2022.

374.1ARTICLE 14
374.2MANDATED REPORTS

374.3    Section 1. Minnesota Statutes 2020, section 62J.692, subdivision 5, is amended to read:
374.4    Subd. 5. Report. (a) Sponsoring institutions receiving funds under this section must
374.5sign and submit a medical education grant verification report (GVR) to verify that the correct
374.6grant amount was forwarded to each eligible training site. If the sponsoring institution fails
374.7to submit the GVR by the stated deadline, or to request and meet the deadline for an
374.8extension, the sponsoring institution is required to return the full amount of funds received
374.9to the commissioner within 30 days of receiving notice from the commissioner. The
374.10commissioner shall distribute returned funds to the appropriate training sites in accordance
374.11with the commissioner's approval letter.
374.12    (b) The reports must provide verification of the distribution of the funds and must include:
374.13    (1) the total number of eligible trainee FTEs in each clinical medical education program;
374.14    (2) the name of each funded program and, for each program, the dollar amount distributed
374.15to each training site and a training site expenditure report;
374.16    (3) documentation of any discrepancies between the initial grant distribution notice
374.17included in the commissioner's approval letter and the actual distribution;
374.18    (4) a statement by the sponsoring institution stating that the completed grant verification
374.19report is valid and accurate; and
374.20    (5) other information the commissioner deems appropriate to evaluate the effectiveness
374.21of the use of funds for medical education.
374.22    (c) Each year, the commissioner shall provide an annual summary report to the legislature
374.23on the implementation of this section. This report is exempt from section 144.05, subdivision
374.247.

374.25    Sec. 2. Minnesota Statutes 2020, section 62Q.37, subdivision 7, is amended to read:
374.26    Subd. 7. Human services. (a) The commissioner of human services shall implement
374.27this section in a manner that is consistent with applicable federal laws and regulations and
374.28that avoids the duplication of review activities performed by a nationally recognized
374.29independent organization.
374.30(b) By December 31 of each year, the commissioner shall submit to the legislature a
374.31written report identifying the number of audits performed by a nationally recognized
375.1independent organization that were accepted, partially accepted, or rejected by the
375.2commissioner under this section. The commissioner shall provide the rationale for partial
375.3acceptance or rejection. If the rationale for the partial acceptance or rejection was based on
375.4the commissioner's determination that the standards used in the audit were not equivalent
375.5to state law, regulation, or contract requirement, the report must document the variances
375.6between the audit standards and the applicable state requirements.

375.7    Sec. 3. Minnesota Statutes 2020, section 144.193, is amended to read:
375.8144.193 INVENTORY OF BIOLOGICAL AND HEALTH DATA.
375.9By February 1, 2014, and annually after that date, the commissioner shall prepare an
375.10inventory of biological specimens, registries, and health data and databases collected or
375.11maintained by the commissioner. In addition to the inventory, the commissioner shall provide
375.12the schedules for storage of health data and biological specimens. The inventories must be
375.13listed in reverse chronological order beginning with the year 2012. The commissioner shall
375.14make the inventory and schedules available on the department's website and submit the
375.15inventory and schedules to the chairs and ranking minority members of the committees of
375.16the legislature with jurisdiction over health policy and data practices issues.

375.17    Sec. 4. Minnesota Statutes 2020, section 144.4199, subdivision 8, is amended to read:
375.18    Subd. 8. Report. By January 15 of each year, the commissioner shall submit a report to
375.19the chairs and ranking minority members of the house of representatives Ways and Means
375.20Committee, the senate Finance Committee, and the house of representatives and senate
375.21committees with jurisdiction over health and human services finance, detailing expenditures
375.22made in the previous calendar year from the public health response contingency account.
375.23This report is exempt from section 144.05, subdivision 7.

375.24    Sec. 5. Minnesota Statutes 2020, section 144A.10, subdivision 17, is amended to read:
375.25    Subd. 17. Agency quality improvement program; annual report on survey
375.26process. (a) The commissioner shall establish a quality improvement program for the nursing
375.27facility survey and complaint processes. The commissioner must regularly consult with
375.28consumers, consumer advocates, and representatives of the nursing home industry and
375.29representatives of nursing home employees in implementing the program. The commissioner,
375.30through the quality improvement program, shall submit to the legislature an annual survey
375.31and certification quality improvement report, beginning December 15, 2004, and each
375.32December 15 thereafter. This report is exempt from section 144.05, subdivision 7.
376.1(b) The report must include, but is not limited to, an analysis of:
376.2(1) the number, scope, and severity of citations by region within the state;
376.3(2) cross-referencing of citations by region within the state and between states within
376.4the Centers for Medicare and Medicaid Services region in which Minnesota is located;
376.5(3) the number and outcomes of independent dispute resolutions;
376.6(4) the number and outcomes of appeals;
376.7(5) compliance with timelines for survey revisits and complaint investigations;
376.8(6) techniques of surveyors in investigations, communication, and documentation to
376.9identify and support citations;
376.10(7) compliance with timelines for providing facilities with completed statements of
376.11deficiencies; and
376.12(8) other survey statistics relevant to improving the survey process.
376.13(c) The report must also identify and explain inconsistencies and patterns across regions
376.14of the state; include analyses and recommendations for quality improvement areas identified
376.15by the commissioner, consumers, consumer advocates, and representatives of the nursing
376.16home industry and nursing home employees; and provide action plans to address problems
376.17that are identified.

376.18    Sec. 6. Minnesota Statutes 2020, section 144A.351, subdivision 1, is amended to read:
376.19    Subdivision 1. Report requirements. (a) The commissioners of health and human
376.20services, with the cooperation of counties and in consultation with stakeholders, including
376.21persons who need or are using long-term care services and supports, lead agencies, regional
376.22entities, senior, disability, and mental health organization representatives, service providers,
376.23and community members shall prepare a report to the legislature by August 15, 2013, and
376.24biennially thereafter, compile data regarding the status of the full range of long-term care
376.25services and supports for the elderly and children and adults with disabilities and mental
376.26illnesses in Minnesota. Any amounts appropriated for this report are available in either year
376.27of the biennium. The report shall address compiled data shall include:
376.28    (1) demographics and need for long-term care services and supports in Minnesota;
376.29    (2) summary of county and regional reports on long-term care gaps, surpluses, imbalances,
376.30and corrective action plans;
377.1    (3) status of long-term care services and related mental health services, housing options,
377.2and supports by county and region including:
377.3    (i) changes in availability of the range of long-term care services and housing options;
377.4    (ii) access problems, including access to the least restrictive and most integrated services
377.5and settings, regarding long-term care services; and
377.6    (iii) comparative measures of long-term care services availability, including serving
377.7people in their home areas near family, and changes over time; and
377.8    (4) recommendations regarding goals for the future of long-term care services and
377.9supports, policy and fiscal changes, and resource development and transition needs.
377.10    (b) The commissioners of health and human services shall make the compiled data
377.11available on at least one of the department's websites.

377.12    Sec. 7. Minnesota Statutes 2020, section 144A.483, subdivision 1, is amended to read:
377.13    Subdivision 1. Annual legislative report on home care licensing. The commissioner
377.14shall establish a quality improvement program for the home care survey and home care
377.15complaint investigation processes. The commissioner shall submit to the legislature an
377.16annual report, beginning October 1, 2015, and each October 1 thereafter, until October 1,
377.172027. Each report will review the previous state fiscal year of home care licensing and
377.18regulatory activities. The report must include, but is not limited to, an analysis of:
377.19(1) the number of FTEs in the Division of Compliance Monitoring, including the Office
377.20of Health Facility Complaints units assigned to home care licensing, survey, investigation,
377.21and enforcement process;
377.22(2) numbers of and descriptive information about licenses issued, complaints received
377.23and investigated, including allegations made and correction orders issued, surveys completed
377.24and timelines, and correction order reconsiderations and results;
377.25(3) descriptions of emerging trends in home care provision and areas of concern identified
377.26by the department in its regulation of home care providers;
377.27(4) information and data regarding performance improvement projects underway and
377.28planned by the commissioner in the area of home care surveys; and
377.29(5) work of the Department of Health Home Care Advisory Council.

378.1    Sec. 8. Minnesota Statutes 2020, section 145.4134, is amended to read:
378.2145.4134 COMMISSIONER'S PUBLIC REPORT.
378.3(a) By July 1 of each year, except for 1998 and 1999 information, the commissioner
378.4shall issue a public report providing statistics for the previous calendar year compiled from
378.5the data submitted under sections 145.4131 to 145.4133 and sections 145.4241 to 145.4249.
378.6For 1998 and 1999 information, the report shall be issued October 1, 2000. Each report
378.7shall provide the statistics for all previous calendar years, adjusted to reflect any additional
378.8information from late or corrected reports. The commissioner shall ensure that none of the
378.9information included in the public reports can reasonably lead to identification of an
378.10individual having performed or having had an abortion. All data included on the forms
378.11under sections 145.4131 to 145.4133 and sections 145.4241 to 145.4249 must be included
378.12in the public report, except that the commissioner shall maintain as confidential, data which
378.13alone or in combination may constitute information from which an individual having
378.14performed or having had an abortion may be identified using epidemiologic principles. The
378.15commissioner shall submit the report to the senate Health and Family Security Committee
378.16and the house of representatives Health and Human Services Committee.
378.17(b) The commissioner may, by rules adopted under chapter 14, alter the submission
378.18dates established under sections 145.4131 to 145.4133 for administrative convenience, fiscal
378.19savings, or other valid reason, provided that physicians or facilities and the commissioner
378.20of human services submit the required information once each year and the commissioner
378.21issues a report once each year.

378.22    Sec. 9. Minnesota Statutes 2020, section 145.928, subdivision 13, is amended to read:
378.23    Subd. 13. Reports. (a) The commissioner shall submit a biennial report to the legislature
378.24on the local community projects, tribal government, and community health board prevention
378.25activities funded under this section. These reports must include information on grant
378.26recipients, activities that were conducted using grant funds, evaluation data, and outcome
378.27measures, if available. These reports are due by January 15 of every other year, beginning
378.28in the year 2003.
378.29(b) The commissioner shall release an annual report to the public and submit the annual
378.30report to the chairs and ranking minority members of the house of representatives and senate
378.31committees with jurisdiction over public health on grants made under subdivision 7 to
378.32decrease racial and ethnic disparities in infant mortality rates. The report must provide
378.33specific information on the amount of each grant awarded to each agency or organization,
378.34an itemized list submitted to the commissioner by each agency or organization awarded a
379.1grant specifying all uses of grant funds and the amount expended for each use, the population
379.2served by each agency or organization, outcomes of the programs funded by each grant,
379.3and the amount of the appropriation retained by the commissioner for administrative and
379.4associated expenses. The commissioner shall issue a report each January 15 for the previous
379.5fiscal year beginning January 15, 2016.

379.6    Sec. 10. Minnesota Statutes 2020, section 245.4661, subdivision 10, is amended to read:
379.7    Subd. 10. Commissioner duty to report on use of grant funds biennially. (a) By
379.8November 1, 2016, and biennially thereafter, the commissioner of human services shall
379.9provide sufficient information to the members of the legislative committees having
379.10jurisdiction over mental health funding and policy issues to evaluate the use of funds
379.11appropriated under this section of law. The commissioner shall provide, at a minimum, the
379.12following information:
379.13    (1) the amount of funding to mental health initiatives, what programs and services were
379.14funded in the previous two years, gaps in services that each initiative brought to the attention
379.15of the commissioner, and outcome data for the programs and services that were funded; and
379.16    (2) the amount of funding for other targeted services and the location of services.
379.17    (b) This subdivision expires January 1, 2032.

379.18    Sec. 11. Minnesota Statutes 2020, section 245.4889, subdivision 3, is amended to read:
379.19    Subd. 3. Commissioner duty to report on use of grant funds biennially. (a) By
379.20November 1, 2016, and biennially thereafter, the commissioner of human services shall
379.21provide sufficient information to the members of the legislative committees having
379.22jurisdiction over mental health funding and policy issues to evaluate the use of funds
379.23appropriated under this section. The commissioner shall provide, at a minimum, the following
379.24information:
379.25    (1) the amount of funding for children's mental health grants, what programs and services
379.26were funded in the previous two years, and outcome data for the programs and services that
379.27were funded; and
379.28    (2) the amount of funding for other targeted services and the location of services.
379.29    (b) This subdivision expires January 1, 2032.

380.1    Sec. 12. Minnesota Statutes 2021 Supplement, section 245A.03, subdivision 7, is amended
380.2to read:
380.3    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an initial license
380.4for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult
380.5foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter
380.6for a physical location that will not be the primary residence of the license holder for the
380.7entire period of licensure. If a family child foster care home or family adult foster care home
380.8license is issued during this moratorium, and the license holder changes the license holder's
380.9primary residence away from the physical location of the foster care license, the
380.10commissioner shall revoke the license according to section 245A.07. The commissioner
380.11shall not issue an initial license for a community residential setting licensed under chapter
380.12245D. When approving an exception under this paragraph, the commissioner shall consider
380.13the resource need determination process in paragraph (h), the availability of foster care
380.14licensed beds in the geographic area in which the licensee seeks to operate, the results of a
380.15person's choices during their annual assessment and service plan review, and the
380.16recommendation of the local county board. The determination by the commissioner is final
380.17and not subject to appeal. Exceptions to the moratorium include:
380.18(1) foster care settings where at least 80 percent of the residents are 55 years of age or
380.19older;
380.20(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
380.21community residential setting licenses replacing adult foster care licenses in existence on
380.22December 31, 2013, and determined to be needed by the commissioner under paragraph
380.23(b);
380.24(3) new foster care licenses or community residential setting licenses determined to be
380.25needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD,
380.26or regional treatment center; restructuring of state-operated services that limits the capacity
380.27of state-operated facilities; or allowing movement to the community for people who no
380.28longer require the level of care provided in state-operated facilities as provided under section
380.29256B.092, subdivision 13, or 256B.49, subdivision 24;
380.30(4) new foster care licenses or community residential setting licenses determined to be
380.31needed by the commissioner under paragraph (b) for persons requiring hospital level care;
380.32(5) new foster care licenses or community residential setting licenses for people receiving
380.33services under chapter 245D and residing in an unlicensed setting before May 1, 2017, and
380.34for which a license is required. This exception does not apply to people living in their own
381.1home. For purposes of this clause, there is a presumption that a foster care or community
381.2residential setting license is required for services provided to three or more people in a
381.3dwelling unit when the setting is controlled by the provider. A license holder subject to this
381.4exception may rebut the presumption that a license is required by seeking a reconsideration
381.5of the commissioner's determination. The commissioner's disposition of a request for
381.6reconsideration is final and not subject to appeal under chapter 14. The exception is available
381.7until June 30, 2018. This exception is available when:
381.8(i) the person's case manager provided the person with information about the choice of
381.9service, service provider, and location of service, including in the person's home, to help
381.10the person make an informed choice; and
381.11(ii) the person's services provided in the licensed foster care or community residential
381.12setting are less than or equal to the cost of the person's services delivered in the unlicensed
381.13setting as determined by the lead agency; or
381.14(6) new foster care licenses or community residential setting licenses for people receiving
381.15customized living or 24-hour customized living services under the brain injury or community
381.16access for disability inclusion waiver plans under section 256B.49 and residing in the
381.17customized living setting before July 1, 2022, for which a license is required. A customized
381.18living service provider subject to this exception may rebut the presumption that a license
381.19is required by seeking a reconsideration of the commissioner's determination. The
381.20commissioner's disposition of a request for reconsideration is final and not subject to appeal
381.21under chapter 14. The exception is available until June 30, 2023. This exception is available
381.22when:
381.23(i) the person's customized living services are provided in a customized living service
381.24setting serving four or fewer people under the brain injury or community access for disability
381.25inclusion waiver plans under section 256B.49 in a single-family home operational on or
381.26before June 30, 2021. Operational is defined in section 256B.49, subdivision 28;
381.27(ii) the person's case manager provided the person with information about the choice of
381.28service, service provider, and location of service, including in the person's home, to help
381.29the person make an informed choice; and
381.30(iii) the person's services provided in the licensed foster care or community residential
381.31setting are less than or equal to the cost of the person's services delivered in the customized
381.32living setting as determined by the lead agency.
381.33(b) The commissioner shall determine the need for newly licensed foster care homes or
381.34community residential settings as defined under this subdivision. As part of the determination,
382.1the commissioner shall consider the availability of foster care capacity in the area in which
382.2the licensee seeks to operate, and the recommendation of the local county board. The
382.3determination by the commissioner must be final. A determination of need is not required
382.4for a change in ownership at the same address.
382.5(c) When an adult resident served by the program moves out of a foster home that is not
382.6the primary residence of the license holder according to section 256B.49, subdivision 15,
382.7paragraph (f), or the adult community residential setting, the county shall immediately
382.8inform the Department of Human Services Licensing Division. The department may decrease
382.9the statewide licensed capacity for adult foster care settings.
382.10(d) Residential settings that would otherwise be subject to the decreased license capacity
382.11established in paragraph (c) shall be exempt if the license holder's beds are occupied by
382.12residents whose primary diagnosis is mental illness and the license holder is certified under
382.13the requirements in subdivision 6a or section 245D.33.
382.14(e) A resource need determination process, managed at the state level, using the available
382.15reports data required by section 144A.351, and other data and information shall be used to
382.16determine where the reduced capacity determined under section 256B.493 will be
382.17implemented. The commissioner shall consult with the stakeholders described in section
382.18144A.351, and employ a variety of methods to improve the state's capacity to meet the
382.19informed decisions of those people who want to move out of corporate foster care or
382.20community residential settings, long-term service needs within budgetary limits, including
382.21seeking proposals from service providers or lead agencies to change service type, capacity,
382.22or location to improve services, increase the independence of residents, and better meet
382.23needs identified by the long-term services and supports reports and statewide data and
382.24information.
382.25(f) At the time of application and reapplication for licensure, the applicant and the license
382.26holder that are subject to the moratorium or an exclusion established in paragraph (a) are
382.27required to inform the commissioner whether the physical location where the foster care
382.28will be provided is or will be the primary residence of the license holder for the entire period
382.29of licensure. If the primary residence of the applicant or license holder changes, the applicant
382.30or license holder must notify the commissioner immediately. The commissioner shall print
382.31on the foster care license certificate whether or not the physical location is the primary
382.32residence of the license holder.
382.33(g) License holders of foster care homes identified under paragraph (f) that are not the
382.34primary residence of the license holder and that also provide services in the foster care home
383.1that are covered by a federally approved home and community-based services waiver, as
383.2authorized under chapter 256S or section 256B.092 or 256B.49, must inform the human
383.3services licensing division that the license holder provides or intends to provide these
383.4waiver-funded services.
383.5(h) The commissioner may adjust capacity to address needs identified in section
383.6144A.351. Under this authority, the commissioner may approve new licensed settings or
383.7delicense existing settings. Delicensing of settings will be accomplished through a process
383.8identified in section 256B.493. Annually, by August 1, the commissioner shall provide
383.9information and data on capacity of licensed long-term services and supports, actions taken
383.10under the subdivision to manage statewide long-term services and supports resources, and
383.11any recommendations for change to the legislative committees with jurisdiction over the
383.12health and human services budget.
383.13(i) The commissioner must notify a license holder when its corporate foster care or
383.14community residential setting licensed beds are reduced under this section. The notice of
383.15reduction of licensed beds must be in writing and delivered to the license holder by certified
383.16mail or personal service. The notice must state why the licensed beds are reduced and must
383.17inform the license holder of its right to request reconsideration by the commissioner. The
383.18license holder's request for reconsideration must be in writing. If mailed, the request for
383.19reconsideration must be postmarked and sent to the commissioner within 20 calendar days
383.20after the license holder's receipt of the notice of reduction of licensed beds. If a request for
383.21reconsideration is made by personal service, it must be received by the commissioner within
383.2220 calendar days after the license holder's receipt of the notice of reduction of licensed beds.
383.23(j) The commissioner shall not issue an initial license for children's residential treatment
383.24services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter
383.25for a program that Centers for Medicare and Medicaid Services would consider an institution
383.26for mental diseases. Facilities that serve only private pay clients are exempt from the
383.27moratorium described in this paragraph. The commissioner has the authority to manage
383.28existing statewide capacity for children's residential treatment services subject to the
383.29moratorium under this paragraph and may issue an initial license for such facilities if the
383.30initial license would not increase the statewide capacity for children's residential treatment
383.31services subject to the moratorium under this paragraph.

383.32    Sec. 13. Minnesota Statutes 2020, section 256.01, subdivision 29, is amended to read:
383.33    Subd. 29. State medical review team. (a) To ensure the timely processing of
383.34determinations of disability by the commissioner's state medical review team under sections
384.1256B.055, subdivisions 7, paragraph (b), and 12, and 256B.057, subdivision 9, the
384.2commissioner shall review all medical evidence and seek information from providers,
384.3applicants, and enrollees to support the determination of disability where necessary. Disability
384.4shall be determined according to the rules of title XVI and title XIX of the Social Security
384.5Act and pertinent rules and policies of the Social Security Administration.
384.6(b) Prior to a denial or withdrawal of a requested determination of disability due to
384.7insufficient evidence, the commissioner shall (1) ensure that the missing evidence is necessary
384.8and appropriate to a determination of disability, and (2) assist applicants and enrollees to
384.9obtain the evidence, including, but not limited to, medical examinations and electronic
384.10medical records.
384.11(c) The commissioner shall provide the chairs of the legislative committees with
384.12jurisdiction over health and human services finance and budget the following information
384.13on the activities of the state medical review team by February 1 of each year:
384.14(1) the number of applications to the state medical review team that were denied,
384.15approved, or withdrawn;
384.16(2) the average length of time from receipt of the application to a decision;
384.17(3) the number of appeals, appeal results, and the length of time taken from the date the
384.18person involved requested an appeal for a written decision to be made on each appeal;
384.19(4) for applicants, their age, health coverage at the time of application, hospitalization
384.20history within three months of application, and whether an application for Social Security
384.21or Supplemental Security Income benefits is pending; and
384.22(5) specific information on the medical certification, licensure, or other credentials of
384.23the person or persons performing the medical review determinations and length of time in
384.24that position.
384.25(d) (c) Any appeal made under section 256.045, subdivision 3, of a disability
384.26determination made by the state medical review team must be decided according to the
384.27timelines under section 256.0451, subdivision 22, paragraph (a). If a written decision is not
384.28issued within the timelines under section 256.0451, subdivision 22, paragraph (a), the appeal
384.29must be immediately reviewed by the chief human services judge.

384.30    Sec. 14. Minnesota Statutes 2020, section 256.021, subdivision 3, is amended to read:
384.31    Subd. 3. Report. (a) By January 15 of each year, the panel shall submit a report to the
384.32committees of the legislature with jurisdiction over section 626.557 regarding the number
385.1of requests for review it receives under this section, the number of cases where the panel
385.2requires the lead investigative agency to reconsider its final disposition, and the number of
385.3cases where the final disposition is changed, and any recommendations to improve the
385.4review or investigative process.
385.5(b) This subdivision expires January 1, 2024.

385.6    Sec. 15. Minnesota Statutes 2021 Supplement, section 256.042, subdivision 4, as amended
385.7by Laws 2022, chapter 53, section 5, is amended to read:
385.8    Subd. 4. Grants. (a) The commissioner of human services shall submit a report of the
385.9grants proposed by the advisory council to be awarded for the upcoming calendar year to
385.10the chairs and ranking minority members of the legislative committees with jurisdiction
385.11over health and human services policy and finance, by December 1 of each year, beginning
385.12March 1, 2020 December 1, 2022. This paragraph expires upon the expiration of the advisory
385.13council.
385.14(b) The grants shall be awarded to proposals selected by the advisory council that address
385.15the priorities in subdivision 1, paragraph (a), clauses (1) to (4), unless otherwise appropriated
385.16by the legislature. The advisory council shall determine grant awards and funding amounts
385.17based on the funds appropriated to the commissioner under section 256.043, subdivision 3,
385.18paragraph (h), and subdivision 3a, paragraph (d). The commissioner shall award the grants
385.19from the opiate epidemic response fund and administer the grants in compliance with section
385.2016B.97. No more than ten percent of the grant amount may be used by a grantee for
385.21administration.

385.22    Sec. 16. Minnesota Statutes 2020, section 256.042, subdivision 5, as amended by Laws
385.232022, chapter 53, section 6, is amended to read:
385.24    Subd. 5. Reports. (a) The advisory council shall report annually to the chairs and ranking
385.25minority members of the legislative committees with jurisdiction over health and human
385.26services policy and finance by January 31 of each year. The report shall include information
385.27about the individual projects that receive grants, the municipality projects funded by direct
385.28payments received as part of a statewide opioid settlement agreement, and the overall role
385.29of the project in addressing the opioid addiction and overdose epidemic in Minnesota. The
385.30report must describe the grantees and municipalities and the activities implemented, along
385.31with measurable outcomes as determined by the council in consultation with the
385.32commissioner of human services and the commissioner of management and budget. At a
385.33minimum, the report must include information about the number of individuals who received
386.1information or treatment, the outcomes the individuals achieved, and demographic
386.2information about the individuals participating in the project; an assessment of the progress
386.3toward achieving statewide access to qualified providers and comprehensive treatment and
386.4recovery services; and an update on the evaluations implemented by the commissioner of
386.5management and budget for the promising practices and theory-based projects that receive
386.6funding.
386.7(b) The commissioner of management and budget, in consultation with the Opiate
386.8Epidemic Response Advisory Council, shall report to the chairs and ranking minority
386.9members of the legislative committees with jurisdiction over health and human services
386.10policy and finance when an evaluation study described in subdivision 1, paragraph (c), is
386.11complete on the promising practices or theory-based projects that are selected for evaluation
386.12activities. The report shall include demographic information; outcome information for the
386.13individuals in the program; the results for the program in promoting recovery, employment,
386.14family reunification, and reducing involvement with the criminal justice system; and other
386.15relevant outcomes determined by the commissioner of management and budget that are
386.16specific to the projects that are evaluated. The report shall include information about the
386.17ability of grant programs to be scaled to achieve the statewide results that the grant project
386.18demonstrated.
386.19(c) The advisory council, in its annual report to the legislature under paragraph (a) due
386.20by January 31, 2024, shall include recommendations on whether the appropriations to the
386.21specified entities under Laws 2019, chapter 63, should be continued, adjusted, or
386.22discontinued; whether funding should be appropriated for other purposes related to opioid
386.23abuse prevention, education, and treatment; and on the appropriate level of funding for
386.24existing and new uses.
386.25(d) Municipalities receiving direct payments from a statewide opioid settlement agreement
386.26must report annually to the commissioner of human services on how the payments were
386.27used on opioid remediation. The report must be submitted in a format prescribed by the
386.28commissioner. The report must include data and measurable outcomes on expenditures
386.29funded with direct payments from a statewide opioid settlement agreement, including details
386.30on services listed in the categories of approved uses, as identified in agreements between
386.31the state of Minnesota, the Association of Minnesota Counties, and the League of Minnesota
386.32Cities. Reporting requirements must include, at a minimum:
386.33(1) contact information;
386.34(2) information on funded services and programs; and
387.1(3) target populations for each funded service and program.
387.2(e) In reporting data and outcomes under paragraph (d), municipalities must include, to
387.3the extent feasible, information on the use of evidence-based and culturally relevant services.
387.4(f) For municipal projects using $25,000 or more of statewide opioid settlement agreement
387.5payments in a calendar year, municipalities must also include in the report required under
387.6paragraph (d):
387.7(1) a brief qualitative description of successes or challenges; and
387.8(2) results using process and quality measures.
387.9(g) This subdivision expires upon the expiration of the advisory council.

387.10    Sec. 17. Minnesota Statutes 2020, section 256.9657, subdivision 8, is amended to read:
387.11    Subd. 8. Commissioner's duties. (a) Beginning October 1, 2023, the commissioner of
387.12human services shall annually report to the legislature quarterly on the first day of January,
387.13April, July, and October chairs and ranking minority members of the legislative committees
387.14with jurisdiction over health care policy and finance regarding the provider surcharge
387.15program. The report shall include information on total billings, total collections, and
387.16administrative expenditures for the previous fiscal year. The report on January 1, 1993,
387.17shall include information on all surcharge billings, collections, federal matching payments
387.18received, efforts to collect unpaid amounts, and administrative costs pertaining to the
387.19surcharge program in effect from July 1, 1991, to September 30, 1992 This paragraph expires
387.20January 1, 2032.
387.21(b) The surcharge shall be adjusted by inflationary and caseload changes in future
387.22bienniums to maintain reimbursement of health care providers in accordance with the
387.23requirements of the state and federal laws governing the medical assistance program,
387.24including the requirements of the Medicaid moratorium amendments of 1991 found in
387.25Public Law No. 102-234.
387.26(c) The commissioner shall request the Minnesota congressional delegation to support
387.27a change in federal law that would prohibit federal disallowances for any state that makes
387.28a good faith effort to comply with Public Law 102-234 by enacting conforming legislation
387.29prior to the issuance of federal implementing regulations.

388.1    Sec. 18. Minnesota Statutes 2020, section 256.975, subdivision 11, is amended to read:
388.2    Subd. 11. Regional and local dementia grants. (a) The Minnesota Board on Aging
388.3shall award competitive grants to eligible applicants for regional and local projects and
388.4initiatives targeted to a designated community, which may consist of a specific geographic
388.5area or population, to increase awareness of Alzheimer's disease and other dementias,
388.6increase the rate of cognitive testing in the population at risk for dementias, promote the
388.7benefits of early diagnosis of dementias, or connect caregivers of persons with dementia to
388.8education and resources.
388.9(b) The project areas for grants include:
388.10(1) local or community-based initiatives to promote the benefits of physician or advanced
388.11practice registered nurse consultations for all individuals who suspect a memory or cognitive
388.12problem;
388.13(2) local or community-based initiatives to promote the benefits of early diagnosis of
388.14Alzheimer's disease and other dementias; and
388.15(3) local or community-based initiatives to provide informational materials and other
388.16resources to caregivers of persons with dementia.
388.17(c) Eligible applicants for local and regional grants may include, but are not limited to,
388.18community health boards, school districts, colleges and universities, community clinics,
388.19tribal communities, nonprofit organizations, and other health care organizations.
388.20(d) Applicants must:
388.21(1) describe the proposed initiative, including the targeted community and how the
388.22initiative meets the requirements of this subdivision; and
388.23(2) identify the proposed outcomes of the initiative and the evaluation process to be used
388.24to measure these outcomes.
388.25(e) In awarding the regional and local dementia grants, the Minnesota Board on Aging
388.26must give priority to applicants who demonstrate that the proposed project:
388.27(1) is supported by and appropriately targeted to the community the applicant serves;
388.28(2) is designed to coordinate with other community activities related to other health
388.29initiatives, particularly those initiatives targeted at the elderly;
388.30(3) is conducted by an applicant able to demonstrate expertise in the project areas;
389.1(4) utilizes and enhances existing activities and resources or involves innovative
389.2approaches to achieve success in the project areas; and
389.3(5) strengthens community relationships and partnerships in order to achieve the project
389.4areas.
389.5(f) The board shall divide the state into specific geographic regions and allocate a
389.6percentage of the money available for the local and regional dementia grants to projects or
389.7initiatives aimed at each geographic region.
389.8(g) The board shall award any available grants by January 1, 2016, and each July 1
389.9thereafter.
389.10(h) Each grant recipient shall report to the board on the progress of the initiative at least
389.11once during the grant period, and within two months of the end of the grant period shall
389.12submit a final report to the board that includes the outcome results.
389.13(i) The Minnesota Board on Aging shall:
389.14(1) develop the criteria and procedures to allocate the grants under this subdivision,
389.15evaluate all applicants on a competitive basis and award the grants, and select qualified
389.16providers to offer technical assistance to grant applicants and grantees. The selected provider
389.17shall provide applicants and grantees assistance with project design, evaluation methods,
389.18materials, and training; and.
389.19(2) submit by January 15, 2017, and on each January 15 thereafter, a progress report on
389.20the dementia grants programs under this subdivision to the chairs and ranking minority
389.21members of the senate and house of representatives committees and divisions with jurisdiction
389.22over health finance and policy. The report shall include:
389.23(i) information on each grant recipient;
389.24(ii) a summary of all projects or initiatives undertaken with each grant;
389.25(iii) the measurable outcomes established by each grantee, an explanation of the
389.26evaluation process used to determine whether the outcomes were met, and the results of the
389.27evaluation; and
389.28(iv) an accounting of how the grant funds were spent.

389.29    Sec. 19. Minnesota Statutes 2020, section 256.975, subdivision 12, is amended to read:
389.30    Subd. 12. Self-directed caregiver grants. The Minnesota Board on Aging shall, in
389.31consultation with area agencies on aging and other community caregiver stakeholders,
390.1administer self-directed caregiver grants to support at-risk family caregivers of older adults
390.2or others eligible under the Older Americans Act of 1965, United States Code, title 42,
390.3chapter 35, sections 3001 to 3058ff, to sustain family caregivers in the caregivers' roles so
390.4older adults can remain at home longer. The board shall submit by January 15, 2022, and
390.5each January 15 thereafter, a progress report on the self-directed caregiver grants program
390.6to the chairs and ranking minority members of the senate and house of representatives
390.7committees and divisions with jurisdiction over human services. The progress report must
390.8include metrics on the use of the grant program.

390.9    Sec. 20. Minnesota Statutes 2020, section 256B.0561, subdivision 4, is amended to read:
390.10    Subd. 4. Report. (a) By September 1, 2019, and each September 1 thereafter, the
390.11commissioner shall submit a report to the chairs and ranking minority members of the house
390.12and senate committees with jurisdiction over human services finance that includes the
390.13number of cases affected by periodic data matching under this section, the number of
390.14recipients identified as possibly ineligible as a result of a periodic data match, and the number
390.15of recipients whose eligibility was terminated as a result of a periodic data match. The report
390.16must also specify, for recipients whose eligibility was terminated, how many cases were
390.17closed due to failure to cooperate.
390.18(b) This subdivision expires January 1, 2027.

390.19    Sec. 21. Minnesota Statutes 2020, section 256B.0911, subdivision 5, is amended to read:
390.20    Subd. 5. Administrative activity. (a) The commissioner shall streamline the processes,
390.21including timelines for when assessments need to be completed, required to provide the
390.22services in this section and shall implement integrated solutions to automate the business
390.23processes to the extent necessary for community support plan approval, reimbursement,
390.24program planning, evaluation, and policy development.
390.25(b) The commissioner of human services shall work with lead agencies responsible for
390.26conducting long-term consultation services to modify the MnCHOICES application and
390.27assessment policies to create efficiencies while ensuring federal compliance with medical
390.28assistance and long-term services and supports eligibility criteria.
390.29(c) The commissioner shall work with lead agencies responsible for conducting long-term
390.30consultation services to develop a set of measurable benchmarks sufficient to demonstrate
390.31quarterly improvement in the average time per assessment and other mutually agreed upon
390.32measures of increasing efficiency. The commissioner shall collect data on these benchmarks
390.33and provide to the lead agencies and the chairs and ranking minority members of the
391.1legislative committees with jurisdiction over human services an annual trend analysis of
391.2the data in order to demonstrate the commissioner's compliance with the requirements of
391.3this subdivision.

391.4    Sec. 22. Minnesota Statutes 2020, section 256B.0949, subdivision 17, is amended to read:
391.5    Subd. 17. Provider shortage; authority for exceptions. (a) In consultation with the
391.6Early Intensive Developmental and Behavioral Intervention Advisory Council and
391.7stakeholders, including agencies, professionals, parents of people with ASD or a related
391.8condition, and advocacy organizations, the commissioner shall determine if a shortage of
391.9EIDBI providers exists. For the purposes of this subdivision, "shortage of EIDBI providers"
391.10means a lack of availability of providers who meet the EIDBI provider qualification
391.11requirements under subdivision 15 that results in the delay of access to timely services under
391.12this section, or that significantly impairs the ability of a provider agency to have sufficient
391.13providers to meet the requirements of this section. The commissioner shall consider
391.14geographic factors when determining the prevalence of a shortage. The commissioner may
391.15determine that a shortage exists only in a specific region of the state, multiple regions of
391.16the state, or statewide. The commissioner shall also consider the availability of various types
391.17of treatment modalities covered under this section.
391.18(b) The commissioner, in consultation with the Early Intensive Developmental and
391.19Behavioral Intervention Advisory Council and stakeholders, must establish processes and
391.20criteria for granting an exception under this paragraph. The commissioner may grant an
391.21exception only if the exception would not compromise a person's safety and not diminish
391.22the effectiveness of the treatment. The commissioner may establish an expiration date for
391.23an exception granted under this paragraph. The commissioner may grant an exception for
391.24the following:
391.25(1) EIDBI provider qualifications under this section;
391.26(2) medical assistance provider enrollment requirements under section 256B.04,
391.27subdivision 21; or
391.28(3) EIDBI provider or agency standards or requirements.
391.29(c) If the commissioner, in consultation with the Early Intensive Developmental and
391.30Behavioral Intervention Advisory Council and stakeholders, determines that a shortage no
391.31longer exists, the commissioner must submit a notice that a shortage no longer exists to the
391.32chairs and ranking minority members of the senate and the house of representatives
391.33committees with jurisdiction over health and human services. The commissioner must post
392.1the notice for public comment for 30 days. The commissioner shall consider public comments
392.2before submitting to the legislature a request to end the shortage declaration. The
392.3commissioner shall annually provide an update on the status of the provider shortage and
392.4exceptions granted to the chairs and ranking minority members of the senate and house of
392.5representatives committees with jurisdiction over health and human services. The
392.6commissioner shall not declare the shortage of EIDBI providers ended without direction
392.7from the legislature to declare it ended.

392.8    Sec. 23. Minnesota Statutes 2020, section 256B.493, subdivision 2, is amended to read:
392.9    Subd. 2. Planned closure process needs determination. A resource need determination
392.10process, managed at the state level, using available reports data required by section 144A.351
392.11and other data and information shall be used by the commissioner to align capacity where
392.12needed.

392.13    Sec. 24. Minnesota Statutes 2020, section 256B.69, subdivision 9d, is amended to read:
392.14    Subd. 9d. Financial and quality assurance audits. (a) The commissioner shall require,
392.15in the request for bids and resulting contracts with managed care plans and county-based
392.16purchasing plans under this section and section 256B.692, that each managed care plan and
392.17county-based purchasing plan submit to and fully cooperate with the independent third-party
392.18financial audits by the legislative auditor under subdivision 9e of the information required
392.19under subdivision 9c, paragraph (b). Each contract with a managed care plan or county-based
392.20purchasing plan under this section or section 256B.692 must provide the commissioner, the
392.21legislative auditor, and vendors contracting with the legislative auditor, access to all data
392.22required to complete audits under subdivision 9e.
392.23(b) Each managed care plan and county-based purchasing plan providing services under
392.24this section shall provide to the commissioner biweekly encounter data and claims data for
392.25state public health care programs and shall participate in a quality assurance program that
392.26verifies the timeliness, completeness, accuracy, and consistency of the data provided. The
392.27commissioner shall develop written protocols for the quality assurance program and shall
392.28make the protocols publicly available. The commissioner shall contract for an independent
392.29third-party audit to evaluate the quality assurance protocols as to the capacity of the protocols
392.30to ensure complete and accurate data and to evaluate the commissioner's implementation
392.31of the protocols.
393.1(c) Upon completion of the evaluation under paragraph (b), the commissioner shall
393.2provide copies of the report to the legislative auditor and the chairs and ranking minority
393.3members of the legislative committees with jurisdiction over health care policy and financing.
393.4(d) Any actuary under contract with the commissioner to provide actuarial services must
393.5meet the independence requirements under the professional code for fellows in the Society
393.6of Actuaries and must not have provided actuarial services to a managed care plan or
393.7county-based purchasing plan that is under contract with the commissioner pursuant to this
393.8section and section 256B.692 during the period in which the actuarial services are being
393.9provided. An actuary or actuarial firm meeting the requirements of this paragraph must
393.10certify and attest to the rates paid to the managed care plans and county-based purchasing
393.11plans under this section and section 256B.692, and the certification and attestation must be
393.12auditable.
393.13(e) The commissioner, to the extent of available funding, shall conduct ad hoc audits of
393.14state public health care program administrative and medical expenses reported by managed
393.15care plans and county-based purchasing plans. This includes: financial and encounter data
393.16reported to the commissioner under subdivision 9c, including payments to providers and
393.17subcontractors; supporting documentation for expenditures; categorization of administrative
393.18and medical expenses; and allocation methods used to attribute administrative expenses to
393.19state public health care programs. These audits also must monitor compliance with data and
393.20financial report certification requirements established by the commissioner for the purposes
393.21of managed care capitation payment rate-setting. The managed care plans and county-based
393.22purchasing plans shall fully cooperate with the audits in this subdivision.
393.23The commissioner shall report to the chairs and ranking minority members of the
393.24legislative committees with jurisdiction over health and human services policy and finance
393.25by February 1, 2016, and each February 1 thereafter, the number of ad hoc audits conducted
393.26in the past calendar year and the results of these audits.
393.27(f) Nothing in this subdivision shall allow the release of information that is nonpublic
393.28data pursuant to section 13.02.

393.29    Sec. 25. Minnesota Statutes 2020, section 256E.28, subdivision 6, is amended to read:
393.30    Subd. 6. Evaluation. (a) Using the outcomes established according to subdivision 3,
393.31the commissioner shall conduct a biennial evaluation of the grant program funded under
393.32this section. Grant recipients shall cooperate with the commissioner in the evaluation and
393.33shall provide the commissioner with the information needed to conduct the evaluation.
394.1    (b) The commissioner shall consult with the legislative task force on child protection
394.2during the evaluation process and.
394.3    (c) The commissioner shall submit a biennial evaluation report to the task force and to
394.4the chairs and ranking minority members of the house of representatives and senate
394.5committees with jurisdiction over child protection funding. This paragraph expires January
394.61, 2032.

394.7    Sec. 26. Minnesota Statutes 2020, section 256R.18, is amended to read:
394.8256R.18 REPORT BY COMMISSIONER OF HUMAN SERVICES.
394.9(a) Beginning January 1, 2019, the commissioner shall provide to the house of
394.10representatives and senate committees with jurisdiction over nursing facility payment rates
394.11a biennial report on the effectiveness of the reimbursement system in improving quality,
394.12restraining costs, and any other features of the system as determined by the commissioner.
394.13(b) This section expires January 1, 2026.

394.14    Sec. 27. Minnesota Statutes 2020, section 257.0725, is amended to read:
394.15257.0725 ANNUAL REPORT.
394.16(a) The commissioner of human services shall publish an annual report on child
394.17maltreatment and on children in out-of-home placement. The commissioner shall confer
394.18with counties, child welfare organizations, child advocacy organizations, the courts, and
394.19other groups on how to improve the content and utility of the department's annual report.
394.20In regard to child maltreatment, the report shall include the number and kinds of maltreatment
394.21reports received and any other data that the commissioner determines is appropriate to
394.22include in a report on child maltreatment. In regard to children in out-of-home placement,
394.23the report shall include, by county and statewide, information on legal status, living
394.24arrangement, age, sex, race, accumulated length of time in placement, reason for most recent
394.25placement, race of family with whom placed, school enrollments within seven days of
394.26placement pursuant to section 120A.21, and other information deemed appropriate on all
394.27children in out-of-home placement. Out-of-home placement includes placement in any
394.28facility by an authorized child-placing agency.
394.29(b) This section expires January 1, 2032.

395.1    Sec. 28. Minnesota Statutes 2020, section 260.775, is amended to read:
395.2260.775 PLACEMENT RECORDS.
395.3(a) The commissioner of human services shall publish annually an inventory of all Indian
395.4children in residential facilities. The inventory shall include, by county and statewide,
395.5information on legal status, living arrangement, age, sex, tribe in which the child is a member
395.6or eligible for membership, accumulated length of time in foster care, and other demographic
395.7information deemed appropriate concerning all Indian children in residential facilities. The
395.8report must also state the extent to which authorized child-placing agencies comply with
395.9the order of preference described in United States Code, title 25, section 1901, et seq. The
395.10commissioner shall include the information required under this paragraph in the annual
395.11report on child maltreatment and on children in out-of-home placement under section
395.12257.0725.
395.13(b) This section expires January 1, 2032.

395.14    Sec. 29. Minnesota Statutes 2020, section 260E.24, subdivision 6, is amended to read:
395.15    Subd. 6. Required referral to early intervention services. (a) A child under age three
395.16who is involved in a substantiated case of maltreatment shall be referred for screening under
395.17the Individuals with Disabilities Education Act, part C. Parents must be informed that the
395.18evaluation and acceptance of services are voluntary. The commissioner of human services
395.19shall monitor referral rates by county and annually report the information to the legislature.
395.20Refusal to have a child screened is not a basis for a child in need of protection or services
395.21petition under chapter 260C.
395.22(b) The commissioner of human services shall include the referral rates by county for
395.23screening under the Individuals with Disabilities Education Act, part C in the annual report
395.24on child maltreatment under section 257.0725. This paragraph expires January 1, 2032.

395.25    Sec. 30. Minnesota Statutes 2020, section 260E.38, subdivision 3, is amended to read:
395.26    Subd. 3. Report required. (a) The commissioner shall produce an annual report of the
395.27summary results of the reviews. The report must only contain aggregate data and may not
395.28include any data that could be used to personally identify any subject whose data is included
395.29in the report. The report is public information and must be provided to the chairs and ranking
395.30minority members of the legislative committees having jurisdiction over child protection
395.31issues. The commissioner shall include the information required under this paragraph in the
396.1annual report on child maltreatment and on children in out-of-home placement under section
396.2257.0725.
396.3(b) This subdivision expires January 1, 2032.

396.4    Sec. 31. Minnesota Statutes 2020, section 518A.77, is amended to read:
396.5518A.77 GUIDELINES REVIEW.
396.6    (a) No later than 2006 and every four years after that, the Department of Human Services
396.7must conduct a review of the child support guidelines.
396.8    (b) This section expires January 1, 2032.

396.9    Sec. 32. Minnesota Statutes 2020, section 626.557, subdivision 12b, is amended to read:
396.10    Subd. 12b. Data management. (a) In performing any of the duties of this section as a
396.11lead investigative agency, the county social service agency shall maintain appropriate
396.12records. Data collected by the county social service agency under this section are welfare
396.13data under section 13.46. Notwithstanding section 13.46, subdivision 1, paragraph (a), data
396.14under this paragraph that are inactive investigative data on an individual who is a vendor
396.15of services are private data on individuals, as defined in section 13.02. The identity of the
396.16reporter may only be disclosed as provided in paragraph (c).
396.17Data maintained by the common entry point are confidential data on individuals or
396.18protected nonpublic data as defined in section 13.02. Notwithstanding section 138.163, the
396.19common entry point shall maintain data for three calendar years after date of receipt and
396.20then destroy the data unless otherwise directed by federal requirements.
396.21(b) The commissioners of health and human services shall prepare an investigation
396.22memorandum for each report alleging maltreatment investigated under this section. County
396.23social service agencies must maintain private data on individuals but are not required to
396.24prepare an investigation memorandum. During an investigation by the commissioner of
396.25health or the commissioner of human services, data collected under this section are
396.26confidential data on individuals or protected nonpublic data as defined in section 13.02.
396.27Upon completion of the investigation, the data are classified as provided in clauses (1) to
396.28(3) and paragraph (c).
396.29(1) The investigation memorandum must contain the following data, which are public:
396.30(i) the name of the facility investigated;
396.31(ii) a statement of the nature of the alleged maltreatment;
397.1(iii) pertinent information obtained from medical or other records reviewed;
397.2(iv) the identity of the investigator;
397.3(v) a summary of the investigation's findings;
397.4(vi) statement of whether the report was found to be substantiated, inconclusive, false,
397.5or that no determination will be made;
397.6(vii) a statement of any action taken by the facility;
397.7(viii) a statement of any action taken by the lead investigative agency; and
397.8(ix) when a lead investigative agency's determination has substantiated maltreatment, a
397.9statement of whether an individual, individuals, or a facility were responsible for the
397.10substantiated maltreatment, if known.
397.11The investigation memorandum must be written in a manner which protects the identity
397.12of the reporter and of the vulnerable adult and may not contain the names or, to the extent
397.13possible, data on individuals or private data listed in clause (2).
397.14(2) Data on individuals collected and maintained in the investigation memorandum are
397.15private data, including:
397.16(i) the name of the vulnerable adult;
397.17(ii) the identity of the individual alleged to be the perpetrator;
397.18(iii) the identity of the individual substantiated as the perpetrator; and
397.19(iv) the identity of all individuals interviewed as part of the investigation.
397.20(3) Other data on individuals maintained as part of an investigation under this section
397.21are private data on individuals upon completion of the investigation.
397.22(c) After the assessment or investigation is completed, the name of the reporter must be
397.23confidential. The subject of the report may compel disclosure of the name of the reporter
397.24only with the consent of the reporter or upon a written finding by a court that the report was
397.25false and there is evidence that the report was made in bad faith. This subdivision does not
397.26alter disclosure responsibilities or obligations under the Rules of Criminal Procedure, except
397.27that where the identity of the reporter is relevant to a criminal prosecution, the district court
397.28shall do an in-camera review prior to determining whether to order disclosure of the identity
397.29of the reporter.
398.1(d) Notwithstanding section 138.163, data maintained under this section by the
398.2commissioners of health and human services must be maintained under the following
398.3schedule and then destroyed unless otherwise directed by federal requirements:
398.4(1) data from reports determined to be false, maintained for three years after the finding
398.5was made;
398.6(2) data from reports determined to be inconclusive, maintained for four years after the
398.7finding was made;
398.8(3) data from reports determined to be substantiated, maintained for seven years after
398.9the finding was made; and
398.10(4) data from reports which were not investigated by a lead investigative agency and for
398.11which there is no final disposition, maintained for three years from the date of the report.
398.12(e) The commissioners of health and human services shall annually publish on their
398.13websites the number and type of reports of alleged maltreatment involving licensed facilities
398.14reported under this section, the number of those requiring investigation under this section,
398.15and the resolution of those investigations.
398.16On a biennial basis, the commissioners of health and human services shall jointly report
398.17the following information to the legislature and the governor:
398.18(1) the number and type of reports of alleged maltreatment involving licensed facilities
398.19reported under this section, the number of those requiring investigations under this section,
398.20the resolution of those investigations, and which of the two lead agencies was responsible;
398.21(2) trends about types of substantiated maltreatment found in the reporting period;
398.22(3) if there are upward trends for types of maltreatment substantiated, recommendations
398.23for addressing and responding to them;
398.24(4) efforts undertaken or recommended to improve the protection of vulnerable adults;
398.25(5) whether and where backlogs of cases result in a failure to conform with statutory
398.26time frames and recommendations for reducing backlogs if applicable;
398.27(6) recommended changes to statutes affecting the protection of vulnerable adults; and
398.28(7) any other information that is relevant to the report trends and findings.
398.29(f) Each lead investigative agency must have a record retention policy.
398.30(g) Lead investigative agencies, prosecuting authorities, and law enforcement agencies
398.31may exchange not public data, as defined in section 13.02, if the agency or authority
399.1requesting the data determines that the data are pertinent and necessary to the requesting
399.2agency in initiating, furthering, or completing an investigation under this section. Data
399.3collected under this section must be made available to prosecuting authorities and law
399.4enforcement officials, local county agencies, and licensing agencies investigating the alleged
399.5maltreatment under this section. The lead investigative agency shall exchange not public
399.6data with the vulnerable adult maltreatment review panel established in section 256.021 if
399.7the data are pertinent and necessary for a review requested under that section.
399.8Notwithstanding section 138.17, upon completion of the review, not public data received
399.9by the review panel must be destroyed.
399.10(h) Each lead investigative agency shall keep records of the length of time it takes to
399.11complete its investigations.
399.12(i) A lead investigative agency may notify other affected parties and their authorized
399.13representative if the lead investigative agency has reason to believe maltreatment has occurred
399.14and determines the information will safeguard the well-being of the affected parties or dispel
399.15widespread rumor or unrest in the affected facility.
399.16(j) Under any notification provision of this section, where federal law specifically
399.17prohibits the disclosure of patient identifying information, a lead investigative agency may
399.18not provide any notice unless the vulnerable adult has consented to disclosure in a manner
399.19which conforms to federal requirements.

399.20    Sec. 33. REPEALER.
399.21(a) Minnesota Statutes 2020, sections 62U.10, subdivision 3; 144.1911, subdivision 10;
399.22144.564, subdivision 3; 144A.483, subdivision 2; 245.981; 246.131; 246B.03, subdivision
399.232; 246B.035; 256.01, subdivision 31; and 256B.0638, subdivision 7, are repealed.
399.24(b) Laws 1998, chapter 382, article 1, section 23, is repealed.

399.25ARTICLE 15
399.26FORECAST ADJUSTMENTS AND CARRY FORWARD AUTHORITY

399.27
 Section 1. HUMAN SERVICES APPROPRIATION.
399.28The dollar amounts shown in the columns marked "Appropriations" are added to or, if
399.29shown in parentheses, are subtracted from the appropriations in Laws 2021, First Special
399.30Session chapter 7, article 16, from the general fund or any fund named to the Department
399.31of Human Services for the purposes specified in this article, to be available for the fiscal
399.32year indicated for each purpose. The figures "2022" and "2023" used in this article mean
399.33that the appropriations listed under them are available for the fiscal years ending June 30,
400.12022, or June 30, 2023, respectively. "The first year" is fiscal year 2022. "The second year"
400.2is fiscal year 2023. "The biennium" is fiscal years 2022 and 2023.
400.3
 APPROPRIATIONS
400.4
 Available for the Year
400.5
 Ending June 30
400.6
 2022
 2023

400.7
400.8
 Sec. 2. COMMISSIONER OF HUMAN
SERVICES
400.9
 Subdivision 1.Total Appropriation
 $
 (585,901,000)
 $
 182,791,000
400.10
 Appropriations by Fund
400.11
 General Fund
 (406,629,000)
 185,395,000
400.12
400.13
 Health Care Access
Fund
 (86,146,000)
 (11,799,000)
400.14
 Federal TANF
 (93,126,000)
 9,195,000
400.15
 Subd. 2.Forecasted Programs
400.16
 (a) MFIP/DWP
400.17
 Appropriations by Fund
400.18
 General Fund
 72,106,000
 (14,397,000)
400.19
 Federal TANF
 (93,126,000)
 9,195,000
400.20
 (b) MFIP Child Care Assistance
 (103,347,000)
 (73,738,000)
400.21
 (c) General Assistance
 (4,175,000)
 (1,488,000)
400.22
 (d) Minnesota Supplemental Aid
 318,000
 1,613,000
400.23
 (e) Housing Support
 (1,994,000)
 9,257,000
400.24
 (f) Northstar Care for Children
 (9,613,000)
 (4,865,000)
400.25
 (g) MinnesotaCare
 (86,146,000)
 (11,799,000)
400.26These appropriations are from the health care
400.27access fund.
400.28
 (h) Medical Assistance
400.29
 Appropriations by Fund
400.30
 General Fund
 (348,364,000)
 292,880,000
400.31
400.32
 Health Care Access
Fund
 -0-
 -0-
400.33
 (i) Alternative Care Program
 -0-
 -0-
401.1
 (j) Behavioral Health Fund
 (11,560,000)
 (23,867,000)
401.2
 Subd. 3.Technical Activities
 -0-
 -0-
401.3These appropriations are from the federal
401.4TANF fund.
401.5EFFECTIVE DATE.This section is effective the day following final enactment.

401.6    Sec. 3. Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 23,
401.7is amended to read:
401.8
401.9
 Subd. 23.Grant Programs; Children and
Community Service Grants
 61,251,000
 61,856,000
60,856,000
401.10EFFECTIVE DATE.This section is effective the day following final enactment.

401.11    Sec. 4. Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 24,
401.12is amended to read:
401.13
401.14
 Subd. 24.Grant Programs; Children and
Economic Support Grants
 29,740,000
 29,740,000
30,740,000
401.15Minnesota Food Assistance Program.
401.16Unexpended funds for the Minnesota food
401.17assistance program for fiscal year 2022 do not
401.18cancel but are available in fiscal year 2023.
401.19EFFECTIVE DATE.This section is effective the day following final enactment.

401.20    Sec. 5. Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 29,
401.21is amended to read:
401.22
 Subd. 29.Grant Programs; Disabilities Grants
 31,398,000
 31,010,000
401.23(a) Training Stipends for Direct Support
401.24Services Providers. $1,000,000 in fiscal year
401.252022 is from the general fund for stipends for
401.26individual providers of direct support services
401.27as defined in Minnesota Statutes, section
401.28256B.0711, subdivision 1. These The stipends
401.29are available to individual providers who have
401.30completed designated voluntary trainings
401.31made available through the State-Provider
402.1Cooperation Committee formed by the State
402.2of Minnesota and the Service Employees
402.3International Union Healthcare Minnesota.
402.4Any unspent appropriation in fiscal year 2022
402.5is available in fiscal year 2023. This is a
402.6onetime appropriation. This appropriation is
402.7available only if the labor agreement between
402.8the state of Minnesota and the Service
402.9Employees International Union Healthcare
402.10Minnesota under Minnesota Statutes, section
402.11179A.54, is approved under Minnesota
402.12Statutes, section 3.855.
402.13(b) Parent-to-Parent Peer Support. $125,000
402.14in fiscal year 2022 and $125,000 in fiscal year
402.152023 are from the general fund for a grant to
402.16an alliance member of Parent to Parent USA
402.17to support the alliance member's
402.18parent-to-parent peer support program for
402.19families of children with a disability or special
402.20health care need.
402.21(c) Self-Advocacy Grants. (1) $143,000 in
402.22fiscal year 2022 and $143,000 in fiscal year
402.232023 are from the general fund for a grant
402.24under Minnesota Statutes, section 256.477,
402.25subdivision 1.
402.26(2) $105,000 in fiscal year 2022 and $105,000
402.27in fiscal year 2023 are from the general fund
402.28for subgrants under Minnesota Statutes,
402.29section 256.477, subdivision 2.
402.30(d) Minnesota Inclusion Initiative Grants.
402.31$150,000 in fiscal year 2022 and $150,000 in
402.32fiscal year 2023 are from the general fund for
402.33grants under Minnesota Statutes, section
402.34256.4772.
403.1(e) Grants to Expand Access to Child Care
403.2for Children with Disabilities. $250,000 in
403.3fiscal year 2022 and $250,000 in fiscal year
403.42023 are from the general fund for grants to
403.5expand access to child care for children with
403.6disabilities. Any unexpended amount in fiscal
403.7year 2022 is available through June 30, 2023.
403.8This is a onetime appropriation.
403.9(f) Parenting with a Disability Pilot Project.
403.10The general fund base includes $1,000,000 in
403.11fiscal year 2024 and $0 in fiscal year 2025 to
403.12implement the parenting with a disability pilot
403.13project.
403.14(g) Base Level Adjustment. The general fund
403.15base is $29,260,000 in fiscal year 2024 and
403.16$22,260,000 in fiscal year 2025.
403.17EFFECTIVE DATE.This section is effective the day following final enactment.

403.18    Sec. 6. Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 31,
403.19is amended to read:
403.20
403.21
 Subd. 31.Grant Programs; Adult Mental Health
Grants
403.22
 Appropriations by Fund
403.23
 General
 98,772,000
 98,703,000
403.24
403.25
 Opiate Epidemic
Response
 2,000,000
 2,000,000
403.26(a) Culturally and Linguistically
403.27Appropriate Services Implementation
403.28Grants. $2,275,000 in fiscal year 2022 and
403.29$2,206,000 in fiscal year 2023 are from the
403.30general fund for grants to disability services,
403.31mental health, and substance use disorder
403.32treatment providers to implement culturally
403.33and linguistically appropriate services
403.34standards, according to the implementation
404.1and transition plan developed by the
404.2commissioner. Any unexpended amount in
404.3fiscal year 2022 is available through June 30,
404.42023. The general fund base for this
404.5appropriation is $1,655,000 in fiscal year 2024
404.6and $0 in fiscal year 2025.
404.7(b) Base Level Adjustment. The general fund
404.8base is $93,295,000 in fiscal year 2024 and
404.9$83,324,000 in fiscal year 2025. The opiate
404.10epidemic response fund base is $2,000,000 in
404.11fiscal year 2024 and $0 in fiscal year 2025.
404.12EFFECTIVE DATE.This section is effective the day following final enactment.

404.13    Sec. 7. Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 32,
404.14is amended to read:
404.15
404.16
 Subd. 32.Grant Programs; Child Mental Health
Grants
 30,167,000
 30,182,000
404.17(a) Children's Residential Facilities.
404.18$1,964,000 in fiscal year 2022 and $1,979,000
404.19in fiscal year 2023 are to reimburse counties
404.20and Tribal governments for a portion of the
404.21costs of treatment in children's residential
404.22facilities. The commissioner shall distribute
404.23the appropriation on an annual basis to
404.24counties and Tribal governments
404.25proportionally based on a methodology
404.26developed by the commissioner. The fiscal
404.27year 2022 appropriation is available until June
404.2830, 2023.
404.29(b) Base Level Adjustment. The general fund
404.30base is $29,580,000 in fiscal year 2024 and
404.31$27,705,000 in fiscal year 2025.
404.32EFFECTIVE DATE.This section is effective the day following final enactment.

405.1    Sec. 8. Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 33,
405.2is amended to read:
405.3
405.4
 Subd. 33.Grant Programs; Chemical
Dependency Treatment Support Grants
405.5
 Appropriations by Fund
405.6
 General
 4,273,000
 4,274,000
405.7
 Lottery Prize
 1,733,000
 1,733,000
405.8
405.9
 Opiate Epidemic
Response
 500,000
 500,000
405.10(a) Problem Gambling. $225,000 in fiscal
405.11year 2022 and $225,000 in fiscal year 2023
405.12are from the lottery prize fund for a grant to
405.13the state affiliate recognized by the National
405.14Council on Problem Gambling. The affiliate
405.15must provide services to increase public
405.16awareness of problem gambling, education,
405.17training for individuals and organizations
405.18providing effective treatment services to
405.19problem gamblers and their families, and
405.20research related to problem gambling.
405.21(b) Recovery Community Organization
405.22Grants. $2,000,000 in fiscal year 2022 and
405.23$2,000,000 in fiscal year 2023 are from the
405.24general fund for grants to recovery community
405.25organizations, as defined in Minnesota
405.26Statutes, section 254B.01, subdivision 8, to
405.27provide for costs and community-based peer
405.28recovery support services that are not
405.29otherwise eligible for reimbursement under
405.30Minnesota Statutes, section 254B.05, as part
405.31of the continuum of care for substance use
405.32disorders. Any unexpended amount in fiscal
405.33year 2022 is available through June 30, 2023.
405.34The general fund base for this appropriation
405.35is $2,000,000 in fiscal year 2024 and $0 in
405.36fiscal year 2025
406.1(c) Base Level Adjustment. The general fund
406.2base is $4,636,000 in fiscal year 2024 and
406.3$2,636,000 in fiscal year 2025. The opiate
406.4epidemic response fund base is $500,000 in
406.5fiscal year 2024 and $0 in fiscal year 2025.
406.6EFFECTIVE DATE.This section is effective the day following final enactment.

406.7    Sec. 9. Laws 2021, First Special Session chapter 7, article 17, section 3, is amended to
406.8read:
406.9    Sec. 3. GRANTS FOR TECHNOLOGY FOR HCBS RECIPIENTS.
406.10(a) This act includes $500,000 in fiscal year 2022 and $2,000,000 in fiscal year 2023
406.11for the commissioner of human services to issue competitive grants to home and
406.12community-based service providers. Grants must be used to provide technology assistance,
406.13including but not limited to Internet services, to older adults and people with disabilities
406.14who do not have access to technology resources necessary to use remote service delivery
406.15and telehealth. Any unexpended amount in fiscal year 2022 is available through June 30,
406.162023. The general fund base included in this act for this purpose is $1,500,000 in fiscal year
406.172024 and $0 in fiscal year 2025.
406.18(b) All grant activities must be completed by March 31, 2024.
406.19(c) This section expires June 30, 2024.
406.20EFFECTIVE DATE.This section is effective the day following final enactment.

406.21    Sec. 10. Laws 2021, First Special Session chapter 7, article 17, section 6, is amended to
406.22read:
406.23    Sec. 6. TRANSITION TO COMMUNITY INITIATIVE.
406.24(a) This act includes $5,500,000 in fiscal year 2022 and $5,500,000 in fiscal year 2023
406.25for additional funding for grants awarded under the transition to community initiative
406.26described in Minnesota Statutes, section 256.478. Any unexpended amount in fiscal year
406.272022 is available through June 30, 2023. The general fund base in this act for this purpose
406.28is $4,125,000 in fiscal year 2024 and $0 in fiscal year 2025.
406.29(b) All grant activities must be completed by March 31, 2024.
406.30(c) This section expires June 30, 2024.
407.1EFFECTIVE DATE.This section is effective the day following final enactment.

407.2    Sec. 11. Laws 2021, First Special Session chapter 7, article 17, section 10, is amended to
407.3read:
407.4    Sec. 10. PROVIDER CAPACITY GRANTS FOR RURAL AND UNDERSERVED
407.5COMMUNITIES.
407.6(a) This act includes $6,000,000 in fiscal year 2022 and $8,000,000 in fiscal year 2023
407.7for the commissioner to establish a grant program for small provider organizations that
407.8provide services to rural or underserved communities with limited home and
407.9community-based services provider capacity. The grants are available to build organizational
407.10capacity to provide home and community-based services in Minnesota and to build new or
407.11expanded infrastructure to access medical assistance reimbursement. Any unexpended
407.12amount in fiscal year 2022 is available through June 30, 2023. The general fund base in this
407.13act for this purpose is $8,000,000 in fiscal year 2024 and $0 in fiscal year 2025.
407.14(b) The commissioner shall conduct community engagement, provide technical assistance,
407.15and establish a collaborative learning community related to the grants available under this
407.16section and work with the commissioner of management and budget and the commissioner
407.17of the Department of Administration to mitigate barriers in accessing grant funds. Funding
407.18awarded for the community engagement activities described in this paragraph is exempt
407.19from state solicitation requirements under Minnesota Statutes, section 16B.97, for activities
407.20that occur in fiscal year 2022.
407.21(c) All grant activities must be completed by March 31, 2024.
407.22(d) This section expires June 30, 2024.
407.23EFFECTIVE DATE.This section is effective the day following final enactment.

407.24    Sec. 12. Laws 2021, First Special Session chapter 7, article 17, section 11, is amended to
407.25read:
407.26    Sec. 11. EXPAND MOBILE CRISIS.
407.27(a) This act includes $8,000,000 in fiscal year 2022 and $8,000,000 in fiscal year 2023
407.28for additional funding for grants for adult mobile crisis services under Minnesota Statutes,
407.29section 245.4661, subdivision 9, paragraph (b), clause (15). Any unexpended amounts in
407.30fiscal year 2022 and fiscal year 2023 are available through June 30, 2024. The general fund
407.31base in this act for this purpose is $4,000,000 in fiscal year 2024 and $0 in fiscal year 2025.
408.1(b) Beginning April 1, 2024, counties may fund and continue conducting activities
408.2funded under this section.
408.3(c) All grant activities must be completed by March 31, 2024.
408.4(d) This section expires June 30, 2024.
408.5EFFECTIVE DATE.This section is effective the day following final enactment.

408.6    Sec. 13. Laws 2021, First Special Session chapter 7, article 17, section 12, is amended to
408.7read:
408.8    Sec. 12. PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY AND CHILD
408.9AND ADOLESCENT MOBILE TRANSITION UNIT.
408.10(a) This act includes $2,500,000 in fiscal year 2022 and $2,500,000 in fiscal year 2023
408.11for the commissioner of human services to create children's mental health transition and
408.12support teams to facilitate transition back to the community of children from psychiatric
408.13residential treatment facilities, and child and adolescent behavioral health hospitals. Any
408.14unexpended amount in fiscal year 2022 is available through June 30, 2023. The general
408.15fund base included in this act for this purpose is $1,875,000 in fiscal year 2024 and $0 in
408.16fiscal year 2025.
408.17(b) Beginning April 1, 2024, counties may fund and continue conducting activities
408.18funded under this section.
408.19(c) This section expires March 31, 2024.
408.20EFFECTIVE DATE.This section is effective the day following final enactment.

408.21    Sec. 14. Laws 2021, First Special Session chapter 7, article 17, section 17, subdivision 3,
408.22is amended to read:
408.23    Subd. 3. Respite services for older adults grants. (a) This act includes $2,000,000 in
408.24fiscal year 2022 and $2,000,000 in fiscal year 2023 for the commissioner of human services
408.25to establish a grant program for respite services for older adults. The commissioner must
408.26award grants on a competitive basis to respite service providers. Any unexpended amount
408.27in fiscal year 2022 is available through June 30, 2023. The general fund base included in
408.28this act for this purpose is $2,000,000 in fiscal year 2024 and $0 in fiscal year 2025.
408.29(b) All grant activities must be completed by March 31, 2024.
408.30(c) This subdivision expires June 30, 2024.
409.1EFFECTIVE DATE.This section is effective the day following final enactment.

409.2    Sec. 15. Laws 2021, First Special Session chapter 7, article 17, section 19, is amended to
409.3read:
409.4    Sec. 19. CENTERS FOR INDEPENDENT LIVING HCBS ACCESS GRANT.
409.5(a) This act includes $1,200,000 in fiscal year 2022 and $1,200,000 in fiscal year 2023
409.6for grants to expand services to support people with disabilities from underserved
409.7communities who are ineligible for medical assistance to live in their own homes and
409.8communities by providing accessibility modifications, independent living services, and
409.9public health program facilitation. The commissioner of human services must award the
409.10grants in equal amounts to the eight organizations grantees. To be eligible, a grantee must
409.11be an organization defined in Minnesota Statutes, section 268A.01, subdivision 8. Any
409.12unexpended amount in fiscal year 2022 is available through June 30, 2023. The general
409.13fund base included in this act for this purpose is $0 in fiscal year 2024 and $0 in fiscal year
409.142025.
409.15(b) All grant activities must be completed by March 31, 2024.
409.16(c) This section expires June 30, 2024.
409.17EFFECTIVE DATE.This section is effective the day following final enactment.

409.18ARTICLE 16
409.19LONG-TERM CARE CONSULTATION SERVICES RECODIFICATION

409.20    Section 1. Minnesota Statutes 2020, section 256B.0911, subdivision 1, is amended to read:
409.21    Subdivision 1. Purpose and goal. (a) The purpose of long-term care consultation services
409.22is to assist persons with long-term or chronic care needs in making care decisions and
409.23selecting support and service options that meet their needs and reflect their preferences.
409.24The availability of, and access to, information and other types of assistance, including
409.25long-term care consultation assessment and community support planning, is also intended
409.26to prevent or delay institutional placements and to provide access to transition assistance
409.27after placement. Further, the goal of long-term care consultation services is to contain costs
409.28associated with unnecessary institutional admissions. Long-term care consultation services
409.29must be available to any person regardless of public program eligibility.
409.30(b) The commissioner of human services shall seek to maximize use of available federal
409.31and state funds and establish the broadest program possible within the funding available.
410.1(c) Long-term care consultation services must be coordinated with long-term care options
410.2counseling provided under subdivision 4d, section 256.975, subdivisions 7 to 7c, and section
410.3256.01, subdivision 24, long-term care options counseling for assisted living, the Disability
410.4Hub, and preadmission screening.
410.5(d) The A lead agency providing long-term care consultation services shall encourage
410.6the use of volunteers from families, religious organizations, social clubs, and similar civic
410.7and service organizations to provide community-based services.

410.8    Sec. 2. Minnesota Statutes 2020, section 256B.0911, subdivision 3c, is amended to read:
410.9    Subd. 3c. Consultation Long-term care options counseling for housing with services
410.10assisted living. (a) The purpose of long-term care consultation for registered housing with
410.11services options counseling for assisted living is to support persons with current or anticipated
410.12long-term care needs in making informed choices among options that include the most
410.13cost-effective and least restrictive settings. Prospective residents maintain the right to choose
410.14housing with services or assisted living if that option is their preference.
410.15    (b) Registered housing with services establishments Licensed assisted living facilities
410.16shall inform each prospective resident or the prospective resident's designated or legal
410.17representative of the availability of long-term care consultation options counseling for
410.18assisted living and the need to receive and verify the consultation counseling prior to signing
410.19a lease or contract. Long-term care consultation for registered housing with services options
410.20counseling for assisted living is provided as determined by the commissioner of human
410.21services. The service is delivered under a partnership between lead agencies as defined in
410.22subdivision 1a 10, paragraph (d) (g), and the Area Agencies on Aging, and is a point of
410.23entry to a combination of telephone-based long-term care options counseling provided by
410.24Senior LinkAge Line and in-person long-term care consultation provided by lead agencies.
410.25The point of entry service must be provided within five working days of the request of the
410.26prospective resident as follows:
410.27    (1) the consultation counseling shall be conducted with the prospective resident, or in
410.28the alternative, the resident's designated or legal representative, if:
410.29(i) the resident verbally requests; or
410.30(ii) the registered housing with services provider assisted living facility has documentation
410.31of the designated or legal representative's authority to enter into a lease or contract on behalf
410.32of the prospective resident and accepts the documentation in good faith;
411.1(2) the consultation counseling shall be performed in a manner that provides objective
411.2and complete information;
411.3    (3) the consultation counseling must include a review of the prospective resident's reasons
411.4for considering housing with services assisted living services, the prospective resident's
411.5personal goals, a discussion of the prospective resident's immediate and projected long-term
411.6care needs, and alternative community services or housing with services settings that may
411.7meet the prospective resident's needs;
411.8    (4) the prospective resident shall must be informed of the availability of a face-to-face
411.9an in-person visit from a long-term care consultation team member at no charge to the
411.10prospective resident to assist the prospective resident in assessment and planning to meet
411.11the prospective resident's long-term care needs; and
411.12(5) verification of counseling shall be generated and provided to the prospective resident
411.13by Senior LinkAge Line upon completion of the telephone-based counseling.
411.14(c) Housing with services establishments registered under chapter 144D An assisted
411.15living facility licensed under chapter 144G shall:
411.16(1) inform each prospective resident or the prospective resident's designated or legal
411.17representative of the availability of and contact information for consultation options
411.18counseling services under this subdivision;
411.19(2) receive a copy of the verification of counseling prior to executing a lease or service
411.20contract with the prospective resident, and prior to executing a service contract with
411.21individuals who have previously entered into lease-only arrangements; and
411.22(3) retain a copy of the verification of counseling as part of the resident's file.
411.23(d) Emergency admissions to registered housing with services establishments licensed
411.24assisted living facilities prior to consultation under paragraph (b) are permitted according
411.25to policies established by the commissioner.

411.26    Sec. 3. Minnesota Statutes 2020, section 256B.0911, subdivision 3d, is amended to read:
411.27    Subd. 3d. Exemptions from long-term care options counseling for assisted
411.28living. Individuals shall be exempt from the requirements outlined in subdivision 3c 7e in
411.29the following circumstances:
411.30(1) the individual is seeking a lease-only arrangement in a subsidized housing setting;
412.1(2) the individual has previously received a long-term care consultation assessment
412.2under this section 256B.0911. In this instance, the assessor who completes the long-term
412.3care consultation assessment will issue a verification code and provide it to the individual;
412.4(3) the individual is receiving or is being evaluated for hospice services from a hospice
412.5provider licensed under sections 144A.75 to 144A.755; or
412.6(4) the individual has used financial planning services and created a long-term care plan
412.7as defined by the commissioner in the 12 months prior to signing a lease or contract with a
412.8registered housing with services establishment licensed assisted living facility.

412.9    Sec. 4. Minnesota Statutes 2020, section 256B.0911, subdivision 3e, is amended to read:
412.10    Subd. 3e. Consultation Long-term care options counseling at hospital discharge. (a)
412.11Hospitals shall refer all individuals described in paragraph (b) prior to discharge from an
412.12inpatient hospital stay to the Senior LinkAge Line for long-term care options counseling.
412.13Hospitals shall make these referrals using referral protocols and processes developed under
412.14section 256.975, subdivision 7. The purpose of the counseling is to support persons with
412.15current or anticipated long-term care needs in making informed choices among options that
412.16include the most cost-effective and least restrictive setting.
412.17(b) The individuals who shall be referred under paragraph (a) include older adults who
412.18are at risk of nursing home placement. Protocols for identifying at-risk individuals shall be
412.19developed under section 256.975, subdivision 7, paragraph (b), clause (12).
412.20(c) Counseling provided under this subdivision shall meet the requirements for the
412.21consultation required under subdivision 3c 7e.

412.22    Sec. 5. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
412.23to read:
412.24    Subd. 10. Definitions. (a) For purposes of this section, the following definitions apply.
412.25(b) "Available service and setting options" or "available options," with respect to the
412.26home and community-based waivers under chapter 256S and sections 256B.092 and 256B.49,
412.27means all services and settings defined under the waiver plan for which a waiver applicant
412.28or waiver participant is eligible.
412.29(c) "Competitive employment" means work in the competitive labor market that is
412.30performed on a full-time or part-time basis in an integrated setting, and for which an
412.31individual is compensated at or above the minimum wage, but not less than the customary
413.1wage and level of benefits paid by the employer for the same or similar work performed by
413.2individuals without disabilities.
413.3(d) "Cost-effective" means community services and living arrangements that cost the
413.4same as or less than institutional care. For an individual found to meet eligibility criteria
413.5for home and community-based service programs under chapter 256S or section 256B.49,
413.6"cost-effectiveness" has the meaning found in the federally approved waiver plan for each
413.7program.
413.8(e) "Independent living" means living in a setting that is not controlled by a provider.
413.9(f) "Informed choice" has the meaning given in section 256B.4905, subdivision 1a.
413.10(g) "Lead agency" means a county administering or a Tribe or health plan under contract
413.11with the commissioner to administer long-term care consultation services.
413.12(h) "Long-term care consultation services" means the activities described in subdivision
413.1311.
413.14(i) "Long-term care options counseling" means the services provided by sections 256.01,
413.15subdivision 24, and 256.975, subdivision 7, and also includes telephone assistance and
413.16follow-up after a long-term care consultation assessment has been completed.
413.17(j) "Long-term care options counseling for assisted living" means the services provided
413.18under section 256.975, subdivisions 7e to 7g.
413.19(k) "Minnesota health care programs" means the medical assistance program under this
413.20chapter and the alternative care program under section 256B.0913.
413.21(l) "Person-centered planning" is a process that includes the active participation of a
413.22person in the planning of the person's services, including in making meaningful and informed
413.23choices about the person's own goals, talents, and objectives, as well as making meaningful
413.24and informed choices about the services the person receives, the settings in which the person
413.25receives the services, and the setting in which the person lives.
413.26(m) "Preadmission screening" means the services provided under section 256.975,
413.27subdivisions 7a to 7c.

413.28    Sec. 6. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
413.29to read:
413.30    Subd. 11. Long-term care consultation services. The following activities are included
413.31in long-term care consultation services:
414.1(1) intake for and access to assistance in identifying services needed to maintain an
414.2individual in the most inclusive environment;
414.3(2) transfer or referral to long-term care options counseling services for telephone
414.4assistance and follow-up after a person requests assistance in identifying community supports
414.5without participating in a complete long-term care consultation assessment;
414.6(3) long-term care consultation assessments conducted according to subdivisions 17 to
414.721, 23, or 24, which may be completed in a hospital, nursing facility, intermediate care
414.8facility for persons with developmental disabilities (ICF/DDs), regional treatment center,
414.9or the person's current or planned residence;
414.10(4) providing recommendations for and referrals to cost-effective community services
414.11that are available to the individual;
414.12(5) providing recommendations for institutional placement when there are no
414.13cost-effective community services available;
414.14(6) providing information regarding eligibility for Minnesota health care programs;
414.15(7) determining service eligibility for the following state plan services:
414.16(i) personal care assistance services under section 256B.0625, subdivisions 19a and 19c;
414.17(ii) consumer support grants under section 256.476; or
414.18(iii) community first services and supports under section 256B.85;
414.19(8) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024,
414.20gaining access to the following services, including obtaining necessary diagnostic information
414.21to determine eligibility:
414.22(i) relocation targeted case management services available under section 256B.0621,
414.23subdivision 2, clause (4);
414.24(ii) case management services targeted to vulnerable adults or people with developmental
414.25disabilities under section 256B.0924; and
414.26(iii) case management services targeted to people with developmental disabilities under
414.27Minnesota Rules, part 9525.0016;
414.28(9) determining eligibility for semi-independent living services under section 252.275,
414.29including obtaining necessary diagnostic information;
414.30(10) determining home and community-based waiver and other service eligibility as
414.31required under chapter 256S and sections 256B.0913, 256B.092, and 256B.49, including:
415.1(i) level of care determination for individuals who need an institutional level of care as
415.2determined under subdivision 26;
415.3(ii) appropriate referrals to obtain necessary diagnostic information; and
415.4(iii) an eligibility determination for consumer-directed community supports;
415.5(11) providing information about competitive employment, with or without supports,
415.6for school-age youth and working-age adults and referrals to the Disability Hub and Disability
415.7Benefits 101 to ensure that an informed choice about competitive employment can be made;
415.8(12) providing information about independent living to ensure that an informed choice
415.9about independent living can be made;
415.10(13) providing information about self-directed services and supports, including
415.11self-directed funding options, to ensure that an informed choice about self-directed options
415.12can be made;
415.13(14) developing an individual's person-centered assessment summary; and
415.14(15) providing access to assistance to transition people back to community settings after
415.15institutional admission.

415.16    Sec. 7. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
415.17to read:
415.18    Subd. 12. Exception to use of MnCHOICES assessment; contracted assessors. (a)
415.19A lead agency that has not implemented MnCHOICES assessments and uses contracted
415.20assessors as of January 1, 2022, is not subject to the requirements of subdivisions 11, clauses
415.21(7) to (9); 13; 14, paragraphs (a) to (c); 16 to 21; 23; 24; and 29 to 31.
415.22(b) This subdivision expires upon statewide implementation of MnCHOICES assessments.
415.23The commissioner shall notify the revisor of statutes when statewide implementation has
415.24occurred.

415.25    Sec. 8. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
415.26to read:
415.27    Subd. 13. MnCHOICES assessor qualifications, training, and certification. (a) The
415.28commissioner shall develop and implement a curriculum and an assessor certification
415.29process.
415.30(b) MnCHOICES certified assessors must:
416.1(1) either have a bachelor's degree in social work, nursing with a public health nursing
416.2certificate, or other closely related field with at least one year of home and community-based
416.3experience or be a registered nurse with at least two years of home and community-based
416.4experience; and
416.5(2) have received training and certification specific to assessment and consultation for
416.6long-term care services in the state.
416.7(c) Certified assessors shall demonstrate best practices in assessment and support
416.8planning, including person-centered planning principles, and have a common set of skills
416.9that ensures consistency and equitable access to services statewide.
416.10(d) Certified assessors must be recertified every three years.

416.11    Sec. 9. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
416.12to read:
416.13    Subd. 14. Use of MnCHOICES certified assessors required. (a) Each lead agency
416.14shall use MnCHOICES certified assessors who have completed MnCHOICES training and
416.15the certification process determined by the commissioner in subdivision 13.
416.16(b) Each lead agency must ensure that the lead agency has sufficient numbers of certified
416.17assessors to provide long-term consultation assessment and support planning within the
416.18timelines and parameters of the service.
416.19(c) A lead agency may choose, according to departmental policies, to contract with a
416.20qualified, certified assessor to conduct assessments and reassessments on behalf of the lead
416.21agency.
416.22(d) Tribes and health plans under contract with the commissioner must provide long-term
416.23care consultation services as specified in the contract.
416.24(e) A lead agency must provide the commissioner with an administrative contact for
416.25communication purposes.

416.26    Sec. 10. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
416.27to read:
416.28    Subd. 15. Long-term care consultation team. (a) Each county board of commissioners
416.29shall establish a long-term care consultation team. Two or more counties may collaborate
416.30to establish a joint local long-term care consultation team or teams.
417.1(b) Each lead agency shall establish and maintain a team of certified assessors qualified
417.2under subdivision 13. Each team member is responsible for providing consultation with
417.3other team members upon request. The team is responsible for providing long-term care
417.4consultation services to all persons located in the county who request the services, regardless
417.5of eligibility for Minnesota health care programs. The team of certified assessors must
417.6include, at a minimum:
417.7(1) a social worker; and
417.8(2) a public health nurse or registered nurse.
417.9(c) The commissioner shall allow arrangements and make recommendations that
417.10encourage counties and Tribes to collaborate to establish joint local long-term care
417.11consultation teams to ensure that long-term care consultations are done within the timelines
417.12and parameters of the service. This includes coordinated service models as required in
417.13subdivision 1, paragraph (c).

417.14    Sec. 11. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
417.15to read:
417.16    Subd. 16. MnCHOICES certified assessors; responsibilities. (a) Certified assessors
417.17must use person-centered planning principles to conduct an interview that identifies what
417.18is important to the person; the person's needs for supports and health and safety concerns;
417.19and the person's abilities, interests, and goals.
417.20(b) Certified assessors are responsible for:
417.21(1) ensuring persons are offered objective, unbiased access to resources;
417.22(2) ensuring persons have the needed information to support informed choice, including
417.23where and how they choose to live and the opportunity to pursue desired employment;
417.24(3) determining level of care and eligibility for long-term services and supports;
417.25(4) using the information gathered from the interview to develop a person-centered
417.26assessment summary that reflects identified needs and support options within the context
417.27of values, interests, and goals important to the person; and
417.28(5) providing the person with an assessment summary of findings, support options, and
417.29agreed-upon next steps.

418.1    Sec. 12. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
418.2to read:
418.3    Subd. 17. MnCHOICES assessments. (a) A person requesting long-term care
418.4consultation services must be visited by a long-term care consultation team within 20
418.5calendar days after the date on which an assessment was requested or recommended.
418.6Assessments must be conducted according to this subdivision and subdivisions 19 to 21,
418.723, 24, and 29 to 31.
418.8(b) Lead agencies shall use certified assessors to conduct the assessment.
418.9(c) For a person with complex health care needs, a public health or registered nurse from
418.10the team must be consulted.
418.11(d) The lead agency must use the MnCHOICES assessment provided by the commissioner
418.12to complete a comprehensive, conversation-based, person-centered assessment. The
418.13assessment must include the health, psychological, functional, environmental, and social
418.14needs of the individual necessary to develop a person-centered assessment summary that
418.15meets the individual's needs and preferences.
418.16(e) Except as provided in subdivision 24, an assessment must be conducted by a certified
418.17assessor in an in-person conversational interview with the person being assessed.

418.18    Sec. 13. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
418.19to read:
418.20    Subd. 18. Exception to use of MnCHOICES assessments; long-term care consultation
418.21team visit; notice. (a) Until statewide implementation of MnCHOICES assessments, the
418.22requirement under subdivision 17, paragraph (a), does not apply to an assessment of a person
418.23requesting personal care assistance services. The commissioner shall provide at least a
418.2490-day notice to lead agencies prior to the effective date of statewide implementation.
418.25(b) This subdivision expires upon statewide implementation of MnCHOICES assessments.
418.26The commissioner shall notify the revisor of statutes when statewide implementation has
418.27occurred.

418.28    Sec. 14. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
418.29to read:
418.30    Subd. 19. MnCHOICES assessments; third-party participation. (a) The person's
418.31legal representative, if any, must provide input during the assessment process and may do
418.32so remotely if requested.
419.1(b) At the request of the person, other individuals may participate in the assessment to
419.2provide information on the needs, strengths, and preferences of the person necessary to
419.3complete the assessment and assessment summary. Except for legal representatives or family
419.4members invited by the person, a person participating in the assessment may not be a provider
419.5of service or have any financial interest in the provision of services.
419.6(c) For a person assessed for elderly waiver customized living or adult day services
419.7under chapter 256S, with the permission of the person being assessed or the person's
419.8designated or legal representative, the client's current or proposed provider of services may
419.9submit a copy of the provider's nursing assessment or written report outlining its
419.10recommendations regarding the client's care needs. The person conducting the assessment
419.11must notify the provider of the date by which to submit this information. This information
419.12must be provided to the person conducting the assessment prior to the assessment.
419.13(d) For a person assessed for waiver services under section 256B.092 or 256B.49, with
419.14the permission of the person being assessed or the person's designated legal representative,
419.15the person's current provider of services may submit a written report outlining
419.16recommendations regarding the person's care needs that the person completed in consultation
419.17with someone who is known to the person and who has interaction with the person on a
419.18regular basis. The provider must submit the report at least 60 days before the end of the
419.19person's current service agreement. The certified assessor must consider the content of the
419.20submitted report prior to finalizing the person's assessment or reassessment.

419.21    Sec. 15. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
419.22to read:
419.23    Subd. 20. MnCHOICES assessments; duration of validity. (a) An assessment that is
419.24completed as part of an eligibility determination for multiple programs for the alternative
419.25care, elderly waiver, developmental disabilities, community access for disability inclusion,
419.26community alternative care, and brain injury waiver programs under chapter 256S and
419.27sections 256B.0913, 256B.092, and 256B.49 is valid to establish service eligibility for no
419.28more than 60 calendar days after the date of the assessment.
419.29(b) The effective eligibility start date for programs in paragraph (a) can never be prior
419.30to the date of assessment. If an assessment was completed more than 60 days before the
419.31effective waiver or alternative care program eligibility start date, assessment and support
419.32plan information must be updated and documented in the department's Medicaid Management
419.33Information System (MMIS). Notwithstanding retroactive medical assistance coverage of
420.1state plan services, the effective date of eligibility for programs included in paragraph (a)
420.2cannot be prior to the completion date of the most recent updated assessment.
420.3(c) If an eligibility update is completed within 90 days of the previous assessment and
420.4documented in the department's Medicaid Management Information System (MMIS), the
420.5effective date of eligibility for programs included in paragraph (a) is the date of the previous
420.6in-person assessment when all other eligibility requirements are met.

420.7    Sec. 16. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
420.8to read:
420.9    Subd. 21. MnCHOICES assessments; exceptions following institutional stay. (a) A
420.10person receiving home and community-based waiver services under section 256B.0913,
420.11256B.092, or 256B.49 or chapter 256S may return to a community with home and
420.12community-based waiver services under the same waiver without being assessed or reassessed
420.13under this section if the person temporarily entered one of the following for 121 or fewer
420.14days:
420.15(1) a hospital;
420.16(2) an institution of mental disease;
420.17(3) a nursing facility;
420.18(4) an intensive residential treatment services program;
420.19(5) a transitional care unit; or
420.20(6) an inpatient substance use disorder treatment setting.
420.21(b) Nothing in paragraph (a) changes annual long-term care consultation reassessment
420.22requirements, payment for institutional or treatment services, medical assistance financial
420.23eligibility, or any other law.

420.24    Sec. 17. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
420.25to read:
420.26    Subd. 22. MnCHOICES reassessments. (a) Prior to a reassessment, the certified assessor
420.27must review the person's most recent assessment.
420.28(b) Reassessments must:
420.29(1) be tailored using the professional judgment of the assessor to the person's known
420.30needs, strengths, preferences, and circumstances;
421.1(2) provide information to support the person's informed choice and opportunities to
421.2express choice regarding activities that contribute to quality of life, as well as information
421.3and opportunity to identify goals related to desired employment, community activities, and
421.4preferred living environment;
421.5(3) provide a review of the most recent assessment, the current support plan's effectiveness
421.6and monitoring of services, and the development of an updated person-centered assessment
421.7summary;
421.8(4) verify continued eligibility, offer alternatives as warranted, and provide an opportunity
421.9for quality assurance of service delivery; and
421.10(5) be conducted annually or as required by federal and state laws.
421.11(c) The certified assessor and the individual responsible for developing the support plan
421.12must ensure the continuity of care for the person receiving services and complete the updated
421.13assessment summary and the updated support plan no more than 60 days after the
421.14reassessment visit.
421.15(d) The commissioner shall develop mechanisms for providers and case managers to
421.16share information with the assessor to facilitate a reassessment and support planning process
421.17tailored to the person's current needs and preferences.

421.18    Sec. 18. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
421.19to read:
421.20    Subd. 23. MnCHOICES reassessments; option for alternative and self-directed
421.21waiver services. (a) At the time of reassessment, the certified assessor shall assess a person
421.22receiving waiver residential supports and services and currently residing in a setting listed
421.23in clauses (1) to (5) to determine if the person would prefer to be served in a
421.24community-living setting as defined in section 256B.49, subdivision 23, or in a setting not
421.25controlled by a provider, or to receive integrated community supports as described in section
421.26245D.03, subdivision 1, paragraph (c), clause (8). The certified assessor shall offer the
421.27person through a person-centered planning process the option to receive alternative housing
421.28and service options. This paragraph applies to those currently residing in a:
421.29(1) community residential setting;
421.30(2) licensed adult foster care home that is either not the primary residence of the license
421.31holder or in which the license holder is not the primary caregiver;
421.32(3) family adult foster care residence;
422.1(4) customized living setting; or
422.2(5) supervised living facility.
422.3(b) At the time of reassessment, the certified assessor shall assess each person receiving
422.4waiver day services to determine if that person would prefer to receive employment services
422.5as described in section 245D.03, subdivision 1, paragraph (c), clauses (5) to (7). The certified
422.6assessor shall describe to the person through a person-centered planning process the option
422.7to receive employment services.
422.8(c) At the time of reassessment, the certified assessor shall assess each person receiving
422.9non-self-directed waiver services to determine if that person would prefer an available
422.10service and setting option that would permit self-directed services and supports. The certified
422.11assessor shall describe to the person through a person-centered planning process the option
422.12to receive self-directed services and supports.

422.13    Sec. 19. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
422.14to read:
422.15    Subd. 24. Remote reassessments. (a) Assessments performed according to subdivisions
422.1617 to 20 and 23 must be in person unless the assessment is a reassessment meeting the
422.17requirements of this subdivision. Remote reassessments conducted by interactive video or
422.18telephone may substitute for in-person reassessments.
422.19(b) For services provided by the developmental disabilities waiver under section
422.20256B.092, and the community access for disability inclusion, community alternative care,
422.21and brain injury waiver programs under section 256B.49, remote reassessments may be
422.22substituted for two consecutive reassessments if followed by an in-person reassessment.
422.23(c) For services provided by alternative care under section 256B.0913, essential
422.24community supports under section 256B.0922, and the elderly waiver under chapter 256S,
422.25remote reassessments may be substituted for one reassessment if followed by an in-person
422.26reassessment.
422.27(d) A remote reassessment is permitted only if the person being reassessed, or the person's
422.28legal representative, and the lead agency case manager both agree that there is no change
422.29in the person's condition, there is no need for a change in service, and that a remote
422.30reassessment is appropriate.
422.31(e) The person being reassessed, or the person's legal representative, may refuse a remote
422.32reassessment at any time.
423.1(f) During a remote reassessment, if the certified assessor determines an in-person
423.2reassessment is necessary in order to complete the assessment, the lead agency shall schedule
423.3an in-person reassessment.
423.4(g) All other requirements of an in-person reassessment apply to a remote reassessment,
423.5including updates to a person's support plan.

423.6    Sec. 20. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
423.7to read:
423.8    Subd. 25. Reassessments for Rule 185 case management. Unless otherwise required
423.9by federal law, the county agency is not required to conduct or arrange for an annual needs
423.10reassessment by a certified assessor for people receiving Rule 185 case management under
423.11Minnesota Rules, part 9525.0016. The case manager who works on behalf of the person to
423.12identify the person's needs and to minimize the impact of the disability on the person's life
423.13must instead develop a person-centered service plan based on the person's assessed needs
423.14and preferences. The person-centered service plan must be reviewed annually for persons
423.15with developmental disabilities who are receiving only case management services under
423.16Minnesota Rules, part 9525.0016, and who make an informed choice to decline an assessment
423.17under this section.

423.18    Sec. 21. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
423.19to read:
423.20    Subd. 26. Determination of institutional level of care. (a) The determination of need
423.21for hospital and intermediate care facility levels of care must be made according to criteria
423.22developed by the commissioner, and in section 256B.092, using forms developed by the
423.23commissioner.
423.24(b) The determination of need for nursing facility level of care must be made based on
423.25criteria in section 144.0724, subdivision 11.

423.26    Sec. 22. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
423.27to read:
423.28    Subd. 27. Transition assistance. (a) Lead agency certified assessors shall provide
423.29transition assistance to persons residing in a nursing facility, hospital, regional treatment
423.30center, or intermediate care facility for persons with developmental disabilities who request
423.31or are referred for assistance.
423.32(b) Transition assistance must include:
424.1(1) assessment;
424.2(2) referrals to long-term care options counseling under section 256.975, subdivision 7,
424.3for support plan implementation and to Minnesota health care programs, including home
424.4and community-based waiver services and consumer-directed options through the waivers;
424.5and
424.6(3) referrals to programs that provide assistance with housing.
424.7(c) Transition assistance must also include information about the Centers for Independent
424.8Living, Disability Hub, and other organizations that can provide assistance with relocation
424.9efforts and information about contacting these organizations to obtain their assistance and
424.10support.
424.11(d) The lead agency shall ensure that:
424.12(1) referrals for in-person assessments are taken from long-term care options counselors
424.13as provided for in section 256.975, subdivision 7, paragraph (b), clause (11);
424.14(2) persons assessed in institutions receive information about available transition
424.15assistance;
424.16(3) the assessment is completed for persons within 20 calendar days of the date of request
424.17or recommendation for assessment;
424.18(4) there is a plan for transition and follow-up for the individual's return to the community,
424.19including notification of other local agencies when a person may require assistance from
424.20agencies located in another county; and
424.21(5) relocation targeted case management as defined in section 256B.0621, subdivision
424.222, clause (4), is authorized for an eligible medical assistance recipient.

424.23    Sec. 23. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
424.24to read:
424.25    Subd. 28. Transition assistance; nursing home residents under 65 years of age. (a)
424.26Upon referral from the Senior LinkAge Line, individuals under 65 years of age who are
424.27admitted to nursing facilities on an emergency basis with only a telephone screening must
424.28receive an in-person assessment from the long-term care consultation team member of the
424.29county in which the facility is located within the timeline established by the commissioner
424.30based on review of data.
424.31(b) At the in-person assessment, the long-term care consultation team member or county
424.32case manager must:
425.1(1) perform the activities required under subdivision 27; and
425.2(2) present information about home and community-based options, including
425.3consumer-directed options, so the individual can make informed choices.
425.4(c) If the individual chooses home and community-based services, the long-term care
425.5consultation team member or case manager must complete a written relocation plan within
425.620 working days of the visit. The plan must describe the services needed to move the
425.7individual out of the facility and a timeline for the move that is designed to ensure a smooth
425.8transition to the individual's home and community.
425.9(d) For individuals under 21 years of age, a screening interview that recommends nursing
425.10facility admission must be in person and approved by the commissioner before the individual
425.11is admitted to the nursing facility.
425.12(e) An individual under 65 years of age residing in a nursing facility must receive an
425.13in-person assessment at least every 12 months to review the person's service choices and
425.14available alternatives unless the individual indicates in writing that annual visits are not
425.15desired. In this case, the individual must receive an in-person assessment at least once every
425.1636 months for the same purposes.
425.17(f) Notwithstanding subdivision 33, the commissioner may pay county agencies directly
425.18for in-person assessments for individuals under 65 years of age who are being considered
425.19for placement or residing in a nursing facility.

425.20    Sec. 24. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
425.21to read:
425.22    Subd. 29. Support planning. (a) The certified assessor and the individual responsible
425.23for developing the support plan must complete the assessment summary and the support
425.24plan no more than 60 calendar days after the assessment visit.
425.25(b) The person or the person's legal representative must be provided with a written
425.26assessment summary within the timelines established by the commissioner, regardless of
425.27whether the person is eligible for Minnesota health care programs.
425.28(c) For a person being assessed for elderly waiver services under chapter 256S, a provider
425.29who submitted information under subdivision 19, paragraph (c), must receive the final
425.30written support plan when available.
425.31(d) The written support plan must include:
425.32(1) a summary of assessed needs as defined in subdivision 17, paragraphs (d) and (e);
426.1(2) the individual's options and choices to meet identified needs, including all available
426.2options for:
426.3(i) case management services and providers;
426.4(ii) employment services, settings, and providers;
426.5(iii) living arrangements;
426.6(iv) self-directed services and supports, including self-directed budget options; and
426.7(v) service provided in a non-disability-specific setting;
426.8(3) identification of health and safety risks and how those risks will be addressed,
426.9including personal risk management strategies;
426.10(4) referral information; and
426.11(5) informal caregiver supports, if applicable.
426.12(e) For a person determined eligible for state plan home care under subdivision 11, clause
426.13(7), the person or person's legal representative must also receive a copy of the home care
426.14service plan developed by the certified assessor.

426.15    Sec. 25. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
426.16to read:
426.17    Subd. 30. Assessment and support planning; supplemental information. The lead
426.18agency must give the person receiving long-term care consultation services or the person's
426.19legal representative materials and forms supplied by the commissioner containing the
426.20following information:
426.21(1) written recommendations for community-based services and consumer-directed
426.22options;
426.23(2) documentation that the most cost-effective alternatives available were offered to the
426.24person;
426.25(3) the need for and purpose of preadmission screening conducted by long-term care
426.26options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects
426.27nursing facility placement. If the person selects nursing facility placement, the lead agency
426.28shall forward information needed to complete the level of care determinations and screening
426.29for developmental disability and mental illness collected during the assessment to the
426.30long-term care options counselor using forms provided by the commissioner;
427.1(4) the role of long-term care consultation assessment and support planning in eligibility
427.2determination for waiver and alternative care programs and state plan home care, case
427.3management, and other services as defined in subdivision 11, clauses (7) to (10);
427.4(5) information about Minnesota health care programs;
427.5(6) the person's freedom to accept or reject the recommendations of the team;
427.6(7) the person's right to confidentiality under the Minnesota Government Data Practices
427.7Act, chapter 13;
427.8(8) the certified assessor's decision regarding the person's need for institutional level of
427.9care as determined under criteria established in subdivision 26 and regarding eligibility for
427.10all services and programs as defined in subdivision 11, clauses (7) to (10);
427.11(9) the person's right to appeal the certified assessor's decision regarding eligibility for
427.12all services and programs as defined in subdivision 11, clauses (5), (7) to (10), and (15),
427.13and the decision regarding the need for institutional level of care or the lead agency's final
427.14decisions regarding public programs eligibility according to section 256.045, subdivision
427.153. The certified assessor must verbally communicate this appeal right to the person and
427.16must visually point out where in the document the right to appeal is stated; and
427.17(10) documentation that available options for employment services, independent living,
427.18and self-directed services and supports were described to the person.

427.19    Sec. 26. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
427.20to read:
427.21    Subd. 31. Assessment and support planning; right to final decision. The person has
427.22the right to make the final decision:
427.23(1) between institutional placement and community placement after the recommendations
427.24have been provided under subdivision 30, clause (1), except as provided in section 256.975,
427.25subdivision 7a, paragraph (d);
427.26(2) between community placement in a setting controlled by a provider and living
427.27independently in a setting not controlled by a provider;
427.28(3) between day services and employment services; and
427.29(4) regarding available options for self-directed services and supports, including
427.30self-directed funding options.

428.1    Sec. 27. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
428.2to read:
428.3    Subd. 32. Administrative activity. (a) The commissioner shall:
428.4(1) streamline the processes, including timelines for when assessments need to be
428.5completed;
428.6(2) provide the services in this section; and
428.7(3) implement integrated solutions to automate the business processes to the extent
428.8necessary for support plan approval, reimbursement, program planning, evaluation, and
428.9policy development.
428.10(b) The commissioner shall work with lead agencies responsible for conducting long-term
428.11care consultation services to:
428.12(1) modify the MnCHOICES application and assessment policies to create efficiencies
428.13while ensuring federal compliance with medical assistance and long-term services and
428.14supports eligibility criteria; and
428.15(2) develop a set of measurable benchmarks sufficient to demonstrate quarterly
428.16improvement in the average time per assessment and other mutually agreed upon measures
428.17of increasing efficiency.
428.18(c) The commissioner shall collect data on the benchmarks developed under paragraph
428.19(b) and provide to the lead agencies and the chairs and ranking minority members of the
428.20legislative committees with jurisdiction over human services an annual trend analysis of
428.21the data in order to demonstrate the commissioner's compliance with the requirements of
428.22this subdivision.

428.23    Sec. 28. Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
428.24to read:
428.25    Subd. 33. Payment for long-term care consultation services. (a) Payments for long-term
428.26care consultation services are available to the county or counties to cover staff salaries and
428.27expenses to provide the services described in subdivision 11. The county shall employ, or
428.28contract with other agencies to employ, within the limits of available funding, sufficient
428.29personnel to provide long-term care consultation services while meeting the state's long-term
428.30care outcomes and objectives as defined in subdivision 1.
428.31(b) The county is accountable for meeting local objectives as approved by the
428.32commissioner in the biennial home and community-based services quality assurance plan.
429.1The county must document its compliance with the local objectives on a form provided by
429.2the commissioner.
429.3(c) The state shall pay 81.9 percent of the nonfederal share as reimbursement to the
429.4counties.

429.5    Sec. 29. DIRECTION TO COMMISSIONER; TRANSITION PROCESS.
429.6(a) The commissioner of human services shall update references to statutes recodified
429.7in this act when printed material is replaced and new printed material is obtained in the
429.8normal course of business. The commissioner is not required to replace existing printed
429.9material to comply with this act.
429.10(b) The commissioner of human services shall update references to statutes recodified
429.11in this act when online documents and websites are edited in the normal course of business.
429.12The commissioner is not required to edit online documents and websites merely to comply
429.13with this act.
429.14(c) The commissioner of human services shall update references to statutes recodified
429.15in this act when the home and community-based service waiver plans are updated in the
429.16normal course of business. The commissioner is not required to update the home and
429.17community-based service waiver plans merely to comply with this act.

429.18    Sec. 30. REVISOR INSTRUCTION.
429.19(a) The revisor of statutes shall renumber each section of Minnesota Statutes listed in
429.20column A with the number listed in column B. The revisor shall also make necessary
429.21cross-reference changes consistent with the renumbering.
429.22
 Column A
 Column B
429.23
 256B.0911, subdivision 3c
 256.975, subdivision 7e
429.24
 256B.0911, subdivision 3d
 256.975, subdivision 7f
429.25
 256B.0911, subdivision 3e
 256.975, subdivision 7g
429.26(b) The revisor of statutes, in consultation with the House of Representatives Research
429.27Department; the Office of Senate Counsel, Research and Fiscal Analysis; and the Department
429.28of Human Services, shall make necessary cross-reference changes and remove statutory
429.29cross-references in Minnesota Statutes to conform with the recodification in this act. The
429.30revisor may make technical and other necessary changes to sentence structure to preserve
429.31the meaning of the text. The revisor may alter the coding in this act to incorporate statutory
429.32changes made by other law in a regular or special session of the 2022 legislature. If a
430.1provision stricken in this act is also amended in a regular or special session of the 2022
430.2legislature by other law, the revisor shall restore the stricken language and give effect to
430.3the amendment, notwithstanding Minnesota Statutes, section 645.30.
430.4(c) If a provision repealed in this article is also amended by a section in this act or any
430.5other act in a regular or special session of the 2022 legislature, the revisor of statutes, in
430.6consultation with the House Research Department, Office of Senate Counsel, Research and
430.7Fiscal Analysis, and the Department of Human Services, shall give effect to the amendment
430.8and incorporate the amendment consistent with the recodification of Minnesota Statutes,
430.9section 256B.0911, by this article, notwithstanding any law to the contrary. When
430.10incorporating any such amendment, the revisor of statutes, in consultation with the House
430.11Research Department, Office of Senate Counsel, Research and Fiscal Analysis, and the
430.12Department of Human Services, may make technical and other necessary changes to sentence
430.13structure to preserve the meaning of the text of the recodification.

430.14    Sec. 31. REPEALER.
430.15Minnesota Statutes 2020, section 256B.0911, subdivisions 2b, 2c, 3, 3b, 3g, 4d, 4e, 5,
430.16and 6, are repealed.
430.17Minnesota Statutes 2021 Supplement, section 256B.0911, subdivisions 1a, 3a, and 3f,
430.18are repealed.

430.19    Sec. 32. EFFECTIVE DATE.
430.20Sections 1 to 31 are effective July 1, 2022.

430.21ARTICLE 17
430.22LONG-TERM CARE CONSULTATION SERVICES RECODIFICATION;
430.23CONFORMING CHANGES

430.24    Section 1. Minnesota Statutes 2021 Supplement, section 144.0724, subdivision 4, is
430.25amended to read:
430.26    Subd. 4. Resident assessment schedule. (a) A facility must conduct and electronically
430.27submit to the federal database MDS assessments that conform with the assessment schedule
430.28defined by the Long Term Care Facility Resident Assessment Instrument User's Manual,
430.29version 3.0, or its successor issued by the Centers for Medicare and Medicaid Services. The
430.30commissioner of health may substitute successor manuals or question and answer documents
430.31published by the United States Department of Health and Human Services, Centers for
431.1Medicare and Medicaid Services, to replace or supplement the current version of the manual
431.2or document.
431.3(b) The assessments required under the Omnibus Budget Reconciliation Act of 1987
431.4(OBRA) used to determine a case mix classification for reimbursement include the following:
431.5(1) a new admission comprehensive assessment, which must have an assessment reference
431.6date (ARD) within 14 calendar days after admission, excluding readmissions;
431.7(2) an annual comprehensive assessment, which must have an ARD within 92 days of
431.8a previous quarterly review assessment or a previous comprehensive assessment, which
431.9must occur at least once every 366 days;
431.10(3) a significant change in status comprehensive assessment, which must have an ARD
431.11within 14 days after the facility determines, or should have determined, that there has been
431.12a significant change in the resident's physical or mental condition, whether an improvement
431.13or a decline, and regardless of the amount of time since the last comprehensive assessment
431.14or quarterly review assessment;
431.15(4) a quarterly review assessment must have an ARD within 92 days of the ARD of the
431.16previous quarterly review assessment or a previous comprehensive assessment;
431.17(5) any significant correction to a prior comprehensive assessment, if the assessment
431.18being corrected is the current one being used for RUG classification;
431.19(6) any significant correction to a prior quarterly review assessment, if the assessment
431.20being corrected is the current one being used for RUG classification;
431.21(7) a required significant change in status assessment when:
431.22(i) all speech, occupational, and physical therapies have ended. The ARD of this
431.23assessment must be set on day eight after all therapy services have ended; and
431.24(ii) isolation for an infectious disease has ended. The ARD of this assessment must be
431.25set on day 15 after isolation has ended; and
431.26(8) any modifications to the most recent assessments under clauses (1) to (7).
431.27(c) In addition to the assessments listed in paragraph (b), the assessments used to
431.28determine nursing facility level of care include the following:
431.29(1) preadmission screening completed under section 256.975, subdivisions 7a to 7c, by
431.30the Senior LinkAge Line or other organization under contract with the Minnesota Board on
431.31Aging; and
432.1(2) a nursing facility level of care determination as provided for under section 256B.0911,
432.2subdivision 4e 26, as part of a face-to-face long-term care consultation assessment completed
432.3under section 256B.0911, by a county, tribe, or managed care organization under contract
432.4with the Department of Human Services.

432.5    Sec. 2. Minnesota Statutes 2020, section 144.0724, subdivision 11, is amended to read:
432.6    Subd. 11. Nursing facility level of care. (a) For purposes of medical assistance payment
432.7of long-term care services, a recipient must be determined, using assessments defined in
432.8subdivision 4, to meet one of the following nursing facility level of care criteria:
432.9    (1) the person requires formal clinical monitoring at least once per day;
432.10    (2) the person needs the assistance of another person or constant supervision to begin
432.11and complete at least four of the following activities of living: bathing, bed mobility, dressing,
432.12eating, grooming, toileting, transferring, and walking;
432.13    (3) the person needs the assistance of another person or constant supervision to begin
432.14and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
432.15    (4) the person has significant difficulty with memory, using information, daily decision
432.16making, or behavioral needs that require intervention;
432.17    (5) the person has had a qualifying nursing facility stay of at least 90 days;
432.18    (6) the person meets the nursing facility level of care criteria determined 90 days after
432.19admission or on the first quarterly assessment after admission, whichever is later; or
432.20    (7) the person is determined to be at risk for nursing facility admission or readmission
432.21through a face-to-face long-term care consultation assessment as specified in section
432.22256B.0911, subdivision 3a, 3b, or 4d subdivision 17 to 21, 23, 24, 27, or 28, by a county,
432.23tribe, or managed care organization under contract with the Department of Human Services.
432.24The person is considered at risk under this clause if the person currently lives alone or will
432.25live alone or be homeless without the person's current housing and also meets one of the
432.26following criteria:
432.27    (i) the person has experienced a fall resulting in a fracture;
432.28    (ii) the person has been determined to be at risk of maltreatment or neglect, including
432.29self-neglect; or
432.30    (iii) the person has a sensory impairment that substantially impacts functional ability
432.31and maintenance of a community residence.
433.1    (b) The assessment used to establish medical assistance payment for nursing facility
433.2services must be the most recent assessment performed under subdivision 4, paragraph (b),
433.3that occurred no more than 90 calendar days before the effective date of medical assistance
433.4eligibility for payment of long-term care services. In no case shall medical assistance payment
433.5for long-term care services occur prior to the date of the determination of nursing facility
433.6level of care.
433.7    (c) The assessment used to establish medical assistance payment for long-term care
433.8services provided under chapter 256S and section 256B.49 and alternative care payment
433.9for services provided under section 256B.0913 must be the most recent face-to-face
433.10assessment performed under section 256B.0911, subdivision 3a, 3b, or 4d subdivisions 17
433.11to 21, 23, 24, 27, or 28, that occurred no more than 60 calendar days before the effective
433.12date of medical assistance eligibility for payment of long-term care services.

433.13    Sec. 3. Minnesota Statutes 2021 Supplement, section 144.0724, subdivision 12, as amended
433.14by Laws 2022, chapter 55, article 1, section 36, is amended to read:
433.15    Subd. 12. Appeal of nursing facility level of care determination. (a) A resident or
433.16prospective resident whose level of care determination results in a denial of long-term care
433.17services can appeal the determination as outlined in section 256B.0911, subdivision 3a,
433.18paragraph (j) 30, clause (9).
433.19    (b) The commissioner of human services shall ensure that notice of changes in eligibility
433.20due to a nursing facility level of care determination is provided to each affected recipient
433.21or the recipient's guardian at least 30 days before the effective date of the change. The notice
433.22shall include the following information:
433.23(1) how to obtain further information on the changes;
433.24(2) how to receive assistance in obtaining other services;
433.25(3) a list of community resources; and
433.26(4) appeal rights.

433.27    Sec. 4. Minnesota Statutes 2020, section 256.975, subdivision 7a, is amended to read:
433.28    Subd. 7a. Preadmission screening activities related to nursing facility admissions. (a)
433.29All individuals seeking admission to Medicaid-certified nursing facilities, including certified
433.30boarding care facilities, must be screened prior to admission regardless of income, assets,
433.31or funding sources for nursing facility care, except as described in subdivision 7b, paragraphs
433.32(a) and (b). The purpose of the screening is to determine the need for nursing facility level
434.1of care as described in section 256B.0911, subdivision 4e 26, and to complete activities
434.2required under federal law related to mental illness and developmental disability as outlined
434.3in paragraph (b).
434.4(b) A person who has a diagnosis or possible diagnosis of mental illness or developmental
434.5disability must receive a preadmission screening before admission regardless of the
434.6exemptions outlined in subdivision 7b, paragraphs (a) and (b), to identify the need for further
434.7evaluation and specialized services, unless the admission prior to screening is authorized
434.8by the local mental health authority or the local developmental disabilities case manager,
434.9or unless authorized by the county agency according to Public Law 101-508.
434.10(c) The following criteria apply to the preadmission screening:
434.11(1) requests for preadmission screenings must be submitted via an online form developed
434.12by the commissioner;
434.13(2) the Senior LinkAge Line must use forms and criteria developed by the commissioner
434.14to identify persons who require referral for further evaluation and determination of the need
434.15for specialized services; and
434.16(3) the evaluation and determination of the need for specialized services must be done
434.17by:
434.18(i) a qualified independent mental health professional, for persons with a primary or
434.19secondary diagnosis of a serious mental illness; or
434.20(ii) a qualified developmental disability professional, for persons with a primary or
434.21secondary diagnosis of developmental disability. For purposes of this requirement, a qualified
434.22developmental disability professional must meet the standards for a qualified developmental
434.23disability professional under Code of Federal Regulations, title 42, section 483.430.
434.24(d) The local county mental health authority or the state developmental disability authority
434.25under Public Laws 100-203 and 101-508 may prohibit admission to a nursing facility if the
434.26individual does not meet the nursing facility level of care criteria or needs specialized
434.27services as defined in Public Laws 100-203 and 101-508. For purposes of this section,
434.28"specialized services" for a person with developmental disability means active treatment as
434.29that term is defined under Code of Federal Regulations, title 42, section 483.440 (a)(1).
434.30(e) In assessing a person's needs, the screener shall:
434.31(1) use an automated system designated by the commissioner;
435.1(2) consult with care transitions coordinators, physician, or advanced practice registered
435.2nurse; and
435.3(3) consider the assessment of the individual's physician or advanced practice registered
435.4nurse.
435.5(f) Other personnel may be included in the level of care determination as deemed
435.6necessary by the screener.

435.7    Sec. 5. Minnesota Statutes 2020, section 256.975, subdivision 7b, is amended to read:
435.8    Subd. 7b. Exemptions and emergency admissions. (a) Exemptions from the federal
435.9screening requirements outlined in subdivision 7a, paragraphs (b) and (c), are limited to:
435.10(1) a person who, having entered an acute care facility from a certified nursing facility,
435.11is returning to a certified nursing facility; or
435.12(2) a person transferring from one certified nursing facility in Minnesota to another
435.13certified nursing facility in Minnesota.
435.14(b) Persons who are exempt from preadmission screening for purposes of level of care
435.15determination include:
435.16(1) persons described in paragraph (a);
435.17(2) an individual who has a contractual right to have nursing facility care paid for
435.18indefinitely by the Veterans Administration;
435.19(3) an individual enrolled in a demonstration project under section 256B.69, subdivision
435.208, at the time of application to a nursing facility; and
435.21(4) an individual currently being served under the alternative care program or under a
435.22home and community-based services waiver authorized under section 1915(c) of the federal
435.23Social Security Act.
435.24(c) Persons admitted to a Medicaid-certified nursing facility from the community on an
435.25emergency basis as described in paragraph (d) or from an acute care facility on a nonworking
435.26day must be screened the first working day after admission.
435.27(d) Emergency admission to a nursing facility prior to screening is permitted when all
435.28of the following conditions are met:
435.29(1) a person is admitted from the community to a certified nursing or certified boarding
435.30care facility during Senior LinkAge Line nonworking hours;
436.1(2) a physician or advanced practice registered nurse has determined that delaying
436.2admission until preadmission screening is completed would adversely affect the person's
436.3health and safety;
436.4(3) there is a recent precipitating event that precludes the client from living safely in the
436.5community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's
436.6inability to continue to provide care;
436.7(4) the attending physician or advanced practice registered nurse has authorized the
436.8emergency placement and has documented the reason that the emergency placement is
436.9recommended; and
436.10(5) the Senior LinkAge Line is contacted on the first working day following the
436.11emergency admission.
436.12(e) Transfer of a patient from an acute care hospital to a nursing facility is not considered
436.13an emergency except for a person who has received hospital services in the following
436.14situations: hospital admission for observation, care in an emergency room without hospital
436.15admission, or following hospital 24-hour bed care and from whom admission is being sought
436.16on a nonworking day.
436.17(e) (f) A nursing facility must provide written information to all persons admitted
436.18regarding the person's right to request and receive long-term care consultation services as
436.19defined in section 256B.0911, subdivision 1a 11. The information must be provided prior
436.20to the person's discharge from the facility and in a format specified by the commissioner.

436.21    Sec. 6. Minnesota Statutes 2020, section 256.975, subdivision 7c, is amended to read:
436.22    Subd. 7c. Screening requirements. (a) A person may be screened for nursing facility
436.23admission by telephone or in a face-to-face screening interview. The Senior LinkAge Line
436.24shall identify each individual's needs using the following categories:
436.25(1) the person needs no face-to-face long-term care consultation assessment completed
436.26under section 256B.0911, subdivision 3a, 3b, or 4d subdivisions 17 to 21, 24, 27 or 28, by
436.27a county, tribe, or managed care organization under contract with the Department of Human
436.28Services to determine the need for nursing facility level of care based on information obtained
436.29from other health care professionals;
436.30(2) the person needs an immediate face-to-face long-term care consultation assessment
436.31completed under section 256B.0911, subdivision 3a, 3b, or 4d subdivisions 17 to 21, 24,
436.3227, or 28, by a county, tribe, or managed care organization under contract with the
437.1Department of Human Services to determine the need for nursing facility level of care and
437.2complete activities required under subdivision 7a; or
437.3(3) the person may be exempt from screening requirements as outlined in subdivision
437.47b, but will need transitional transition assistance after admission or in-person follow-along
437.5after a return home.
437.6(b) The Senior LinkAge Line shall refer individuals under 65 years of age who are
437.7admitted to nursing facilities with only a telephone screening must receive a face-to-face
437.8for an in-person assessment from the long-term care consultation team member of the county
437.9in which the facility is located or from the recipient's county case manager within 40 calendar
437.10days of admission as described in section 256B.0911, subdivision 4d 28, paragraph (c) (a).
437.11(c) Persons admitted on a nonemergency basis to a Medicaid-certified nursing facility
437.12must be screened prior to admission.
437.13(d) Screenings provided by the Senior LinkAge Line must include processes to identify
437.14persons who may require transition assistance described in subdivision 7, paragraph (b),
437.15clause (12), and section 256B.0911, subdivision 3b 27.

437.16    Sec. 7. Minnesota Statutes 2020, section 256.975, subdivision 7d, is amended to read:
437.17    Subd. 7d. Payment for preadmission screening. Funding (a) The Department of Human
437.18Services shall provide funding for preadmission screening shall be provided to the Minnesota
437.19Board on Aging by the Department of Human Services to cover screener salaries and
437.20expenses to provide the services described in subdivisions 7a to 7c. The Minnesota Board
437.21on Aging shall:
437.22(1) employ, or contract with other agencies to employ, within the limits of available
437.23funding, sufficient personnel to provide preadmission screening and level of care
437.24determination services; and shall
437.25(2) seek to maximize federal funding for the service as provided under section 256.01,
437.26subdivision 2, paragraph (aa).
437.27(b) The Department of Human Services shall provide funding for preadmission screening
437.28follow-up to the Disability Hub for the under-60 population to cover options counseling
437.29salaries and expenses to provide the services described in subdivisions 7a to 7c. The
437.30Disability Hub shall:
437.31(1) employ, or contract with other agencies to employ, within the limits of available
437.32funding, sufficient personnel to provide preadmission screening follow-up services; and
438.1(2) seek to maximize federal funding for the service as provided under section 256.01,
438.2subdivision 2, paragraph (aa).

438.3    Sec. 8. Minnesota Statutes 2020, section 256B.051, subdivision 4, is amended to read:
438.4    Subd. 4. Assessment requirements. (a) An individual's assessment of functional need
438.5must be conducted by one of the following methods:
438.6(1) an assessor according to the criteria established in section 256B.0911, subdivision
438.73a subdivisions 17 to 21, 23, 24, and 29 to 31, using a format established by the
438.8commissioner;
438.9(2) documented need for services as verified by a professional statement of need as
438.10defined in section 256I.03, subdivision 12; or
438.11(3) according to the continuum of care coordinated assessment system established in
438.12Code of Federal Regulations, title 24, section 578.3, using a format established by the
438.13commissioner.
438.14(b) An individual must be reassessed within one year of initial assessment, and annually
438.15thereafter.

438.16    Sec. 9. Minnesota Statutes 2020, section 256B.0646, is amended to read:
438.17256B.0646 MINNESOTA RESTRICTED RECIPIENT PROGRAM; PERSONAL
438.18CARE ASSISTANCE SERVICES.
438.19(a) When a recipient's use of personal care assistance services or community first services
438.20and supports under section 256B.85 results in abusive or fraudulent billing, the commissioner
438.21may place a recipient in the Minnesota restricted recipient program under Minnesota Rules,
438.22part 9505.2165. A recipient placed in the Minnesota restricted recipient program under this
438.23section must: (1) use a designated traditional personal care assistance provider agency; and
438.24(2) obtain a new assessment under section 256B.0911, including consultation with a registered
438.25or public health nurse on the long-term care consultation team pursuant to section 256B.0911,
438.26subdivision 3 15, paragraph (b), clause (2).
438.27(b) A recipient must comply with additional conditions for the use of personal care
438.28assistance services or community first services and supports if the commissioner determines
438.29it is necessary to prevent future misuse of personal care assistance services or abusive or
438.30fraudulent billing. Additional conditions may include but are not limited to restricting service
438.31authorizations for a duration of no more than one month and requiring a qualified professional
438.32to monitor and report services on a monthly basis.
439.1(c) A recipient placed in the Minnesota restricted recipient program under this section
439.2may appeal the placement according to section 256.045.

439.3    Sec. 10. Minnesota Statutes 2020, section 256B.0659, subdivision 3a, is amended to read:
439.4    Subd. 3a. Assessment; defined. (a) "Assessment" means a review and evaluation of a
439.5recipient's need for personal care assistance services conducted in person. Assessments for
439.6personal care assistance services shall be conducted by the county public health nurse or a
439.7certified public health nurse under contract with the county except when a long-term care
439.8consultation assessment is being conducted for the purposes of determining a person's
439.9eligibility for home and community-based waiver services including personal care assistance
439.10services according to section 256B.0911. During the transition to MnCHOICES, a certified
439.11assessor may complete the assessment defined in this subdivision. An in-person assessment
439.12must include: documentation of health status, determination of need, evaluation of service
439.13effectiveness, identification of appropriate services, service plan development or modification,
439.14coordination of services, referrals and follow-up to appropriate payers and community
439.15resources, completion of required reports, recommendation of service authorization, and
439.16consumer education. Once the need for personal care assistance services is determined under
439.17this section, the county public health nurse or certified public health nurse under contract
439.18with the county is responsible for communicating this recommendation to the commissioner
439.19and the recipient. An in-person assessment must occur at least annually or when there is a
439.20significant change in the recipient's condition or when there is a change in the need for
439.21personal care assistance services. A service update may substitute for the annual face-to-face
439.22assessment when there is not a significant change in recipient condition or a change in the
439.23need for personal care assistance service. A service update may be completed by telephone,
439.24used when there is no need for an increase in personal care assistance services, and used
439.25for two consecutive assessments if followed by a face-to-face assessment. A service update
439.26must be completed on a form approved by the commissioner. A service update or review
439.27for temporary increase includes a review of initial baseline data, evaluation of service
439.28effectiveness, redetermination of service need, modification of service plan and appropriate
439.29referrals, update of initial forms, obtaining service authorization, and on going ongoing
439.30consumer education. Assessments or reassessments must be completed on forms provided
439.31by the commissioner within 30 days of a request for home care services by a recipient or
439.32responsible party.
439.33(b) This subdivision expires when notification is given by the commissioner as described
439.34in section 256B.0911, subdivision 3a 18.

440.1    Sec. 11. Minnesota Statutes 2020, section 256B.0913, subdivision 4, is amended to read:
440.2    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients. (a)
440.3Funding for services under the alternative care program is available to persons who meet
440.4the following criteria:
440.5    (1) the person is a citizen of the United States or a United States national;
440.6    (2) the person has been determined by a community assessment under section 256B.0911
440.7to be a person who would require the level of care provided in a nursing facility, as
440.8determined under section 256B.0911, subdivision 4e 26, but for the provision of services
440.9under the alternative care program;
440.10    (3) the person is age 65 or older;
440.11    (4) the person would be eligible for medical assistance within 135 days of admission to
440.12a nursing facility;
440.13    (5) the person is not ineligible for the payment of long-term care services by the medical
440.14assistance program due to an asset transfer penalty under section 256B.0595 or equity
440.15interest in the home exceeding $500,000 as stated in section 256B.056;
440.16    (6) the person needs long-term care services that are not funded through other state or
440.17federal funding, or other health insurance or other third-party insurance such as long-term
440.18care insurance;
440.19    (7) except for individuals described in clause (8), the monthly cost of the alternative
440.20care services funded by the program for this person does not exceed 75 percent of the
440.21monthly limit described under section 256S.18. This monthly limit does not prohibit the
440.22alternative care client from payment for additional services, but in no case may the cost of
440.23additional services purchased under this section exceed the difference between the client's
440.24monthly service limit defined under section 256S.04, and the alternative care program
440.25monthly service limit defined in this paragraph. If care-related supplies and equipment or
440.26environmental modifications and adaptations are or will be purchased for an alternative
440.27care services recipient, the costs may be prorated on a monthly basis for up to 12 consecutive
440.28months beginning with the month of purchase. If the monthly cost of a recipient's other
440.29alternative care services exceeds the monthly limit established in this paragraph, the annual
440.30cost of the alternative care services shall be determined. In this event, the annual cost of
440.31alternative care services shall not exceed 12 times the monthly limit described in this
440.32paragraph;
441.1    (8) for individuals assigned a case mix classification A as described under section
441.2256S.18, with (i) no dependencies in activities of daily living, or (ii) up to two dependencies
441.3in bathing, dressing, grooming, walking, and eating when the dependency score in eating
441.4is three or greater as determined by an assessment performed under section 256B.0911, the
441.5monthly cost of alternative care services funded by the program cannot exceed $593 per
441.6month for all new participants enrolled in the program on or after July 1, 2011. This monthly
441.7limit shall be applied to all other participants who meet this criteria at reassessment. This
441.8monthly limit shall be increased annually as described in section 256S.18. This monthly
441.9limit does not prohibit the alternative care client from payment for additional services, but
441.10in no case may the cost of additional services purchased exceed the difference between the
441.11client's monthly service limit defined in this clause and the limit described in clause (7) for
441.12case mix classification A; and
441.13(9) the person is making timely payments of the assessed monthly fee. A person is
441.14ineligible if payment of the fee is over 60 days past due, unless the person agrees to:
441.15    (i) the appointment of a representative payee;
441.16    (ii) automatic payment from a financial account;
441.17    (iii) the establishment of greater family involvement in the financial management of
441.18payments; or
441.19    (iv) another method acceptable to the lead agency to ensure prompt fee payments.
441.20    (b) The lead agency may extend the client's eligibility as necessary while making
441.21arrangements to facilitate payment of past-due amounts and future premium payments.
441.22Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
441.23reinstated for a period of 30 days.
441.24    (b) (c) Alternative care funding under this subdivision is not available for a person who
441.25is a medical assistance recipient or who would be eligible for medical assistance without a
441.26spenddown or waiver obligation. A person whose initial application for medical assistance
441.27and the elderly waiver program is being processed may be served under the alternative care
441.28program for a period up to 60 days. If the individual is found to be eligible for medical
441.29assistance, medical assistance must be billed for services payable under the federally
441.30approved elderly waiver plan and delivered from the date the individual was found eligible
441.31for the federally approved elderly waiver plan. Notwithstanding this provision, alternative
441.32care funds may not be used to pay for any service the cost of which: (i) is payable by medical
441.33assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to pay a
442.1medical assistance income spenddown for a person who is eligible to participate in the
442.2federally approved elderly waiver program under the special income standard provision.
442.3    (c) (d) Alternative care funding is not available for a person who resides in a licensed
442.4nursing home, certified boarding care home, hospital, or intermediate care facility, except
442.5for case management services which are provided in support of the discharge planning
442.6process for a nursing home resident or certified boarding care home resident to assist with
442.7a relocation process to a community-based setting.
442.8    (d) (e) Alternative care funding is not available for a person whose income is greater
442.9than the maintenance needs allowance under section 256S.05, but equal to or less than 120
442.10percent of the federal poverty guideline effective July 1 in the fiscal year for which alternative
442.11care eligibility is determined, who would be eligible for the elderly waiver with a waiver
442.12obligation.

442.13    Sec. 12. Minnesota Statutes 2020, section 256B.092, subdivision 1a, is amended to read:
442.14    Subd. 1a. Case management services. (a) Each recipient of a home and community-based
442.15waiver shall be provided case management services by qualified vendors as described in
442.16the federally approved waiver application.
442.17(b) Case management service activities provided to or arranged for a person include:
442.18(1) development of the person-centered coordinated service and support plan under
442.19subdivision 1b;
442.20(2) informing the individual or the individual's legal guardian or conservator, or parent
442.21if the person is a minor, of service options, including all service options available under the
442.22waiver plan;
442.23(3) consulting with relevant medical experts or service providers;
442.24(4) assisting the person in the identification of potential providers of chosen services,
442.25including:
442.26(i) providers of services provided in a non-disability-specific setting;
442.27(ii) employment service providers;
442.28(iii) providers of services provided in settings that are not controlled by a provider; and
442.29(iv) providers of financial management services;
442.30(5) assisting the person to access services and assisting in appeals under section 256.045;
442.31(6) coordination of services, if coordination is not provided by another service provider;
443.1(7) evaluation and monitoring of the services identified in the coordinated service and
443.2support plan, which must incorporate at least one annual face-to-face visit by the case
443.3manager with each person; and
443.4(8) reviewing coordinated service and support plans and providing the lead agency with
443.5recommendations for service authorization based upon the individual's needs identified in
443.6the coordinated service and support plan.
443.7(c) Case management service activities that are provided to the person with a
443.8developmental disability shall be provided directly by county agencies or under contract.
443.9Case management services must be provided by a public or private agency that is enrolled
443.10as a medical assistance provider determined by the commissioner to meet all of the
443.11requirements in the approved federal waiver plans. Case management services must not be
443.12provided to a recipient by a private agency that has a financial interest in the provision of
443.13any other services included in the recipient's coordinated service and support plan. For
443.14purposes of this section, "private agency" means any agency that is not identified as a lead
443.15agency under section 256B.0911, subdivision 1a, paragraph (e) 10.
443.16(d) Case managers are responsible for service provisions listed in paragraphs (a) and
443.17(b). Case managers shall collaborate with consumers, families, legal representatives, and
443.18relevant medical experts and service providers in the development and annual review of the
443.19person-centered coordinated service and support plan and habilitation plan.
443.20(e) For persons who need a positive support transition plan as required in chapter 245D,
443.21the case manager shall participate in the development and ongoing evaluation of the plan
443.22with the expanded support team. At least quarterly, the case manager, in consultation with
443.23the expanded support team, shall evaluate the effectiveness of the plan based on progress
443.24evaluation data submitted by the licensed provider to the case manager. The evaluation must
443.25identify whether the plan has been developed and implemented in a manner to achieve the
443.26following within the required timelines:
443.27(1) phasing out the use of prohibited procedures;
443.28(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's
443.29timeline; and
443.30(3) accomplishment of identified outcomes.
443.31If adequate progress is not being made, the case manager shall consult with the person's
443.32expanded support team to identify needed modifications and whether additional professional
443.33support is required to provide consultation.
444.1(f) The Department of Human Services shall offer ongoing education in case management
444.2to case managers. Case managers shall receive no less than ten hours of case management
444.3education and disability-related training each year. The education and training must include
444.4person-centered planning. For the purposes of this section, "person-centered planning" or
444.5"person-centered" has the meaning given in section 256B.0911, subdivision 1a, paragraph
444.6(f) 10.

444.7    Sec. 13. Minnesota Statutes 2020, section 256B.092, subdivision 1b, is amended to read:
444.8    Subd. 1b. Coordinated service and support plan. (a) Each recipient of home and
444.9community-based waivered services shall be provided a copy of the written person-centered
444.10coordinated service and support plan that:
444.11(1) is developed with and signed by the recipient within the timelines established by the
444.12commissioner and section 256B.0911, subdivision 3a, paragraph (e) 29;
444.13(2) includes the person's need for service, including identification of service needs that
444.14will be or that are met by the person's relatives, friends, and others, as well as community
444.15services used by the general public;
444.16(3) reasonably ensures the health and welfare of the recipient;
444.17(4) identifies the person's preferences for services as stated by the person, the person's
444.18legal guardian or conservator, or the parent if the person is a minor, including the person's
444.19choices made on self-directed options, services and supports to achieve employment goals,
444.20and living arrangements;
444.21(5) provides for an informed choice, as defined in section 256B.77, subdivision 2,
444.22paragraph (o), of service and support providers, and identifies all available options for case
444.23management services and providers;
444.24(6) identifies long-range and short-range goals for the person;
444.25(7) identifies specific services and the amount and frequency of the services to be provided
444.26to the person based on assessed needs, preferences, and available resources. The
444.27person-centered coordinated service and support plan shall also specify other services the
444.28person needs that are not available;
444.29(8) identifies the need for an individual program plan to be developed by the provider
444.30according to the respective state and federal licensing and certification standards, and
444.31additional assessments to be completed or arranged by the provider after service initiation;
445.1(9) identifies provider responsibilities to implement and make recommendations for
445.2modification to the coordinated service and support plan;
445.3(10) includes notice of the right to request a conciliation conference or a hearing under
445.4section 256.045;
445.5(11) is agreed upon and signed by the person, the person's legal guardian or conservator,
445.6or the parent if the person is a minor, and the authorized county representative;
445.7(12) is reviewed by a health professional if the person has overriding medical needs that
445.8impact the delivery of services; and
445.9(13) includes the authorized annual and monthly amounts for the services.
445.10(b) In developing the person-centered coordinated service and support plan, the case
445.11manager is encouraged to include the use of volunteers, religious organizations, social clubs,
445.12and civic and service organizations to support the individual in the community. The lead
445.13agency must be held harmless for damages or injuries sustained through the use of volunteers
445.14and agencies under this paragraph, including workers' compensation liability.
445.15(c) Approved, written, and signed changes to a consumer's services that meet the criteria
445.16in this subdivision shall be an addendum to that consumer's individual service plan.

445.17    Sec. 14. Minnesota Statutes 2020, section 256B.0922, subdivision 1, is amended to read:
445.18    Subdivision 1. Essential community supports. (a) The purpose of the essential
445.19community supports program is to provide targeted services to persons age 65 and older
445.20who need essential community support, but whose needs do not meet the level of care
445.21required for nursing facility placement under section 144.0724, subdivision 11.
445.22(b) Essential community supports are available not to exceed $400 per person per month.
445.23Essential community supports may be used as authorized within an authorization period
445.24not to exceed 12 months. Services must be available to a person who:
445.25(1) is age 65 or older;
445.26(2) is not eligible for medical assistance;
445.27(3) has received a community assessment under section 256B.0911, subdivision 3a or
445.283b subdivisions 17 to 21, 23, 24, or 27, and does not require the level of care provided in a
445.29nursing facility;
445.30(4) meets the financial eligibility criteria for the alternative care program under section
445.31256B.0913, subdivision 4;
446.1(5) has a community support plan; and
446.2(6) has been determined by a community assessment under section 256B.0911,
446.3subdivision 3a or 3b subdivisions 17 to 21, 23, 24 or 27, to be a person who would require
446.4provision of at least one of the following services, as defined in the approved elderly waiver
446.5plan, in order to maintain their community residence:
446.6(i) adult day services;
446.7(ii) caregiver support;
446.8(iii) homemaker support;
446.9(iv) chores;
446.10(v) a personal emergency response device or system;
446.11(vi) home-delivered meals; or
446.12(vii) community living assistance as defined by the commissioner.
446.13(c) The person receiving any of the essential community supports in this subdivision
446.14must also receive service coordination, not to exceed $600 in a 12-month authorization
446.15period, as part of their community support plan.
446.16(d) A person who has been determined to be eligible for essential community supports
446.17must be reassessed at least annually and continue to meet the criteria in paragraph (b) to
446.18remain eligible for essential community supports.
446.19(e) The commissioner is authorized to use federal matching funds for essential community
446.20supports as necessary and to meet demand for essential community supports as outlined in
446.21subdivision 2, and that amount of federal funds is appropriated to the commissioner for this
446.22purpose.

446.23    Sec. 15. Minnesota Statutes 2020, section 256B.49, subdivision 12, is amended to read:
446.24    Subd. 12. Informed choice. Persons who are determined likely to require the level of
446.25care provided in a nursing facility as determined under section 256B.0911, subdivision 4e
446.2626, or a hospital shall be informed of the home and community-based support alternatives
446.27to the provision of inpatient hospital services or nursing facility services. Each person must
446.28be given the choice of either institutional or home and community-based services using the
446.29provisions described in section 256B.77, subdivision 2, paragraph (p).

447.1    Sec. 16. Minnesota Statutes 2020, section 256B.49, subdivision 13, is amended to read:
447.2    Subd. 13. Case management. (a) Each recipient of a home and community-based waiver
447.3shall be provided case management services by qualified vendors as described in the federally
447.4approved waiver application. The case management service activities provided must include:
447.5(1) finalizing the person-centered written coordinated service and support plan within
447.6the timelines established by the commissioner and section 256B.0911, subdivision 3a,
447.7paragraph (e) 29;
447.8(2) informing the recipient or the recipient's legal guardian or conservator of service
447.9options, including all service options available under the waiver plans;
447.10(3) assisting the recipient in the identification of potential service providers of chosen
447.11services, including:
447.12(i) available options for case management service and providers;
447.13(ii) providers of services provided in a non-disability-specific setting;
447.14(iii) employment service providers;
447.15(iv) providers of services provided in settings that are not community residential settings;
447.16and
447.17(v) providers of financial management services;
447.18(4) assisting the recipient to access services and assisting with appeals under section
447.19256.045; and
447.20(5) coordinating, evaluating, and monitoring of the services identified in the service
447.21plan.
447.22(b) The case manager may delegate certain aspects of the case management service
447.23activities to another individual provided there is oversight by the case manager. The case
447.24manager may not delegate those aspects which require professional judgment including:
447.25(1) finalizing the person-centered coordinated service and support plan;
447.26(2) ongoing assessment and monitoring of the person's needs and adequacy of the
447.27approved person-centered coordinated service and support plan; and
447.28(3) adjustments to the person-centered coordinated service and support plan.
447.29(c) Case management services must be provided by a public or private agency that is
447.30enrolled as a medical assistance provider determined by the commissioner to meet all of
447.31the requirements in the approved federal waiver plans. Case management services must not
448.1be provided to a recipient by a private agency that has any financial interest in the provision
448.2of any other services included in the recipient's coordinated service and support plan. For
448.3purposes of this section, "private agency" means any agency that is not identified as a lead
448.4agency under section 256B.0911, subdivision 1a, paragraph (e) 10.
448.5(d) For persons who need a positive support transition plan as required in chapter 245D,
448.6the case manager shall participate in the development and ongoing evaluation of the plan
448.7with the expanded support team. At least quarterly, the case manager, in consultation with
448.8the expanded support team, shall evaluate the effectiveness of the plan based on progress
448.9evaluation data submitted by the licensed provider to the case manager. The evaluation must
448.10identify whether the plan has been developed and implemented in a manner to achieve the
448.11following within the required timelines:
448.12(1) phasing out the use of prohibited procedures;
448.13(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's
448.14timeline; and
448.15(3) accomplishment of identified outcomes.
448.16If adequate progress is not being made, the case manager shall consult with the person's
448.17expanded support team to identify needed modifications and whether additional professional
448.18support is required to provide consultation.
448.19(e) The Department of Human Services shall offer ongoing education in case management
448.20to case managers. Case managers shall receive no less than ten hours of case management
448.21education and disability-related training each year. The education and training must include
448.22person-centered planning. For the purposes of this section, "person-centered planning" or
448.23"person-centered" has the meaning given in section 256B.0911, subdivision 1a, paragraph
448.24(f) 10.

448.25    Sec. 17. Minnesota Statutes 2021 Supplement, section 256B.49, subdivision 14, is amended
448.26to read:
448.27    Subd. 14. Assessment and reassessment. (a) Assessments and reassessments shall be
448.28conducted by certified assessors according to section 256B.0911, subdivision 2b subdivisions
448.2913 and 14.
448.30(b) There must be a determination that the client requires a hospital level of care or a
448.31nursing facility level of care as defined in section 256B.0911, subdivision 4e 26, at initial
448.32and subsequent assessments to initiate and maintain participation in the waiver program.
449.1(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
449.2appropriate to determine nursing facility level of care for purposes of medical assistance
449.3payment for nursing facility services, only assessments conducted according to section
449.4256B.0911, subdivisions 3a, 3b, and 4d 17 to 21, 23, 24, and 27 to 31, that result in a hospital
449.5level of care determination or a nursing facility level of care determination must be accepted
449.6for purposes of initial and ongoing access to waiver services payment.
449.7(d) Recipients who are found eligible for home and community-based services under
449.8this section before their 65th birthday may remain eligible for these services after their 65th
449.9birthday if they continue to meet all other eligibility factors.

449.10    Sec. 18. Minnesota Statutes 2021 Supplement, section 256B.85, subdivision 2, is amended
449.11to read:
449.12    Subd. 2. Definitions. (a) For the purposes of this section and section 256B.851, the terms
449.13defined in this subdivision have the meanings given.
449.14(b) "Activities of daily living" or "ADLs" means:
449.15(1) dressing, including assistance with choosing, applying, and changing clothing and
449.16applying special appliances, wraps, or clothing;
449.17(2) grooming, including assistance with basic hair care, oral care, shaving, applying
449.18cosmetics and deodorant, and care of eyeglasses and hearing aids. Grooming includes nail
449.19care, except for recipients who are diabetic or have poor circulation;
449.20(3) bathing, including assistance with basic personal hygiene and skin care;
449.21(4) eating, including assistance with hand washing and applying orthotics required for
449.22eating, transfers, or feeding;
449.23(5) transfers, including assistance with transferring the participant from one seating or
449.24reclining area to another;
449.25(6) mobility, including assistance with ambulation and use of a wheelchair. Mobility
449.26does not include providing transportation for a participant;
449.27(7) positioning, including assistance with positioning or turning a participant for necessary
449.28care and comfort; and
449.29(8) toileting, including assistance with bowel or bladder elimination and care, transfers,
449.30mobility, positioning, feminine hygiene, use of toileting equipment or supplies, cleansing
449.31the perineal area, inspection of the skin, and adjusting clothing.
450.1(c) "Agency-provider model" means a method of CFSS under which a qualified agency
450.2provides services and supports through the agency's own employees and policies. The agency
450.3must allow the participant to have a significant role in the selection and dismissal of support
450.4workers of their choice for the delivery of their specific services and supports.
450.5(d) "Behavior" means a description of a need for services and supports used to determine
450.6the home care rating and additional service units. The presence of Level I behavior is used
450.7to determine the home care rating.
450.8(e) "Budget model" means a service delivery method of CFSS that allows the use of a
450.9service budget and assistance from a financial management services (FMS) provider for a
450.10participant to directly employ support workers and purchase supports and goods.
450.11(f) "Complex health-related needs" means an intervention listed in clauses (1) to (8) that
450.12has been ordered by a physician, advanced practice registered nurse, or physician's assistant
450.13and is specified in a community support plan, including:
450.14(1) tube feedings requiring:
450.15(i) a gastrojejunostomy tube; or
450.16(ii) continuous tube feeding lasting longer than 12 hours per day;
450.17(2) wounds described as:
450.18(i) stage III or stage IV;
450.19(ii) multiple wounds;
450.20(iii) requiring sterile or clean dressing changes or a wound vac; or
450.21(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require specialized
450.22care;
450.23(3) parenteral therapy described as:
450.24(i) IV therapy more than two times per week lasting longer than four hours for each
450.25treatment; or
450.26(ii) total parenteral nutrition (TPN) daily;
450.27(4) respiratory interventions, including:
450.28(i) oxygen required more than eight hours per day;
450.29(ii) respiratory vest more than one time per day;
450.30(iii) bronchial drainage treatments more than two times per day;
451.1(iv) sterile or clean suctioning more than six times per day;
451.2(v) dependence on another to apply respiratory ventilation augmentation devices such
451.3as BiPAP and CPAP; and
451.4(vi) ventilator dependence under section 256B.0651;
451.5(5) insertion and maintenance of catheter, including:
451.6(i) sterile catheter changes more than one time per month;
451.7(ii) clean intermittent catheterization, and including self-catheterization more than six
451.8times per day; or
451.9(iii) bladder irrigations;
451.10(6) bowel program more than two times per week requiring more than 30 minutes to
451.11perform each time;
451.12(7) neurological intervention, including:
451.13(i) seizures more than two times per week and requiring significant physical assistance
451.14to maintain safety; or
451.15(ii) swallowing disorders diagnosed by a physician, advanced practice registered nurse,
451.16or physician's assistant and requiring specialized assistance from another on a daily basis;
451.17and
451.18(8) other congenital or acquired diseases creating a need for significantly increased direct
451.19hands-on assistance and interventions in six to eight activities of daily living.
451.20(g) "Community first services and supports" or "CFSS" means the assistance and supports
451.21program under this section needed for accomplishing activities of daily living, instrumental
451.22activities of daily living, and health-related tasks through hands-on assistance to accomplish
451.23the task or constant supervision and cueing to accomplish the task, or the purchase of goods
451.24as defined in subdivision 7, clause (3), that replace the need for human assistance.
451.25(h) "Community first services and supports service delivery plan" or "CFSS service
451.26delivery plan" means a written document detailing the services and supports chosen by the
451.27participant to meet assessed needs that are within the approved CFSS service authorization,
451.28as determined in subdivision 8. Services and supports are based on the coordinated service
451.29and support plan identified in sections 256B.092, subdivision 1b, and 256S.10.
451.30(i) "Consultation services" means a Minnesota health care program enrolled provider
451.31organization that provides assistance to the participant in making informed choices about
452.1CFSS services in general and self-directed tasks in particular, and in developing a
452.2person-centered CFSS service delivery plan to achieve quality service outcomes.
452.3(j) "Critical activities of daily living" means transferring, mobility, eating, and toileting.
452.4(k) "Dependency" in activities of daily living means a person requires hands-on assistance
452.5or constant supervision and cueing to accomplish one or more of the activities of daily living
452.6every day or on the days during the week that the activity is performed; however, a child
452.7must not be found to be dependent in an activity of daily living if, because of the child's
452.8age, an adult would either perform the activity for the child or assist the child with the
452.9activity and the assistance needed is the assistance appropriate for a typical child of the
452.10same age.
452.11(l) "Extended CFSS" means CFSS services and supports provided under CFSS that are
452.12included in the CFSS service delivery plan through one of the home and community-based
452.13services waivers and as approved and authorized under chapter 256S and sections 256B.092,
452.14subdivision 5, and 256B.49, which exceed the amount, duration, and frequency of the state
452.15plan CFSS services for participants. Extended CFSS excludes the purchase of goods.
452.16(m) "Financial management services provider" or "FMS provider" means a qualified
452.17organization required for participants using the budget model under subdivision 13 that is
452.18an enrolled provider with the department to provide vendor fiscal/employer agent financial
452.19management services (FMS).
452.20(n) "Health-related procedures and tasks" means procedures and tasks related to the
452.21specific assessed health needs of a participant that can be taught or assigned by a
452.22state-licensed health care or mental health professional and performed by a support worker.
452.23(o) "Instrumental activities of daily living" means activities related to living independently
452.24in the community, including but not limited to: meal planning, preparation, and cooking;
452.25shopping for food, clothing, or other essential items; laundry; housecleaning; assistance
452.26with medications; managing finances; communicating needs and preferences during activities;
452.27arranging supports; and assistance with traveling around and participating in the community,
452.28including traveling to medical appointments. For purposes of this paragraph, traveling
452.29includes driving and accompanying the recipient in the recipient's chosen mode of
452.30transportation and according to the individual CFSS service delivery plan.
452.31(p) "Lead agency" has the meaning given in section 256B.0911, subdivision 1a, paragraph
452.32(e) 10.
453.1(q) "Legal representative" means parent of a minor, a court-appointed guardian, or
453.2another representative with legal authority to make decisions about services and supports
453.3for the participant. Other representatives with legal authority to make decisions include but
453.4are not limited to a health care agent or an attorney-in-fact authorized through a health care
453.5directive or power of attorney.
453.6(r) "Level I behavior" means physical aggression toward self or others or destruction of
453.7property that requires the immediate response of another person.
453.8(s) "Medication assistance" means providing verbal or visual reminders to take regularly
453.9scheduled medication, and includes any of the following supports listed in clauses (1) to
453.10(3) and other types of assistance, except that a support worker must not determine medication
453.11dose or time for medication or inject medications into veins, muscles, or skin:
453.12(1) under the direction of the participant or the participant's representative, bringing
453.13medications to the participant including medications given through a nebulizer, opening a
453.14container of previously set-up medications, emptying the container into the participant's
453.15hand, opening and giving the medication in the original container to the participant, or
453.16bringing to the participant liquids or food to accompany the medication;
453.17(2) organizing medications as directed by the participant or the participant's representative;
453.18and
453.19(3) providing verbal or visual reminders to perform regularly scheduled medications.
453.20(t) "Participant" means a person who is eligible for CFSS.
453.21(u) "Participant's representative" means a parent, family member, advocate, or other
453.22adult authorized by the participant or participant's legal representative, if any, to serve as a
453.23representative in connection with the provision of CFSS. If the participant is unable to assist
453.24in the selection of a participant's representative, the legal representative shall appoint one.
453.25(v) "Person-centered planning process" means a process that is directed by the participant
453.26to plan for CFSS services and supports.
453.27(w) "Service budget" means the authorized dollar amount used for the budget model or
453.28for the purchase of goods.
453.29(x) "Shared services" means the provision of CFSS services by the same CFSS support
453.30worker to two or three participants who voluntarily enter into a written agreement to receive
453.31services at the same time, in the same setting, and through the same agency-provider or
453.32FMS provider.
454.1(y) "Support worker" means a qualified and trained employee of the agency-provider
454.2as required by subdivision 11b or of the participant employer under the budget model as
454.3required by subdivision 14 who has direct contact with the participant and provides services
454.4as specified within the participant's CFSS service delivery plan.
454.5(z) "Unit" means the increment of service based on hours or minutes identified in the
454.6service agreement.
454.7(aa) "Vendor fiscal employer agent" means an agency that provides financial management
454.8services.
454.9(bb) "Wages and benefits" means the hourly wages and salaries, the employer's share
454.10of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation,
454.11mileage reimbursement, health and dental insurance, life insurance, disability insurance,
454.12long-term care insurance, uniform allowance, contributions to employee retirement accounts,
454.13or other forms of employee compensation and benefits.
454.14(cc) "Worker training and development" means services provided according to subdivision
454.1518a for developing workers' skills as required by the participant's individual CFSS service
454.16delivery plan that are arranged for or provided by the agency-provider or purchased by the
454.17participant employer. These services include training, education, direct observation and
454.18supervision, and evaluation and coaching of job skills and tasks, including supervision of
454.19health-related tasks or behavioral supports.

454.20    Sec. 19. Minnesota Statutes 2021 Supplement, section 256B.85, subdivision 5, is amended
454.21to read:
454.22    Subd. 5. Assessment requirements. (a) The assessment of functional need must:
454.23(1) be conducted by a certified assessor according to the criteria established in section
454.24256B.0911, subdivision 3a subdivisions 17 to 21, 23, 24, and 29 to 31;
454.25(2) be conducted face-to-face, initially and at least annually thereafter, or when there is
454.26a significant change in the participant's condition or a change in the need for services and
454.27supports, or at the request of the participant when the participant experiences a change in
454.28condition or needs a change in the services or supports; and
454.29(3) be completed using the format established by the commissioner.
454.30(b) The results of the assessment and any recommendations and authorizations for CFSS
454.31must be determined and communicated in writing by the lead agency's assessor as defined
454.32in section 256B.0911 to the participant or the participant's representative and chosen CFSS
455.1providers within ten business days and must include the participant's right to appeal the
455.2assessment under section 256.045, subdivision 3.
455.3(c) The lead agency assessor may authorize a temporary authorization for CFSS services
455.4to be provided under the agency-provider model. The lead agency assessor may authorize
455.5a temporary authorization for CFSS services to be provided under the agency-provider
455.6model without using the assessment process described in this subdivision. Authorization
455.7for a temporary level of CFSS services under the agency-provider model is limited to the
455.8time specified by the commissioner, but shall not exceed 45 days. The level of services
455.9authorized under this paragraph shall have no bearing on a future authorization. For CFSS
455.10services needed beyond the 45-day temporary authorization, the lead agency must conduct
455.11an assessment as described in this subdivision and participants must use consultation services
455.12to complete their orientation and selection of a service model.

455.13    Sec. 20. Minnesota Statutes 2020, section 256S.02, subdivision 15, is amended to read:
455.14    Subd. 15. Lead agency. "Lead agency" means a county administering long-term care
455.15consultation services as defined in section 256B.0911, subdivision 1a 10, or a tribe or
455.16managed care organization under contract with the commissioner to administer long-term
455.17care consultation services as defined in section 256B.0911, subdivision 1a 10.

455.18    Sec. 21. Minnesota Statutes 2020, section 256S.02, subdivision 20, is amended to read:
455.19    Subd. 20. Nursing facility level of care determination. "Nursing facility level of care
455.20determination" refers to determination of institutional level of care described in section
455.21256B.0911, subdivision 4e 26.

455.22    Sec. 22. Minnesota Statutes 2021 Supplement, section 256S.05, subdivision 2, is amended
455.23to read:
455.24    Subd. 2. Nursing facility level of care determination required. Notwithstanding other
455.25assessments identified in section 144.0724, subdivision 4, only assessments conducted
455.26according to section 256B.0911, subdivisions 3, 3a, and 3b, that result in a nursing facility
455.27level of care determination at initial and subsequent assessments shall be accepted for
455.28purposes of a participant's initial and ongoing participation in the elderly waiver and a
455.29service provider's access to service payments under this chapter.

456.1    Sec. 23. Minnesota Statutes 2020, section 256S.06, subdivision 1, is amended to read:
456.2    Subdivision 1. Initial assessments. A lead agency shall provide each participant with
456.3an initial long-term care consultation assessment of strengths, informal supports, and need
456.4for services according to section 256B.0911, subdivisions 3, 3a, and 3b.

456.5    Sec. 24. Minnesota Statutes 2020, section 256S.06, subdivision 2, is amended to read:
456.6    Subd. 2. Annual reassessments. At least every 12 months, a lead agency shall provide
456.7each participant with an annual long-term care consultation reassessment according to
456.8section 256B.0911, subdivisions 3, 3a, and 3b 22 to 25.

456.9    Sec. 25. Minnesota Statutes 2020, section 256S.10, subdivision 2, is amended to read:
456.10    Subd. 2. Plan development timeline. Within the timelines established by the
456.11commissioner and section 256B.0911, subdivision 3a, paragraph (e) 29, the case manager
456.12must develop with the participant and the participant must sign the participant's individualized
456.13written coordinated service and support plan.

456.14    Sec. 26. REVISOR INSTRUCTION.
456.15(a) The revisor of statutes shall change the term "coordinated service and support plan"
456.16and similar terms to "support plan" and similar terms wherever these terms appear in
456.17Minnesota Statutes, sections 144G.911, 245A.11, 245D.02, 245D.04, 245D.05, 245D.051,
456.18245D.06, 245D.061, 245D.07, 245D.071, 245D.081, 245D.09, 245D.091, 245D.095,
456.19245D.11, 245D.22, 245D.31, 252.41, 252.42, 252.44, 252.45, 252A.02, 256B.0913,
456.20256B.092, 256B.49, 256B.4911, 256B.4914, 256B.85, 256S.01, 256S.08, 256S.09, 256S.10,
456.21256S.11, and 325F.722. The revisor shall also make necessary grammatical changes related
456.22to the change in terms in order to preserve the meaning of the text.
456.23(b) The revisor of statutes shall change the term "community support plan" and similar
456.24terms to "assessment summary" and similar terms wherever these terms appear in Minnesota
456.25Statutes, sections 245.462, 245.4711, 245.477, 245.4835, 245.4871, 245.4873, 245.4881,
456.26245.4885, 245.4887, 245D.091, 256.975, 256B.0623, 256B.0659, 256B.092, 256B.0922,
456.27256B.4911, 256B.4914, and 256B.85. The revisor shall also make necessary grammatical
456.28changes related to the change in terms in order to preserve the meaning of the text.

456.29    Sec. 27. EFFECTIVE DATE.
456.30Sections 1 to 26 are effective July 1, 2022."
457.1Delete the title and insert:
457.2"A bill for an act
457.3relating to state government; modifying provisions governing the Department of
457.4Health, health care, health-related licensing boards, health insurance, community
457.5supports, behavioral health, continuing care for older adults, child and vulnerable
457.6adult protection, economic assistance, direct care and treatment, preventing
457.7homelessness, human services licensing and operations, the Minnesota Rare Disease
457.8Advisory Council, nonintoxicating hemp regulation, organ donation regulation,
457.9mandated reports, and long-term care consultation services; making forecast
457.10adjustments; requiring reports; appropriating money;amending Minnesota Statutes
457.112020, sections 13.46, subdivision 7; 34A.01, subdivision 4; 62J.2930, subdivision
457.123; 62J.692, subdivision 5; 62Q.37, subdivision 7; 137.68; 144.057, subdivision 1;
457.13144.0724, subdivision 11; 144.1201, subdivisions 2, 4; 144.1503; 144.1911,
457.14subdivision 4; 144.193; 144.292, subdivision 6; 144.294, subdivision 2; 144.4199,
457.15subdivision 8; 144.497; 144.565, subdivision 4; 144.6502, subdivision 1; 144A.01;
457.16144A.03, subdivision 1; 144A.04, subdivisions 4, 6; 144A.06; 144A.10, subdivision
457.1717; 144A.351, subdivision 1; 144A.4799, subdivisions 1, 3; 144A.483, subdivision
457.181; 144A.75, subdivision 12; 144G.08, by adding a subdivision; 144G.15; 144G.17;
457.19144G.19, by adding a subdivision; 144G.20, subdivisions 1, 4, 5, 8, 9, 12, 15;
457.20144G.30, subdivision 5; 144G.31, subdivisions 4, 8; 144G.41, subdivisions 7, 8;
457.21144G.42, subdivision 10; 144G.45, subdivision 7; 144G.50, subdivision 2; 144G.52,
457.22subdivisions 2, 8, 9; 144G.53; 144G.55, subdivisions 1, 3; 144G.56, subdivisions
457.233, 5; 144G.57, subdivisions 1, 3, 5; 144G.70, subdivisions 2, 4; 144G.80,
457.24subdivision 2; 144G.90, subdivision 1, by adding a subdivision; 144G.91,
457.25subdivisions 13, 21; 144G.92, subdivision 1; 144G.93; 144G.95; 145.4134; 145.928,
457.26subdivision 13; 148B.33, by adding a subdivision; 148E.100, subdivision 3;
457.27148E.105, subdivision 3, as amended; 148E.106, subdivision 3; 148E.110,
457.28subdivision 7; 150A.06, subdivisions 1c, 2c, 6, by adding a subdivision; 150A.09;
457.29150A.091, subdivisions 2, 5, 8, 9, by adding subdivisions; 150A.10, subdivision
457.301a; 150A.105, subdivision 8; 151.01, subdivision 27; 151.72, subdivisions 1, 2,
457.313, 4, 6, by adding a subdivision; 152.02, subdivision 2; 152.125; 153.16, subdivision
457.321; 242.19, subdivision 2; 245.462, subdivision 4; 245.4661, subdivision 10;
457.33245.4889, subdivision 3, by adding a subdivision; 245.713, subdivision 2; 245A.02,
457.34subdivision 5a; 245A.11, subdivisions 2, 2a, by adding a subdivision; 245A.14,
457.35subdivision 14; 245A.1443; 245C.31, subdivisions 1, 2, by adding subdivisions;
457.36245D.10, subdivision 3a; 245D.12; 245F.15, subdivision 1; 245F.16, subdivision
457.371; 245G.01, subdivisions 4, 17, by adding a subdivision; 245G.06, subdivision 3,
457.38by adding subdivisions; 245G.07, by adding a subdivision; 245G.08, subdivision
457.395; 245G.09, subdivision 3; 245G.11, subdivisions 1, 10; 245G.12; 245G.13,
457.40subdivision 1; 245G.20; 245G.22, subdivision 7; 253B.18, subdivision 6; 256.01,
457.41subdivision 29; 256.021, subdivision 3; 256.042, subdivision 5, as amended;
457.42256.045, subdivision 3; 256.9657, subdivision 8; 256.975, subdivisions 7a, 7b, 7c,
457.437d, 11, 12; 256B.051, subdivision 4; 256B.055, subdivision 2; 256B.056,
457.44subdivisions 3b, 3c, 11; 256B.0561, subdivision 4; 256B.0595, subdivision 1;
457.45256B.0625, subdivision 64; 256B.0646; 256B.0659, subdivisions 3a, 19;
457.46256B.0911, subdivisions 1, 3c, 3d, 3e, 5, by adding subdivisions; 256B.0913,
457.47subdivision 4; 256B.092, subdivisions 1a, 1b; 256B.0922, subdivision 1;
457.48256B.0941, by adding a subdivision; 256B.0949, subdivisions 8, 17; 256B.49,
457.49subdivisions 12, 13; 256B.493, subdivision 2; 256B.69, subdivision 9d; 256B.77,
457.50subdivision 13; 256D.0515; 256E.28, subdivision 6; 256E.33, subdivisions 1, 2;
457.51256E.36, subdivision 1; 256G.02, subdivision 6; 256I.03, subdivision 6; 256K.26,
457.52subdivisions 2, 6, 7; 256K.45, subdivision 6, by adding a subdivision; 256P.04,
457.53subdivision 11; 256Q.06, by adding a subdivision; 256R.02, subdivisions 4, 17,
457.5418, 22, 29, 42a, 48a, by adding subdivisions; 256R.07, subdivisions 1, 2, 3;
457.55256R.08, subdivision 1; 256R.09, subdivisions 2, 5; 256R.10, by adding a
457.56subdivision; 256R.13, subdivision 4; 256R.16, subdivision 1; 256R.17, subdivision
457.573; 256R.18; 256R.26, subdivision 1; 256R.261, subdivision 13; 256R.37; 256R.39;
458.1256S.02, subdivisions 15, 20; 256S.06, subdivisions 1, 2; 256S.10, subdivision 2;
458.2257.0725; 260.012; 260.775; 260B.331, subdivision 1; 260C.001, subdivision 3;
458.3260C.007, subdivision 27; 260C.151, subdivision 6; 260C.152, subdivision 5;
458.4260C.175, subdivision 2; 260C.176, subdivision 2; 260C.178, subdivision 1;
458.5260C.181, subdivision 2; 260C.193, subdivision 3; 260C.201, subdivisions 1, 2;
458.6260C.202; 260C.203; 260C.204; 260C.212, subdivision 4a; 260C.221; 260C.331,
458.7subdivision 1; 260C.513; 260C.607, subdivisions 2, 5; 260C.613, subdivisions 1,
458.85; 260E.22, subdivision 2; 260E.24, subdivisions 2, 6; 260E.38, subdivision 3;
458.9268.19, subdivision 1; 477A.0126, subdivision 7, by adding a subdivision; 518.17,
458.10subdivision 1; 518A.43, subdivision 1; 518A.77; 626.557, subdivisions 4, 9, 9b,
458.119c, 9d, 10, 10b, 12b; 626.5571, subdivisions 1, 2; 626.5572, subdivisions 2, 4, 17;
458.12Minnesota Statutes 2021 Supplement, sections 62A.673, subdivision 2; 144.0724,
458.13subdivisions 4, 12, as amended; 144.551, subdivision 1; 148B.5301, subdivision
458.142; 148F.11, subdivision 1; 151.72, subdivision 5; 245.467, subdivisions 2, 3;
458.15245.4871, subdivision 21; 245.4876, subdivisions 2, 3; 245.4889, subdivision 1;
458.16245.735, subdivision 3; 245A.03, subdivision 7; 245A.14, subdivision 4; 245C.03,
458.17subdivision 5a; 245I.02, subdivisions 19, 36; 245I.03, subdivisions 5, 9; 245I.04,
458.18subdivision 4; 245I.05, subdivision 3; 245I.08, subdivision 4; 245I.09, subdivision
458.192; 245I.10, subdivisions 2, 6; 245I.20, subdivision 5; 245I.23, subdivision 22;
458.20254B.05, subdivision 5; 256.01, subdivision 42; 256.042, subdivision 4, as
458.21amended; 256B.0371, subdivision 4, as amended; 256B.0622, subdivision 2;
458.22256B.0625, subdivisions 3b, 5m; 256B.0638, subdivision 5; 256B.0671, subdivision
458.236; 256B.0911, subdivision 3a; 256B.0943, subdivisions 1, 3, 4, 6, 7, 9, 11;
458.24256B.0946, subdivision 1; 256B.0947, subdivisions 2, 3, 5, 6; 256B.0949,
458.25subdivisions 2, 13; 256B.49, subdivision 14; 256B.69, subdivision 9f; 256B.85,
458.26subdivisions 2, 5; 256P.01, subdivision 6a; 256P.06, subdivision 3; 256S.05,
458.27subdivision 2; 256S.205; 260C.212, subdivisions 1, 2; 260C.605, subdivision 1;
458.28260C.607, subdivision 6; 260E.20, subdivision 2; 363A.50; Laws 2009, chapter
458.2979, article 13, section 3, subdivision 10, as amended; Laws 2020, First Special
458.30Session chapter 7, section 1, subdivisions 1, as amended, 5, as amended; Laws
458.312021, First Special Session chapter 7, article 10, sections 1; 3; article 11, section
458.3238; article 16, sections 2, subdivisions 23, 24, 29, 31, 32, 33; 3, subdivision 2; 5;
458.33article 17, sections 1, subdivision 2; 3; 6; 10; 11; 12; 17, subdivision 3; 19; Laws
458.342021, First Special Session chapter 8, article 6, section 1, subdivision 7; proposing
458.35coding for new law in Minnesota Statutes, chapters 4; 144A; 145; 245A; 256B;
458.36626; repealing Minnesota Statutes 2020, sections 62U.10, subdivision 3; 144.1911,
458.37subdivision 10; 144.564, subdivision 3; 144A.483, subdivision 2; 150A.091,
458.38subdivisions 3, 15, 17; 245.981; 245A.03, subdivision 5; 245F.15, subdivision 2;
458.39245G.11, subdivision 2; 246.0136; 246.131; 246B.03, subdivision 2; 246B.035;
458.40252.025, subdivision 7; 252.035; 254A.04; 254A.21; 254B.14, subdivisions 1, 2,
458.413, 4, 6; 256.01, subdivision 31; 256B.057, subdivision 7; 256B.0638, subdivision
458.427; 256B.0911, subdivisions 2b, 2c, 3, 3b, 3g, 4d, 4e, 5, 6; 256B.0943, subdivision
458.438a; 256B.69, subdivision 20; 256D.055; 256R.08, subdivision 2; 501C.0408,
458.44subdivision 4; 501C.1206; Minnesota Statutes 2021 Supplement, sections 144G.07,
458.45subdivision 6; 254B.14, subdivision 5; 256B.0911, subdivisions 1a, 3a, 3f; Laws
458.461998, chapter 382, article 1, section 23; Minnesota Rules, parts 2960.0460, subpart
458.472; 9530.6565, subpart 2; 9555.6255."
458.48The motion prevailed. #did not prevail. So the amendment was #not adopted.