SF 3322

1st Engrossment - 91st Legislature (2019 - 2020) Posted on 05/12/2020 11:59am

A bill for an act
relating to human services; child care; foster care; disability services; civil
commitment; requiring students in foster care who change schools to be enrolled
within seven days; requiring responsible social services agencies to initiate and
facilitate phone calls between parents and foster care providers for children in
out-of-home placement; directing the commissioner of human services to modify
a report and develop training; prohibiting the commissioner of human services
from imposing new or additional reporting requirements on community-based
mental health service providers unless the commissioner first increases
reimbursement rates; extending the corporate adult foster care moratorium exception
for a fifth bed until 2024; modifying timelines for intensive support service
planning; permitting delegation of competency evaluations of direct support staff;
modifying the training requirements for direct support staff providing licensed
home and community-based services; codifying an existing grant program for fetal
alcohol disorder prevention activities; clarifying the excess income standard for
medical assistance; extending end date for first three years of life demonstration
project; permitting advanced practice registered nurses and physician assistants
to order home health services under Medical Assistance; codifying existing session
law governing consumer-directed community supports; modifying provisions
regarding post-arrest community-based service coordination; Birth to Age Eight
pilot project participation requirements; eliminating requirement to involve state
medical review agent in determination and documentation of medically necessary
psychiatric residential treatment facility services; requiring establishment of per
diem rate per provider of youth psychiatric residential treatment services; permitting
facilities or licensed professionals to submit billing for arranged services; changing
definition relating to children's mental health crisis response services; modifying
intensive rehabilitative mental health services requirements and provider standards;
establishing a foster care moratorium exception for family to corporate foster care
conversions; establishing state policy regrading services offered to people with
disabilities; modifying existing direction to the commissioner of human services
regarding proposing changes to the home and community-based waivers; modifying
requirements for service planning for home and community-based services;
modifying definitions, requirements and eligibility for long-term care consultation
services; modifying case management requirements for individuals receiving
services through the home and community-based services waivers; transferring
authority to issue certain home and community-based services designations to
licensed home care providers from the commissioner of health to the commissioner
of human services; establishing a moratorium on initial home and community-based
services designations for providers providing certain customized living services
in unlicensed settings; modifying provisions relating to child care services grants;
clarifying commissioner authority to waive child care assistance program provider
requirements during declared disaster; modifying eligibility for children's mental
health respite grants; clarifying child care training requirements; removing certain
categories from being exempt from foster care initial license moratorium; modifying
provisions relating to home and community-based services; clarifying circumstances
for termination of state-operated services for individuals with complex behavioral
needs; removing provision limiting medical assistance coverage for intensive
mental health outpatient treatment to adults; modifying provisions relating to
withdrawal management, substance use disorder, housing support, and general
assistance programs; authorizing correction of housing support payments; permitting
child care assistance program providers to serve children over the age of 13 in
certain circumstances; modifying definition of "qualified professional" for purposes
of applying for housing support and general assistance; authorizing imposition of
fine for repeat violations of chemical dependency or substance abuse disorder
treatment program requirements; directing commissioner of human services to
consider continuous licenses for family day care providers; instructing the revisor
of statutes to modify references to the Disability Linkage Line; modifying
provisions governing civil commitment; authorizing engagement services pilot
project; requiring reports; amending Minnesota Statutes 2018, sections 119B.21;
119B.26; 144A.484, subdivisions 2, 4, 5, 6; 245.4682, subdivision 2; 245.4876,
by adding a subdivision; 245A.11, subdivision 2a; 245D.02, by adding a
subdivision; 245D.04, subdivision 3; 245D.071, subdivision 3; 245D.081,
subdivision 2; 245D.09, subdivisions 4, 4a; 245D.10, subdivision 3a; 245F.02,
subdivisions 7, 14; 245F.06, subdivision 2; 245F.12, subdivisions 2, 3; 245G.02,
subdivision 2; 245G.09, subdivision 1; 245H.08, subdivisions 4, 5; 253B.02,
subdivisions 4b, 7, 8, 9, 10, 13, 16, 17, 18, 19, 21, 22, 23, by adding a subdivision;
253B.03, subdivisions 1, 2, 3, 4a, 5, 6, 6b, 6d, 7, 10; 253B.04, subdivisions 1, 1a,
2; 253B.045, subdivisions 2, 3, 5, 6; 253B.06, subdivisions 1, 2, 3; 253B.07,
subdivisions 1, 2, 2a, 2b, 2d, 3, 5, 7; 253B.08, subdivisions 1, 2a, 5, 5a; 253B.09,
subdivisions 1, 2, 3a, 5; 253B.092; 253B.0921; 253B.095, subdivision 3; 253B.097,
subdivisions 1, 2, 3, 6; 253B.10; 253B.12, subdivisions 1, 3, 4, 7; 253B.13,
subdivision 1; 253B.14; 253B.141; 253B.15, subdivisions 1, 1a, 2, 3, 3a, 3b, 3c,
5, 7, 9, 10, by adding a subdivision; 253B.16; 253B.17; 253B.18, subdivisions 1,
2, 3, 4a, 4b, 4c, 5, 5a, 6, 7, 8, 10, 11, 12, 14, 15; 253B.19, subdivision 2; 253B.20,
subdivisions 1, 2, 3, 4, 6; 253B.21, subdivisions 1, 2, 3; 253B.212, subdivisions
1, 1a, 1b, 2; 253B.22, subdivisions 1, 2, 3, 4; 253B.23, subdivisions 1, 1b, 2;
253B.24; 253D.02, subdivision 6; 253D.07, subdivision 2; 253D.10, subdivision
2; 253D.28, subdivision 2; 256B.0625, subdivisions 5l, 56a; 256B.0652, subdivision
10; 256B.0653, subdivisions 5, 7; 256B.0654, subdivisions 1, 2a; 256B.0911,
subdivisions 1, 3, 3b, 4d, by adding subdivisions; 256B.092, subdivision 1a;
256B.0941, subdivisions 1, 3; 256B.0944, subdivision 1; 256B.0947, subdivisions
2, 4, 5, 6; 256B.0949, subdivisions 2, 5, 6, 9, 13, 14, 15, 16; 256B.49, subdivision
16; 256D.02, subdivision 17; 256I.03, subdivisions 3, 14; 256I.05, subdivisions
1c, 1n, 8; 256I.06, subdivision 2, by adding a subdivision; 256J.08, subdivision
73a; 256P.01, by adding a subdivision; 257.0725; 260C.219; Minnesota Statutes
2019 Supplement, sections 144A.484, subdivision 1; 245.4889, subdivision 1;
245A.03, subdivision 7; 245A.149; 245A.40, subdivision 7; 245D.071, subdivision
5; 245D.09, subdivision 5; 254A.03, subdivision 3, as amended; 254B.05,
subdivision 1; 256B.056, subdivision 5c; 256B.064, subdivision 2; 256B.0711,
subdivision 1; 256B.0911, subdivisions 1a, 3a, 3f; 256B.092, subdivision 1b;
256B.49, subdivisions 13, 14; 256B.4914, subdivision 10a; 256I.04, subdivision
2b; 256S.01, subdivision 6; 256S.19, subdivision 4; Laws 2016, chapter 189, article
15, section 29; Laws 2017, First Special Session chapter 6, article 7, section 33;
Laws 2019, First Special Session chapter 9, article 5, section 86; article 14, section
2, subdivision 33; proposing coding for new law in Minnesota Statutes, chapters
120A; 245D; 253B; 254A; 256B; repealing Minnesota Statutes 2018, sections
245F.02, subdivision 20; 253B.02, subdivisions 6, 12a; 253B.05, subdivisions 1,
2, 2b, 3, 4; 253B.064; 253B.065; 253B.066; 253B.09, subdivision 3; 253B.12,
subdivision 2; 253B.15, subdivision 11; 253B.20, subdivision 7; Laws 2005, First
Special Session chapter 4, article 7, sections 50; 51; Laws 2012, chapter 247, article
4, section 47, as amended; Laws 2015, chapter 71, article 7, section 54, as amended;
Laws 2017, First Special Session chapter 6, article 1, sections 44, as amended; 45,
as amended.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

ARTICLE 1

CHILD PROTECTION AND OUT-OF-HOME PLACEMENT

Section 1.

new text begin [120A.21] ENROLLMENT OF A STUDENT IN FOSTER CARE.
new text end

new text begin A student placed in foster care must remain enrolled in the student's prior school unless
it is determined that remaining enrolled in the prior school is not in the student's best interests.
If the student does not remain enrolled in the prior school, the student must be enrolled in
a new school within seven school days.
new text end

Sec. 2.

Minnesota Statutes 2018, section 257.0725, is amended to read:

257.0725 ANNUAL REPORT.

The commissioner of human services shall publish an annual report on child maltreatment
and on children in out-of-home placement. The commissioner shall confer with counties,
child welfare organizations, child advocacy organizations, the courts, and other groups on
how to improve the content and utility of the department's annual report. In regard to child
maltreatment, the report shall include the number and kinds of maltreatment reports received
and any other data that the commissioner determines is appropriate to include in a report
on child maltreatment. In regard to children in out-of-home placement, the report shall
include, by county and statewide, information on legal status, living arrangement, age, sex,
race, accumulated length of time in placement, reason for most recent placement, race of
family with whom placed, new text begin school enrollments within seven days of placement pursuant to
section 120A.21, new text end and other information deemed appropriate on all children in out-of-home
placement. Out-of-home placement includes placement in any facility by an authorized
child-placing agency.

Sec. 3.

Minnesota Statutes 2018, section 260C.219, is amended to read:

260C.219 AGENCY RESPONSIBILITIES FOR PARENTS AND CHILDREN IN
PLACEMENT.

new text begin Subdivision 1. new text end

new text begin Responsibilities for parents; noncustodial parents. new text end

(a) When a child
is in foster care, the responsible social services agency shall make diligent efforts to identify,
locate, and, where appropriate, offer services to both parents of the child.

deleted text begin (1) deleted text end new text begin (b) new text end The responsible social services agency shall assess whether a noncustodial or
nonadjudicated parent is willing and capable of providing for the day-to-day care of the
child temporarily or permanently. An assessment under this deleted text begin clause deleted text end new text begin paragraph new text end may include,
but is not limited to, obtaining information under section 260C.209. If after assessment, the
responsible social services agency determines that a noncustodial or nonadjudicated parent
is willing and capable of providing day-to-day care of the child, the responsible social
services agency may seek authority from the custodial parent or the court to have that parent
assume day-to-day care of the child. If a parent is not an adjudicated parent, the responsible
social services agency shall require the nonadjudicated parent to cooperate with paternity
establishment procedures as part of the case plan.

deleted text begin (2) deleted text end new text begin (c) new text end If, after assessment, the responsible social services agency determines that the
child cannot be in the day-to-day care of either parent, the agency shall:

deleted text begin (i) deleted text end new text begin (1) new text end prepare an out-of-home placement plan addressing the conditions that each parent
must meet before the child can be in that parent's day-to-day care; and

deleted text begin (ii) deleted text end new text begin (2) new text end provide a parent who is the subject of a background study under section 260C.209
15 days' notice that it intends to use the study to recommend against putting the child with
that parent, and the court shall afford the parent an opportunity to be heard concerning the
study.

The results of a background study of a noncustodial parent shall not be used by the agency
to determine that the parent is incapable of providing day-to-day care of the child unless
the agency reasonably believes that placement of the child into the home of that parent
would endanger the child's health, safety, or welfare.

deleted text begin (3) deleted text end new text begin (d) new text end If, after the provision of services following an out-of-home placement plan under
this deleted text begin section deleted text end new text begin subdivision new text end , the child cannot return to the care of the parent from whom the
child was removed or who had legal custody at the time the child was placed in foster care,
the agency may petition on behalf of a noncustodial parent to establish legal custody with
that parent under section 260C.515, subdivision 4. If paternity has not already been
established, it may be established in the same proceeding in the manner provided for under
chapter 257.

deleted text begin (4) deleted text end new text begin (e) new text end The responsible social services agency may be relieved of the requirement to
locate and offer services to both parents by the juvenile court upon a finding of good cause
after the filing of a petition under section 260C.141.

new text begin Subd. 2. new text end

new text begin Notice to parent or guardian. new text end

deleted text begin (b) deleted text end The responsible social services agency shall
give notice to the parent or guardian of each child in foster care, other than a child in
voluntary foster care for treatment under chapter 260D, of the following information:

(1) that the child's placement in foster care may result in termination of parental rights
or an order permanently placing the child out of the custody of the parent, but only after
notice and a hearing as required under this chapter and the juvenile court rules;

(2) time limits on the length of placement and of reunification services, including the
date on which the child is expected to be returned to and safely maintained in the home of
the parent or parents or placed for adoption or otherwise permanently removed from the
care of the parent by court order;

(3) the nature of the services available to the parent;

(4) the consequences to the parent and the child if the parent fails or is unable to use
services to correct the circumstances that led to the child's placement;

(5) the first consideration for placement with relatives;

(6) the benefit to the child in getting the child out of foster care as soon as possible,
preferably by returning the child home, but if that is not possible, through a permanent legal
placement of the child away from the parent;

(7) when safe for the child, the benefits to the child and the parent of maintaining
visitation with the child as soon as possible in the course of the case and, in any event,
according to the visitation plan under this section; and

(8) the financial responsibilities and obligations, if any, of the parent or parents for the
support of the child during the period the child is in foster care.

new text begin Subd. 3. new text end

new text begin Information for a parent considering voluntary placement. new text end

deleted text begin (c) deleted text end The
responsible social services agency shall inform a parent considering voluntary placement
of a child under section 260C.227 of the following information:

(1) the parent and the child each has a right to separate legal counsel before signing a
voluntary placement agreement, but not to counsel appointed at public expense;

(2) the parent is not required to agree to the voluntary placement, and a parent who enters
a voluntary placement agreement may at any time request that the agency return the child.
If the parent so requests, the child must be returned within 24 hours of the receipt of the
request;

(3) evidence gathered during the time the child is voluntarily placed may be used at a
later time as the basis for a petition alleging that the child is in need of protection or services
or as the basis for a petition seeking termination of parental rights or other permanent
placement of the child away from the parent;

(4) if the responsible social services agency files a petition alleging that the child is in
need of protection or services or a petition seeking the termination of parental rights or other
permanent placement of the child away from the parent, the parent would have the right to
appointment of separate legal counsel and the child would have a right to the appointment
of counsel and a guardian ad litem as provided by law, and that counsel will be appointed
at public expense if they are unable to afford counsel; and

(5) the timelines and procedures for review of voluntary placements under section
260C.212, subdivision 3, and the effect the time spent in voluntary placement on the
scheduling of a permanent placement determination hearing under sections 260C.503 to
260C.521.

new text begin Subd. 4. new text end

new text begin Medical examinations. new text end

deleted text begin (d) deleted text end When an agency accepts a child for placement, the
agency shall determine whether the child has had a physical examination by or under the
direction of a licensed physician within the 12 months immediately preceding the date when
the child came into the agency's care. If there is documentation that the child has had an
examination within the last 12 months, the agency is responsible for seeing that the child
has another physical examination within one year of the documented examination and
annually in subsequent years. If the agency determines that the child has not had a physical
examination within the 12 months immediately preceding placement, the agency shall ensure
that the child has an examination within 30 days of coming into the agency's care and once
a year in subsequent years.

new text begin Subd. 5. new text end

new text begin Children reaching age of majority; copies of records. new text end

deleted text begin (e) deleted text end Whether under
state guardianship or not, if a child leaves foster care by reason of having attained the age
of majority under state law, the child must be given at no cost a copy of the child's social
and medical history, as defined in section 259.43, and education report.

new text begin Subd. 6. new text end

new text begin Prenatal alcohol exposure screening. new text end

new text begin The responsible social services agency
shall coordinate a prenatal alcohol exposure screening for any child who enters foster care
as soon as practicable but no later than 45 days after the removal of the child from the child's
home, if the agency has determined that the child has not previously been screened or
identified as being prenatally exposed to alcohol. The responsible social services agency
shall ensure that the screening is conducted in accordance with existing prenatal alcohol
exposure screening best practice guidelines and criteria developed and provided to the
responsible social services agencies by the statewide organization that focuses solely on
prevention of and intervention with fetal alcohol spectrum disorder and receives funding
under the appropriation for fetal alcohol spectrum disorder in Laws 2007, chapter 147,
article 19, section 4, subdivision 2.
new text end

new text begin Subd. 7. new text end

new text begin Initial foster care phone call. new text end

new text begin (a) When a child enters foster care or moves to
a new foster care placement, the responsible social services agency shall coordinate a phone
call between the foster parent or facility and the child's parent or legal guardian to establish
a connection and encourage ongoing information sharing between the child's parent or legal
guardian and the foster parent or facility; and to provide an opportunity to share any
information regarding the child, the child's needs, or the child's care that would facilitate
the child's adjustment to the foster home, promote stability, reduce the risk of trauma, or
otherwise improve the quality of the child's care.
new text end

new text begin (b) The responsible social services agency shall coordinate the phone call in paragraph
(a) as soon as practicable after the child arrives at the placement but no later than 48 hours
after the child's placement. If the responsible social services agency determines that the
phone call is not in the child's best interests, or if the agency is unable to identify, locate,
or contact the child's parent or legal guardian despite reasonable efforts, or despite active
efforts if the child is an American Indian child, the agency may delay the phone call until
up to 48 hours after the agency determines that the phone call is in the child's best interests,
or up to 48 hours after the child's parent or legal guardian is located or becomes available
for the phone call.
new text end

new text begin (c) The responsible social services agency shall document the date and time of the phone
call in paragraph (a), its efforts to coordinate the phone call, its efforts to identify, locate,
or find availability for the child's parent or legal guardian, any determination of whether
the phone call is in the child's best interests, and any reasons that the phone call did not
occur.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for children who enter foster care on or
after August 1, 2020, except subdivision 7 is effective for children entering out-of-home
placement or moving between placements on or after November 1, 2020.
new text end

Sec. 4. new text begin DIRECTION TO COMMISSIONER; INITIAL FOSTER CARE PHONE
CALL TRAINING.
new text end

new text begin By August 1, 2020, the commissioner of human services shall issue written guidance to
county social services agencies, foster parents, and facilities to fully implement the initial
foster care phone call procedures in Minnesota Statutes, section 260C.219, subdivision 6.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

ARTICLE 2

COMMUNITY SUPPORTS ADMINISTRATION

Section 1.

Minnesota Statutes 2018, section 245.4682, subdivision 2, is amended to read:

Subd. 2.

General provisions.

(a) In the design and implementation of reforms to the
mental health system, the commissioner shall:

(1) consult with consumers, families, counties, tribes, advocates, providers, and other
stakeholders;

(2) bring to the legislature, and the State Advisory Council on Mental Health, by January
15, 2008, recommendations for legislation to update the role of counties and to clarify the
case management roles, functions, and decision-making authority of health plans and
counties, and to clarify county retention of the responsibility for the delivery of social
services as required under subdivision 3, paragraph (a);

(3) withhold implementation of any recommended changes in case management roles,
functions, and decision-making authority until after the release of the report due January
15, 2008;

(4) ensure continuity of care for persons affected by these reforms including ensuring
client choice of provider by requiring broad provider networks and developing mechanisms
to facilitate a smooth transition of service responsibilities;

(5) provide accountability for the efficient and effective use of public and private
resources in achieving positive outcomes for consumers;

(6) ensure client access to applicable protections and appeals; and

(7) make budget transfers necessary to implement the reallocation of services and client
responsibilities between counties and health care programs that do not increase the state
and county costs and efficiently allocate state funds.

(b) When making transfers under paragraph (a) necessary to implement movement of
responsibility for clients and services between counties and health care programs, the
commissioner, in consultation with counties, shall ensure that any transfer of state grants
to health care programs, including the value of case management transfer grants under
section 256B.0625, subdivision 20, does not exceed the value of the services being transferred
for the latest 12-month period for which data is available. The commissioner may make
quarterly adjustments based on the availability of additional data during the first four quarters
after the transfers first occur. If case management transfer grants under section 256B.0625,
subdivision 20, are repealed and the value, based on the last year prior to repeal, exceeds
the value of the services being transferred, the difference becomes an ongoing part of each
county's adult mental health grants under sections 245.4661 and 256E.12.

(c) This appropriation is not authorized to be expended after December 31, 2010, unless
approved by the legislature.

new text begin (d) Beginning July 1, 2020, the commissioner of human services shall not impose new
or additional state reporting requirements to those existing in law as of July 1, 2020, for
community-based mental health service providers as a condition for reimbursement for
mental health services provided through medical assistance or MinnesotaCare, unless the
corresponding service reimbursement rates are first increased. This provision does not apply
to any new services offered by community-based mental health service providers after July
1, 2020.
new text end

Sec. 2.

Minnesota Statutes 2018, section 245.4876, is amended by adding a subdivision
to read:

new text begin Subd. 8. new text end

new text begin Prohibition against new or additional state reporting
requirements. new text end

new text begin Beginning July 1, 2020, the commissioner of human services shall not impose
new or additional state reporting requirements to those existing in law as of July 1, 2020,
for community-based mental health service providers as a condition for reimbursement for
children's mental health services provided through medical assistance or MinnesotaCare,
unless the corresponding service reimbursement rates are first increased. This provision
does not apply to any new children's mental health services offered by community-based
mental health service providers after July 1, 2020.
new text end

Sec. 3.

Minnesota Statutes 2018, section 245A.11, subdivision 2a, is amended to read:

Subd. 2a.

Adult foster care and community residential setting license capacity.

(a)
The commissioner shall issue adult foster care and community residential setting licenses
with a maximum licensed capacity of four beds, including nonstaff roomers and boarders,
except that the commissioner may issue a license with a capacity of five beds, including
roomers and boarders, according to paragraphs (b) to (g).

(b) The license holder may have a maximum license capacity of five if all persons in
care are age 55 or over and do not have a serious and persistent mental illness or a
developmental disability.

(c) The commissioner may grant variances to paragraph (b) to allow a facility with a
licensed capacity of up to five persons to admit an individual under the age of 55 if the
variance complies with section 245A.04, subdivision 9, and approval of the variance is
recommended by the county in which the licensed facility is located.

(d) The commissioner may grant variances to paragraph (a) to allow the use of an
additional bed, up to five, for emergency crisis services for a person with serious and
persistent mental illness or a developmental disability, regardless of age, if the variance
complies with section 245A.04, subdivision 9, and approval of the variance is recommended
by the county in which the licensed facility is located.

(e) The commissioner may grant a variance to paragraph (b) to allow for the use of an
additional bed, up to five, for respite services, as defined in section 245A.02, for persons
with disabilities, regardless of age, if the variance complies with sections 245A.03,
subdivision 7, and 245A.04, subdivision 9, and approval of the variance is recommended
by the county in which the licensed facility is located. Respite care may be provided under
the following conditions:

(1) staffing ratios cannot be reduced below the approved level for the individuals being
served in the home on a permanent basis;

(2) no more than two different individuals can be accepted for respite services in any
calendar month and the total respite days may not exceed 120 days per program in any
calendar year;

(3) the person receiving respite services must have his or her own bedroom, which could
be used for alternative purposes when not used as a respite bedroom, and cannot be the
room of another person who lives in the facility; and

(4) individuals living in the facility must be notified when the variance is approved. The
provider must give 60 days' notice in writing to the residents and their legal representatives
prior to accepting the first respite placement. Notice must be given to residents at least two
days prior to service initiation, or as soon as the license holder is able if they receive notice
of the need for respite less than two days prior to initiation, each time a respite client will
be served, unless the requirement for this notice is waived by the resident or legal guardian.

(f) The commissioner may issue an adult foster care or community residential setting
license with a capacity of five adults if the fifth bed does not increase the overall statewide
capacity of licensed adult foster care or community residential setting beds in homes that
are not the primary residence of the license holder, as identified in a plan submitted to the
commissioner by the county, when the capacity is recommended by the county licensing
agency of the county in which the facility is located and if the recommendation verifies
that:

(1) the facility meets the physical environment requirements in the adult foster care
licensing rule;

(2) the five-bed living arrangement is specified for each resident in the resident's:

(i) individualized plan of care;

(ii) individual service plan under section 256B.092, subdivision 1b, if required; or

(iii) individual resident placement agreement under Minnesota Rules, part 9555.5105,
subpart 19, if required;

(3) the license holder obtains written and signed informed consent from each resident
or resident's legal representative documenting the resident's informed choice to remain
living in the home and that the resident's refusal to consent would not have resulted in
service termination; and

(4) the facility was licensed for adult foster care before March 1, deleted text begin 2011 deleted text end new text begin 2016 new text end .

(g) The commissioner shall not issue a new adult foster care license under paragraph (f)
after June 30, deleted text begin 2019 deleted text end new text begin 2024 new text end . The commissioner shall allow a facility with an adult foster care
license issued under paragraph (f) before June 30, deleted text begin 2019 deleted text end new text begin 2024 new text end , to continue with a capacity
of five adults if the license holder continues to comply with the requirements in paragraph
(f).

Sec. 4.

Minnesota Statutes 2018, section 245D.02, is amended by adding a subdivision to
read:

new text begin Subd. 32a. new text end

new text begin Sexual violence. new text end

new text begin "Sexual violence" means the use of sexual actions or words
that are unwanted or harmful to another person.
new text end

Sec. 5.

Minnesota Statutes 2018, section 245D.071, subdivision 3, is amended to read:

Subd. 3.

Assessment and initial service planning.

(a) Within 15 days of service initiation
the license holder must complete a preliminary coordinated service and support plan
addendum based on the coordinated service and support plan.

(b) Within the scope of services, the license holder must, at a minimum, complete
assessments in the following areas before the 45-day planning meeting:

(1) the person's ability to self-manage health and medical needs to maintain or improve
physical, mental, and emotional well-being, including, when applicable, allergies, seizures,
choking, special dietary needs, chronic medical conditions, self-administration of medication
or treatment orders, preventative screening, and medical and dental appointments;

(2) the person's ability to self-manage personal safety to avoid injury or accident in the
service setting, including, when applicable, risk of falling, mobility, regulating water
temperature, community survival skills, water safety skills, and sensory disabilities; and

(3) the person's ability to self-manage symptoms or behavior that may otherwise result
in an incident as defined in section 245D.02, subdivision 11, clauses (4) to (7), suspension
or termination of services by the license holder, or other symptoms or behaviors that may
jeopardize the health and welfare of the person or others.

Assessments must produce information about the person that describes the person's overall
strengths, functional skills and abilities, and behaviors or symptoms. Assessments must be
based on the person's status within the last 12 months at the time of service initiation.
Assessments based on older information must be documented and justified. Assessments
must be conducted annually at a minimum or within 30 days of a written request from the
person or the person's legal representative or case manager. The results must be reviewed
by the support team or expanded support team as part of a service plan review.

(c) deleted text begin Within deleted text end new text begin Before providing new text end 45 days of service deleted text begin initiation deleted text end new text begin or within 60 calendar days of
service initiation, whichever is shorter new text end , the license holder must meet with the person, the
person's legal representative, the case manager, deleted text begin and deleted text end other members of the support team or
expanded support team new text begin , and other people as identified by the person or the person's legal
representative new text end to determine the following based on information obtained from the assessments
identified in paragraph (b), the person's identified needs in the coordinated service and
support plan, and the requirements in subdivision 4 and section 245D.07, subdivision 1a:

(1) the scope of the services to be provided to support the person's daily needs and
activities;

(2) the person's desired outcomes and the supports necessary to accomplish the person's
desired outcomes;

(3) the person's preferences for how services and supports are provided, including how
the provider will support the person to have control of the person's schedule;

(4) whether the current service setting is the most integrated setting available and
appropriate for the person; deleted text begin and
deleted text end

new text begin (5) opportunities to develop and maintain essential and life-enriching skills, abilities,
strengths, interests, and preferences;
new text end

new text begin (6) opportunities for community access, participation, and inclusion in preferred
community activities;
new text end

new text begin (7) opportunities to develop and strengthen personal relationships with other persons of
the person's choice in the community;
new text end

new text begin (8) opportunities to seek competitive employment and work at competitively paying
jobs in the community; and
new text end

deleted text begin (5) deleted text end new text begin (9) new text end how services must be coordinated across other providers licensed under this
chapter serving the person and members of the support team or expanded support team to
ensure continuity of care and coordination of services for the person.

(d) A discussion of how technology might be used to meet the person's desired outcomes
must be included in the 45-day planning meeting. The coordinated service and support plan
or support plan addendum must include a summary of this discussion. The summary must
include a statement regarding any decision that is made regarding the use of technology
and a description of any further research that needs to be completed before a decision
regarding the use of technology can be made. Nothing in this paragraph requires that the
coordinated service and support plan include the use of technology for the provision of
services.

Sec. 6.

Minnesota Statutes 2018, section 245D.081, subdivision 2, is amended to read:

Subd. 2.

Coordination and evaluation of individual service delivery.

(a) Delivery
and evaluation of services provided by the license holder must be coordinated by a designated
staff person. new text begin Except as provided in clause (3), new text end the designated coordinator must provide
supervision, support, and evaluation of activities that include:

(1) oversight of the license holder's responsibilities assigned in the person's coordinated
service and support plan and the coordinated service and support plan addendum;

(2) taking the action necessary to facilitate the accomplishment of the outcomes according
to the requirements in section 245D.07;

(3) instruction and assistance to direct support staff implementing the coordinated service
and support plan and the service outcomes, including direct observation of service delivery
sufficient to assess staff competency new text begin . The designated coordinator may delegate the direct
observation and competency assessment of the service delivery activities of direct support
staff to an individual whom the designated coordinator has previously deemed competent
in those activities new text end ; and

(4) evaluation of the effectiveness of service delivery, methodologies, and progress on
the person's outcomes based on the measurable and observable criteria for identifying when
the desired outcome has been achieved according to the requirements in section 245D.07.

(b) The license holder must ensure that the designated coordinator is competent to
perform the required duties identified in paragraph (a) through education, training, and work
experience relevant to the primary disability of persons served by the license holder and
the individual persons for whom the designated coordinator is responsible. The designated
coordinator must have the skills and ability necessary to develop effective plans and to
design and use data systems to measure effectiveness of services and supports. The license
holder must verify and document competence according to the requirements in section
245D.09, subdivision 3. The designated coordinator must minimally have:

(1) a baccalaureate degree in a field related to human services, and one year of full-time
work experience providing direct care services to persons with disabilities or persons age
65 and older;

(2) an associate degree in a field related to human services, and two years of full-time
work experience providing direct care services to persons with disabilities or persons age
65 and older;

(3) a diploma in a field related to human services from an accredited postsecondary
institution and three years of full-time work experience providing direct care services to
persons with disabilities or persons age 65 and older; or

(4) a minimum of 50 hours of education and training related to human services and
disabilities; and

(5) four years of full-time work experience providing direct care services to persons
with disabilities or persons age 65 and older under the supervision of a staff person who
meets the qualifications identified in clauses (1) to (3).

Sec. 7.

Minnesota Statutes 2018, section 245D.09, subdivision 4, is amended to read:

Subd. 4.

Orientation to program requirements.

Except for a license holder who does
not supervise any direct support staff, within 60 calendar days of hire, unless stated otherwise,
the license holder must provide and ensure completion of orientation sufficient to create
staff competency for direct support staff that combines supervised on-the-job training with
review of and instruction in the following areas:

(1) the job description and how to complete specific job functions, including:

(i) responding to and reporting incidents as required under section 245D.06, subdivision
1; and

(ii) following safety practices established by the license holder and as required in section
245D.06, subdivision 2;

(2) the license holder's current policies and procedures required under this chapter,
including their location and access, and staff responsibilities related to implementation of
those policies and procedures;

(3) data privacy requirements according to sections 13.01 to 13.10 and 13.46, the federal
Health Insurance Portability and Accountability Act of 1996 (HIPAA), and staff
responsibilities related to complying with data privacy practices;

(4) the service recipient rights and staff responsibilities related to ensuring the exercise
and protection of those rights according to the requirements in section 245D.04;

(5) sections 245A.65, 245A.66, 626.556, and 626.557, governing maltreatment reporting
and service planning for children and vulnerable adults, and staff responsibilities related to
protecting persons from maltreatment and reporting maltreatment. This orientation must be
provided within 72 hours of first providing direct contact services and annually thereafter
according to section 245A.65, subdivision 3;

(6) the principles of person-centered service planning and delivery as identified in section
245D.07, subdivision 1a, and how they apply to direct support service provided by the staff
person;

(7) the safe and correct use of manual restraint on an emergency basis according to the
requirements in section 245D.061 or successor provisions, and what constitutes the use of
restraints, time out, and seclusion, including chemical restraint;

(8) staff responsibilities related to prohibited procedures under section 245D.06,
subdivision 5, or successor provisions, why such procedures are not effective for reducing
or eliminating symptoms or undesired behavior, and why such procedures are not safe;

(9) basic first aid; deleted text begin and
deleted text end

(10) new text begin strategies to minimize the risk of sexual violence, including concepts of healthy
relationships, consent, and bodily autonomy of people with disabilities; and
new text end

new text begin (11) new text end other topics as determined necessary in the person's coordinated service and support
plan by the case manager or other areas identified by the license holder.

Sec. 8.

Minnesota Statutes 2018, section 245D.09, subdivision 4a, is amended to read:

Subd. 4a.

Orientation to individual service recipient needs.

(a) Before having
unsupervised direct contact with a person served by the program, or for whom the staff
person has not previously provided direct support, or any time the plans or procedures
identified in paragraphs (b) to (f) are revised, the staff person must review and receive
instruction on the requirements in paragraphs (b) to (f) as they relate to the staff person's
job functions for that person.

(b) For community residential services, training and competency evaluations must include
the following, if identified in the coordinated service and support plan:

(1) appropriate and safe techniques in personal hygiene and grooming, including hair
care; bathing; care of teeth, gums, and oral prosthetic devices; and other activities of daily
living (ADLs) as defined under section 256B.0659, subdivision 1;

(2) an understanding of what constitutes a healthy diet according to data from the Centers
for Disease Control and Prevention and the skills necessary to prepare that diet; and

(3) skills necessary to provide appropriate support in instrumental activities of daily
living (IADLs) as defined under section 256B.0659, subdivision 1.

(c) The staff person must review and receive instruction on the person's coordinated
service and support plan or coordinated service and support plan addendum as it relates to
the responsibilities assigned to the license holder, and when applicable, the person's individual
abuse prevention plan, to achieve and demonstrate an understanding of the person as a
unique individual, and how to implement those plans.

(d) The staff person must review and receive instruction on medication setup, assistance,
or administration procedures established for the person when assigned to the license holder
according to section 245D.05, subdivision 1, paragraph (b). Unlicensed staff may perform
medication setup or medication administration only after successful completion of a
medication setup or medication administration training, from a training curriculum developed
by a registered nurse or appropriate licensed health professional. The training curriculum
must incorporate an observed skill assessment conducted by the trainer to ensure unlicensed
staff demonstrate the ability to safely and correctly follow medication procedures.

Medication administration must be taught by a registered nurse, clinical nurse specialist,
certified nurse practitioner, physician assistant, or physician if, at the time of service initiation
or any time thereafter, the person has or develops a health care condition that affects the
service options available to the person because the condition requires:

(1) specialized or intensive medical or nursing supervision; and

(2) nonmedical service providers to adapt their services to accommodate the health and
safety needs of the person.

(e) The staff person must review and receive instruction on the safe and correct operation
of medical equipment used by the person to sustain life or to monitor a medical condition
that could become life-threatening without proper use of the medical equipment, including
but not limited to ventilators, feeding tubes, or endotracheal tubes. The training must be
provided by a licensed health care professional or a manufacturer's representative and
incorporate an observed skill assessment to ensure staff demonstrate the ability to safely
and correctly operate the equipment according to the treatment orders and the manufacturer's
instructions.

(f) The staff person must review and receive instruction on mental health crisis response,
de-escalation techniques, and suicide intervention when providing direct support to a person
with a serious mental illness.

(g) In the event of an emergency service initiation, the license holder must ensure the
training required in this subdivision occurs within 72 hours of the direct support staff person
first having unsupervised contact with the person receiving services. The license holder
must document the reason for the unplanned or emergency service initiation and maintain
the documentation in the person's service recipient record.

(h) License holders who provide direct support services themselves must complete the
orientation required in subdivision 4, clauses (3) to deleted text begin (10) deleted text end new text begin (11) new text end .

Sec. 9.

Minnesota Statutes 2019 Supplement, section 245D.09, subdivision 5, is amended
to read:

Subd. 5.

Annual training.

A license holder must provide annual training to direct support
staff on the topics identified in subdivision 4, clauses (3) to deleted text begin (10) deleted text end new text begin (11) new text end . If the direct support
staff has a first aid certification, annual training under subdivision 4, clause (9), is not
required as long as the certification remains current.

Sec. 10.

new text begin [254A.21] FETAL ALCOHOL SPECTRUM DISORDERS PREVENTION
GRANTS.
new text end

new text begin (a) The commissioner of human services shall award a grant to a statewide organization
that focuses solely on prevention of and intervention with fetal alcohol spectrum disorders.
The grant recipient must make subgrants to eligible regional collaboratives in rural and
urban areas of the state for the purposes specified in paragraph (c).
new text end

new text begin (b) "Eligible regional collaboratives" means a partnership between at least one local
government or tribal government and at least one community-based organization and, where
available, a family home visiting program. For purposes of this paragraph, a local government
includes a county or a multicounty organization, a county-based purchasing entity, or a
community health board.
new text end

new text begin (c) Eligible regional collaboratives must use subgrant funds to reduce the incidence of
fetal alcohol spectrum disorders and other prenatal drug-related effects in children in
Minnesota by identifying and serving pregnant women suspected of or known to use or
abuse alcohol or other drugs. Eligible regional collaboratives must provide intensive services
to chemically dependent women to increase positive birth outcomes.
new text end

new text begin (d) An eligible regional collaborative that receives a subgrant under this section must
report to the grant recipient by January 15 of each year on the services and programs funded
by the subgrant. The report must include measurable outcomes for the previous year,
including the number of pregnant women served and the number of toxic-free babies born.
The grant recipient must compile the information in the subgrant reports and submit a
summary report to the commissioner of human services by February 15 of each year.
new text end

Sec. 11.

Minnesota Statutes 2019 Supplement, section 256B.056, subdivision 5c, is
amended to read:

Subd. 5c.

Excess income standard.

(a) The excess income standard for parents and
caretaker relatives, pregnant women, infants, and children ages two through 20 is the standard
specified in subdivision 4, paragraph (b).

(b) The excess income standard for a person whose eligibility is based on blindness,
disability, or age of 65 or more years shall equal:

(1) 81 percent of the federal poverty guidelines; and

(2) effective July 1, 2022, deleted text begin 100 percent of the federal poverty guidelines deleted text end new text begin the standard
specified in subdivision 4, paragraph (a) new text end .

Sec. 12.

Minnesota Statutes 2018, section 256B.0625, subdivision 56a, is amended to
read:

Subd. 56a.

deleted text begin Post-arrest deleted text end new text begin Officer-involved new text end community-based deleted text begin service deleted text end new text begin care
new text end coordination.

(a) Medical assistance covers deleted text begin post-arrest deleted text end new text begin officer-involved new text end community-based
deleted text begin service deleted text end new text begin care new text end coordination for an individual who:

(1) has deleted text begin been identified as having deleted text end new text begin screened positive for benefiting from treatment for new text end a
mental illness or substance use disorder using a deleted text begin screening deleted text end tool approved by the commissioner;

(2) does not require the security of a public detention facility and is not considered an
inmate of a public institution as defined in Code of Federal Regulations, title 42, section
435.1010;

(3) meets the eligibility requirements in section 256B.056; and

(4) has agreed to participate in deleted text begin post-arrest deleted text end new text begin officer-involved new text end community-based deleted text begin service deleted text end
new text begin care new text end coordination deleted text begin through a diversion contract in lieu of incarceration deleted text end .

(b) deleted text begin Post-arrest deleted text end new text begin Officer-involved new text end community-based deleted text begin service deleted text end new text begin care new text end coordination means
navigating services to address a client's mental health, chemical health, social, economic,
and housing needs, or any other activity targeted at reducing the incidence of jail utilization
and connecting individuals with existing covered services available to them, including, but
not limited to, targeted case management, waiver case management, or care coordination.

(c) deleted text begin Post-arrest deleted text end new text begin Officer-involved new text end community-based deleted text begin service deleted text end new text begin care new text end coordination must be
provided by an individual who is an employee of deleted text begin a county deleted text end or is under contract with a county new text begin ,
or is an employee of or under contract with an Indian health service facility or facility owned
and operated by a tribe or a tribal organization operating under Public Law 93-638 as a 638
facility new text end to provide deleted text begin post-arrest deleted text end new text begin officer-involved new text end community-based new text begin care new text end coordination and is
qualified under one of the following criteria:

(1) a licensed mental health professional as defined in section 245.462, subdivision 18,
clauses (1) to (6);

(2) a mental health practitioner as defined in section 245.462, subdivision 17, working
under the clinical supervision of a mental health professional; deleted text begin or
deleted text end

(3) a certified peer specialist under section 256B.0615, working under the clinical
supervision of a mental health professional deleted text begin . deleted text end new text begin ;
new text end

new text begin (4) an individual qualified as an alcohol and drug counselor under section 245G.11,
subdivision 5; or
new text end

new text begin (5) a recovery peer qualified under section 245G.11, subdivision 8, working under the
supervision of an individual qualified as an alcohol and drug counselor under section
245G.11, subdivision 5.
new text end

(d) Reimbursement is allowed for up to 60 days following the initial determination of
eligibility.

(e) Providers of deleted text begin post-arrest deleted text end new text begin officer-involved new text end community-based deleted text begin service deleted text end new text begin care new text end coordination
shall annually report to the commissioner on the number of individuals served, and number
of the community-based services that were accessed by recipients. The commissioner shall
ensure that services and payments provided under deleted text begin post-arrest deleted text end new text begin officer-involved
new text end community-based deleted text begin service deleted text end new text begin care new text end coordination do not duplicate services or payments provided
under section 256B.0625, subdivision 20, 256B.0753, 256B.0755, or 256B.0757.

(f) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of cost for
post-arrest community-based service coordination services shall be provided by the county
providing the services, from sources other than federal funds or funds used to match other
federal funds.

Sec. 13.

Minnesota Statutes 2018, section 256B.0653, subdivision 5, is amended to read:

Subd. 5.

Home care therapies.

(a) Home care therapies include the following: physical
therapy, occupational therapy, respiratory therapy, and speech and language pathology
therapy services.

(b) Home care therapies must be:

(1) provided in the recipient's residence or in the community where normal life activities
take the recipient after it has been determined the recipient is unable to access outpatient
therapy;

(2) prescribed, ordered, or referred by a physician new text begin , advanced practice registered nurse,
or physician assistant, new text end and documented in a plan of care and reviewed, according to
Minnesota Rules, part 9505.0390;

(3) assessed by an appropriate therapist; and

(4) provided by a Medicare-certified home health agency enrolled as a Medicaid provider
agency.

(c) Restorative and specialized maintenance therapies must be provided according to
Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be used
as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B.

(d) For both physical and occupational therapies, the therapist and the therapist's assistant
may not both bill for services provided to a recipient on the same day.

Sec. 14.

Minnesota Statutes 2018, section 256B.0653, subdivision 7, is amended to read:

Subd. 7.

Face-to-face encounter.

(a) A face-to-face encounter by a qualifying provider
must be completed for all home health services regardless of the need for prior authorization,
except when providing a onetime perinatal visit by skilled nursing. The face-to-face encounter
may occur through telemedicine as defined in section 256B.0625, subdivision 3b. The
encounter must be related to the primary reason the recipient requires home health services
and must occur within the 90 days before or the 30 days after the start of services. The
face-to-face encounter may be conducted by one of the following practitioners, licensed in
Minnesota:

(1) a physician;

(2) a nurse practitioner or clinical nurse specialist;

(3) a certified nurse midwife; or

(4) a physician assistant.

(b) deleted text begin The allowed nonphysician practitioner, as described in this subdivision, performing
the face-to-face encounter must communicate the clinical findings of that face-to-face
encounter to the ordering physician. Those deleted text end new text begin The new text end clinical findings new text begin of that face-to-face encounter
new text end must be incorporated into a written or electronic document included in the recipient's medical
record. To assure clinical correlation between the face-to-face encounter and the associated
home health services, the physician new text begin , advanced practice registered nurse, or physician assistant new text end
responsible for ordering the services must:

(1) document that the face-to-face encounter, which is related to the primary reason the
recipient requires home health services, occurred within the required time period; and

(2) indicate the practitioner who conducted the encounter and the date of the encounter.

(c) For home health services requiring authorization, including prior authorization, home
health agencies must retain the qualifying documentation of a face-to-face encounter as part
of the recipient health service record, and submit the qualifying documentation to the
commissioner or the commissioner's designee upon request.

Sec. 15.

Minnesota Statutes 2018, section 256B.0654, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

(a) "Complex home care nursing" means home care nursing
services provided to recipients who meet the criteria for regular home care nursing and
require life-sustaining interventions to reduce the risk of long-term injury or death.

(b) "Home care nursing" means ongoing deleted text begin physician-ordered deleted text end hourly nursing services
new text begin ordered by a physician, advanced practice registered nurse, or physician assistant, new text end performed
by a registered nurse or licensed practical nurse within the scope of practice as defined by
the Minnesota Nurse Practice Act under sections 148.171 to 148.285, in order to maintain
or restore a person's health.

(c) "Home care nursing agency" means a medical assistance enrolled provider licensed
under chapter 144A to provide home care nursing services.

(d) "Regular home care nursing" means home care nursing provided because:

(1) the recipient requires more individual and continuous care than can be provided
during a skilled nurse visit; or

(2) the cares are outside of the scope of services that can be provided by a home health
aide or personal care assistant.

(e) "Shared home care nursing" means the provision of home care nursing services by
a home care nurse to two recipients at the same time and in the same setting.

Sec. 16.

Minnesota Statutes 2018, section 256B.0654, subdivision 2a, is amended to read:

Subd. 2a.

Home care nursing services.

(a) Home care nursing services must be used:

(1) in the recipient's home or outside the home when normal life activities require;

(2) when the recipient requires more individual and continuous care than can be provided
during a skilled nurse visit; and

(3) when the care required is outside of the scope of services that can be provided by a
home health aide or personal care assistant.

(b) Home care nursing services must be:

(1) assessed by a registered nurse on a form approved by the commissioner;

(2) ordered by a physician new text begin , advanced practice registered nurse, or physician assistant, new text end
and documented in a plan of care that is reviewed by the new text begin ordering new text end physician new text begin , advanced
practice registered nurse, or physician assistant new text end at least once every 60 days; and

(3) authorized by the commissioner under section 256B.0652.

Sec. 17.

Minnesota Statutes 2019 Supplement, section 256B.0711, subdivision 1, is
amended to read:

Subdivision 1.

Definitions.

For purposes of this section:

(a) "Commissioner" means the commissioner of human services unless otherwise
indicated.

(b) "Covered program" means a program to provide direct support services funded in
whole or in part by the state of Minnesota, including the community first services and
supports program new text begin under section 256B.85, subdivision 2, paragraph (e) new text end ; deleted text begin consumer directed deleted text end new text begin
consumer-directed new text end community supports deleted text begin services deleted text end and extended state plan personal care
assistance services available under programs established pursuant to home and
community-based service waivers authorized under section 1915(c) of the Social Security
Act, and Minnesota Statutes, including, but not limited to, chapter 256S and sections
256B.092 and 256B.49, and under the alternative care program deleted text begin , as offered pursuant to deleted text end new text begin under new text end
section 256B.0913; the personal care assistance choice program deleted text begin , as established pursuant to deleted text end new text begin
under new text end section 256B.0659, subdivisions 18 to 20; and any similar program that may provide
similar services in the future.

(c) "Direct support services" means personal care assistance services covered by medical
assistance under section 256B.0625, subdivisions 19a and 19c; assistance with activities of
daily living as defined in section 256B.0659, subdivision 1, paragraph (b), and instrumental
activities of daily living as defined in section 256B.0659, subdivision 1, paragraph (i); and
other similar, in-home, nonprofessional long-term services and supports provided to an
elderly person or person with a disability by the person's employee or the employee of the
person's representative to meet such person's daily living needs and ensure that such person
may adequately function in the person's home and have safe access to the community.

(d) "Individual provider" means an individual selected by and working under the direction
of a participant in a covered program, or a participant's representative, to provide direct
support services to the participant, but does not include an employee of a provider agency,
subject to the agency's direction and control commensurate with agency employee status.

(e) "Participant" means a person who receives direct support services through a covered
program.

(f) "Participant's representative" means a participant's legal guardian or an individual
having the authority and responsibility to act on behalf of a participant with respect to the
provision of direct support services through a covered program.

Sec. 18.

Minnesota Statutes 2018, section 256B.0941, subdivision 1, is amended to read:

Subdivision 1.

Eligibility.

(a) An individual who is eligible for mental health treatment
services in a psychiatric residential treatment facility must meet all of the following criteria:

(1) before admission, services are determined to be medically necessary deleted text begin by the state's
medical review agent deleted text end according to Code of Federal Regulations, title 42, section 441.152;

(2) is younger than 21 years of age at the time of admission. Services may continue until
the individual meets criteria for discharge or reaches 22 years of age, whichever occurs
first;

(3) has a mental health diagnosis as defined in the most recent edition of the Diagnostic
and Statistical Manual for Mental Disorders, as well as clinical evidence of severe aggression,
or a finding that the individual is a risk to self or others;

(4) has functional impairment and a history of difficulty in functioning safely and
successfully in the community, school, home, or job; an inability to adequately care for
one's physical needs; or caregivers, guardians, or family members are unable to safely fulfill
the individual's needs;

(5) requires psychiatric residential treatment under the direction of a physician to improve
the individual's condition or prevent further regression so that services will no longer be
needed;

(6) utilized and exhausted other community-based mental health services, or clinical
evidence indicates that such services cannot provide the level of care needed; and

(7) was referred for treatment in a psychiatric residential treatment facility by a qualified
mental health professional licensed as defined in section 245.4871, subdivision 27, clauses
(1) to (6).

(b) deleted text begin A mental health professional making a referral shall submit documentation to the
deleted text end deleted text begin state's medical review agent containing all information necessary to determine medical
deleted text end deleted text begin necessity, including a standard diagnostic assessment completed within 180 days of the
deleted text end deleted text begin individual's admission. Documentation shall include evidence of family participation in the
deleted text end deleted text begin individual's treatment planning and signed consent for services deleted text end new text begin The commissioner shall
provide oversight and review the use of referrals for clients admitted to psychiatric residential
treatment facilities to ensure that eligibility criteria, clinical services, and treatment planning
reflect clinical, state, and federal standards for psychiatric residential treatment facility level
of care. The commissioner shall coordinate the production of a statewide list of children
and youth who meet the medical necessity criteria for psychiatric residential treatment
facility level of care and who are awaiting admission. The commissioner and any recipient
of the list shall not use the statewide list to direct admission of children and youth to specific
facilities new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2020, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 19.

Minnesota Statutes 2018, section 256B.0941, subdivision 3, is amended to read:

Subd. 3.

Per diem rate.

(a) The commissioner deleted text begin shall deleted text end new text begin must new text end establish deleted text begin a statewide deleted text end new text begin one new text end per
diem rate new text begin per provider new text end for psychiatric residential treatment facility services for individuals
21 years of age or younger. The rate for a provider must not exceed the rate charged by that
provider for the same service to other payers. Payment must not be made to more than one
entity for each individual for services provided under this section on a given day. The
commissioner deleted text begin shall deleted text end new text begin must new text end set rates prospectively for the annual rate period. The commissioner
deleted text begin shall deleted text end new text begin must new text end require providers to submit annual cost reports on a uniform cost reporting form
and deleted text begin shall deleted text end new text begin must new text end use submitted cost reports to inform the rate-setting process. The cost reporting
deleted text begin shall deleted text end new text begin must new text end be done according to federal requirements for Medicare cost reports.

(b) The following are included in the rate:

(1) costs necessary for licensure and accreditation, meeting all staffing standards for
participation, meeting all service standards for participation, meeting all requirements for
active treatment, maintaining medical records, conducting utilization review, meeting
inspection of care, and discharge planning. The direct services costs must be determined
using the actual cost of salaries, benefits, payroll taxes, and training of direct services staff
and service-related transportation; and

(2) payment for room and board provided by facilities meeting all accreditation and
licensing requirements for participation.

(c) A facility may submit a claim for payment outside of the per diem for professional
services arranged by and provided at the facility by an appropriately licensed professional
who is enrolled as a provider with Minnesota health care programs. Arranged services deleted text begin must
be billed by the facility on a separate claim, and the facility shall be responsible for payment
to the provider deleted text end new text begin may be billed by either the facility or the licensed professional new text end . These services
must be included in the individual plan of care and are subject to prior authorization deleted text begin by the
state's medical review agent deleted text end .

(d) Medicaid deleted text begin shall deleted text end new text begin must new text end reimburse for concurrent services as approved by the
commissioner to support continuity of care and successful discharge from the facility.
"Concurrent services" means services provided by another entity or provider while the
individual is admitted to a psychiatric residential treatment facility. Payment for concurrent
services may be limited and these services are subject to prior authorization by the state's
medical review agent. Concurrent services may include targeted case management, assertive
community treatment, clinical care consultation, team consultation, and treatment planning.

(e) Payment rates under this subdivision deleted text begin shall deleted text end new text begin must new text end not include the costs of providing
the following services:

(1) educational services;

(2) acute medical care or specialty services for other medical conditions;

(3) dental services; and

(4) pharmacy drug costs.

(f) For purposes of this section, "actual cost" means costs that are allowable, allocable,
reasonable, and consistent with federal reimbursement requirements in Code of Federal
Regulations, title 48, chapter 1, part 31, relating to for-profit entities, and the Office of
Management and Budget Circular Number A-122, relating to nonprofit entities.

Sec. 20.

Minnesota Statutes 2018, section 256B.0944, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

For purposes of this section, the following terms have the
meanings given them.

(a) "Mental health crisis" means a child's behavioral, emotional, or psychiatric situation
that, but for the provision of crisis response services to the child, would likely result in
significantly reduced levels of functioning in primary activities of daily living, an emergency
situation, or the child's placement in a more restrictive setting, including, but not limited
to, inpatient hospitalization.

(b) "Mental health emergency" means a child's behavioral, emotional, or psychiatric
situation that causes an immediate need for mental health services and is consistent with
section 62Q.55. A physician, mental health professional, or crisis mental health practitioner
determines a mental health crisis or emergency for medical assistance reimbursement with
input from the client and the client's family, if possible.

(c) "Mental health crisis assessment" means an immediate face-to-face assessment by
a physician, mental health professional, or mental health practitioner under the clinical
supervision of a mental health professional, following a screening that suggests the child
may be experiencing a mental health crisis or mental health emergency situation.

(d) "Mental health mobile crisis intervention services" means face-to-face, short-term
intensive mental health services initiated during a mental health crisis or mental health
emergency. Mental health mobile crisis services must help the recipient cope with immediate
stressors, identify and utilize available resources and strengths, and begin to return to the
recipient's baseline level of functioning. Mental health mobile services must be provided
on site by a mobile crisis intervention team outside of deleted text begin an emergency room, urgent care, or deleted text end
an inpatient hospital setting.

(e) "Mental health crisis stabilization services" means individualized mental health
services provided to a recipient following crisis intervention services that are designed to
restore the recipient to the recipient's prior functional level. The individual treatment plan
recommending mental health crisis stabilization must be completed by the intervention team
or by staff after an inpatient or urgent care visit. Mental health crisis stabilization services
may be provided in the recipient's home, the home of a family member or friend of the
recipient, schools, another community setting, or a short-term supervised, licensed residential
program if the service is not included in the facility's cost pool or per diem. Mental health
crisis stabilization is not reimbursable when provided as part of a partial hospitalization or
day treatment program.

Sec. 21.

Minnesota Statutes 2018, section 256B.0947, subdivision 2, is amended to read:

Subd. 2.

Definitions.

For purposes of this section, the following terms have the meanings
given them.

(a) "Intensive nonresidential rehabilitative mental health services" means child
rehabilitative mental health services as defined in section 256B.0943, except that these
services are provided by a multidisciplinary staff using a total team approach consistent
with assertive community treatment, as adapted for youth, and are directed to recipients
ages 16, 17, 18, 19, or 20 with a serious mental illness or co-occurring mental illness and
substance abuse addiction who require intensive services to prevent admission to an inpatient
psychiatric hospital or placement in a residential treatment facility or who require intensive
services to step down from inpatient or residential care to community-based care.

(b) "Co-occurring mental illness and substance abuse addiction" means a dual diagnosis
of at least one form of mental illness and at least one substance use disorder. Substance use
disorders include alcohol or drug abuse or dependence, excluding nicotine use.

(c) "Diagnostic assessment" has the meaning given to it in Minnesota Rules, part
9505.0370, subpart 11. A diagnostic assessment must be provided according to Minnesota
Rules, part 9505.0372, subpart 1, and for this section must incorporate a determination of
the youth's necessary level of care using a standardized functional assessment instrument
approved and periodically updated by the commissioner.

(d) "Education specialist" means an individual with knowledge and experience working
with youth regarding special education requirements and goals, special education plans,
and coordination of educational activities with health care activities.

(e) "Housing access support" means an ancillary activity to help an individual find,
obtain, retain, and move to safe and adequate housing. Housing access support does not
provide monetary assistance for rent, damage deposits, or application fees.

(f) "Integrated dual disorders treatment" means the integrated treatment of co-occurring
mental illness and substance use disorders by a team of cross-trained clinicians within the
same program, and is characterized by assertive outreach, stage-wise comprehensive
treatment, treatment goal setting, and flexibility to work within each stage of treatment.

(g) "Medication education services" means services provided individually or in groups,
which focus on:

(1) educating the client and client's family or significant nonfamilial supporters about
mental illness and symptoms;

(2) the role and effects of medications in treating symptoms of mental illness; and

(3) the side effects of medications.

Medication education is coordinated with medication management services and does not
duplicate it. Medication education services are provided by physicians, pharmacists, or
registered nurses with certification in psychiatric and mental health care.

(h) "Peer specialist" means an employed team member who is a mental health certified
peer specialist according to section 256B.0615 and also a former children's mental health
consumer who:

(1) provides direct services to clients including social, emotional, and instrumental
support and outreach;

(2) assists younger peers to identify and achieve specific life goals;

(3) works directly with clients to promote the client's self-determination, personal
responsibility, and empowerment;

(4) assists youth with mental illness to regain control over their lives and their
developmental process in order to move effectively into adulthood;

(5) provides training and education to other team members, consumer advocacy
organizations, and clients on resiliency and peer support; and

(6) meets the following criteria:

(i) is at least 22 years of age;

(ii) has had a diagnosis of mental illness, as defined in Minnesota Rules, part 9505.0370,
subpart 20, or co-occurring mental illness and substance abuse addiction;

(iii) is a former consumer of child and adolescent mental health services, or a former or
current consumer of adult mental health services for a period of at least two years;

(iv) has at least a high school diploma or equivalent;

(v) has successfully completed training requirements determined and periodically updated
by the commissioner;

(vi) is willing to disclose the individual's own mental health history to team members
and clients; and

(vii) must be free of substance use problems for at least one year.

(i) "Provider agency" means a for-profit or nonprofit organization established to
administer an assertive community treatment for youth team.

(j) "Substance use disorders" means one or more of the disorders defined in the diagnostic
and statistical manual of mental disorders, current edition.

(k) "Transition services" means:

(1) activities, materials, consultation, and coordination that ensures continuity of the
client's care in advance of and in preparation for the client's move from one stage of care
or life to another by maintaining contact with the client and assisting the client to establish
provider relationships;

(2) providing the client with knowledge and skills needed posttransition;

(3) establishing communication between sending and receiving entities;

(4) supporting a client's request for service authorization and enrollment; and

(5) establishing and enforcing procedures and schedules.

A youth's transition from the children's mental health system and services to the adult
mental health system and services and return to the client's home and entry or re-entry into
community-based mental health services following discharge from an out-of-home placement
or inpatient hospital stay.

(l) "Treatment team" means all staff who provide services to recipients under this section.

new text begin (m) "Family peer specialist" means a staff person qualified under section 256B.0616.
new text end

Sec. 22.

Minnesota Statutes 2018, section 256B.0947, subdivision 4, is amended to read:

Subd. 4.

Provider contract requirements.

(a) The intensive nonresidential rehabilitative
mental health services provider agency shall have a contract with the commissioner to
provide intensive transition youth rehabilitative mental health services.

(b) The commissioner shall develop deleted text begin administrative and clinical contract standards and deleted text end
performance evaluation criteria for providers, including county providers, and may require
applicants new text begin and providers new text end to submit documentation as needed to allow the commissioner to
determine whether the deleted text begin standards deleted text end new text begin criteria new text end are met.

Sec. 23.

Minnesota Statutes 2018, section 256B.0947, subdivision 5, is amended to read:

Subd. 5.

Standards for intensive nonresidential rehabilitative providers.

(a) Services
must be provided by a provider entity as provided in subdivision 4.

(b) The treatment team for intensive nonresidential rehabilitative mental health services
comprises both permanently employed core team members and client-specific team members
as follows:

(1) The core treatment team is an entity that operates under the direction of an
independently licensed mental health professional, who is qualified under Minnesota Rules,
part 9505.0371, subpart 5, item A, and that assumes comprehensive clinical responsibility
for clients. Based on professional qualifications and client needs, clinically qualified core
team members are assigned on a rotating basis as the client's lead worker to coordinate a
client's care. The core team must comprise at least four full-time equivalent direct care staff
and must include, but is not limited to:

(i) an independently licensed mental health professional, qualified under Minnesota
Rules, part 9505.0371, subpart 5, item A, who serves as team leader to provide administrative
direction and clinical supervision to the team;

(ii) an advanced-practice registered nurse with certification in psychiatric or mental
health care or a board-certified child and adolescent psychiatrist, either of which must be
credentialed to prescribe medications;

(iii) a licensed alcohol and drug counselor who is also trained in mental health
interventions; and

(iv) a peer specialist as defined in subdivision 2, paragraph (h).

(2) The core team may also include any of the following:

(i) additional mental health professionals;

(ii) a vocational specialist;

(iii) an educational specialist;

(iv) a child and adolescent psychiatrist who may be retained on a consultant basis;

(v) a mental health practitioner, as defined in section 245.4871, subdivision 26;

(vi) a deleted text begin mental health manager deleted text end new text begin case management service provider new text end , as defined in section
245.4871, subdivision 4; deleted text begin and
deleted text end

(vii) a housing access specialist new text begin ; and
new text end

new text begin (viii) a family peer specialist as defined in subdivision 2, paragraph (m) new text end .

(3) A treatment team may include, in addition to those in clause (1) or (2), ad hoc
members not employed by the team who consult on a specific client and who must accept
overall clinical direction from the treatment team for the duration of the client's placement
with the treatment team and must be paid by the provider agency at the rate for a typical
session by that provider with that client or at a rate negotiated with the client-specific
member. Client-specific treatment team members may include:

(i) the mental health professional treating the client prior to placement with the treatment
team;

(ii) the client's current substance abuse counselor, if applicable;

(iii) a lead member of the client's individualized education program team or school-based
mental health provider, if applicable;

(iv) a representative from the client's health care home or primary care clinic, as needed
to ensure integration of medical and behavioral health care;

(v) the client's probation officer or other juvenile justice representative, if applicable;
and

(vi) the client's current vocational or employment counselor, if applicable.

(c) The clinical supervisor shall be an active member of the treatment team and shall
function as a practicing clinician at least on a part-time basis. The treatment team shall meet
with the clinical supervisor at least weekly to discuss recipients' progress and make rapid
adjustments to meet recipients' needs. The team meeting must include client-specific case
reviews and general treatment discussions among team members. Client-specific case
reviews and planning must be documented in the individual client's treatment record.

(d) The staffing ratio must not exceed ten clients to one full-time equivalent treatment
team position.

(e) The treatment team shall serve no more than 80 clients at any one time. Should local
demand exceed the team's capacity, an additional team must be established rather than
exceed this limit.

(f) Nonclinical staff shall have prompt access in person or by telephone to a mental
health practitioner or mental health professional. The provider shall have the capacity to
promptly and appropriately respond to emergent needs and make any necessary staffing
adjustments to deleted text begin assure deleted text end new text begin ensure new text end the health and safety of clients.

(g) The intensive nonresidential rehabilitative mental health services provider shall
participate in evaluation of the assertive community treatment for youth (Youth ACT) model
as conducted by the commissioner, including the collection and reporting of data and the
reporting of performance measures as specified by contract with the commissioner.

(h) A regional treatment team may serve multiple counties.

Sec. 24.

Minnesota Statutes 2018, section 256B.0947, subdivision 6, is amended to read:

Subd. 6.

Service standards.

The standards in this subdivision apply to intensive
nonresidential rehabilitative mental health services.

(a) The treatment team deleted text begin shall deleted text end new text begin must new text end use team treatment, not an individual treatment model.

(b) Services must be available at times that meet client needs.

new text begin (c) Services must be age-appropriate and meet the specific needs of the client.
new text end

deleted text begin (c) deleted text end new text begin (d) new text end The initial functional assessment must be completed within ten days of intake
and updated at least every deleted text begin three deleted text end new text begin six new text end months or prior to discharge from the service, whichever
comes first.

deleted text begin (d) deleted text end new text begin (e) new text end An individual treatment plan must deleted text begin be completed for each client, according to
criteria specified in section 256B.0943, subdivision 6, paragraph (b), clause (2), and,
additionally, must deleted text end :

new text begin (1) be based on the information in the client's diagnostic assessment and baselines;
new text end

new text begin (2) identify goals and objectives of treatment, a treatment strategy, a schedule for
accomplishing treatment goals and objectives, and the individuals responsible for providing
treatment services and supports;
new text end

new text begin (3) be developed after completion of the client's diagnostic assessment by a mental health
professional or clinical trainee and before the provision of children's therapeutic services
and supports;
new text end

new text begin (4) be developed through a child-centered, family-driven, culturally appropriate planning
process, including allowing parents and guardians to observe or participate in individual
and family treatment services, assessments, and treatment planning;
new text end

new text begin (5) be reviewed at least once every six months and revised to document treatment progress
on each treatment objective and next goals or, if progress is not documented, to document
changes in treatment;
new text end

new text begin (6) be signed by the clinical supervisor and by the client or by the client's parent or other
person authorized by statute to consent to mental health services for the client. A client's
parent may approve the client's individual treatment plan by secure electronic signature or
by documented oral approval that is later verified by written signature;
new text end

deleted text begin (1) deleted text end new text begin (7) new text end be completed in consultation with the client's current therapist and key providers
and provide for ongoing consultation with the client's current therapist to ensure therapeutic
continuity and to facilitate the client's return to the community new text begin . For clients under the age of
18, the treatment team must consult with parents and guardians in developing the treatment
plan new text end ;

deleted text begin (2) deleted text end new text begin (8) new text end if a need for substance use disorder treatment is indicated by validated assessment:

(i) identify goals, objectives, and strategies of substance use disorder treatment; develop
a schedule for accomplishing treatment goals and objectives; and identify the individuals
responsible for providing treatment services and supports;

(ii) be reviewed at least once every 90 days and revised, if necessary;

deleted text begin (3) deleted text end new text begin (9) new text end be signed by the clinical supervisor and by the client and, if the client is a minor,
by the client's parent or other person authorized by statute to consent to mental health
treatment and substance use disorder treatment for the client; and

deleted text begin (4) deleted text end new text begin (10) new text end provide for the client's transition out of intensive nonresidential rehabilitative
mental health services by defining the team's actions to assist the client and subsequent
providers in the transition to less intensive or "stepped down" services.

deleted text begin (e) deleted text end new text begin (f) new text end The treatment team shall actively and assertively engage the client's family
members and significant others by establishing communication and collaboration with the
family and significant others and educating the family and significant others about the
client's mental illness, symptom management, and the family's role in treatment, unless the
team knows or has reason to suspect that the client has suffered or faces a threat of suffering
any physical or mental injury, abuse, or neglect from a family member or significant other.

deleted text begin (f) deleted text end new text begin (g) new text end For a client age 18 or older, the treatment team may disclose to a family member,
other relative, or a close personal friend of the client, or other person identified by the client,
the protected health information directly relevant to such person's involvement with the
client's care, as provided in Code of Federal Regulations, title 45, part 164.502(b). If the
client is present, the treatment team shall obtain the client's agreement, provide the client
with an opportunity to object, or reasonably infer from the circumstances, based on the
exercise of professional judgment, that the client does not object. If the client is not present
or is unable, by incapacity or emergency circumstances, to agree or object, the treatment
team may, in the exercise of professional judgment, determine whether the disclosure is in
the best interests of the client and, if so, disclose only the protected health information that
is directly relevant to the family member's, relative's, friend's, or client-identified person's
involvement with the client's health care. The client may orally agree or object to the
disclosure and may prohibit or restrict disclosure to specific individuals.

deleted text begin (g) deleted text end new text begin (h) new text end The treatment team shall provide interventions to promote positive interpersonal
relationships.

Sec. 25.

Minnesota Statutes 2018, section 256B.49, subdivision 16, is amended to read:

Subd. 16.

Services and supports.

(a) Services and supports included in the home and
community-based waivers for persons with disabilities deleted text begin shall deleted text end new text begin must new text end meet the requirements
set out in United States Code, title 42, section 1396n. The services and supports, which are
offered as alternatives to institutional care, deleted text begin shall deleted text end new text begin must new text end promote consumer choice, community
inclusion, self-sufficiency, and self-determination.

(b) deleted text begin Beginning January 1, 2003, deleted text end The commissioner deleted text begin shall deleted text end new text begin must new text end simplify and improve
access to home and community-based waivered services, to the extent possible, through the
establishment of a common service menu that is available to eligible recipients regardless
of age, disability type, or waiver program.

(c) deleted text begin Consumer directed community support services shall deleted text end new text begin Consumer-directed community
supports must new text end be offered as an option to all persons eligible for services under subdivision
11 deleted text begin , by January 1, 2002 deleted text end .

(d) Services and supports deleted text begin shall deleted text end new text begin must new text end be arranged and provided consistent with
individualized written plans of care for eligible waiver recipients.

(e) A transitional supports allowance deleted text begin shall deleted text end new text begin must new text end be available to all persons under a home
and community-based waiver who are moving from a licensed setting to a community
setting. "Transitional supports allowance" means a onetime payment of up to $3,000, to
cover the costs, not covered by other sources, associated with moving from a licensed setting
to a community setting. Covered costs include:

(1) lease or rent deposits;

(2) security deposits;

(3) utilities setup costs, including telephone;

(4) essential furnishings and supplies; and

(5) personal supports and transports needed to locate and transition to community settings.

(f) The state of Minnesota and county agencies that administer home and
community-based waivered services for persons with disabilities, deleted text begin shall deleted text end new text begin must new text end not be liable
for damages, injuries, or liabilities sustained through the purchase of supports by the
individual, the individual's family, legal representative, or the authorized representative
with funds received through deleted text begin the deleted text end consumer-directed community deleted text begin support service deleted text end new text begin supports new text end
under this section. Liabilities include but are not limited to deleted text begin : deleted text end workers' compensation liability,
the Federal Insurance Contributions Act (FICA), or the Federal Unemployment Tax Act
(FUTA).

Sec. 26.

new text begin [256B.4911] CONSUMER-DIRECTED COMMUNITY SUPPORTS.
new text end

new text begin Subdivision 1. new text end

new text begin Federal authority. new text end

new text begin Consumer-directed community supports, as referenced
in sections 256B.0913, subdivision 5, clause (17); 256B.092, subdivision 1b, clause (4);
256B.49, subdivision 16, paragraph (c); and chapter 256S are governed, in whole, by the
federally-approved waiver plans for home and community-based services.
new text end

new text begin Subd. 2. new text end

new text begin Costs associated with physical activities. new text end

new text begin The expenses allowed for adults
under the consumer-directed community supports option must include the costs at the lowest
rate available considering daily, monthly, semiannual, annual, or membership rates, including
transportation, associated with physical exercise or other physical activities to maintain or
improve the person's health and functioning.
new text end

new text begin Subd. 3. new text end

new text begin Expansion and increase of budget exceptions. new text end

new text begin (a) The commissioner of human
services must provide up to 30 percent more funds for either:
new text end

new text begin (1) consumer-directed community supports participants under sections 256B.092 and
256B.49 who have a coordinated service and support plan which identifies the need for
more services or supports under consumer-directed community supports than the amount
the participants are currently receiving under the consumer-directed community supports
budget methodology to:
new text end

new text begin (i) increase the amount of time a person works or otherwise improves employment
opportunities;
new text end

new text begin (ii) plan a transition to, move to, or live in a setting described in section 256D.44,
subdivision 5, paragraph (g), clause (1), item (iii); or
new text end

new text begin (iii) develop and implement a positive behavior support plan; or
new text end

new text begin (2) home and community-based waiver participants under sections 256B.092 and 256B.49
who are currently using licensed providers for: (i) employment supports or services during
the day; or (ii) residential services, either of which cost more annually than the person would
spend under a consumer-directed community supports plan for any or all of the supports
needed to meet a goal identified in clause (1), item (i), (ii), or (iii).
new text end

new text begin (b) The exception under paragraph (a), clause (1), is limited to persons who can
demonstrate that they will have to discontinue using consumer-directed community supports
and accept other non-self-directed waiver services because their supports needed for a goal
described in paragraph (a), clause (1), item (i), (ii), or (iii), cannot be met within the
consumer-directed community supports budget limits.
new text end

new text begin (c) The exception under paragraph (a), clause (2), is limited to persons who can
demonstrate that, upon choosing to become a consumer-directed community supports
participant, the total cost of services, including the exception, will be less than the cost of
current waiver services.
new text end

new text begin Subd. 4. new text end

new text begin Budget exception for persons leaving institutions and crisis residential
settings. new text end

new text begin (a) The commissioner must establish an institutional and crisis bed
consumer-directed community supports budget exception process in the home and
community-based services waivers under sections 256B.092 and 256B.49. This budget
exception process must be available for any individual who:
new text end

new text begin (1) is not offered available and appropriate services within 60 days since approval for
discharge from the individual's current institutional setting; and
new text end

new text begin (2) requires services that are more expensive than appropriate services provided in a
noninstitutional setting using the consumer-directed community supports option.
new text end

new text begin (b) Institutional settings for purposes of this exception include intermediate care facilities
for persons with developmental disabilities; nursing facilities; acute care hospitals; Anoka
Metro Regional Treatment Center; Minnesota Security Hospital; and crisis beds.
new text end

new text begin (c) The budget exception must be limited to no more than the amount of appropriate
services provided in a noninstitutional setting as determined by the lead agency managing
the individual's home and community-based services waiver. The lead agency must notify
the Department of Human Services of the budget exception.
new text end

new text begin Subd. 5. new text end

new text begin Shared services. new text end

new text begin (a) Medical assistance payments for shared services under
consumer-directed community supports are limited to this subdivision.
new text end

new text begin (b) For purposes of this subdivision, "shared services" means services provided at the
same time by the same direct care worker for individuals who have entered into an agreement
to share consumer-directed community support services.
new text end

new text begin (c) Shared services may include services in the personal assistance category as outlined
in the consumer-directed community supports community support plan and shared services
agreement, except:
new text end

new text begin (1) services for more than three individuals provided by one worker at one time;
new text end

new text begin (2) use of more than one worker for the shared services; and
new text end

new text begin (3) a child care program licensed under chapter 245A or operated by a local school
district or private school.
new text end

new text begin (d) The individuals, or as needed the individuals' representatives, must develop the plan
for shared services when developing or amending the consumer-directed community supports
plan, and must follow the consumer-directed community supports process for approval of
the plan by the lead agency. The plan for shared services in an individual's consumer-directed
community supports plan must include the intention to utilize shared services based on
individuals' needs and preferences.
new text end

new text begin (e) Individuals sharing services must use the same financial management services
provider.
new text end

new text begin (f) Individuals whose consumer-directed community supports community support plans
include an intent to utilize shared services must jointly develop, with the support of the
individuals' representatives as needed, a shared services agreement. This agreement must
include:
new text end

new text begin (1) the names of the individuals receiving shared services;
new text end

new text begin (2) the individuals' representative, if identified in their consumer-directed community
supports plans, and their duties;
new text end

new text begin (3) the names of the case managers;
new text end

new text begin (4) the financial management services provider;
new text end

new text begin (5) the shared services that must be provided;
new text end

new text begin (6) the schedule for shared services;
new text end

new text begin (7) the location where shared services must be provided;
new text end

new text begin (8) the training specific to each individual served;
new text end

new text begin (9) the training specific to providing shared services to the individuals identified in the
agreement;
new text end

new text begin (10) instructions to follow all required documentation for time and services provided;
new text end

new text begin (11) a contingency plan for each individual that accounts for service provision and billing
in the absence of one of the individuals in a shared services setting due to illness or other
circumstances;
new text end

new text begin (12) signatures of all parties involved in the shared services; and
new text end

new text begin (13) agreement by each individual who is sharing services on the number of shared hours
for services provided.
new text end

new text begin (g) Any individual or any individual's representative may withdraw from participating
in a shared services agreement at any time.
new text end

new text begin (h) The lead agency for each individual must authorize the use of the shared services
option based on the criteria that the shared service is appropriate to meet the needs, health,
and safety of each individual for whom they provide case management or care coordination.
new text end

new text begin (i) This subdivision must not be construed to reduce the total authorized
consumer-directed community supports budget for an individual.
new text end

new text begin (j) No later than September 30, 2019, the commissioner of human services must:
new text end

new text begin (1) submit an amendment to the Centers for Medicare and Medicaid Services for the
home and community-based services waivers authorized under sections 256B.0913,
256B.092, and 256B.49, and chapter 256S, to allow for a shared services option under
consumer-directed community supports; and
new text end

new text begin (2) with stakeholder input, develop guidance for shared services in consumer-directed
community supports within the community-based services manual. Guidance must include:
new text end

new text begin (i) recommendations for negotiating payment for one-to-two and one-to-three services;
and
new text end

new text begin (ii) a template of the shared services agreement.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment, except
for subdivision 5, paragraphs (a) to (i), which are effective the day following final enactment
or upon federal approval, whichever occurs later. The commissioner of human services
must notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 27.

Minnesota Statutes 2019 Supplement, section 256B.4914, subdivision 10a, is
amended to read:

Subd. 10a.

Reporting and analysis of cost data.

(a) The commissioner must ensure
that wage values and component values in subdivisions 5 to 9 reflect the cost to provide the
service. As determined by the commissioner, in consultation with stakeholders identified
in subdivision 17, a provider enrolled to provide services with rates determined under this
section must submit requested cost data to the commissioner to support research on the cost
of providing services that have rates determined by the disability waiver rates system.
Requested cost data may include, but is not limited to:

(1) worker wage costs;

(2) benefits paid;

(3) supervisor wage costs;

(4) executive wage costs;

(5) vacation, sick, and training time paid;

(6) taxes, workers' compensation, and unemployment insurance costs paid;

(7) administrative costs paid;

(8) program costs paid;

(9) transportation costs paid;

(10) new text begin staff new text end vacancy rates; deleted text begin and
deleted text end

(11) new text begin recipient absence rates; and
new text end

new text begin (12) new text end other data relating to costs required to provide services requested by the
commissioner.

(b) At least once in any five-year period, a provider must submit cost data for a fiscal
year that ended not more than 18 months prior to the submission date. The commissioner
shall provide each provider a 90-day notice prior to its submission due date. If a provider
fails to submit required reporting data, the commissioner shall provide notice to providers
that have not provided required data 30 days after the required submission date, and a second
notice for providers who have not provided required data 60 days after the required
submission date. The commissioner shall temporarily suspend payments to the provider if
cost data is not received 90 days after the required submission date. Withheld payments
shall be made once data is received by the commissioner.

(c) The commissioner shall conduct a random validation of data submitted under
paragraph (a) to ensure data accuracy. The commissioner shall analyze cost documentation
in paragraph (a) and provide recommendations for adjustments to cost components.

(d) The commissioner shall analyze cost documentation in paragraph (a) and, in
consultation with stakeholders identified in subdivision 17, may submit recommendations
on component values and inflationary factor adjustments to the chairs and ranking minority
members of the legislative committees with jurisdiction over human services every four
years beginning January 1, 2021. new text begin When analyzing the costs associated with absences from
day programs, unit-based services with programming, and unit-based services without
programming except respite, and when recommending adjustments to the absence and
utilization ratios for these services, the commissioner must use at least 24 consecutive
months of cost reporting data, claims data, or other available data. The commissioner must
not include in the commissioner's analysis or recommendations factors unsupported by the
cost or claims data, including but not limited to assumptions regarding variable expenses.
new text end The commissioner shall make recommendations in conjunction with reports submitted to
the legislature according to subdivision 10, paragraph (c). The commissioner shall release
cost data in an aggregate form, and cost data from individual providers shall not be released
except as provided for in current law.

(e) The commissioner, in consultation with stakeholders identified in subdivision 17,
shall develop and implement a process for providing training and technical assistance
necessary to support provider submission of cost documentation required under paragraph
(a).

(f) By December 31, 2020, providers paid with rates calculated under subdivision 5,
paragraph (b), shall identify additional revenues from the competitive workforce factor and
prepare a written distribution plan for the revenues. A provider shall make the provider's
distribution plan available and accessible to all direct care staff for a minimum of one
calendar year. Upon request, a provider shall submit the written distribution plan to the
commissioner.

(g) Providers enrolled to provide services with rates determined under section 256B.4914,
subdivision 3, shall submit labor market data to the commissioner annually on or before
November 1, including but not limited to:

(1) number of direct care staff;

(2) wages of direct care staff;

(3) overtime wages of direct care staff;

(4) hours worked by direct care staff;

(5) overtime hours worked by direct care staff;

(6) benefits provided to direct care staff;

(7) direct care staff job vacancies; and

(8) direct care staff retention rates.

(h) The commissioner shall publish annual reports on provider and state-level labor
market data, including but not limited to the data obtained under paragraph (g).

(i) The commissioner may temporarily suspend payments to the provider if data requested
under paragraph (g) is not received 90 days after the required submission date. Withheld
payments shall be made once data is received by the commissioner.

(j) Providers who receive payment under this section for less than 25 percent of their
clients in the year prior to the report may attest to the commissioner in a manner determined
by the commissioner that they are declining to provide the data required under paragraph
(g) and will not be subject to the payment suspension in paragraph (i).

Sec. 28.

Minnesota Statutes 2019 Supplement, section 256S.01, subdivision 6, is amended
to read:

Subd. 6.

Immunity; consumer-directed community supports.

The state of Minnesota,
or a county, managed care plan, county-based purchasing plan, or tribal government under
contract to administer the elderly waiver, is not liable for damages, injuries, or liabilities
sustained as a result of the participant, the participant's family, or the participant's authorized
representatives purchasing direct supports or goods with funds received through
consumer-directed community deleted text begin support services deleted text end new text begin supports new text end under the elderly waiver. Liabilities
include, but are not limited to, workers' compensation liability, Federal Insurance
Contributions Act under United States Code, title 26, subtitle c, chapter 21, or Federal
Unemployment Tax Act under Internal Revenue Code, chapter 23.

Sec. 29.

Minnesota Statutes 2019 Supplement, section 256S.19, subdivision 4, is amended
to read:

Subd. 4.

Calculation of monthly conversion budget cap with consumer-directed
community supports.

For the elderly waiver monthly conversion budget cap for the cost
of elderly waiver services with consumer-directed community deleted text begin support services deleted text end new text begin supports new text end ,
the nursing facility case mix adjusted total payment rate used under subdivision 3 to calculate
the monthly conversion budget cap for elderly waiver services without consumer-directed
community supports must be reduced by a percentage equal to the percentage difference
between the consumer-directed deleted text begin services deleted text end new text begin community supports new text end budget limit that would be
assigned according to the elderly waiver plan and the corresponding monthly case mix
budget cap under this chapter, but not to exceed 50 percent.

Sec. 30.

Laws 2016, chapter 189, article 15, section 29, is amended to read:

Sec. 29. DIRECTION TO COMMISSIONERS; INCOME AND ASSET EXCLUSION.

(a) The commissioner of human services shall not count payments made to families by
the income and child development in the first three years of life demonstration project as
income or assets for purposes of determining or redetermining eligibility for child care
assistance programs under Minnesota Statutes, chapter 119B; the Minnesota family
investment program, work benefit program, or diversionary work program under Minnesota
Statutes, chapter 256J, during the duration of the demonstration.

(b) The commissioner of human services shall not count payments made to families by
the income and child development in the first three years of life demonstration project as
income for purposes of determining or redetermining eligibility for medical assistance under
Minnesota Statutes, chapter 256B, and MinnesotaCare under Minnesota Statutes, chapter
256L.

(c) For the purposes of this section, "income and child development in the first three
years of life demonstration project" means a demonstration project funded by the United
States Department of Health and Human Services National Institutes of Health to evaluate
whether the unconditional cash payments have a causal effect on the cognitive,
socioemotional, and brain development of infants and toddlers.

(d) This section shall only be implemented if Minnesota is chosen as a site for the child
development in the first three years of life demonstration project, and expires January 1,
deleted text begin 2022 deleted text end new text begin 2026 new text end .

(e) The commissioner of human services shall provide a report to the chairs and ranking
minority members of the legislative committees having jurisdiction over human services
issues by January 1, deleted text begin 2023 deleted text end new text begin 2027 new text end , informing the legislature on the progress and outcomes of
the demonstration under this section.

Sec. 31.

Laws 2017, First Special Session chapter 6, article 7, section 33, subdivision 2,
is amended to read:

Subd. 2.

Pilot design and goals.

The pilot will establish deleted text begin five deleted text end key developmental milestone
markers from birth to age eight. deleted text begin Enrollees in the deleted text end Pilot new text begin program participants new text end will be
developmentally assessed and tracked by a technology solution that tracks developmental
milestones along the established developmental continuum. If a deleted text begin child's deleted text end new text begin pilot program
participant's new text end progress falls below established milestones deleted text begin and the weighted scoring deleted text end , the
coordinated service system will focus on identified areas of concern deleted text begin , mobilize appropriate
supportive services, deleted text end and offer new text begin referrals or new text end services to deleted text begin identified children and their families deleted text end new text begin
pilot program participants new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 32.

Laws 2017, First Special Session chapter 6, article 7, section 33, subdivision 3,
is amended to read:

Subd. 3.

Program participants in deleted text begin phase 1 deleted text end target population.

Pilot program participants
must new text begin opt in and provide parental or guardian consent to participate and be enrolled or engaged
in one or more of the following new text end :

(1) deleted text begin be enrolled in a deleted text end Women's Infant & Children (WIC) program;

(2) deleted text begin be participating in a deleted text end family home visiting program deleted text begin , deleted text end or deleted text begin nurse family practice, or
Healthy Families America (HFA) deleted text end new text begin Follow Along Program new text end ;

deleted text begin (3) be children and families qualifying for and participating in early language learners
(ELL) in the school district in which they reside; and
deleted text end

deleted text begin (4) opt in and provide parental consent to participate in the pilot project.
deleted text end

new text begin (3) school's early childhood screening; or
new text end

new text begin (4) any other Dakota County or school program that is determined as useful for identifying
children at risk of falling below established guidelines.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 33.

Laws 2019, First Special Session chapter 9, article 14, section 2, subdivision 33,
is amended to read:

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

Appropriations by Fund
General	2,636,000	2,636,000
Lottery Prize	1,733,000	1,733,000

(a) Problem Gambling. $225,000 in fiscal
year 2020 and $225,000 in fiscal year 2021
are from the lottery prize fund for a grant to
the state affiliate recognized by the National
Council on Problem Gambling. The affiliate
must provide services to increase public
awareness of problem gambling, education,
and training for individuals and organizations
providing effective treatment services to
problem gamblers and their families, and
research related to problem gambling.

(b) Fetal Alcohol Spectrum Disorders
Grants new text begin for Fiscal Year 2020 new text end . (1) $500,000
in fiscal year 2020 deleted text begin and $500,000 in fiscal year
2021 are from deleted text end new text begin is from new text end the general fund for a
grant to Proof Alliance. Of this appropriation,
Proof Alliance shall make grants to eligible
regional collaboratives for the purposes
specified in clause (3).

(2) "Eligible regional collaboratives" means
a partnership between at least one local
government new text begin or tribal government new text end and at least
one community-based organization and, where
available, a family home visiting program. For
purposes of this clause, a local government
includes a county or multicounty organization,
deleted text begin a tribal government, deleted text end a county-based
purchasing entity, or a community health
board.

(3) Eligible regional collaboratives must use
grant funds to reduce the incidence of fetal
alcohol spectrum disorders and other prenatal
drug-related effects in children in Minnesota
by identifying and serving pregnant women
suspected of or known to use or abuse alcohol
or other drugs. Eligible regional collaboratives
must provide intensive services to chemically
dependent women to increase positive birth
outcomes.

(4) Proof Alliance must make grants to eligible
regional collaboratives from both rural and
urban areas of the state.

(5) An eligible regional collaborative that
receives a grant under this paragraph must
report to Proof Alliance by January 15 of each
year on the services and programs funded by
the grant. The report must include measurable
outcomes for the previous year, including the
number of pregnant women served and the
number of toxic-free babies born. Proof
Alliance must compile the information in these
reports and report that information to the
commissioner of human services by February
15 of each year.

new text begin (c) Fetal Alcohol Spectrum Disorders
Grants for Fiscal Year 2021. new text end new text begin $500,000 in
fiscal year 2021 is from the general fund for
a grant under Minnesota Statutes, section
254A.21, to a statewide organization that
focuses solely on prevention of and
intervention with fetal alcohol spectrum
disorders.
new text end

Sec. 34. new text begin ADULT FOSTER CARE MORATORIUM EXEMPTION.
new text end

new text begin A family foster care home located in Elk River, Sherburne County, and initially licensed
in 2003 to serve four people that seeks to transition to a corporate foster care home or
community residential setting is exempt from the moratorium under Minnesota Statutes,
section 245A.03, subdivision 7, and has until July 1, 2021, to transition to a corporate foster
care or community residential setting.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2020.
new text end

Sec. 35. new text begin TREATMENT OF PREVIOUSLY OBTAINED FEDERAL APPROVALS.
new text end

new text begin This act must not be construed to require the commissioner to seek federal approval for
provisions in Minnesota Statutes, section 256B.4911, for which the commissioner has
already received federal approval. Federal approvals the commissioner previously obtained
for provisions repealed in section 30 survive and apply to the corresponding subdivisions
in Minnesota Statutes, section 256B.4911.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 36. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Laws 2005, First Special Session chapter 4, article 7, section 50, new text end new text begin is repealed.
new text end

new text begin (b) new text end new text begin Laws 2005, First Special Session chapter 4, article 7, section 51, new text end new text begin is repealed.
new text end

new text begin (c) new text end new text begin Laws 2012, chapter 247, article 4, section 47, as amended by Laws 2014, chapter
312, article 27, section 72, Laws 2015, chapter 71, article 7, section 58, Laws 2016, chapter
144, section 1, Laws 2017, First Special Session chapter 6, article 1, section 43, Laws 2017,
First Special Session chapter 6, article 1, section 54, new text end new text begin is repealed.
new text end

new text begin (d) new text end new text begin Laws 2015, chapter 71, article 7, section 54, as amended by Laws 2017, First Special
Session chapter 6, article 1, section 54, new text end new text begin is repealed.
new text end

new text begin (e) new text end new text begin Laws 2017, First Special Session chapter 6, article 1, section 44, as amended by
Laws 2019, First Special Session chapter 9, article 5, section 80, new text end new text begin is repealed.
new text end

new text begin (f) new text end new text begin Laws 2017, First Special Session chapter 6, article 1, section 45, as amended by Laws
2019, First Special Session chapter 9, article 5, section 81, new text end new text begin is repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

ARTICLE 3

EMPLOYMENT FIRST, INDEPENDENT LIVING FIRST, AND SELF-DIRECTION
FIRST

Section 1.

new text begin [256B.4905] HOME AND COMMUNITY-BASED SERVICES POLICY
STATEMENT.
new text end

new text begin Subdivision 1. new text end

new text begin Employment first policy. new text end

new text begin It is the policy of this state that all working-age
Minnesotans with disabilities can work, want to work, and can achieve competitive integrated
employment, and that each working-age Minnesotan with a disability be offered the
opportunity to work and earn a competitive wage before being offered other supports and
services.
new text end

new text begin Subd. 2. new text end

new text begin Employment first implementation for disability waiver services. new text end

new text begin The
commissioner of human services shall ensure that:
new text end

new text begin (1) the disability waivers under sections 256B.092 and 256B.49 support the presumption
that all working-age Minnesotans with disabilities can work, want to work, and can achieve
competitive integrated employment; and
new text end

new text begin (2) each waiver recipient of working age be offered, after an informed decision-making
process and during a person-centered planning process, the opportunity to work and earn a
competitive wage before being offered exclusively day services as defined in section
245D.03, subdivision 1, paragraph (c), clause (4), or successor provisions.
new text end

new text begin Subd. 3. new text end

new text begin Independent living first policy. new text end

new text begin It is the policy of this state that all adult
Minnesotans with disabilities can and want to live independently with proper supports and
services; and that each adult Minnesotan with a disability be offered the opportunity to live
as independently as possible before being offered supports and services in provider-controlled
settings.
new text end

new text begin Subd. 4. new text end

new text begin Independent living first implementation for disability waiver services. new text end

new text begin The
commissioner of human services shall ensure that:
new text end

new text begin (1) the disability waivers under sections 256B.092 and 256B.49 support the presumption
that all adult Minnesotans with disabilities can and want to live independently with proper
services and supports as needed; and
new text end

new text begin (2) each adult waiver recipient be offered, after an informed decision-making process
and during a person-centered planning process, the opportunity to live as independently as
possible before being offered customized living services provided in a single family home
or residential supports and services as defined in section 245D.03, subdivision 1, paragraph
(c), clause (3), or successor provisions, unless the residential supports and services are
provided in a family adult foster care residence under a shared living option as described
in Laws 2013, chapter 108, article 7, section 62.
new text end

new text begin Subd. 5. new text end

new text begin Self-direction first policy. new text end

new text begin It is the policy of this state that adult Minnesotans
with disabilities and families of children with disabilities can and want to use self-directed
services and supports; and that each adult Minnesotan with a disability and each family of
the child with a disability be offered the opportunity to choose self-directed services and
supports before being offered services and supports that are not self-directed.
new text end

new text begin Subd. 6. new text end

new text begin Self-directed first implementation for disability waiver services. new text end

new text begin The
commissioner of human services shall ensure that:
new text end

new text begin (1) the disability waivers under sections 256B.092 and 256B.49 support the presumption
that adult Minnesotans with disabilities and families of children with disabilities can and
want to use self-directed services and supports, including self-directed funding options; and
new text end

new text begin (2) each waiver recipient be offered, after an informed decision-making process and
during a person-centered planning process, the opportunity to choose self-directed services
and supports, including self-directed funding options, before being offered services and
supports that are not self-directed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 2.

Laws 2019, First Special Session chapter 9, article 5, section 86, is amended to
read:

Sec. 86. DISABILITY WAIVER RECONFIGURATION.

Subdivision 1.

Intent.

It is the intent of the legislature to reform the medical assistance
waiver programs for people with disabilities to simplify administration of the programs deleted text begin , deleted text end new text begin .
Disability waiver reconfiguration must new text end incentivize inclusive new text begin , new text end person-centered new text begin , individualized new text end
supports deleted text begin , deleted text end new text begin and services; new text end enhance each person's new text begin self-determination and new text end personal authority
over the person's service choice deleted text begin , deleted text end new text begin ; new text end align benefits across waivers deleted text begin , encourage deleted text end new text begin ; ensure new text end equity
across programs and populations deleted text begin , and deleted text end new text begin ; new text end promote long-term sustainability of deleted text begin needed deleted text end new text begin waiver new text end
services deleted text begin . To the maximum extent possible, the Disability waiver reconfiguration must deleted text end new text begin ; and new text end
maintain service stability and continuity of care deleted text begin , deleted text end while new text begin prioritizing, new text end promoting deleted text begin the most deleted text end new text begin ,
and creating incentives for new text end independent deleted text begin and deleted text end new text begin , new text end integrated new text begin , and individualized new text end supports deleted text begin of each
person's choosing in both short- and long-term deleted text end new text begin and services chosen by each person through
an informed decision-making process and person-centered new text end planning.

Subd. 2.

Report.

By January 15, 2021, the commissioner of human services shall submit
a report to the members of the legislative committees with jurisdiction over human services
on any necessary waivers, state plan amendments, requests for new funding or realignment
of existing funds, any changes to state statute or rule, and any other federal authority
necessary to implement this section. The report must include information about the
commissioner's work to collect feedback and input from providers, persons accessing home
and community-based services waivers and their families, and client advocacy organizations.

Subd. 3.

Proposal.

By January 15, 2021, the commissioner shall develop a proposal to
reconfigure the medical assistance waivers provided in sections 256B.092 and 256B.49.
The proposal shall include all necessary plans for implementing two home and
community-based services waiver programs, as authorized under section 1915(c) of the
Social Security Act that serve persons who are determined to require the levels of care
provided in a nursing home, a hospital, a neurobehavioral hospital, or an intermediate care
facility for persons with developmental disabilities. new text begin The proposal must include in each home
and community-based waiver program options to self-direct services. new text end Before submitting
the final report to the legislature, the commissioner shall publish a draft report with sufficient
time for interested persons to offer additional feedback.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

ARTICLE 4

ASSESSMENT, CASE MANAGEMENT, AND SERVICE PLANNING
MODIFICATIONS

Section 1.

Minnesota Statutes 2019 Supplement, section 245D.071, subdivision 5, is
amended to read:

Subd. 5.

Service plan review and evaluation.

(a) The license holder must give the
person or the person's legal representative and case manager an opportunity to participate
in the ongoing review and development of the service plan and the methods used to support
the person and accomplish outcomes identified in subdivisions 3 and 4. At least once per
year, or within 30 days of a written request by the person, the person's legal representative,
or the case manager, the license holder, in coordination with the person's support team or
expanded support team, must meet with the person, the person's legal representative, and
the case manager, and participate in service plan review meetings following stated timelines
established in the person's coordinated service and support plan or coordinated service and
support plan addendum. The purpose of the service plan review is to determine whether
changes are needed to the service plan based on the assessment information, the license
holder's evaluation of progress deleted text begin towards deleted text end new text begin toward new text end accomplishing outcomes, or other information
provided by the support team or expanded support team.

(b) At least once per year, the license holder, in coordination with the person's support
team or expanded support team, must meet with the person, the person's legal representative,
and the case manager to discuss how technology might be used to meet the person's desired
outcomes. The coordinated service and support plan addendum must include a summary of
this discussion. The summary must include a statement regarding any decision made related
to the use of technology and a description of any further research that must be completed
before a decision regarding the use of technology can be made. Nothing in this paragraph
requires the coordinated service and support plan addendum to include the use of technology
for the provision of services.

(c) new text begin At least once per year, the license holder, in coordination with the person's support
team or expanded support team, must meet with a person receiving residential supports and
services, the person's legal representative, and the case manager to discuss options for
transitioning out of a community setting controlled by a provider and into a setting not
controlled by a provider.
new text end

new text begin (d) The coordinated service and support plan addendum must include a summary of the
discussion required in paragraph (c). The summary must include a statement about any
decision made regarding transitioning out of a provider-controlled setting and a description
of any further research or education that must be completed before a decision regarding
transitioning out of a provider-controlled setting can be made.
new text end

new text begin (e) At least once per year, the license holder, in coordination with the person's support
team or expanded support team, must meet with a person receiving day services, the person's
legal representative, and the case manager to discuss options for transitioning to an
employment service described in section 245D.03, subdivision 1, paragraph (c), clauses (5)
to (7).
new text end

new text begin (f) The coordinated service and support plan addendum must include a summary of the
discussion required in paragraph (e). The summary must include a statement about any
decision made concerning transition to an employment service and a description of any
further research or education that must be completed before a decision regarding transitioning
to an employment service can be made.
new text end

new text begin (g) new text end The license holder must summarize the person's status and progress toward achieving
the identified outcomes and make recommendations and identify the rationale for changing,
continuing, or discontinuing implementation of supports and methods identified in
subdivision 4 in a report available at the time of the progress review meeting. The report
must be sent at least five working days prior to the progress review meeting if requested by
the team in the coordinated service and support plan or coordinated service and support
plan addendum.

deleted text begin (d) deleted text end new text begin (h) new text end The license holder must send the coordinated service and support plan addendum
to the person, the person's legal representative, and the case manager by mail within ten
working days of the progress review meeting. Within ten working days of the mailing of
the coordinated service and support plan addendum, the license holder must obtain dated
signatures from the person or the person's legal representative and the case manager to
document approval of any changes to the coordinated service and support plan addendum.

deleted text begin (e) deleted text end new text begin (i) new text end If, within ten working days of submitting changes to the coordinated service and
support plan and coordinated service and support plan addendum, the person or the person's
legal representative or case manager has not signed and returned to the license holder the
coordinated service and support plan or coordinated service and support plan addendum or
has not proposed written modifications to the license holder's submission, the submission
is deemed approved and the coordinated service and support plan addendum becomes
effective and remains in effect until the legal representative or case manager submits a
written request to revise the coordinated service and support plan addendum.

Sec. 2.

Minnesota Statutes 2018, section 256B.0911, subdivision 1, is amended to read:

Subdivision 1.

Purpose and goal.

(a) The purpose of long-term care consultation services
is to assist persons with long-term or chronic care needs in making care decisions and
selecting support and service options that meet their needs and reflect their preferences.
The availability of, and access to, information and other types of assistance, including
new text begin long-term care consultation new text end assessment and new text begin community new text end support planning, is also intended
to prevent or delay institutional placements and to provide access to transition assistance
after deleted text begin admission deleted text end new text begin placement new text end . Further, the goal of deleted text begin these deleted text end new text begin long-term care consultation new text end services
is to contain costs associated with unnecessary institutional admissions. deleted text begin Long-term
consultation services must be available to any person regardless of public program eligibility.
deleted text end

new text begin (b) new text end The commissioner of human services shall seek to maximize use of available federal
and state funds deleted text begin and establish the broadest program possible within the funding available deleted text end .

deleted text begin (b) These deleted text end new text begin (c) Long-term care consultation new text end services must be coordinated with long-term
care options counseling provided under subdivision 4d, section 256.975, subdivisions 7 to
7c, and section 256.01, subdivision 24.

new text begin (d) new text end The lead agency providing long-term care consultation services shall encourage the
use of volunteers from families, religious organizations, social clubs, and similar civic and
service organizations to provide community-based services.

Sec. 3.

Minnesota Statutes 2019 Supplement, section 256B.0911, subdivision 1a, is
amended to read:

Subd. 1a.

Definitions.

For purposes of this section, the following definitions apply:

(a) Until additional requirements apply under paragraph (b), "long-term care consultation
services" means:

(1) intake for and access to assistance in identifying services needed to maintain an
individual in the most inclusive environment;

(2) providing recommendations for and referrals to cost-effective community services
that are available to the individual;

(3) development of an individual's person-centered community support plan;

(4) providing information regarding eligibility for Minnesota health care programs;

(5) face-to-face long-term care consultation assessments, which may be completed in a
hospital, nursing facility, intermediate care facility for persons with developmental disabilities
(ICF/DDs), regional treatment centers, or the person's current or planned residence;

(6) determination of home and community-based waiver and other service eligibility as
required under chapter 256S and sections 256B.0913, 256B.092, and 256B.49, including
level of care determination for individuals who need an institutional level of care as
determined under subdivision 4e, based on new text begin a long-term care consultation new text end assessment and
community support plan development, appropriate referrals to obtain necessary diagnostic
information, and including an eligibility determination for consumer-directed community
supports;

(7) providing recommendations for institutional placement when there are no
cost-effective community services available;

(8) providing access to assistance to transition people back to community settings after
institutional admission; deleted text begin and
deleted text end

(9) providing information about competitive employment, with or without supports, for
school-age youth and working-age adults and referrals to the Disability Linkage Line and
Disability Benefits 101 to ensure that an informed choice about competitive employment
can be made. For the purposes of this subdivision, "competitive employment" means work
in the competitive labor market that is performed on a full-time or part-time basis in an
integrated setting, and for which an individual is compensated at or above the minimum
wage, but not less than the customary wage and level of benefits paid by the employer for
the same or similar work performed by individuals without disabilities new text begin ;
new text end

new text begin (10) providing information about independent living to ensure that a fully informed
choice about independent living can be made; and
new text end

new text begin (11) providing information about self-directed services and supports, including
self-directed funding options, to ensure that a fully informed choice about self-directed
options can be made new text end .

(b) Upon statewide implementation of lead agency requirements in subdivisions 2b, 2c,
and 3a, "long-term care consultation services" also means:

(1) service eligibility determination for new text begin the following new text end state plan services deleted text begin identified in deleted text end :

(i) new text begin personal care assistance services under new text end section 256B.0625, subdivisions 19a and 19c;

(ii) consumer support grants under section 256.476; or

(iii) new text begin community first services and supports under new text end section 256B.85;

(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024,
gaining access to new text begin :
new text end

new text begin (i) relocation-targeted new text end case management services available under deleted text begin sections deleted text end new text begin section new text end
256B.0621, subdivision 2, clause (4) deleted text begin , deleted text end new text begin ;
new text end

new text begin (ii) case management services targeted to vulnerable adults or developmental disabilities
under section new text end 256B.0924 deleted text begin , deleted text end new text begin ; new text end and

new text begin (iii) case management services targeted to people with developmental disabilities under
new text end Minnesota Rules, part 9525.0016;

(3) determination of eligibility for semi-independent living services under section
252.275; and

(4) obtaining necessary diagnostic information to determine eligibility under clauses (2)
and (3).

(c) "Long-term care options counseling" means the services provided by the linkage
lines as mandated by sections 256.01, subdivision 24, and 256.975, subdivision 7, and also
includes telephone assistance and follow up once a long-term care consultation assessment
has been completed.

(d) "Minnesota health care programs" means the medical assistance program under this
chapter and the alternative care program under section 256B.0913.

(e) "Lead agencies" means counties administering or tribes and health plans under
contract with the commissioner to administer long-term care consultation deleted text begin assessment and
support planning deleted text end services.

(f) "Person-centered planning" is a process that includes the active participation of a
person in the planning of the person's services, including in making meaningful and informed
choices about the person's own goals, talents, and objectives, as well as making meaningful
and informed choices about the services the person receives deleted text begin . For the purposes of this section deleted text end , new text begin
the settings in which the person receives them, and the setting in which the person lives.
new text end

new text begin (g) new text end "Informed choice" means a voluntary choice of services new text begin , settings, and living
arrangement new text end by a person from all available service new text begin and setting new text end options based on accurate
and complete information concerning all available service new text begin and setting new text end options and concerning
the person's own preferences, abilities, goals, and objectives. In order for a person to make
an informed choice, all available options must be developed and presented to the person new text begin in
a way the person can understand new text end to empower the person to make deleted text begin decisions deleted text end new text begin fully informed
choices new text end .

new text begin (h) "Available service and setting options" or "available options," with respect to the
home and community-based waivers under chapter 256S and sections 256B.092 and 256B.49,
means all services and settings defined under the relevant waiver plan.
new text end

new text begin (i) "Independent living" means living in a setting that is not controlled by a provider.
new text end

Sec. 4.

Minnesota Statutes 2018, section 256B.0911, is amended by adding a subdivision
to read:

new text begin Subd. 1b. new text end

new text begin Eligibility. new text end

new text begin (a) To be eligible for long-term care consultation services, a person
must be:
new text end

new text begin (1) enrolled in medical assistance;
new text end

new text begin (2) determined financially eligible for the alternative care program;
new text end

new text begin (3) determined to have a developmental disability or related condition as defined in
Minnesota Rules, part 9525.0016, subpart 2, items A to E; or
new text end

new text begin (4) referred to a lead agency under section 256.975, subdivision 7c, paragraph (a), clause
(2), following a nursing facility preadmission screening.
new text end

new text begin (b) To be eligible for long-term care consultation services, a person enrolled in medical
assistance must also have utilized state plan services for at least six months and be either:
new text end

new text begin (1) age 65 or older;
new text end

new text begin (2) blind; or
new text end

new text begin (3) determined to have a disability by the commissioner's state medical review team as
identified in section 256B.055, subdivision 7, or by the Social Security Administration.
new text end

Sec. 5.

Minnesota Statutes 2018, section 256B.0911, is amended by adding a subdivision
to read:

new text begin Subd. 1c. new text end

new text begin Assessments for personal care assistance services. new text end

new text begin Notwithstanding
subdivision 1b, paragraph (b), a lead agency may assess a recipient's need for personal care
assistance services under this section.
new text end

Sec. 6.

Minnesota Statutes 2018, section 256B.0911, subdivision 3, is amended to read:

Subd. 3.

Long-term care consultation team.

(a) A long-term care consultation team
shall be established by the county board of commissioners. Two or more counties may
collaborate to establish a joint local consultation team or teams.

(b) Each lead agency shall establish and maintain a team of certified assessors qualified
under subdivision 2b, paragraph (b). Each team member is responsible for providing
consultation with other team members upon request. The team is responsible for providing
long-term care consultation services to all new text begin eligible new text end persons located in the county who request
the services deleted text begin , regardless of eligibility for Minnesota health care programs deleted text end . The team of
certified assessors must include, at a minimum:

(1) a social worker; and

(2) a public health nurse or registered nurse.

(c) The commissioner shall allow arrangements and make recommendations that
encourage counties and tribes to collaborate to establish joint local long-term care
consultation teams to ensure that long-term care consultations are done within the timelines
and parameters of the service. This includes integrated service models as required in
subdivision 1, paragraph (b).

(d) Tribes and health plans under contract with the commissioner must provide long-term
care consultation services as specified in the contract.

(e) The lead agency must provide the commissioner with an administrative contact for
communication purposes.

Sec. 7.

Minnesota Statutes 2019 Supplement, section 256B.0911, subdivision 3a, is
amended to read:

Subd. 3a.

Assessment and support planning.

(a) new text begin Eligible new text end persons requesting assessment,
services planning, or other assistance intended to support community-based living, including
persons who need assessment in order to determine waiver or alternative care program
eligibility, must be visited by a long-term care consultation team within 20 calendar days
after the date on which an assessment was requested or recommended. Upon statewide
implementation of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment
of a person requesting personal care assistance services. new text begin The commissioner shall provide
at least a 90-day notice to lead agencies prior to the effective date of this requirement.
new text end Face-to-face assessments must be conducted according to paragraphs (b) to (i).

(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified
assessors to conduct the assessment. For a person with complex health care needs, a public
health or registered nurse from the team must be consulted.

(c) The MnCHOICES assessment provided by the commissioner to lead agencies must
be used to complete a comprehensive, conversation-based, person-centered assessment.
The assessment must include the health, psychological, functional, environmental, and
social needs of the individual necessary to develop a new text begin person-centered new text end community support
plan that meets the individual's needs and preferences.

(d) The assessment must be conducted new text begin by a certified assessor new text end in a face-to-face
conversational interview with the person being assessed. The person's legal representative
must provide input during the assessment process and may do so remotely if requested. At
the request of the person, other individuals may participate in the assessment to provide
information on the needs, strengths, and preferences of the person necessary to develop a
community support plan that ensures the person's health and safety. Except for legal
representatives or family members invited by the person, persons participating in the
assessment may not be a provider of service or have any financial interest in the provision
of services. For persons who are to be assessed for elderly waiver customized living or adult
day services under chapter 256S, with the permission of the person being assessed or the
person's designated or legal representative, the client's current or proposed provider of
services may submit a copy of the provider's nursing assessment or written report outlining
its recommendations regarding the client's care needs. The person conducting the assessment
must notify the provider of the date by which this information is to be submitted. This
information shall be provided to the person conducting the assessment prior to the assessment.
For a person who is to be assessed for waiver services under section 256B.092 or 256B.49,
with the permission of the person being assessed or the person's designated legal
representative, the person's current provider of services may submit a written report outlining
recommendations regarding the person's care needs the person completed in consultation
with someone who is known to the person and has interaction with the person on a regular
basis. The provider must submit the report at least 60 days before the end of the person's
current service agreement. The certified assessor must consider the content of the submitted
report prior to finalizing the person's assessment or reassessment.

(e) The certified assessor and the individual responsible for developing the coordinated
service and support plan must complete the community support plan and the coordinated
service and support plan no more than 60 calendar days from the assessment visit. The
person or the person's legal representative must be provided with a written community
support plan within the timelines established by the commissioner, regardless of whether
the person is eligible for Minnesota health care programs.

(f) For a person being assessed for elderly waiver services under chapter 256S, a provider
who submitted information under paragraph (d) shall receive the final written community
support plan when available and the Residential Services Workbook.

(g) The written community support plan must include:

(1) a summary of assessed needs as defined in paragraphs (c) and (d);

(2) the individual's options and choices to meet identified needs, including new text begin :
new text end

new text begin (i) new text end all available options for case management services and providers deleted text begin , including deleted text end new text begin ;
new text end

new text begin (ii) all available options for employment services, settings, and providers;
new text end

new text begin (iii) all available options for living arrangements;
new text end

new text begin (iv) all available options for self-directed services and supports, including self-directed
budget options; and
new text end

new text begin (v) new text end service provided in a non-disability-specific setting;

(3) identification of health and safety risks and how those risks will be addressed,
including personal risk management strategies;

(4) referral information; and

(5) informal caregiver supports, if applicable.

For a person determined eligible for state plan home care under subdivision 1a, paragraph
(b), clause (1), the person or person's representative must also receive a copy of the home
care service plan developed by the certified assessor.

(h) deleted text begin A person may request assistance in identifying community supports without
participating in a complete assessment. deleted text end Upon a request for assistance identifying community
support, deleted text begin the deleted text end new text begin a new text end person new text begin who is not eligible for long-term care consultations services new text end must be
transferred or referred to long-term care options counseling services available under sections
256.975, subdivision 7, and 256.01, subdivision 24, for telephone assistance and follow up.

(i) The person has the right to make the final decision new text begin :
new text end

new text begin (1) new text end between institutional placement and community placement after the recommendations
have been provided, except as provided in section 256.975, subdivision 7a, paragraph (d) new text begin ;
new text end

new text begin (2) between community placement in a setting controlled by a provider and living
independently in a setting not controlled by a provider;
new text end

new text begin (3) between day services and employment services; and
new text end

new text begin (4) regarding available options for self-directed services and supports, including
self-directed funding options new text end .

(j) The lead agency must give the person receiving assessment deleted text begin or support planning, deleted text end or
the person's legal representative, materials, and forms supplied by the commissioner
containing the following information:

(1) written recommendations for community-based services and consumer-directed
options;

(2) documentation that the most cost-effective alternatives available were offered to the
individual. For purposes of this clause, "cost-effective" means community services and
living arrangements that cost the same as or less than institutional care. For an individual
found to meet eligibility criteria for home and community-based service programs under
chapter 256S or section 256B.49, "cost-effectiveness" has the meaning found in the federally
approved waiver plan for each program;

(3) the need for and purpose of preadmission screening conducted by long-term care
options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects
nursing facility placement. If the individual selects nursing facility placement, the lead
agency shall forward information needed to complete the level of care determinations and
screening for developmental disability and mental illness collected during the assessment
to the long-term care options counselor using forms provided by the commissioner;

(4) the role of long-term care consultation assessment and support planning in eligibility
determination for waiver and alternative care programs, and state plan home care, case
management, and other services as defined in subdivision 1a, paragraphs (a), clause (6),
and (b);

(5) information about Minnesota health care programs;

(6) the person's freedom to accept or reject the recommendations of the team;

(7) the person's right to confidentiality under the Minnesota Government Data Practices
Act, chapter 13;

(8) the certified assessor's decision regarding the person's need for institutional level of
care as determined under criteria established in subdivision 4e and the certified assessor's
decision regarding eligibility for all services and programs as defined in subdivision 1a,
paragraphs (a), clause (6), and (b); deleted text begin and
deleted text end

(9) the person's right to appeal the certified assessor's decision regarding eligibility for
all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and
(8), and (b), and incorporating the decision regarding the need for institutional level of care
deleted text begin or the lead agency's final decisions regarding public programs eligibility deleted text end according to section
256.045, subdivision 3. The certified assessor must verbally communicate this appeal right
to the person and must visually point out where in the document the right to appeal is stated new text begin ;
and
new text end

new text begin (10) documentation that available options for employment services, independent living,
and self-directed services and supports were offered to the individual new text end .

(k) Face-to-face assessment completed as part of new text begin service new text end eligibility determination for
the alternative care, elderly waiver, developmental disabilities, community access for
disability inclusion, community alternative care, and brain injury waiver programs under
chapter 256S and sections 256B.0913, 256B.092, and 256B.49 is valid to establish service
eligibility for no more than 60 calendar days after the date of assessment.

(l) The effective eligibility start date for programs in paragraph (k) can never be prior
to the date of assessment. If an assessment was completed more than 60 days before the
effective waiver or alternative care program eligibility start date, assessment and support
plan information must be updated and documented in the department's Medicaid Management
Information System (MMIS). Notwithstanding retroactive medical assistance coverage of
state plan services, the effective date of eligibility for programs included in paragraph (k)
cannot be prior to the date the most recent updated assessment is completed.

(m) If an eligibility update is completed within 90 days of the previous face-to-face
assessment and documented in the department's Medicaid Management Information System
(MMIS), the effective date of eligibility for programs included in paragraph (k) is the date
of the previous face-to-face assessment when all other eligibility requirements are met.

(n) At the time of reassessment, the certified assessor shall assess each person receiving
waiver new text begin residential supports and new text end services currently residing in a community residential setting,
deleted text begin or deleted text end licensed adult foster care home that is new text begin either new text end not the primary residence of the license
holder deleted text begin , deleted text end or in which the license holder is not the primary caregiver new text begin , family adult foster care
residence new text end , new text begin or supervised living facility new text end to determine if that person would prefer to be served
in a community-living setting as defined in section 256B.49, subdivision 23 new text begin , in a setting
not controlled by a provider, or to receive integrated community supports as described in
section 245D.03, subdivision 1, paragraph (c), clause (8) new text end . The certified assessor shall offer
the person, through a person-centered planning process, the option to receive alternative
housing and service options.

new text begin (o) At the time of reassessment, the certified assessor shall assess each person receiving
waiver day services to determine if that person would prefer to receive employment services
as described in section 245D.03, subdivision 1, paragraph (c), clauses (5) to (7). The certified
assessor shall offer the person through a person-centered planning process the option to
receive employment services.
new text end

new text begin (p) At the time of reassessment, the certified assessor shall assess each person receiving
non-self-directed waiver services to determine if that person would prefer an available
service and setting option that would permit self-directed services and supports. The certified
assessor shall offer the person through a person-centered planning process the option to
receive self-directed services and supports.
new text end

Sec. 8.

Minnesota Statutes 2018, section 256B.0911, subdivision 3b, is amended to read:

Subd. 3b.

Transition assistance.

(a) new text begin Notwithstanding subdivision 1b, new text end lead agency
certified assessors shall provide assistance to new text begin all new text end persons residing in a nursing facility,
hospital, regional treatment center, or intermediate care facility for persons with
developmental disabilities who request or are referred for assistance. Transition assistance
must include assessment, community support plan development, referrals to long-term care
options counseling under section 256.975, subdivision 7, for community support plan
implementation and to Minnesota health care programs, including home and
community-based waiver services and consumer-directed options through the waivers, and
referrals to programs that provide assistance with housing. Transition assistance must also
include information about the Centers for Independent Living, Disability Linkage Line, and
about other organizations that can provide assistance with relocation efforts, and information
about contacting these organizations to obtain their assistance and support.

(b) The lead agency shall ensure that:

(1) referrals for in-person assessments are taken from long-term care options counselors
as provided for in section 256.975, subdivision 7, paragraph (b), clause (11);

(2) persons assessed in institutions receive information about transition assistance that
is available;

(3) the assessment is completed for persons within 20 calendar days of the date of request
or recommendation for assessment;

(4) there is a plan for transition and follow-up for the individual's return to the community,
including notification of other local agencies when a person may require assistance from
agencies located in another county; and

(5) deleted text begin relocation targeted deleted text end new text begin relocation-targeted new text end case management as defined in section
256B.0621, subdivision 2, clause (4), is authorized for an eligible medical assistance
recipient.

Sec. 9.

Minnesota Statutes 2019 Supplement, section 256B.0911, subdivision 3f, is amended
to read:

Subd. 3f.

Long-term care reassessments and community support plan updates.

(a)
Prior to a face-to-face reassessment, the certified assessor must review the person's most
recent assessment. Reassessments must be tailored using the professional judgment of the
assessor to the person's known needs, strengths, preferences, and circumstances.
Reassessments provide information to support the person's informed choice and opportunities
to express choice regarding activities that contribute to quality of life, as well as information
and opportunity to identify goals related to desired employment, community activities, and
preferred living environment. Reassessments require a review of the most recent assessment,
review of the current coordinated service and support plan's effectiveness, monitoring of
services, and the development of an updated person-centered community support plan.
Reassessments new text begin must new text end verify continued new text begin service new text end eligibility deleted text begin or deleted text end new text begin , new text end offer alternatives as warranted new text begin , new text end
and provide an opportunity for quality assurance of service delivery. Face-to-face
reassessments must be conducted annually or as required by federal and state laws and rules.
For reassessments, the certified assessor and the individual responsible for developing the
coordinated service and support plan must ensure the continuity of care for the person
receiving services and complete the updated community support plan and the updated
coordinated service and support plan no more than 60 days from the reassessment visit.

(b) The commissioner shall develop mechanisms for providers and case managers to
share information with the assessor to facilitate a reassessment and support planning process
tailored to the person's current needs and preferences.

new text begin (c) An individual or an individual's legal representative may indicate, in writing, at the
conclusion of an annual reassessment that a complete annual long-term care consultation
reassessment is not desired for up to two years. Before granting an individual's request to
decline one or two complete annual reassessments, the certified assessor must provide the
individual sufficient information to make a fully informed choice to decline complete annual
reassessments. An eligible individual may request a reassessment at any time. In lieu of an
annual complete long-term care consultation assessment for individuals who decline the
assessment, certified assessors shall annually perform only those activities required by
federal law to maintain the individual's service eligibility.
new text end

Sec. 10.

Minnesota Statutes 2018, section 256B.0911, subdivision 4d, is amended to read:

Subd. 4d.

Preadmission screening of individuals under 65 years of age.

(a) It is the
policy of the state of Minnesota to ensure that individuals with disabilities or chronic illness
are served in the most integrated setting appropriate to their needs and have the necessary
information to make informed choices about home and community-based service options.

(b) Individuals under 65 years of age who are admitted to a Medicaid-certified nursing
facility must be screened prior to admission according to the requirements outlined in section
256.975, subdivisions 7a to 7c. This shall be provided by the Senior LinkAge Line as
required under section 256.975, subdivision 7.

(c) new text begin Notwithstanding subdivision 1b, new text end individuals under 65 years of age who are admitted
to nursing facilities with only a telephone screening must receive a face-to-face assessment
from the long-term care consultation team member of the county in which the facility is
located or from the recipient's county case manager within the timeline established by the
commissioner, based on review of data.

(d) At the face-to-face assessment, the long-term care consultation team member or
county case manager must perform the activities required under subdivision 3b.

(e) For individuals under 21 years of age, a screening interview which recommends
nursing facility admission must be face-to-face and approved by the commissioner before
the individual is admitted to the nursing facility.

(f) In the event that an individual under 65 years of age is admitted to a nursing facility
on an emergency basis, the Senior LinkAge Line must be notified of the admission on the
next working day, and a face-to-face assessment as described in paragraph (c) must be
conducted within the timeline established by the commissioner, based on review of data.

(g) At the face-to-face assessment, the long-term care consultation team member or the
case manager must present information about home and community-based options, including
consumer-directed options, so the individual can make informed choices. If the individual
chooses home and community-based services, the long-term care consultation team member
or case manager must complete a written relocation plan within 20 working days of the
visit. The plan shall describe the services needed to move out of the facility and a time line
for the move which is designed to ensure a smooth transition to the individual's home and
community.

(h) new text begin Notwithstanding subdivision 1b, new text end an individual under 65 years of age residing in a
nursing facility shall receive a face-to-face assessment at least every 12 months to review
the person's service choices and available alternatives unless the individual indicates, in
writing, that annual visits are not desired. In this case, the individual must receive a
face-to-face assessment at least once every 36 months for the same purposes.

(i) Notwithstanding the provisions of subdivision 6, the commissioner may pay county
agencies directly for face-to-face assessments for individuals under 65 years of age who
are being considered for placement or residing in a nursing facility.

(j) Funding for preadmission screening follow-up shall be provided to the Disability
Linkage Line for the under-60 population by the Department of Human Services to cover
options counseling salaries and expenses to provide the services described in subdivisions
7a to 7c. The Disability Linkage Line shall employ, or contract with other agencies to
employ, within the limits of available funding, sufficient personnel to provide preadmission
screening follow-up services and shall seek to maximize federal funding for the service as
provided under section 256.01, subdivision 2, paragraph (aa).

Sec. 11.

Minnesota Statutes 2018, section 256B.092, subdivision 1a, is amended to read:

Subd. 1a.

Case management services.

(a) Each recipient of a home and community-based
waiver shall be provided case management services by qualified vendors as described in
the federally approved waiver application.

(b) Case management service activities provided to or arranged for a person include:

(1) development of the new text begin person-centered new text end coordinated service and support plan under
subdivision 1b;

(2) informing the individual or the individual's legal guardian or conservator, or parent
if the person is a minor, of service options new text begin , including all service options available under the
waiver plan new text end ;

(3) consulting with relevant medical experts or service providers;

(4) assisting the person in the identification of potential providers, including new text begin :
new text end

new text begin (i) providers of new text end services provided in a non-disability-specific setting;

new text begin (ii) employment service providers;
new text end

new text begin (iii) providers of services provided in settings that are not controlled by a provider; and
new text end

new text begin (iv) providers of financial management services;
new text end

(5) assisting the person to access services and assisting in appeals under section 256.045;

(6) coordination of services, if coordination is not provided by another service provider;

(7) evaluation and monitoring of the services identified in the coordinated service and
support plan, which must incorporate at least one annual face-to-face visit by the case
manager with each person; and

(8) reviewing coordinated service and support plans and providing the lead agency with
recommendations for service authorization based upon the individual's needs identified in
the coordinated service and support plan.

(c) Case management service activities that are provided to the person with a
developmental disability shall be provided directly by county agencies or under contract.
Case management services must be provided by a public or private agency that is enrolled
as a medical assistance provider determined by the commissioner to meet all of the
requirements in the approved federal waiver plans. Case management services must not be
provided to a recipient by a private agency that has a financial interest in the provision of
any other services included in the recipient's coordinated service and support plan. For
purposes of this section, "private agency" means any agency that is not identified as a lead
agency under section 256B.0911, subdivision 1a, paragraph (e).

(d) Case managers are responsible for service provisions listed in paragraphs (a) and
(b). Case managers shall collaborate with consumers, families, legal representatives, and
relevant medical experts and service providers in the development and annual review of the
new text begin person-centered new text end coordinated service and support plan and habilitation plan.

(e) For persons who need a positive support transition plan as required in chapter 245D,
the case manager shall participate in the development and ongoing evaluation of the plan
with the expanded support team. At least quarterly, the case manager, in consultation with
the expanded support team, shall evaluate the effectiveness of the plan based on progress
evaluation data submitted by the licensed provider to the case manager. The evaluation must
identify whether the plan has been developed and implemented in a manner to achieve the
following within the required timelines:

(1) phasing out the use of prohibited procedures;

(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's
timeline; and

(3) accomplishment of identified outcomes.

If adequate progress is not being made, the case manager shall consult with the person's
expanded support team to identify needed modifications and whether additional professional
support is required to provide consultation.

(f) The Department of Human Services shall offer ongoing education in case management
to case managers. Case managers shall receive no less than ten hours of case management
education and disability-related training each year. new text begin The education and training must include
person-centered planning. For the purposes of this section, "person-centered planning" or
"person-centered" has the meaning given in section 256B.0911, subdivision 1a, paragraph
(f).
new text end

Sec. 12.

Minnesota Statutes 2019 Supplement, section 256B.092, subdivision 1b, is
amended to read:

Subd. 1b.

Coordinated service and support plan.

(a) Each recipient of home and
community-based waivered services shall be provided a copy of the written new text begin person-centered
new text end coordinated service and support plan that:

(1) is developed with and signed by the recipient within the timelines established by the
commissioner and section 256B.0911, subdivision 3a, paragraph (e);

(2) includes the person's need for service, including identification of service needs that
will be or that are met by the person's relatives, friends, and others, as well as community
services used by the general public;

(3) reasonably ensures the health and welfare of the recipient;

(4) identifies the person's preferences for services as stated by the person, the person's
legal guardian or conservator, or the parent if the person is a minor, including the person's
choices made on self-directed options deleted text begin and on deleted text end new text begin , new text end services and supports to achieve employment
goals new text begin , and living arrangements new text end ;

(5) provides for an informed choice, as defined in section 256B.77, subdivision 2,
paragraph (o), of service and support providers, and identifies all available options for case
management services and providers;

(6) identifies long-range and short-range goals for the person;

(7) identifies specific services and the amount and frequency of the services to be provided
to the person based on assessed needs, preferences, and available resources. The
new text begin person-centered new text end coordinated service and support plan shall also specify other services the
person needs that are not available;

(8) identifies the need for an individual program plan to be developed by the provider
according to the respective state and federal licensing and certification standards, and
additional assessments to be completed or arranged by the provider after service initiation;

(9) identifies provider responsibilities to implement and make recommendations for
modification to the coordinated service and support plan;

(10) includes notice of the right to request a conciliation conference or a hearing under
section 256.045;

(11) is agreed upon and signed by the person, the person's legal guardian or conservator,
or the parent if the person is a minor, and the authorized county representative;

(12) is reviewed by a health professional if the person has overriding medical needs that
impact the delivery of services; and

(13) includes the authorized annual and monthly amounts for the services.

(b) In developing the new text begin person-centered new text end coordinated service and support plan, the case
manager is encouraged to include the use of volunteers, religious organizations, social clubs,
and civic and service organizations to support the individual in the community. The lead
agency must be held harmless for damages or injuries sustained through the use of volunteers
and agencies under this paragraph, including workers' compensation liability.

(c) Approved, written, and signed changes to a consumer's services that meet the criteria
in this subdivision shall be an addendum to that consumer's individual service plan.

Sec. 13.

Minnesota Statutes 2019 Supplement, section 256B.49, subdivision 13, is amended
to read:

Subd. 13.

Case management.

(a) Each recipient of a home and community-based waiver
shall be provided case management services by qualified vendors as described in the federally
approved waiver application. The case management service activities provided must include:

(1) finalizing the new text begin person-centered new text end written coordinated service and support plan within
the timelines established by the commissioner and section 256B.0911, subdivision 3a,
paragraph (e);

(2) informing the recipient or the recipient's legal guardian or conservator of service
options new text begin , including all service options available under the waiver plans new text end ;

(3) assisting the recipient in the identification of potential service providers deleted text begin and deleted text end new text begin , including:
new text end

new text begin (i) new text end available options for case management service and providers deleted text begin , including deleted text end new text begin ;
new text end

new text begin (ii) new text end new text begin providers of new text end services provided in a non-disability-specific setting;

new text begin (iii) employment service providers;
new text end

new text begin (iv) providers of services provided in settings that are not community residential settings;
and
new text end

new text begin (v) providers of financial management services;
new text end

(4) assisting the recipient to access services and assisting with appeals under section
256.045; and

(5) coordinating, evaluating, and monitoring of the services identified in the service
plan.

(b) The case manager may delegate certain aspects of the case management service
activities to another individual provided there is oversight by the case manager. The case
manager may not delegate those aspects which require professional judgment including:

(1) finalizing the new text begin person-centered new text end coordinated service and support plan;

(2) ongoing assessment and monitoring of the person's needs and adequacy of the
approved new text begin person-centered new text end coordinated service and support plan; and

(3) adjustments to the new text begin person-centered new text end coordinated service and support plan.

(c) Case management services must be provided by a public or private agency that is
enrolled as a medical assistance provider determined by the commissioner to meet all of
the requirements in the approved federal waiver plans. Case management services must not
be provided to a recipient by a private agency that has any financial interest in the provision
of any other services included in the recipient's coordinated service and support plan. For
purposes of this section, "private agency" means any agency that is not identified as a lead
agency under section 256B.0911, subdivision 1a, paragraph (e).

(d) For persons who need a positive support transition plan as required in chapter 245D,
the case manager shall participate in the development and ongoing evaluation of the plan
with the expanded support team. At least quarterly, the case manager, in consultation with
the expanded support team, shall evaluate the effectiveness of the plan based on progress
evaluation data submitted by the licensed provider to the case manager. The evaluation must
identify whether the plan has been developed and implemented in a manner to achieve the
following within the required timelines:

(1) phasing out the use of prohibited procedures;

(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's
timeline; and

(3) accomplishment of identified outcomes.

If adequate progress is not being made, the case manager shall consult with the person's
expanded support team to identify needed modifications and whether additional professional
support is required to provide consultation.

new text begin (e) The Department of Human Services shall offer ongoing education in case management
to case managers. Case managers shall receive no less than ten hours of case management
education and disability-related training each year. The education and training must include
person-centered planning. For the purposes of this section, "person-centered planning" or
"person-centered" has the meaning given in section 256B.0911, subdivision 1a, paragraph
(f).
new text end

Sec. 14.

Minnesota Statutes 2019 Supplement, section 256B.49, subdivision 14, is amended
to read:

Subd. 14.

Assessment and reassessment.

(a) Assessments and reassessments shall be
conducted by certified assessors according to section 256B.0911, subdivision 2b. The
certified assessor, with the permission of the recipient or the recipient's designated legal
representative, may invite other individuals to attend the assessment. With the permission
of the recipient or the recipient's designated legal representative, the recipient's current
provider of services may submit a written report outlining their recommendations regarding
the recipient's care needs prepared by a direct service employee who is familiar with the
person. The provider must submit the report at least 60 days before the end of the person's
current service agreement. The certified assessor must consider the content of the submitted
report prior to finalizing the person's assessment or reassessment.

(b) There must be a determination that the client requires a hospital level of care or a
nursing facility level of care as defined in section 256B.0911, subdivision 4e, at initial and
subsequent assessments to initiate and maintain participation in the waiver program.

(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
appropriate to determine nursing facility level of care for purposes of medical assistance
payment for nursing facility services, only face-to-face assessments conducted according
to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
determination or a nursing facility level of care determination must be accepted for purposes
of initial and ongoing access to waiver services payment.

(d) Recipients who are found eligible for home and community-based services under
this section before their 65th birthday may remain eligible for these services after their 65th
birthday if they continue to meet all other eligibility factors.

new text begin (e) At the time of reassessment, the certified assessor shall assess each person receiving
waiver residential supports and services currently residing in a community residential setting,
family adult foster care residence, or supervised living facility to determine if that person
would prefer to be served in a community-living setting as defined in subdivision 23 or to
receive integrated community supports as described in section 245D.03, subdivision 1,
paragraph (c), clause (8). The certified assessor shall offer the person through a
person-centered planning process the option to receive alternative housing and service
options.
new text end

new text begin (f) At the time of reassessment, the certified assessor shall assess each person receiving
waiver day services to determine if that person would prefer to receive employment services
as described in section 245D.03, subdivision 1, paragraph (c), clauses (5) to (7). The certified
assessor shall offer the person through a person-centered planning process the option to
receive employment services.
new text end

new text begin (g) At the time of reassessment, the certified assessor shall assess each person receiving
nonself-directed waiver services to determine if that person would prefer an available service
and setting option that would permit self-directed services and supports. The certified
assessor shall offer the person through a person-centered planning process the option to
receive self-directed services and supports.
new text end

ARTICLE 5

CUSTOMIZED LIVING MODIFICATIONS

Section 1.

Minnesota Statutes 2019 Supplement, section 144A.484, subdivision 1, is
amended to read:

Subdivision 1.

Integrated licensing established.

new text begin (a) new text end A home care provider applicant
or license holder may apply new text begin annually new text end to the commissioner of health for a home and
community-based services designation for the provision of basic support services identified
under section 245D.03, subdivision 1, paragraph (b). The designation allows the license
holder to provide basic support services new text begin , except for the provision under section 256B.49 of
customized living services as defined in the brain injury or the community access for
disability inclusion waivers new text end that would otherwise require licensure under chapter 245D,
under the license holder's home care license governed by sections 144A.43 to 144A.4799.

new text begin (b) A home care provider applicant or license holder may apply annually to the
commissioner of human services under section 245D.35 for a home and community-based
services designation for each location in which the applicant or license holder provides
under section 256B.49 customized living services as defined in the brain injury or the
community access for disability inclusion waivers. The designation allows the license holder
to provide customized living services that would otherwise require licensure under chapter
245D, under the license holder's home care license governed by sections 144A.43 to
144A.4799.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective June 1, 2020, and applies to home care
license applications; home care license renewals; home and community-based services
designation applications; and home and community-based services designation applications
occurring on or after that date.
new text end

Sec. 2.

Minnesota Statutes 2018, section 144A.484, subdivision 2, is amended to read:

Subd. 2.

Application for home and community-based services designation.

An
application for a home and community-based services designation new text begin under subdivision 1,
paragraph (a), new text end must be made on the forms and in the manner prescribed by the commissioner.
The commissioner shall provide the applicant with instruction for completing the application
and provide information about the requirements of other state agencies that affect the
applicant. Application for the home and community-based services designation new text begin under
subdivision 1, paragraph (a), new text end is subject to the requirements under section 144A.473.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective June 1, 2020, and applies to home care
license applications; home care license renewals; home and community-based services
designation applications; and home and community-based services designation applications
occurring on or after that date.
new text end

Sec. 3.

Minnesota Statutes 2018, section 144A.484, subdivision 4, is amended to read:

Subd. 4.

Applicability of home and community-based services requirements.

A
home care provider with a home and community-based services designation new text begin under subdivision
1 new text end must comply with the requirements for home care services governed by this chapter. For
the provision of basic support services, new text begin including customized living services, new text end the home care
provider must also comply with the following home and community-based services licensing
requirements:

(1) service planning and delivery requirements in section 245D.07;

(2) protection standards in section 245D.06;

(3) emergency use of manual restraints in section 245D.061; and

(4) protection-related rights in section 245D.04, subdivision 3, paragraph (a), clauses
(5), (7), (8), (12), and (13), and paragraph (b).

A home care provider with the integrated license-home and community-based services
designation new text begin under subdivision 1 new text end may utilize a bill of rights which incorporates the service
recipient rights in section 245D.04, subdivision 3, paragraph (a), clauses (5), (7), (8), (12),
and (13), and paragraph (b) with the home care bill of rights in section 144A.44.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective June 1, 2020, and applies to home care
license applications; home care license renewals; home and community-based services
designation applications; and home and community-based services designation applications
occurring on or after that date.
new text end

Sec. 4.

Minnesota Statutes 2018, section 144A.484, subdivision 5, is amended to read:

Subd. 5.

Monitoring and enforcement.

(a) The commissioner shall monitor for
compliance with the home and community-based services requirements identified in
subdivision 4, in accordance with this section and any agreements by the commissioners of
health and human services.

(b) The commissioner shall enforce compliance with applicable home and
community-based services licensing requirements as follows:

(1) the commissioner may deny a home and community-based services designation
new text begin under subdivision 1, paragraph (a), new text end in accordance with section 144A.473 or 144A.475; and

(2) if the commissioner finds that the applicant or license holder has failed to comply
with the applicable home and community-based services designation requirements, the
commissioner may issue:

(i) a correction order in accordance with section 144A.474;

(ii) an order of conditional license in accordance with section 144A.475;

(iii) a sanction in accordance with section 144A.475; or

(iv) any combination of clauses (i) to (iii).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective June 1, 2020, and applies to home care
license applications; home care license renewals; home and community-based services
designation applications; and home and community-based services designation applications
occurring on or after that date.
new text end

Sec. 5.

Minnesota Statutes 2018, section 144A.484, subdivision 6, is amended to read:

Subd. 6.

Appeals.

A home care provider applicant that has been denied a temporary
license will also be denied their application for the home and community-based services
designation. The applicant may request reconsideration in accordance with section 144A.473,
subdivision 3. A licensed home care provider whose application for a home and
community-based services designation new text begin under subdivision 1, paragraph (a), new text end has been denied
or whose designation has been suspended or revoked may appeal the denial, suspension,
revocation, or refusal to renew a home and community-based services designation in
accordance with section 144A.475. A license holder may request reconsideration of a
correction order in accordance with section 144A.474, subdivision 12.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective June 1, 2020, and applies to home care
license applications; home care license renewals; home and community-based services
designation applications; and home and community-based services designation applications
occurring on or after that date.
new text end

Sec. 6.

new text begin [245D.35] HOME AND COMMUNITY-BASED SERVICES DESIGNATION.
new text end

new text begin Subdivision 1. new text end

new text begin Designation for customized living services. new text end

new text begin (a) Notwithstanding section
245A.03, subdivision 2, paragraph (a), clause (23), a home care provider applying for
licensure under chapter 144A or a home care provider licensed under chapter 144A may
apply annually to the commissioner for a home and community-based services designation
for each location in which the applicant or license holder provides under section 256B.49
customized living services as defined in the brain injury or the community access for
disability inclusion waivers. The designation allows the license holder to provide customized
living services that would otherwise require licensure under this chapter, under the license
holder's home care license governed by chapter 144A.
new text end

new text begin (b) Unless designated by the commissioner under this section, an individual, organization,
or government entity must not provide customized living services under section 256B.49
in a setting that is not otherwise licensed by the commissioner.
new text end

new text begin (c) Licensed home care providers and home care license applicants seeking designation
under this section must request this designation for each location in which the provider
intends to provide customized living services under section 256B.49. The provider or
applicant must request the designation on forms and in the manner prescribed by the
commissioner.
new text end

new text begin Subd. 2. new text end

new text begin Designation for customized living services moratorium. new text end

new text begin (a) The commissioner
shall not issue an initial home and community-based services designation for a location in
which customized living services as defined under the brain injury or community access
for disability inclusion waiver plans are provided under section 256B.49. The commissioner
may renew designations previously issued by the commissioner or the commissioner of
health under section 144A.484.
new text end

new text begin (b) Exceptions to the moratorium include new locations for the provision of customized
living services under section 256B.49 the commissioner determines are needed.
new text end

new text begin (c) When approving an exception under paragraph (b), the commissioner shall consider
the availability of beds in registered housing with services establishments, licensed assisted
living facilities, and licensed foster care homes in the geographic area in which the home
care provider seeks to operate, the results of a person's choices during their annual assessment
and service plan review, and the recommendation of the local county board. The
determination by the commissioner regarding an exception is final and not subject to appeal.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective June 1, 2020, and applies to home care
license applications; home care license renewals; home and community-based services
designation applications; and home and community-based services designation applications
occurring on or after that date.
new text end

Sec. 7. new text begin DIRECTION TO THE COMMISSIONER; CUSTOMIZED LIVING
REPORT.
new text end

new text begin By December 1, 2020, the commissioner of human services shall submit a report to the
chairs and ranking minority members of the legislative committees with jurisdiction over
human services policy and finance. The report must include the commissioner's assessment
of the prevalence of customized living services provided under Minnesota Statutes, section
256B.49, supplanting the provision of residential services and supports licensed under
Minnesota Statutes, chapter 245D, and provided in settings licensed under Minnesota
Statutes, chapter 245A. The commissioner shall include recommendations regarding the
continuation of the moratorium on home and community-based services designations under
Minnesota Statutes, section 245D.35, and other policy recommendations to ensure that
customized living services are being provided in a manner consistent with the policy
objectives of the foster care licensing moratorium under Minnesota Statutes, section 245A.03,
subdivision 3.
new text end

ARTICLE 6

DEPARTMENT OF HUMAN SERVICES POLICY PROPOSALS

Section 1.

Minnesota Statutes 2018, section 119B.21, is amended to read:

119B.21 CHILD CARE new text begin SERVICES new text end GRANTS.

Subdivision 1.

Distribution of grant funds.

(a) The commissioner shall distribute funds
to the child care resource and referral programs designated under deleted text begin section deleted text end new text begin sections 119B.189
and new text end 119B.19, subdivision 1a, for child care new text begin services new text end grants to deleted text begin centers under subdivision 5
and family child care programs based upon the following factors deleted text end new text begin improve child care quality,
support start-up of new programs, and expand existing programs new text end .

(b) Up to ten percent of funds appropriated for grants under this section may be used by
the commissioner for statewide child care development initiatives, training initiatives,
collaboration programs, and research and data collection. The commissioner shall develop
eligibility guidelines and a process to distribute funds under this paragraph.

(c) At least 90 percent of funds appropriated for grants under this section may be
distributed by the commissioner to child care resource and referral programs under deleted text begin section deleted text end new text begin
sections 119B.189 and new text end 119B.19, subdivision 1a, deleted text begin for child care center grants and family
child care grants deleted text end based on the following factors:

(1) the number of children under 13 years of age needing child care in the region;

(2) the region served by the program;

(3) the ratio of children under 13 years of age needing child care to the number of licensed
spaces in the region;

(4) the number of licensed child care providers and school-age care programs in the
region; and

(5) other related factors determined by the commissioner.

(d) Child care resource and referral programs must award child care deleted text begin center grants and
family child care deleted text end new text begin services new text end grants based on the recommendation of the child care district
proposal review committees under subdivision 3.

(e) The commissioner may distribute funds under this section for a two-year period.

new text begin Subd. 1a. new text end

new text begin Eligible programs. new text end

new text begin A child care resource and referral program designated
under section 119B.19, subdivision 1a, may award child care services grants to:
new text end

new text begin (1) a child care center licensed under Minnesota Rules, chapter 9503, or in the process
of becoming licensed;
new text end

new text begin (2) a family or group family child care home licensed under Minnesota Rules, chapter
9502, or in the process of becoming licensed;
new text end

new text begin (3) corporations or public agencies that develop or provide child care services;
new text end

new text begin (4) a school-age care program;
new text end

new text begin (5) a tribally licensed child care program;
new text end

new text begin (6) legal nonlicensed or family, friend, and neighbor child care providers; or
new text end

new text begin (7) other programs as determined by the commissioner.
new text end

Subd. 3.

Child care district proposal review committees.

(a) Child care district proposal
review committees review applications for deleted text begin family child care grants and deleted text end child care deleted text begin center deleted text end new text begin
services new text end grants under this section and make funding recommendations to the child care
resource and referral program designated under deleted text begin section deleted text end new text begin sections 119B.189 and new text end 119B.19,
subdivision 1a. Each region within a district must be represented on the review committee.
The child care district proposal review committees must complete their reviews and forward
their recommendations to the child care resource and referral district programs by the date
specified by the commissioner.

(b) A child care resource and referral district program shall establish a process to select
members of the child care district proposal review committee. Members must reflect a broad
cross-section of the community, and may include the following constituent groups: family
child care providers, child care center providers, school-age care providers, parents who
use child care services, health services, social services, public schools, Head Start, employers,
representatives of cultural and ethnic communities, and other citizens with demonstrated
interest in child care issues. Members of the proposal review committee with a direct financial
interest in a pending grant proposal may not provide a recommendation or participate in
the ranking of that grant proposal.

(c) The child care resource and referral district program may deleted text begin reimburse committee
members for their actual travel, child care, and child care provider substitute expenses for
up to two committee meetings per year. The program may also pay deleted text end new text begin offer new text end a stipend to deleted text begin parent
representatives deleted text end new text begin proposal review committee members new text end for participating in deleted text begin two meetings per
year deleted text end new text begin the grant review process new text end .

Subd. 5.

Child care services grants.

(a) A child care resource and referral program
designated under deleted text begin section deleted text end new text begin sections 119B.189 and new text end 119B.19, subdivision 1a, may award child
care services grants for:

(1) creating new licensed child care facilities and expanding existing facilities, including,
but not limited to, supplies, equipment, facility renovation, and remodeling;

(2) deleted text begin improving licensed child care facility programs deleted text end new text begin facility improvements, including but
not limited to improvements to meet licensing requirements new text end ;

(3) staff training and development services including, but not limited to, in-service
training, curriculum development, accreditation, certification, consulting, resource centers,
program and resource materials, supporting effective teacher-child interactions, child-focused
teaching, and content-driven classroom instruction;

(4) capacity building through the purchase of appropriate technology to create, enhance,
and maintain business management systems;

(5) emergency assistance for child care programs;

(6) new programs or projects for the creation, expansion, or improvement of programs
that serve ethnic immigrant and refugee communities; deleted text begin and
deleted text end

(7) targeted recruitment initiatives to expand and build the capacity of the child care
system and to improve the quality of care provided by legal nonlicensed child care providers deleted text begin . deleted text end new text begin ;
and
new text end

new text begin (8) other uses as approved by the commissioner.
new text end

(b) A child care resource and referral organization designated under deleted text begin section deleted text end new text begin sections
119B.189 and new text end 119B.19, subdivision 1a, may award child care services grants deleted text begin of up to $1,000
to family child care providers. These grants may be used deleted text end for deleted text begin : deleted text end new text begin eligible programs in amounts
up to a maximum determined by the commissioner for each type of eligible program.
new text end

deleted text begin (1) facility improvements, including, but not limited to, improvements to meet licensing
requirements;
deleted text end

deleted text begin (2) improvements to expand a child care facility or program;
deleted text end

deleted text begin (3) toys and equipment;
deleted text end

deleted text begin (4) technology and software to create, enhance, and maintain business management
systems;
deleted text end

deleted text begin (5) start-up costs;
deleted text end

deleted text begin (6) staff training and development; and
deleted text end

deleted text begin (7) other uses approved by the commissioner.
deleted text end

deleted text begin (c) A child care resource and referral program designated under section 119B.19,
subdivision 1a, may award child care services grants to:
deleted text end

deleted text begin (1) licensed providers;
deleted text end

deleted text begin (2) providers in the process of being licensed;
deleted text end

deleted text begin (3) corporations or public agencies that develop or provide child care services;
deleted text end

deleted text begin (4) school-age care programs;
deleted text end

deleted text begin (5) legal nonlicensed or family, friend, and neighbor care providers; or
deleted text end

deleted text begin (6) any combination of clauses (1) to (5).
deleted text end

deleted text begin (d) A child care center that is a recipient of a child care services grant for facility
improvements or staff training and development must provide a 25 percent local match. A
local match is not required for grants to family child care providers.
deleted text end

deleted text begin (e) Beginning July 1, 2009, grants to child care centers under this subdivision shall be
increasingly awarded for activities that improve provider quality, including activities under
paragraph (a), clauses (1) to (3) and (6). Grants to family child care providers shall be
increasingly awarded for activities that improve provider quality, including activities under
paragraph (b), clauses (1), (3), and (6).
deleted text end

Sec. 2.

Minnesota Statutes 2018, section 119B.26, is amended to read:

119B.26 AUTHORITY TO WAIVE REQUIREMENTS DURING DISASTER
PERIODS.

The commissioner may waive requirements under this chapter for up to nine months
after the disaster in areas where a federal disaster has been declared under United States
Code, title 42, section 5121, et seq., or the governor has exercised authority under chapter
12. new text begin The commissioner may waive requirements retroactively from the date of the disaster. new text end
The commissioner shall notify the chairs of the house of representatives and senate
committees with jurisdiction over this chapter and the house of representatives Ways and
Means Committee deleted text begin ten days before the effective date of any waiver granted deleted text end new text begin within five
business days after the commissioner grants a waiver new text end under this section.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2020.
new text end

Sec. 3.

Minnesota Statutes 2019 Supplement, section 245.4889, subdivision 1, is amended
to read:

Subdivision 1.

Establishment and authority.

(a) The commissioner is authorized to
make grants from available appropriations to assist:

(1) counties;

(2) Indian tribes;

(3) children's collaboratives under section 124D.23 or 245.493; or

(4) mental health service providers.

(b) The following services are eligible for grants under this section:

(1) services to children with emotional disturbances as defined in section 245.4871,
subdivision 15, and their families;

(2) transition services under section 245.4875, subdivision 8, for young adults under
age 21 and their families;

(3) respite care services for children with new text begin emotional disturbances or new text end severe emotional
disturbances who are at risk of out-of-home placement new text begin . A child is not required to have case
management services to receive respite care services new text end ;

(4) children's mental health crisis services;

(5) mental health services for people from cultural and ethnic minorities;

(6) children's mental health screening and follow-up diagnostic assessment and treatment;

(7) services to promote and develop the capacity of providers to use evidence-based
practices in providing children's mental health services;

(8) school-linked mental health services under section 245.4901;

(9) building evidence-based mental health intervention capacity for children birth to age
five;

(10) suicide prevention and counseling services that use text messaging statewide;

(11) mental health first aid training;

(12) training for parents, collaborative partners, and mental health providers on the
impact of adverse childhood experiences and trauma and development of an interactive
website to share information and strategies to promote resilience and prevent trauma;

(13) transition age services to develop or expand mental health treatment and supports
for adolescents and young adults 26 years of age or younger;

(14) early childhood mental health consultation;

(15) evidence-based interventions for youth at risk of developing or experiencing a first
episode of psychosis, and a public awareness campaign on the signs and symptoms of
psychosis;

(16) psychiatric consultation for primary care practitioners; and

(17) providers to begin operations and meet program requirements when establishing a
new children's mental health program. These may be start-up grants.

(c) Services under paragraph (b) must be designed to help each child to function and
remain with the child's family in the community and delivered consistent with the child's
treatment plan. Transition services to eligible young adults under this paragraph must be
designed to foster independent living in the community.

(d) As a condition of receiving grant funds, a grantee shall obtain all available third-party
reimbursement sources, if applicable.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 4.

Minnesota Statutes 2019 Supplement, section 245A.03, subdivision 7, is amended
to read:

Subd. 7.

Licensing moratorium.

(a) The commissioner shall not issue an initial license
for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult
foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter
for a physical location that will not be the primary residence of the license holder for the
entire period of licensure. If a license is issued during this moratorium, and the license
holder changes the license holder's primary residence away from the physical location of
the foster care license, the commissioner shall revoke the license according to section
245A.07. The commissioner shall not issue an initial license for a community residential
setting licensed under chapter 245D. When approving an exception under this paragraph,
the commissioner shall consider the resource need determination process in paragraph (h),
the availability of foster care licensed beds in the geographic area in which the licensee
seeks to operate, the results of a person's choices during their annual assessment and service
plan review, and the recommendation of the local county board. The determination by the
commissioner is final and not subject to appeal. Exceptions to the moratorium include:

(1) foster care settings that are required to be registered under chapter 144D;

(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
community residential setting licenses replacing adult foster care licenses in existence on
December 31, 2013, and determined to be needed by the commissioner under paragraph
(b);

(3) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD,
or regional treatment center; restructuring of state-operated services that limits the capacity
of state-operated facilities; or allowing movement to the community for people who no
longer require the level of care provided in state-operated facilities as provided under section
256B.092, subdivision 13, or 256B.49, subdivision 24;

(4) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for persons requiring hospital level care; new text begin
or
new text end

(5) deleted text begin new foster care licenses or community residential setting licenses determined to be
needed by the commissioner for the transition of people from personal care assistance to
the home and community-based services;
deleted text end

deleted text begin (6) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner for the transition of people from the residential care waiver
services to foster care services. This exception applies only when:
deleted text end

deleted text begin (i) the person's case manager provided the person with information about the choice of
service, service provider, and location of service to help the person make an informed choice;
and
deleted text end

deleted text begin (ii) the person's foster care services are less than or equal to the cost of the person's
services delivered in the residential care waiver service setting as determined by the lead
agency; or
deleted text end

deleted text begin (7) deleted text end new foster care licenses or community residential setting licenses for people receiving
services under chapter 245D and residing in an unlicensed setting before May 1, 2017, and
for which a license is required. This exception does not apply to people living in their own
home. For purposes of this clause, there is a presumption that a foster care or community
residential setting license is required for services provided to three or more people in a
dwelling unit when the setting is controlled by the provider. A license holder subject to this
exception may rebut the presumption that a license is required by seeking a reconsideration
of the commissioner's determination. The commissioner's disposition of a request for
reconsideration is final and not subject to appeal under chapter 14. The exception is available
until June 30, 2018. This exception is available when:

(i) the person's case manager provided the person with information about the choice of
service, service provider, and location of service, including in the person's home, to help
the person make an informed choice; and

(ii) the person's services provided in the licensed foster care or community residential
setting are less than or equal to the cost of the person's services delivered in the unlicensed
setting as determined by the lead agency.

(b) The commissioner shall determine the need for newly licensed foster care homes or
community residential settings as defined under this subdivision. As part of the determination,
the commissioner shall consider the availability of foster care capacity in the area in which
the licensee seeks to operate, and the recommendation of the local county board. The
determination by the commissioner must be final. A determination of need is not required
for a change in ownership at the same address.

(c) When an adult resident served by the program moves out of a foster home that is not
the primary residence of the license holder according to section 256B.49, subdivision 15,
paragraph (f), or the adult community residential setting, the county shall immediately
inform the Department of Human Services Licensing Division. The department may decrease
the statewide licensed capacity for adult foster care settings.

(d) Residential settings that would otherwise be subject to the decreased license capacity
established in paragraph (c) shall be exempt if the license holder's beds are occupied by
residents whose primary diagnosis is mental illness and the license holder is certified under
the requirements in subdivision 6a or section 245D.33.

(e) A resource need determination process, managed at the state level, using the available
reports required by section 144A.351, and other data and information shall be used to
determine where the reduced capacity determined under section 256B.493 will be
implemented. The commissioner shall consult with the stakeholders described in section
144A.351, and employ a variety of methods to improve the state's capacity to meet the
informed decisions of those people who want to move out of corporate foster care or
community residential settings, long-term service needs within budgetary limits, including
seeking proposals from service providers or lead agencies to change service type, capacity,
or location to improve services, increase the independence of residents, and better meet
needs identified by the long-term services and supports reports and statewide data and
information.

(f) At the time of application and reapplication for licensure, the applicant and the license
holder that are subject to the moratorium or an exclusion established in paragraph (a) are
required to inform the commissioner whether the physical location where the foster care
will be provided is or will be the primary residence of the license holder for the entire period
of licensure. If the primary residence of the applicant or license holder changes, the applicant
or license holder must notify the commissioner immediately. The commissioner shall print
on the foster care license certificate whether or not the physical location is the primary
residence of the license holder.

(g) License holders of foster care homes identified under paragraph (f) that are not the
primary residence of the license holder and that also provide services in the foster care home
that are covered by a federally approved home and community-based services waiver, as
authorized under chapter 256S or section 256B.092 or 256B.49, must inform the human
services licensing division that the license holder provides or intends to provide these
waiver-funded services.

(h) The commissioner may adjust capacity to address needs identified in section
144A.351. Under this authority, the commissioner may approve new licensed settings or
delicense existing settings. Delicensing of settings will be accomplished through a process
identified in section 256B.493. Annually, by August 1, the commissioner shall provide
information and data on capacity of licensed long-term services and supports, actions taken
under the subdivision to manage statewide long-term services and supports resources, and
any recommendations for change to the legislative committees with jurisdiction over the
health and human services budget.

(i) The commissioner must notify a license holder when its corporate foster care or
community residential setting licensed beds are reduced under this section. The notice of
reduction of licensed beds must be in writing and delivered to the license holder by certified
mail or personal service. The notice must state why the licensed beds are reduced and must
inform the license holder of its right to request reconsideration by the commissioner. The
license holder's request for reconsideration must be in writing. If mailed, the request for
reconsideration must be postmarked and sent to the commissioner within 20 calendar days
after the license holder's receipt of the notice of reduction of licensed beds. If a request for
reconsideration is made by personal service, it must be received by the commissioner within
20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.

(j) The commissioner shall not issue an initial license for children's residential treatment
services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter
for a program that Centers for Medicare and Medicaid Services would consider an institution
for mental diseases. Facilities that serve only private pay clients are exempt from the
moratorium described in this paragraph. The commissioner has the authority to manage
existing statewide capacity for children's residential treatment services subject to the
moratorium under this paragraph and may issue an initial license for such facilities if the
initial license would not increase the statewide capacity for children's residential treatment
services subject to the moratorium under this paragraph.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 5.

Minnesota Statutes 2019 Supplement, section 245A.149, is amended to read:

245A.149 SUPERVISION OF FAMILY CHILD CARE LICENSE HOLDER'S
OWN CHILD.

(a) Notwithstanding Minnesota Rules, part 9502.0365, subpart 5, new text begin and with the license
holder's consent, new text end an individual may be present in the licensed space, may supervise the
family child care license holder's own child both inside and outside of the licensed space,
and is exempt from the training and supervision requirements of this chapter and Minnesota
Rules, chapter 9502, if the individual:

(1) is related to the license holder new text begin or to the license holder's child new text end , as defined in section
245A.02, subdivision 13 new text begin , or is a household member who the license holder has reported to
the county agency new text end ;

(2) deleted text begin is not a designated caregiver, helper, or substitute for the licensed program;
deleted text end

deleted text begin (3) deleted text end is involved only in the care of the license holder's own child; and

deleted text begin (4) deleted text end new text begin (3) new text end does not have direct, unsupervised contact with any nonrelative children receiving
services.

(b) If the individual in paragraph (a) is not a household member, the individual is also
exempt from background study requirements under chapter 245C.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 6.

Minnesota Statutes 2019 Supplement, section 245A.40, subdivision 7, is amended
to read:

Subd. 7.

In-service.

(a) A license holder must ensure that the center director, staff
persons, substitutes, and unsupervised volunteers complete in-service training each calendar
year.

(b) The center director and staff persons who work more than 20 hours per week must
complete 24 hours of in-service training each calendar year. Staff persons who work 20
hours or less per week must complete 12 hours of in-service training each calendar year.
Substitutes and unsupervised volunteers must complete the requirements of paragraphs deleted text begin (e)
to (h) deleted text end new text begin (d) to (g) new text end and do not otherwise have a minimum number of hours of training to
complete.

(c) The number of in-service training hours may be prorated for individuals not employed
for an entire year.

(d) Each year, in-service training must include:

(1) the center's procedures for maintaining health and safety according to section 245A.41
and Minnesota Rules, part 9503.0140, and handling emergencies and accidents according
to Minnesota Rules, part 9503.0110;

(2) the reporting responsibilities under section 626.556 and Minnesota Rules, part
9503.0130;

(3) at least one-half hour of training on the standards under section 245A.1435 and on
reducing the risk of sudden unexpected infant death as required under subdivision 5, if
applicable; and

(4) at least one-half hour of training on the risk of abusive head trauma from shaking
infants and young children as required under subdivision 5a, if applicable.

(e) Each year, or when a change is made, whichever is more frequent, in-service training
must be provided on: (1) the center's risk reduction plan under section 245A.66, subdivision
2; and (2) a child's individual child care program plan as required under Minnesota Rules,
part 9503.0065, subpart 3.

(f) At least once every two calendar years, the in-service training must include:

(1) child development and learning training under subdivision 2;

(2) pediatric first aid that meets the requirements of subdivision 3;

(3) pediatric cardiopulmonary resuscitation training that meets the requirements of
subdivision 4;

(4) cultural dynamics training to increase awareness of cultural differences; and

(5) disabilities training to increase awareness of differing abilities of children.

(g) At least once every five years, in-service training must include child passenger
restraint training that meets the requirements of subdivision 6, if applicable.

(h) The remaining hours of the in-service training requirement must be met by completing
training in the following content areas of the Minnesota Knowledge and Competency
Framework:

(1) Content area I: child development and learning;

(2) Content area II: developmentally appropriate learning experiences;

(3) Content area III: relationships with families;

(4) Content area IV: assessment, evaluation, and individualization;

(5) Content area V: historical and contemporary development of early childhood
education;

(6) Content area VI: professionalism;

(7) Content area VII: health, safety, and nutrition; and

(8) Content area VIII: application through clinical experiences.

(i) For purposes of this subdivision, the following terms have the meanings given them.

(1) "Child development and learning training" means training in understanding how
children develop physically, cognitively, emotionally, and socially and learn as part of the
children's family, culture, and community.

(2) "Developmentally appropriate learning experiences" means creating positive learning
experiences, promoting cognitive development, promoting social and emotional development,
promoting physical development, and promoting creative development.

(3) "Relationships with families" means training on building a positive, respectful
relationship with the child's family.

(4) "Assessment, evaluation, and individualization" means training in observing,
recording, and assessing development; assessing and using information to plan; and assessing
and using information to enhance and maintain program quality.

(5) "Historical and contemporary development of early childhood education" means
training in past and current practices in early childhood education and how current events
and issues affect children, families, and programs.

(6) "Professionalism" means training in knowledge, skills, and abilities that promote
ongoing professional development.

(7) "Health, safety, and nutrition" means training in establishing health practices, ensuring
safety, and providing healthy nutrition.

(8) "Application through clinical experiences" means clinical experiences in which a
person applies effective teaching practices using a range of educational programming models.

(j) The license holder must ensure that documentation, as required in subdivision 10,
includes the number of total training hours required to be completed, name of the training,
the Minnesota Knowledge and Competency Framework content area, number of hours
completed, and the director's approval of the training.

(k) In-service training completed by a staff person that is not specific to that child care
center is transferable upon a staff person's change in employment to another child care
program.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 7.

Minnesota Statutes 2018, section 245D.04, subdivision 3, is amended to read:

Subd. 3.

Protection-related rights.

(a) A person's protection-related rights include the
right to:

(1) have personal, financial, service, health, and medical information kept private, and
be advised of disclosure of this information by the license holder;

(2) access records and recorded information about the person in accordance with
applicable state and federal law, regulation, or rule;

(3) be free from maltreatment;

(4) be free from restraint, time out, seclusion, restrictive intervention, or other prohibited
procedure identified in section 245D.06, subdivision 5, or successor provisions, except for:
(i) emergency use of manual restraint to protect the person from imminent danger to self
or others according to the requirements in section 245D.061 or successor provisions; or (ii)
the use of safety interventions as part of a positive support transition plan under section
245D.06, subdivision 8, or successor provisions;

(5) receive services in a clean and safe environment when the license holder is the owner,
lessor, or tenant of the service site;

(6) be treated with courtesy and respect and receive respectful treatment of the person's
property;

(7) reasonable observance of cultural and ethnic practice and religion;

(8) be free from bias and harassment regarding race, gender, age, disability, spirituality,
and sexual orientation;

(9) be informed of and use the license holder's grievance policy and procedures, including
knowing how to contact persons responsible for addressing problems and to appeal under
section 256.045;

(10) know the name, telephone number, and the website, e-mail, and street addresses of
protection and advocacy services, including the appropriate state-appointed ombudsman,
and a brief description of how to file a complaint with these offices;

(11) assert these rights personally, or have them asserted by the person's family,
authorized representative, or legal representative, without retaliation;

(12) give or withhold written informed consent to participate in any research or
experimental treatment;

(13) associate with other persons of the person's choice new text begin , in the community new text end ;

(14) personal privacy, including the right to use the lock on the person's bedroom or unit
door;

(15) engage in chosen activities; and

(16) access to the person's personal possessions at any time, including financial resources.

(b) For a person residing in a residential site licensed according to chapter 245A, or
where the license holder is the owner, lessor, or tenant of the residential service site,
protection-related rights also include the right to:

(1) have daily, private access to and use of a non-coin-operated telephone for local calls
and long-distance calls made collect or paid for by the person;

(2) receive and send, without interference, uncensored, unopened mail or electronic
correspondence or communication;

(3) have use of and free access to common areas in the residence and the freedom to
come and go from the residence at will;

(4) choose the person's visitors and time of visits and have privacy for visits with the
person's spouse, next of kin, legal counsel, religious adviser, or others, in accordance with
section 363A.09 of the Human Rights Act, including privacy in the person's bedroom;

(5) have access to three nutritionally balanced meals and nutritious snacks between
meals each day;

(6) have freedom and support to access food and potable water at any time;

(7) have the freedom to furnish and decorate the person's bedroom or living unit;

(8) a setting that is clean and free from accumulation of dirt, grease, garbage, peeling
paint, mold, vermin, and insects;

(9) a setting that is free from hazards that threaten the person's health or safety; and

(10) a setting that meets the definition of a dwelling unit within a residential occupancy
as defined in the State Fire Code.

(c) Restriction of a person's rights under paragraph (a), clauses (13) to (16), or paragraph
(b) is allowed only if determined necessary to ensure the health, safety, and well-being of
the person. Any restriction of those rights must be documented in the person's coordinated
service and support plan or coordinated service and support plan addendum. The restriction
must be implemented in the least restrictive alternative manner necessary to protect the
person and provide support to reduce or eliminate the need for the restriction in the most
integrated setting and inclusive manner. The documentation must include the following
information:

(1) the justification for the restriction based on an assessment of the person's vulnerability
related to exercising the right without restriction;

(2) the objective measures set as conditions for ending the restriction;

(3) a schedule for reviewing the need for the restriction based on the conditions for
ending the restriction to occur semiannually from the date of initial approval, at a minimum,
or more frequently if requested by the person, the person's legal representative, if any, and
case manager; and

(4) signed and dated approval for the restriction from the person, or the person's legal
representative, if any. A restriction may be implemented only when the required approval
has been obtained. Approval may be withdrawn at any time. If approval is withdrawn, the
right must be immediately and fully restored.

Sec. 8.

Minnesota Statutes 2018, section 245D.10, subdivision 3a, is amended to read:

Subd. 3a.

Service termination.

(a) The license holder must establish policies and
procedures for service termination that promote continuity of care and service coordination
with the person and the case manager and with other licensed caregivers, if any, who also
provide support to the person. The policy must include the requirements specified in
paragraphs (b) to (f).

(b) The license holder must permit each person to remain in the program and must not
terminate services unless:

(1) the termination is necessary for the person's welfare and the new text begin facility cannot meet the new text end
person's needs deleted text begin cannot be met in the facility deleted text end ;

(2) the safety of the person or others in the program is endangered and positive support
strategies were attempted and have not achieved and effectively maintained safety for the
person or others;

(3) the health of the person or others in the program would otherwise be endangered;

(4) the program has not been paid for services;

(5) the program ceases to operate; deleted text begin or
deleted text end

(6) the person has been terminated by the lead agency from waiver eligibility deleted text begin . deleted text end new text begin ; or
new text end

new text begin (7) for state-operated community-based services, the person no longer demonstrates
complex behavioral needs that cannot be met by private community-based providers
identified in section 252.50, subdivision 5, paragraph (a), clause (1).
new text end

(c) Prior to giving notice of service termination, the license holder must document actions
taken to minimize or eliminate the need for termination. Action taken by the license holder
must include, at a minimum:

(1) consultation with the person's support team or expanded support team to identify
and resolve issues leading to issuance of the new text begin termination new text end notice; deleted text begin and
deleted text end

(2) a request to the case manager for intervention services identified in section 245D.03,
subdivision 1, paragraph (c), clause (1), or other professional consultation or intervention
services to support the person in the program. This requirement does not apply to notices
of service termination issued under paragraph (b), deleted text begin clause (4). deleted text end new text begin clauses (4) and (7); and
new text end

new text begin (3) consultation with the person's support team or expanded support team to identify
that the person no longer demonstrates complex behavioral needs that cannot be met by
private community-based providers identified in section 252.50, subdivision 5, paragraph
(a), clause (1).
new text end

If, based on the best interests of the person, the circumstances at the time of the notice were
such that the license holder was unable to take the action specified in clauses (1) and (2),
the license holder must document the specific circumstances and the reason for being unable
to do so.

(d) The notice of service termination must meet the following requirements:

(1) the license holder must notify the person or the person's legal representative and the
case manager in writing of the intended service termination. If the service termination is
from residential supports and services as defined in section 245D.03, subdivision 1, paragraph
(c), clause (3), the license holder must also notify the commissioner in writing; and

(2) the notice must include:

(i) the reason for the action;

(ii) except for a service termination under paragraph (b), clause (5), a summary of actions
taken to minimize or eliminate the need for service termination or temporary service
suspension as required under paragraph (c), and why these measures failed to prevent the
termination or suspension;

(iii) the person's right to appeal the termination of services under section 256.045,
subdivision 3, paragraph (a); and

(iv) the person's right to seek a temporary order staying the termination of services
according to the procedures in section 256.045, subdivision 4a or 6, paragraph (c).

(e) Notice of the proposed termination of service, including those situations that began
with a temporary service suspension, must be given at least 60 days prior to termination
when a license holder is providing intensive supports and services identified in section
245D.03, subdivision 1, paragraph (c), new text begin 90 days prior to termination of services under section
245D.10, subdivision 3a, paragraph (b), clause (7), new text end and 30 days prior to termination for all
other services licensed under this chapter. This notice may be given in conjunction with a
notice of temporary service suspension under subdivision 3.

(f) During the service termination notice period, the license holder must:

(1) work with the support team or expanded support team to develop reasonable
alternatives to protect the person and others and to support continuity of care;

(2) provide information requested by the person or case manager; and

(3) maintain information about the service termination, including the written notice of
intended service termination, in the service recipient record.

Sec. 9.

Minnesota Statutes 2018, section 245F.02, subdivision 7, is amended to read:

Subd. 7.

Clinically managed program.

"Clinically managed program" means a
residential setting with staff comprised of a medical director and a licensed practical nurse.
A licensed practical nurse must be on site 24 hours a day, seven days a week. A deleted text begin qualified
medical professional deleted text end new text begin licensed practitioner new text end must be available by telephone or in person for
consultation 24 hours a day. Patients admitted to this level of service receive medical
observation, evaluation, and stabilization services during the detoxification process; access
to medications administered by trained, licensed staff to manage withdrawal; and a
comprehensive assessment pursuant to section deleted text begin 245G.05 deleted text end new text begin 245F.06 new text end .

Sec. 10.

Minnesota Statutes 2018, section 245F.02, subdivision 14, is amended to read:

Subd. 14.

Medically monitored program.

"Medically monitored program" means a
residential setting with staff that includes a registered nurse and a medical director. A
registered nurse must be on site 24 hours a day. A deleted text begin medical director deleted text end new text begin licensed practitioner new text end
must be deleted text begin on site deleted text end new text begin available new text end seven days a week, and patients must have the ability to be seen
by a deleted text begin medical director deleted text end new text begin licensed practitioner new text end within 24 hours. Patients admitted to this level
of service receive medical observation, evaluation, and stabilization services during the
detoxification process; medications administered by trained, licensed staff to manage
withdrawal; and a comprehensive assessment pursuant to deleted text begin Minnesota Rules, part 9530.6422 deleted text end new text begin
section 245F.06 new text end .

Sec. 11.

Minnesota Statutes 2018, section 245F.06, subdivision 2, is amended to read:

Subd. 2.

Comprehensive assessment new text begin and assessment summary new text end .

(a) Prior to a medically
stable discharge, but not later than 72 hours following admission, a license holder must
provide a comprehensive assessment new text begin and assessment summary new text end according to sections
245.4863, paragraph (a), and 245G.05, for each patient who has a positive screening for a
substance use disorder. If a patient's medical condition prevents a comprehensive assessment
from being completed within 72 hours, the license holder must document why the assessment
was not completed. The comprehensive assessment must include documentation of the
appropriateness of an involuntary referral through the civil commitment process.

(b) If available to the program, a patient's previous comprehensive assessment may be
used in the patient record. If a previously completed comprehensive assessment is used, its
contents must be reviewed to ensure the assessment is accurate and current and complies
with the requirements of this chapter. The review must be completed by a staff person
qualified according to section 245G.11, subdivision 5. The license holder must document
that the review was completed and that the previously completed assessment is accurate
and current, or the license holder must complete an updated or new assessment.

Sec. 12.

Minnesota Statutes 2018, section 245F.12, subdivision 2, is amended to read:

Subd. 2.

Services provided at clinically managed programs.

In addition to the services
listed in subdivision 1, clinically managed programs must:

(1) have a licensed practical nurse on site 24 hours a day and a medical director;

(2) provide an initial health assessment conducted by a nurse upon admission;

(3) provide daily on-site medical evaluation by a nurse;

(4) have a registered nurse available by telephone or in person for consultation 24 hours
a day;

(5) have a deleted text begin qualified medical professional deleted text end new text begin licensed practitioner new text end available by telephone
or in person for consultation 24 hours a day; and

(6) have appropriately licensed staff available to administer medications according to
prescriber-approved orders.

Sec. 13.

Minnesota Statutes 2018, section 245F.12, subdivision 3, is amended to read:

Subd. 3.

Services provided at medically monitored programs.

In addition to the
services listed in subdivision 1, medically monitored programs must have a registered nurse
on site 24 hours a day and a medical director. Medically monitored programs must provide
intensive inpatient withdrawal management services which must include:

(1) an initial health assessment conducted by a registered nurse upon admission;

(2) the availability of a medical evaluation and consultation with a registered nurse 24
hours a day;

(3) the availability of a deleted text begin qualified medical professional deleted text end new text begin licensed practitioner new text end by telephone
or in person for consultation 24 hours a day;

(4) the ability to be seen within 24 hours or sooner by a deleted text begin qualified medical professional deleted text end new text begin
licensed practitioner new text end if the initial health assessment indicates the need to be seen;

(5) the availability of on-site monitoring of patient care seven days a week by a deleted text begin qualified
medical professional deleted text end new text begin licensed practitioner new text end ; and

(6) appropriately licensed staff available to administer medications according to
prescriber-approved orders.

Sec. 14.

Minnesota Statutes 2018, section 245G.02, subdivision 2, is amended to read:

Subd. 2.

Exemption from license requirement.

This chapter does not apply to a county
or recovery community organization that is providing a service for which the county or
recovery community organization is an eligible vendor under section 254B.05. This chapter
does not apply to an organization whose primary functions are information, referral,
diagnosis, case management, and assessment for the purposes of client placement, education,
support group services, or self-help programs. This chapter does not apply to the activities
of a licensed professional in private practice. new text begin A license holder providing the initial set of
substance use disorder services allowable under section 254A.03, subdivision 3, paragraph
(c), to an individual referred to a licensed nonresidential substance use disorder treatment
program after a positive screen for alcohol or substance misuse is exempt from sections
245G.05; 245G.06, subdivisions 1, 2, and 4; 245G.07, subdivisions 1, paragraph (a), clauses
(2) to (4), and 2, clauses (1) to (7); and 245G.17.
new text end

Sec. 15.

Minnesota Statutes 2018, section 245G.09, subdivision 1, is amended to read:

Subdivision 1.

Client records required.

(a) A license holder must maintain a file of
current and accurate client records on the premises where the treatment service is provided
or coordinated. For services provided off site, client records must be available at the program
and adhere to the same clinical and administrative policies and procedures as services
provided on site. The content and format of client records must be uniform and entries in
each record must be signed and dated by the staff member making the entry. Client records
must be protected against loss, tampering, or unauthorized disclosure according to section
254A.09, chapter 13, and Code of Federal Regulations, title 42, chapter 1, part 2, subpart
B, sections 2.1 to 2.67, and title 45, parts 160 to 164.

(b) The program must have a policy and procedure that identifies how the program will
track and record client attendance at treatment activities, including the date, duration, and
nature of each treatment service provided to the client.

new text begin (c) The program must identify in the client record designation of an individual who is
receiving services under section 254A.03, subdivision 3, including the start date and end
date of services eligible under section 254A.03, subdivision 3.
new text end

Sec. 16.

Minnesota Statutes 2018, section 245H.08, subdivision 4, is amended to read:

Subd. 4.

Maximum group size.

(a) For a child six weeks old through 16 months old,
the maximum group size shall be no more than eight children.

(b) For a child 16 months old through 33 months old, the maximum group size shall be
no more than 14 children.

(c) For a child 33 months old through prekindergarten, a maximum group size shall be
no more than 20 children.

(d) For a child in kindergarten through 13 years old, a maximum group size shall be no
more than 30 children.

(e) The maximum group size applies at all times except during group activity coordination
time not exceeding 15 minutes, during a meal, outdoor activity, field trip, nap and rest, and
special activity including a film, guest speaker, indoor large muscle activity, or holiday
program.

new text begin (f) Notwithstanding paragraph (d), a certified center may continue to serve a child older
than 13 years if one of the following conditions is true:
new text end

new text begin (1) the child remains eligible for child care assistance under section 119B.09, subdivision
1, paragraph (e); or
new text end

new text begin (2) the certified center serves children in a middle-school-only program, defined as
grades 6 through 8.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 17.

Minnesota Statutes 2018, section 245H.08, subdivision 5, is amended to read:

Subd. 5.

Ratios.

(a) The minimally acceptable staff-to-child ratios are:

six weeks old through 16 months old	1:4
16 months old through 33 months old	1:7
33 months old through prekindergarten	1:10
kindergarten through 13 years old	1:15

(b) Kindergarten includes a child of sufficient age to have attended the first day of
kindergarten or who is eligible to enter kindergarten within the next four months.

(c) For mixed groups, the ratio for the age group of the youngest child applies.

new text begin (d) Notwithstanding paragraph (a), a certified center may continue to serve a child older
than 13 years if one of the following conditions is true:
new text end

new text begin (1) the child remains eligible for child care assistance under section 119B.09, subdivision
1, paragraph (e); or
new text end

new text begin (2) the certified center serves children in a middle-school-only program, defined as
grades 6 through 8.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 18.

Minnesota Statutes 2019 Supplement, section 254A.03, subdivision 3, as amended
by Laws 2020, chapter 74, article 3, section 3, is amended to read:

Subd. 3.

Rules for substance use disorder care.

(a) The commissioner of human
services shall establish by rule criteria to be used in determining the appropriate level of
chemical dependency care for each recipient of public assistance seeking treatment for
substance misuse or substance use disorder. Upon federal approval of a comprehensive
assessment as a Medicaid benefit, or on July 1, 2018, whichever is later, and notwithstanding
the criteria in Minnesota Rules, parts 9530.6600 to 9530.6655, an eligible vendor of
comprehensive assessments under section 254B.05 may determine and approve the
appropriate level of substance use disorder treatment for a recipient of public assistance.
The process for determining an individual's financial eligibility for the consolidated chemical
dependency treatment fund or determining an individual's enrollment in or eligibility for a
publicly subsidized health plan is not affected by the individual's choice to access a
comprehensive assessment for placement.

(b) The commissioner shall develop and implement a utilization review process for
publicly funded treatment placements to monitor and review the clinical appropriateness
and timeliness of all publicly funded placements in treatment.

(c) If a screen result is positive for alcohol or substance misuse, a brief screening for
alcohol or substance use disorder that is provided to a recipient of public assistance within
a primary care clinic, hospital, or other medical setting or school setting establishes medical
necessity and approval for an initial set of substance use disorder services identified in
section 254B.05, subdivision 5. The initial set of services approved for a recipient whose
screen result is positive may include any combination of up to four hours of individual or
group substance use disorder treatment, two hours of substance use disorder treatment
coordination, or two hours of substance use disorder peer support services provided by a
qualified individual according to chapter 245G. A recipient must obtain an assessment
pursuant to paragraph (a) to be approved for additional treatment services new text begin . Minnesota Rules,
parts 9530.6600 to 9530.6655, and a comprehensive assessment pursuant to section 245G.05
are not applicable to the initial set of services allowed under this subdivision. A positive
screen result establishes eligibility for the initial set of services allowed under this
subdivision new text end .

(d) Notwithstanding Minnesota Rules, parts 9530.6600 to 9530.6655, an individual may
choose to obtain a comprehensive assessment as provided in section 245G.05. Individuals
obtaining a comprehensive assessment may access any enrolled provider that is licensed to
provide the level of service authorized pursuant to section 254A.19, subdivision 3, paragraph
(d). If the individual is enrolled in a prepaid health plan, the individual must comply with
any provider network requirements or limitations. This paragraph expires July 1, 2022.

Sec. 19.

Minnesota Statutes 2019 Supplement, section 254B.05, subdivision 1, is amended
to read:

Subdivision 1.

Licensure required.

(a) Programs licensed by the commissioner are
eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors,
notwithstanding the provisions of section 245A.03. American Indian programs that provide
substance use disorder treatment, extended care, transitional residence, or outpatient treatment
services, and are licensed by tribal government are eligible vendors.

(b) A licensed professional in private practice new text begin as defined in section 245G.01, subdivision
17, new text end who meets the requirements of section 245G.11, subdivisions 1 and 4, is an eligible
vendor of a comprehensive assessment and assessment summary provided according to
section 245G.05, and treatment services provided according to sections 245G.06 and
245G.07, subdivision 1, paragraphs (a), clauses (1) to (4), and (b); and subdivision 2.

(c) A county is an eligible vendor for a comprehensive assessment and assessment
summary when provided by an individual who meets the staffing credentials of section
245G.11, subdivisions 1 and 5, and completed according to the requirements of section
245G.05. A county is an eligible vendor of care coordination services when provided by an
individual who meets the staffing credentials of section 245G.11, subdivisions 1 and 7, and
provided according to the requirements of section 245G.07, subdivision 1, paragraph (a),
clause (5).

(d) A recovery community organization that meets certification requirements identified
by the commissioner is an eligible vendor of peer support services.

(e) Detoxification programs licensed under Minnesota Rules, parts 9530.6510 to
9530.6590, are not eligible vendors. Programs that are not licensed as a residential or
nonresidential substance use disorder treatment or withdrawal management program by the
commissioner or by tribal government or do not meet the requirements of subdivisions 1a
and 1b are not eligible vendors.

Sec. 20.

Minnesota Statutes 2018, section 256B.0625, subdivision 5l, is amended to read:

Subd. 5l.

Intensive mental health outpatient treatment.

Medical assistance covers
intensive mental health outpatient treatment for dialectical behavioral therapy deleted text begin for adults deleted text end .
The commissioner shall establish:

(1) certification procedures to ensure that providers of these services are qualified; and

(2) treatment protocols including required service components and criteria for admission,
continued treatment, and discharge.

Sec. 21.

Minnesota Statutes 2019 Supplement, section 256B.064, subdivision 2, is amended
to read:

Subd. 2.

Imposition of monetary recovery and sanctions.

(a) The commissioner shall
determine any monetary amounts to be recovered and sanctions to be imposed upon a vendor
of medical care under this section. Except as provided in paragraphs (b) and (d), neither a
monetary recovery nor a sanction will be imposed by the commissioner without prior notice
and an opportunity for a hearing, according to chapter 14, on the commissioner's proposed
action, provided that the commissioner may suspend or reduce payment to a vendor of
medical care, except a nursing home or convalescent care facility, after notice and prior to
the hearing if in the commissioner's opinion that action is necessary to protect the public
welfare and the interests of the program.

(b) Except when the commissioner finds good cause not to suspend payments under
Code of Federal Regulations, title 42, section 455.23 (e) or (f), the commissioner shall
withhold or reduce payments to a vendor of medical care without providing advance notice
of such withholding or reduction if either of the following occurs:

(1) the vendor is convicted of a crime involving the conduct described in subdivision
1a; or

(2) the commissioner determines there is a credible allegation of fraud for which an
investigation is pending under the program. A credible allegation of fraud is an allegation
which has been verified by the state, from any source, including but not limited to:

(i) fraud hotline complaints;

(ii) claims data mining; and

(iii) patterns identified through provider audits, civil false claims cases, and law
enforcement investigations.

Allegations are considered to be credible when they have an indicia of reliability and
the state agency has reviewed all allegations, facts, and evidence carefully and acts
judiciously on a case-by-case basis.

(c) The commissioner must send notice of the withholding or reduction of payments
under paragraph (b) within five days of taking such action unless requested in writing by a
law enforcement agency to temporarily withhold the notice. The notice must:

(1) state that payments are being withheld according to paragraph (b);

(2) set forth the general allegations as to the nature of the withholding action, but need
not disclose any specific information concerning an ongoing investigation;

(3) except in the case of a conviction for conduct described in subdivision 1a, state that
the withholding is for a temporary period and cite the circumstances under which withholding
will be terminated;

(4) identify the types of claims to which the withholding applies; and

(5) inform the vendor of the right to submit written evidence for consideration by the
commissioner.

The withholding or reduction of payments will not continue after the commissioner
determines there is insufficient evidence of fraud by the vendor, or after legal proceedings
relating to the alleged fraud are completed, unless the commissioner has sent notice of
intention to impose monetary recovery or sanctions under paragraph (a). Upon conviction
for a crime related to the provision, management, or administration of a health service under
medical assistance, a payment held pursuant to this section by the commissioner or a managed
care organization that contracts with the commissioner under section 256B.035 is forfeited
to the commissioner or managed care organization, regardless of the amount charged in the
criminal complaint or the amount of criminal restitution ordered.

(d) The commissioner shall suspend or terminate a vendor's participation in the program
without providing advance notice and an opportunity for a hearing when the suspension or
termination is required because of the vendor's exclusion from participation in Medicare.
Within five days of taking such action, the commissioner must send notice of the suspension
or termination. The notice must:

(1) state that suspension or termination is the result of the vendor's exclusion from
Medicare;

(2) identify the effective date of the suspension or termination; and

(3) inform the vendor of the need to be reinstated to Medicare before reapplying for
participation in the program.

(e) Upon receipt of a notice under paragraph (a) that a monetary recovery or sanction is
to be imposed, a vendor may request a contested case, as defined in section 14.02, subdivision
3, by filing with the commissioner a written request of appeal. The appeal request must be
received by the commissioner no later than 30 days after the date the notification of monetary
recovery or sanction was mailed to the vendor. The appeal request must specify:

(1) each disputed item, the reason for the dispute, and an estimate of the dollar amount
involved for each disputed item;

(2) the computation that the vendor believes is correct;

(3) the authority in statute or rule upon which the vendor relies for each disputed item;

(4) the name and address of the person or entity with whom contacts may be made
regarding the appeal; and

(5) other information required by the commissioner.

(f) The commissioner may order a vendor to forfeit a fine for failure to fully document
services according to standards in this chapter and Minnesota Rules, chapter 9505. The
commissioner may assess fines if specific required components of documentation are
missing. The fine for incomplete documentation shall equal 20 percent of the amount paid
on the claims for reimbursement submitted by the vendor, or up to $5,000, whichever is
less. If the commissioner determines that a vendor repeatedly violated this chapter new text begin , chapter
254B or 245G, new text end or Minnesota Rules, chapter 9505, related to the provision of services to
program recipients and the submission of claims for payment, the commissioner may order
a vendor to forfeit a fine based on the nature, severity, and chronicity of the violations, in
an amount of up to $5,000 or 20 percent of the value of the claims, whichever is greater.

(g) The vendor shall pay the fine assessed on or before the payment date specified. If
the vendor fails to pay the fine, the commissioner may withhold or reduce payments and
recover the amount of the fine. A timely appeal shall stay payment of the fine until the
commissioner issues a final order.

Sec. 22.

Minnesota Statutes 2018, section 256B.0652, subdivision 10, is amended to read:

Subd. 10.

Authorization for foster care setting.

(a) Home care services provided in
an adult or child foster care setting must receive authorization by the commissioner according
to the limits established in subdivision 11.

(b) The commissioner may not authorize:

(1) home care services that are the responsibility of the foster care provider under the
terms of the foster care placement agreement, deleted text begin difficulty of care rate as of January 1, 2010 deleted text end new text begin
assessment under sections 256N.24 and 260C.4411 new text end , and administrative rules;

(2) personal care assistance services when the foster care license holder is also the
personal care provider or personal care assistant, unless the foster home is the licensed
provider's primary residence as defined in section 256B.0625, subdivision 19a; or

(3) personal care assistant and home care nursing services when the licensed capacity
is greater than deleted text begin four deleted text end new text begin six, unless all conditions for a variance under section 245A.04,
subdivision 9a, are satisfied for a sibling, as defined in section 260C.007, subdivision 32 new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 23.

Minnesota Statutes 2018, section 256B.0949, subdivision 2, is amended to read:

Subd. 2.

Definitions.

(a) The terms used in this section have the meanings given in this
subdivision.

(b) "Agency" means the legal entity that is enrolled with Minnesota health care programs
as a medical assistance provider according to Minnesota Rules, part 9505.0195, to provide
EIDBI services and that has the legal responsibility to ensure that its employees or contractors
carry out the responsibilities defined in this section. Agency includes a licensed individual
professional who practices independently and acts as an agency.

(c) "Autism spectrum disorder or a related condition" or "ASD or a related condition"
means either autism spectrum disorder (ASD) as defined in the current version of the
Diagnostic and Statistical Manual of Mental Disorders (DSM) or a condition that is found
to be closely related to ASD, as identified under the current version of the DSM, and meets
all of the following criteria:

(1) is severe and chronic;

(2) results in impairment of adaptive behavior and function similar to that of a person
with ASD;

(3) requires treatment or services similar to those required for a person with ASD; and

(4) results in substantial functional limitations in three core developmental deficits of
ASD: social new text begin or interpersonal new text end interaction; new text begin functional communication, including new text end nonverbal
or social communication; and restrictive deleted text begin , deleted text end new text begin or new text end repetitive behaviors or hyperreactivity or
hyporeactivity to sensory input; and may include deficits or a high level of support in one
or more of the following domains:

(i) new text begin behavioral challenges and new text end self-regulation;

new text begin (ii) cognition;
new text end

new text begin (iii) learning and play;
new text end

deleted text begin (ii) deleted text end new text begin (iv) new text end self-care; new text begin or
new text end

deleted text begin (iii) behavioral challenges;
deleted text end

deleted text begin (iv) expressive communication;
deleted text end

deleted text begin (v) receptive communication;
deleted text end

deleted text begin (vi) cognitive functioning; or
deleted text end

deleted text begin (vii) deleted text end new text begin (v) new text end safety.

(d) "Person" means a person under 21 years of age.

(e) "Clinical supervision" means the overall responsibility for the control and direction
of EIDBI service delivery, including individual treatment planning, staff supervision,
individual treatment plan progress monitoring, and treatment review for each person. Clinical
supervision is provided by a qualified supervising professional (QSP) who takes full
professional responsibility for the service provided by each supervisee.

(f) "Commissioner" means the commissioner of human services, unless otherwise
specified.

(g) "Comprehensive multidisciplinary evaluation" or "CMDE" means a comprehensive
evaluation of a person to determine medical necessity for EIDBI services based on the
requirements in subdivision 5.

(h) "Department" means the Department of Human Services, unless otherwise specified.

(i) "Early intensive developmental and behavioral intervention benefit" or "EIDBI
benefit" means a variety of individualized, intensive treatment modalities approved new text begin and
published new text end by the commissioner that are based in behavioral and developmental science
consistent with best practices on effectiveness.

(j) "Generalizable goals" means results or gains that are observed during a variety of
activities over time with different people, such as providers, family members, other adults,
and people, and in different environments including, but not limited to, clinics, homes,
schools, and the community.

(k) "Incident" means when any of the following occur:

(1) an illness, accident, or injury that requires first aid treatment;

(2) a bump or blow to the head; or

(3) an unusual or unexpected event that jeopardizes the safety of a person or staff,
including a person leaving the agency unattended.

(l) "Individual treatment plan" or "ITP" means the person-centered, individualized written
plan of care that integrates and coordinates person and family information from the CMDE
for a person who meets medical necessity for the EIDBI benefit. An individual treatment
plan must meet the standards in subdivision 6.

(m) "Legal representative" means the parent of a child who is under 18 years of age, a
court-appointed guardian, or other representative with legal authority to make decisions
about service for a person. For the purpose of this subdivision, "other representative with
legal authority to make decisions" includes a health care agent or an attorney-in-fact
authorized through a health care directive or power of attorney.

(n) "Mental health professional" has the meaning given in section 245.4871, subdivision
27, clauses (1) to (6).

(o) "Person-centered" means a service that both responds to the identified needs, interests,
values, preferences, and desired outcomes of the person or the person's legal representative
and respects the person's history, dignity, and cultural background and allows inclusion and
participation in the person's community.

(p) "Qualified EIDBI provider" means a person who is a QSP or a level I, level II, or
level III treatment provider.

Sec. 24.

Minnesota Statutes 2018, section 256B.0949, subdivision 5, is amended to read:

Subd. 5.

Comprehensive multidisciplinary evaluation.

(a) A CMDE must be completed
to determine medical necessity of EIDBI services. For the commissioner to authorize EIDBI
services, the CMDE provider must submit the CMDE to the commissioner and the person
or the person's legal representative as determined by the commissioner. Information and
assessments must be performed, reviewed, and relied upon for the eligibility determination,
treatment and services recommendations, and treatment plan development for the person.

new text begin (b) The CMDE provider must review the diagnostic assessment to confirm the person
has an eligible diagnosis and the diagnostic assessment meets standards required under
subdivision 4. If the CMDE provider elects to complete the diagnostic assessment at the
same time as the CMDE, the CMDE provider must certify that the CMDE meets all standards
as required under subdivision 4.
new text end

deleted text begin (b) deleted text end new text begin (c) new text end The CMDE must:

(1) include an assessment of the person's developmental skills, functional behavior,
needs, and capacities based on direct observation of the person which must be administered
by a CMDE provider, include medical or assessment information from the person's physician
or advanced practice registered nurse, and may also include input from family members,
school personnel, child care providers, or other caregivers, as well as any medical or
assessment information from other licensed professionals such as rehabilitation or habilitation
therapists, licensed school personnel, or mental health professionals;

(2) include and document the person's legal representative's or primary caregiver's
preferences for involvement in the person's treatment; and

(3) provide information about the range of current EIDBI treatment modalities recognized
by the commissioner.

Sec. 25.

Minnesota Statutes 2018, section 256B.0949, subdivision 6, is amended to read:

Subd. 6.

Individual treatment plan.

(a) The QSP, level I treatment provider, or level
II treatment provider who integrates and coordinates person and family information from
the CMDE and ITP progress monitoring process to develop the ITP must develop and
monitor the ITP.

(b) Each person's ITP must be:

(1) culturally and linguistically appropriate, as required under subdivision 3a,
individualized, and person-centered; and

(2) based on the diagnosis and CMDE information specified in subdivisions 4 and 5.

(c) The ITP must specify:

(1) the medically necessary treatment and service;

(2) the treatment modality that shall be used to meet the goals and objectives, including:

(i) baseline measures and projected dates of accomplishment;

(ii) the frequency, intensity, location, and duration of each service provided;

(iii) the level of legal representative or primary caregiver training and counseling;

(iv) any change or modification to the physical and social environments necessary to
provide a service;

(v) significant changes in the person's condition or family circumstance;

deleted text begin (vi) any specialized equipment or material required;
deleted text end

deleted text begin (vii) deleted text end new text begin (vi) new text end techniques that support and are consistent with the person's communication
mode and learning style;

deleted text begin (viii) deleted text end new text begin (vii) new text end the name of the QSP; and

deleted text begin (ix) deleted text end new text begin (viii) new text end progress monitoring results and goal mastery data; and

(3) the discharge criteria that deleted text begin shall deleted text end new text begin must new text end be used and a defined transition plan that meets
the requirement of paragraph (g).

(d) Implementation of the ITP must be supervised by a QSP.

(e) The ITP must be submitted to the commissioner and the person or the person's legal
representative for approval in a manner determined by the commissioner for this purpose.

(f) A service included in the ITP must meet all applicable requirements for medical
necessity and coverage.

(g) To terminate service, the provider must send notice of termination to the person or
the person's legal representative. The transition period begins when the person or the person's
legal representative receives notice of termination from the EIDBI service and ends when
the EIDBI service is terminated. Up to 30 days of continued service is allowed during the
transition period. Services during the transition period shall be consistent with the ITP. The
transition plan deleted text begin shall deleted text end new text begin must new text end include:

(1) protocols for changing service when medically necessary;

(2) how the transition will occur;

(3) the time allowed to make the transition; and

(4) a description of how the person or the person's legal representative will be informed
of and involved in the transition.

Sec. 26.

Minnesota Statutes 2018, section 256B.0949, subdivision 9, is amended to read:

Subd. 9.

Revision of treatment options.

(a) The commissioner may revise covered
treatment deleted text begin options deleted text end new text begin modalities new text end as needed based on outcome data and other evidence. EIDBI
treatment modalities approved by the department must:

(1) cause no harm to the person or the person's family;

(2) be individualized and person-centered;

(3) be developmentally appropriate and highly structured, with well-defined goals and
objectives that provide a strategic direction for treatment;

(4) be based in recognized principles of developmental and behavioral science;

(5) utilize sound practices that are replicable across providers and maintain the fidelity
of the specific modality;

(6) demonstrate an evidentiary basis;

(7) have goals and objectives that are measurable, achievable, and regularly evaluated
and adjusted to ensure that adequate progress is being made;

(8) be provided intensively with a high staff-to-person ratio; and

(9) include participation by the person and the person's legal representative in decision
making, knowledge building and capacity building, and developing and implementing the
person's ITP.

(b) Before revisions in department recognized treatment modalities become effective,
the commissioner must provide public notice of the changes, the reasons for the change,
and a 30-day public comment period to those who request notice through an electronic list
accessible to the public on the department's website.

Sec. 27.

Minnesota Statutes 2018, section 256B.0949, subdivision 13, is amended to read:

Subd. 13.

Covered services.

(a) The services described in paragraphs (b) to (i) are
eligible for reimbursement by medical assistance under this section. Services must be
provided by a qualified EIDBI provider and supervised by a QSP. An EIDBI service must
address the person's medically necessary treatment goals and must be targeted to develop,
enhance, or maintain the individual developmental skills of a person with ASD or a related
condition to improve functional communication, new text begin including nonverbal or social
communication, new text end social or interpersonal interaction, new text begin restrictive or repetitive behaviors,
hyperreactivity or hyporeactivity to sensory input, new text end behavioral challenges and self-regulation,
cognition, learning and play, self-care, and safety.

(b) EIDBI deleted text begin modalities include, but are not limited to: deleted text end new text begin treatment must be delivered
consistent with the standards of an approved modality, as published by the commissioner.
EIDBI modalities include:
new text end

(1) applied behavior analysis (ABA);

(2) developmental individual-difference relationship-based model (DIR/Floortime);

(3) early start Denver model (ESDM);

(4) PLAY project; deleted text begin or
deleted text end

(5) relationship development intervention (RDI) deleted text begin . deleted text end new text begin ; or
new text end

new text begin (6) additional modalities not listed in clauses (1) to (5) upon approval by the
commissioner.
new text end

(c) An EIDBI provider may use one or more of the EIDBI modalities in paragraph (b),
clauses (1) to (5), as the primary modality for treatment as a covered service, or several
EIDBI modalities in combination as the primary modality of treatment, as approved by the
commissioner. An EIDBI provider that identifies and provides assurance of qualifications
for a single specific treatment modality must document the required qualifications to meet
fidelity to the specific model. deleted text begin Additional EIDBI modalities not listed in paragraph (b) may
deleted text end deleted text begin be covered upon approval by the commissioner.
deleted text end

new text begin (d) Each qualified EIDBI provider must identify and provide assurance of qualifications
for professional licensure certification, or training in evidence-based treatment methods,
and must document the required qualifications outlined in subdivision 15 in a manner
determined by the commissioner.
new text end

deleted text begin (d) deleted text end new text begin (e) new text end CMDE is a comprehensive evaluation of the person's developmental status to
determine medical necessity for EIDBI services and meets the requirements of subdivision
5. The services must be provided by a qualified CMDE provider.

deleted text begin (e) deleted text end new text begin (f) new text end EIDBI intervention observation and direction is the clinical direction and oversight
of EIDBI services by the QSP, level I treatment provider, or level II treatment provider,
including developmental and behavioral techniques, progress measurement, data collection,
function of behaviors, and generalization of acquired skills for the direct benefit of a person.
EIDBI intervention observation and direction informs any modification of the deleted text begin methods deleted text end new text begin
current treatment protocol new text end to support the outcomes new text begin outlined new text end in the ITP. deleted text begin EIDBI intervention
observation and direction provides a real-time response to EIDBI interventions to maximize
the benefit to the person.
deleted text end

new text begin (g) Intervention is medically necessary direct treatment provided to a person with ASD
or a related condition as outlined in their ITP. All intervention services must be provided
under the direction of a QSP. Intervention may take place across multiple settings. The
frequency and intensity of intervention services are provided based on the number of
treatment goals, person and family or caregiver preferences, and other factors. Intervention
services may be provided individually or in a group. Intervention with a higher provider
ratio may occur when deemed medically necessary through the person's ITP.
new text end

new text begin (1) Individual intervention is treatment by protocol administered by a single qualified
EIDBI provider delivered face-to-face to one person.
new text end

new text begin (2) Group intervention is treatment by protocol provided by one or more qualified EIDBI
providers, delivered to at least two people who receive EIDBI services.
new text end

deleted text begin (f) deleted text end new text begin (h) new text end ITP development and ITP progress monitoring is development of the initial,
annual, and progress monitoring of an ITP. ITP development and ITP progress monitoring
documents deleted text begin , provides deleted text end new text begin provide new text end oversight and ongoing evaluation of a person's treatment and
progress on targeted goals and objectives deleted text begin , deleted text end and deleted text begin integrates deleted text end new text begin integrate new text end and deleted text begin coordinates deleted text end new text begin coordinate new text end
the person's and the person's legal representative's information from the CMDE and ITP
progress monitoring. This service must be reviewed and completed by the QSP, and may
include input from a level I deleted text begin treatment deleted text end provider or a level II deleted text begin treatment deleted text end provider.

deleted text begin (g) deleted text end new text begin (i) new text end Family caregiver training and counseling is specialized training and education
for a family or primary caregiver to understand the person's developmental status and help
with the person's needs and development. This service must be provided by the QSP, level
I deleted text begin treatment deleted text end provider, or level II deleted text begin treatment deleted text end provider.

deleted text begin (h) deleted text end new text begin (j) new text end A coordinated care conference is a voluntary face-to-face meeting with the person
and the person's family to review the CMDE or ITP progress monitoring and to integrate
and coordinate services across providers and service-delivery systems to develop the ITP.
This service must be provided by the QSP and may include the CMDE provider or a level
I deleted text begin treatment deleted text end provider or a level II deleted text begin treatment deleted text end provider.

deleted text begin (i) deleted text end new text begin (k) new text end Travel time is allowable billing for traveling to and from the person's home,
school, a community setting, or place of service outside of an EIDBI center, clinic, or office
from a specified location to provide face-to-face EIDBI intervention, observation and
direction, or family caregiver training and counseling. The person's ITP must specify the
reasons the provider must travel to the person.

deleted text begin (j) deleted text end new text begin (l) new text end Medical assistance covers medically necessary EIDBI services and consultations
delivered by a licensed health care provider via telemedicine, as defined under section
256B.0625, subdivision 3b, in the same manner as if the service or consultation was delivered
in person. deleted text begin Medical assistance coverage is limited to three telemedicine services per person
per calendar week.
deleted text end

Sec. 28.

Minnesota Statutes 2018, section 256B.0949, subdivision 14, is amended to read:

Subd. 14.

Person's rights.

A person or the person's legal representative has the right to:

(1) protection as defined under the health care bill of rights under section 144.651;

(2) designate an advocate to be present in all aspects of the person's and person's family's
services at the request of the person or the person's legal representative;

(3) be informed of the agency policy on assigning staff to a person;

(4) be informed of the opportunity to observe the person while receiving services;

(5) be informed of services in a manner that respects and takes into consideration the
person's and the person's legal representative's culture, values, and preferences in accordance
with subdivision 3a;

(6) be free from seclusion and restraint, except for emergency use of manual restraint
in emergencies as defined in section 245D.02, subdivision 8a;

(7) be under the supervision of a responsible adult at all times;

(8) be notified by the agency within 24 hours if an incident occurs or the person is injured
while receiving services, including what occurred and how agency staff responded to the
incident;

(9) request a voluntary coordinated care conference; deleted text begin and
deleted text end

(10) request a CMDE provider of the person's or the person's legal representative's
choice deleted text begin . deleted text end new text begin ; and
new text end

new text begin (11) be free of all prohibitions as defined in Minnesota Rules, part 9544.0060.
new text end

Sec. 29.

Minnesota Statutes 2018, section 256B.0949, subdivision 15, is amended to read:

Subd. 15.

EIDBI provider qualifications.

(a) A QSP must be employed by an agency
and be:

(1) a licensed mental health professional who has at least 2,000 hours of supervised
clinical experience or training in examining or treating people with ASD or a related condition
or equivalent documented coursework at the graduate level by an accredited university in
ASD diagnostics, ASD developmental and behavioral treatment strategies, and typical child
development; or

(2) a developmental or behavioral pediatrician who has at least 2,000 hours of supervised
clinical experience or training in examining or treating people with ASD or a related condition
or equivalent documented coursework at the graduate level by an accredited university in
the areas of ASD diagnostics, ASD developmental and behavioral treatment strategies, and
typical child development.

(b) A level I treatment provider must be employed by an agency and:

(1) have at least 2,000 hours of supervised clinical experience or training in examining
or treating people with ASD or a related condition or equivalent documented coursework
at the graduate level by an accredited university in ASD diagnostics, ASD developmental
and behavioral treatment strategies, and typical child development or an equivalent
combination of documented coursework or hours of experience; and

(2) have or be at least one of the following:

(i) a master's degree in behavioral health or child development or related fields including,
but not limited to, mental health, special education, social work, psychology, speech
pathology, or occupational therapy from an accredited college or university;

(ii) a bachelor's degree in a behavioral health, child development, or related field
including, but not limited to, mental health, special education, social work, psychology,
speech pathology, or occupational therapy, from an accredited college or university, and
advanced certification in a treatment modality recognized by the department;

(iii) a board-certified behavior analyst; or

(iv) a board-certified assistant behavior analyst with 4,000 hours of supervised clinical
experience that meets all registration, supervision, and continuing education requirements
of the certification.

(c) A level II treatment provider must be employed by an agency and must be:

(1) a person who has a bachelor's degree from an accredited college or university in a
behavioral or child development science or related field including, but not limited to, mental
health, special education, social work, psychology, speech pathology, or occupational
therapy; and deleted text begin meet deleted text end new text begin meets new text end at least one of the following:

(i) has at least 1,000 hours of supervised clinical experience or training in examining or
treating people with ASD or a related condition or equivalent documented coursework at
the graduate level by an accredited university in ASD diagnostics, ASD developmental and
behavioral treatment strategies, and typical child development or a combination of
coursework or hours of experience;

(ii) has certification as a board-certified assistant behavior analyst from the Behavior
Analyst Certification Board;

(iii) is a registered behavior technician as defined by the Behavior Analyst Certification
Board; or

(iv) is certified in one of the other treatment modalities recognized by the department;
or

(2) a person who has:

(i) an associate's degree in a behavioral or child development science or related field
including, but not limited to, mental health, special education, social work, psychology,
speech pathology, or occupational therapy from an accredited college or university; and

(ii) at least 2,000 hours of supervised clinical experience in delivering treatment to people
with ASD or a related condition. Hours worked as a mental health behavioral aide or level
III treatment provider may be included in the required hours of experience; or

(3) a person who has at least 4,000 hours of supervised clinical experience in delivering
treatment to people with ASD or a related condition. Hours worked as a mental health
behavioral aide or level III treatment provider may be included in the required hours of
experience; or

(4) a person who is a graduate student in a behavioral science, child development science,
or related field and is receiving clinical supervision by a QSP affiliated with an agency to
meet the clinical training requirements for experience and training with people with ASD
or a related condition; or

(5) a person who is at least 18 years of age and who:

(i) is fluent in a non-English language;

(ii) completed the level III EIDBI training requirements; and

(iii) receives observation and direction from a QSP or level I treatment provider at least
once a week until the person meets 1,000 hours of supervised clinical experience.

(d) A level III treatment provider must be employed by an agency, have completed the
level III training requirement, be at least 18 years of age, and have at least one of the
following:

(1) a high school diploma or commissioner of education-selected high school equivalency
certification;

(2) fluency in a non-English language; deleted text begin or
deleted text end

(3) one year of experience as a primary personal care assistant, community health worker,
waiver service provider, or special education assistant to a person with ASD or a related
condition within the previous five years deleted text begin . deleted text end new text begin ; or
new text end

new text begin (4) completion of all required EIDBI training within six months of employment.
new text end

Sec. 30.

Minnesota Statutes 2018, section 256B.0949, subdivision 16, is amended to read:

Subd. 16.

Agency duties.

(a) An agency delivering an EIDBI service under this section
must:

(1) enroll as a medical assistance Minnesota health care program provider according to
Minnesota Rules, part 9505.0195, and section 256B.04, subdivision 21, and meet all
applicable provider standards and requirements;

(2) demonstrate compliance with federal and state laws for EIDBI service;

(3) verify and maintain records of a service provided to the person or the person's legal
representative as required under Minnesota Rules, parts 9505.2175 and 9505.2197;

(4) demonstrate that while enrolled or seeking enrollment as a Minnesota health care
program provider the agency did not have a lead agency contract or provider agreement
discontinued because of a conviction of fraud; or did not have an owner, board member, or
manager fail a state or federal criminal background check or appear on the list of excluded
individuals or entities maintained by the federal Department of Human Services Office of
Inspector General;

(5) have established business practices including written policies and procedures, internal
controls, and a system that demonstrates the organization's ability to deliver quality EIDBI
services;

(6) have an office located in Minnesota new text begin or a border state new text end ;

(7) conduct a criminal background check on an individual who has direct contact with
the person or the person's legal representative;

(8) report maltreatment according to sections 626.556 and 626.557;

(9) comply with any data requests consistent with the Minnesota Government Data
Practices Act, sections 256B.064 and 256B.27;

(10) provide training for all agency staff on the requirements and responsibilities listed
in the Maltreatment of Minors Act, section 626.556, and the Vulnerable Adult Protection
Act, section 626.557, including mandated and voluntary reporting, nonretaliation, and the
agency's policy for all staff on how to report suspected abuse and neglect;

(11) have a written policy to resolve issues collaboratively with the person and the
person's legal representative when possible. The policy must include a timeline for when
the person and the person's legal representative will be notified about issues that arise in
the provision of services;

(12) provide the person's legal representative with prompt notification if the person is
injured while being served by the agency. An incident report must be completed by the
agency staff member in charge of the person. A copy of all incident and injury reports must
remain on file at the agency for at least five years from the report of the incident; and

(13) before starting a service, provide the person or the person's legal representative a
description of the treatment modality that the person shall receive, including the staffing
certification levels and training of the staff who shall provide a treatment.

(b) When delivering the ITP, and annually thereafter, an agency must provide the person
or the person's legal representative with:

(1) a written copy and a verbal explanation of the person's or person's legal
representative's rights and the agency's responsibilities;

(2) documentation in the person's file the date that the person or the person's legal
representative received a copy and explanation of the person's or person's legal
representative's rights and the agency's responsibilities; and

(3) reasonable accommodations to provide the information in another format or language
as needed to facilitate understanding of the person's or person's legal representative's rights
and the agency's responsibilities.

Sec. 31.

Minnesota Statutes 2018, section 256D.02, subdivision 17, is amended to read:

Subd. 17.

Professional certification.

"Professional certification" means a statement
about a person's illness, injury, or incapacity that is signed by a "qualified professional" as
defined in section deleted text begin 256J.08, subdivision 73a deleted text end new text begin 256P.01, subdivision 6a new text end .

Sec. 32.

Minnesota Statutes 2018, section 256I.03, subdivision 3, is amended to read:

Subd. 3.

Housing support.

"Housing support" means deleted text begin a group living situation deleted text end new text begin assistance new text end
that provides at a minimum room and board to deleted text begin unrelated deleted text end persons who meet the eligibility
requirements of section 256I.04. To receive payment for deleted text begin a group residence rate deleted text end new text begin housing
support new text end , the residence must meet the requirements under section 256I.04, subdivisions 2a
to 2f.

Sec. 33.

Minnesota Statutes 2018, section 256I.03, subdivision 14, is amended to read:

Subd. 14.

Qualified professional.

"Qualified professional" means an individual as
defined in section deleted text begin 256J.08, subdivision 73a, or deleted text end 245G.11, subdivision 3, 4, or 5 new text begin , or 256P.01,
subdivision 6a new text end ; or an individual approved by the director of human services or a designee
of the director.

Sec. 34.

Minnesota Statutes 2019 Supplement, section 256I.04, subdivision 2b, is amended
to read:

Subd. 2b.

Housing support agreements.

(a) Agreements between agencies and providers
of housing support must be in writing on a form developed and approved by the commissioner
and must specify the name and address under which the establishment subject to the
agreement does business and under which the establishment, or service provider, if different
from the deleted text begin group residential housing deleted text end establishment, is licensed by the Department of Health
or the Department of Human Services; the specific license or registration from the
Department of Health or the Department of Human Services held by the provider and the
number of beds subject to that license; the address of the location or locations at which
deleted text begin group residential deleted text end housing new text begin support new text end is provided under this agreement; the per diem and monthly
rates that are to be paid from housing support funds for each eligible resident at each location;
the number of beds at each location which are subject to the agreement; whether the license
holder is a not-for-profit corporation under section 501(c)(3) of the Internal Revenue Code;
and a statement that the agreement is subject to the provisions of sections 256I.01 to 256I.06
and subject to any changes to those sections.

(b) Providers are required to verify the following minimum requirements in the
agreement:

(1) current license or registration, including authorization if managing or monitoring
medications;

(2) all staff who have direct contact with recipients meet the staff qualifications;

(3) the provision of housing support;

(4) the provision of supplementary services, if applicable;

(5) reports of adverse events, including recipient death or serious injury;

(6) submission of residency requirements that could result in recipient eviction; and

(7) confirmation that the provider will not limit or restrict the number of hours an
applicant or recipient chooses to be employed, as specified in subdivision 5.

(c) Agreements may be terminated with or without cause by the commissioner, the
agency, or the provider with two calendar months prior notice. The commissioner may
immediately terminate an agreement under subdivision 2d.

Sec. 35.

Minnesota Statutes 2018, section 256I.05, subdivision 1c, is amended to read:

Subd. 1c.

Rate increases.

An agency may not increase the rates negotiated for housing
support above those in effect on June 30, 1993, except as provided in paragraphs (a) to (f).

(a) An agency may increase the rates for room and board to the MSA equivalent rate
for those settings whose current rate is below the MSA equivalent rate.

(b) An agency may increase the rates for residents in adult foster care whose difficulty
of care has increased. The total housing support rate for these residents must not exceed the
maximum rate specified in subdivisions 1 and 1a. Agencies must not include nor increase
difficulty of care rates for adults in foster care whose difficulty of care is eligible for funding
by home and community-based waiver programs under title XIX of the Social Security Act.

(c) The room and board rates will be increased each year when the MSA equivalent rate
is adjusted for SSI cost-of-living increases by the amount of the annual SSI increase, less
the amount of the increase in the medical assistance personal needs allowance under section
256B.35.

(d) When housing support pays for an individual's room and board, or other costs
necessary to provide room and board, the rate payable to the residence must continue for
up to 18 calendar days per incident that the person is temporarily absent from the residence,
not to exceed 60 days in a calendar year, if the absence or absences deleted text begin have received the prior
approval of deleted text end new text begin are reported in advance to new text end the county agency's social service staff. deleted text begin Prior approval deleted text end new text begin
Advance reporting new text end is not required for emergency absences due to crisis, illness, or injury.

(e) For facilities meeting substantial change criteria within the prior year. Substantial
change criteria exists if the establishment experiences a 25 percent increase or decrease in
the total number of its beds, if the net cost of capital additions or improvements is in excess
of 15 percent of the current market value of the residence, or if the residence physically
moves, or changes its licensure, and incurs a resulting increase in operation and property
costs.

(f) Until June 30, 1994, an agency may increase by up to five percent the total rate paid
for recipients of assistance under sections 256D.01 to 256D.21 or 256D.33 to 256D.54 who
reside in residences that are licensed by the commissioner of health as a boarding care home,
but are not certified for the purposes of the medical assistance program. However, an increase
under this clause must not exceed an amount equivalent to 65 percent of the 1991 medical
assistance reimbursement rate for nursing home resident class A, in the geographic grouping
in which the facility is located, as established under Minnesota Rules, parts 9549.0051 to
9549.0058.

Sec. 36.

Minnesota Statutes 2018, section 256I.05, subdivision 1n, is amended to read:

Subd. 1n.

Supplemental rate; Mahnomen County.

Notwithstanding the provisions of
this section, for the rate period July 1, 2010, to June 30, 2011, a county agency shall negotiate
a supplemental service rate in addition to the rate specified in subdivision 1, not to exceed
$753 per month or the existing rate, including any legislative authorized inflationary
adjustments, for a deleted text begin group residential deleted text end new text begin housing support new text end provider located in Mahnomen County
that operates a 28-bed facility providing 24-hour care to individuals who are homeless,
disabled, chemically dependent, mentally ill, or chronically homeless.

Sec. 37.

Minnesota Statutes 2018, section 256I.05, subdivision 8, is amended to read:

Subd. 8.

State participation.

For a deleted text begin resident of a group residence deleted text end new text begin person new text end who is eligible
under section 256I.04, subdivision 1, paragraph (b), state participation in the deleted text begin group residential deleted text end
housing new text begin support new text end payment is determined according to section 256D.03, subdivision 2. For
a deleted text begin resident of a group residence deleted text end new text begin person new text end who is eligible under section 256I.04, subdivision 1,
paragraph (a), state participation in the deleted text begin group residential deleted text end housing new text begin support new text end rate is determined
according to section 256D.36.

Sec. 38.

Minnesota Statutes 2018, section 256I.06, subdivision 2, is amended to read:

Subd. 2.

Time of payment.

A county agency may make payments in advance for an
individual whose stay is expected to last beyond the calendar month for which the payment
is made. Housing support payments made by a county agency on behalf of an individual
who is not expected to remain in the deleted text begin group residence deleted text end new text begin establishment new text end beyond the month for
which payment is made must be made subsequent to the individual's departure from the
residence.

Sec. 39.

Minnesota Statutes 2018, section 256I.06, is amended by adding a subdivision
to read:

new text begin Subd. 10. new text end

new text begin Correction of overpayments and underpayments. new text end

new text begin The agency shall make
an adjustment to housing support payments issued to individuals consistent with requirements
of federal law and regulation and state law and rule and shall issue or recover benefits as
appropriate. A recipient or former recipient is not responsible for overpayments due to
agency error, unless the amount of the overpayment is large enough that a reasonable person
would know it is an error.
new text end

Sec. 40.

Minnesota Statutes 2018, section 256J.08, subdivision 73a, is amended to read:

Subd. 73a.

Qualified professional.

new text begin "Qualified professional" means an individual as
defined in section 256P.01, subdivision 6a. new text end deleted text begin (a) For physical illness, injury, or incapacity, a
"qualified professional" means a licensed physician, a physician assistant, a nurse practitioner,
or a licensed chiropractor.
deleted text end

deleted text begin (b) For developmental disability and intelligence testing, a "qualified professional"
means an individual qualified by training and experience to administer the tests necessary
to make determinations, such as tests of intellectual functioning, assessments of adaptive
behavior, adaptive skills, and developmental functioning. These professionals include
licensed psychologists, certified school psychologists, or certified psychometrists working
under the supervision of a licensed psychologist.
deleted text end

deleted text begin (c) For learning disabilities, a "qualified professional" means a licensed psychologist or
school psychologist with experience determining learning disabilities.
deleted text end

deleted text begin (d) For mental health, a "qualified professional" means a licensed physician or a qualified
mental health professional. A "qualified mental health professional" means:
deleted text end

deleted text begin (1) for children, in psychiatric nursing, a registered nurse who is licensed under sections
148.171 to 148.285, and who is certified as a clinical specialist in child and adolescent
psychiatric or mental health nursing by a national nurse certification organization or who
has a master's degree in nursing or one of the behavioral sciences or related fields from an
accredited college or university or its equivalent, with at least 4,000 hours of post-master's
supervised experience in the delivery of clinical services in the treatment of mental illness;
deleted text end

deleted text begin (2) for adults, in psychiatric nursing, a registered nurse who is licensed under sections
148.171 to 148.285, and who is certified as a clinical specialist in adult psychiatric and
mental health nursing by a national nurse certification organization or who has a master's
degree in nursing or one of the behavioral sciences or related fields from an accredited
college or university or its equivalent, with at least 4,000 hours of post-master's supervised
experience in the delivery of clinical services in the treatment of mental illness;
deleted text end

deleted text begin (3) in clinical social work, a person licensed as an independent clinical social worker
under chapter 148D, or a person with a master's degree in social work from an accredited
college or university, with at least 4,000 hours of post-master's supervised experience in
the delivery of clinical services in the treatment of mental illness;
deleted text end

deleted text begin (4) in psychology, an individual licensed by the Board of Psychology under sections
148.88 to 148.98, who has stated to the Board of Psychology competencies in the diagnosis
and treatment of mental illness;
deleted text end

deleted text begin (5) in psychiatry, a physician licensed under chapter 147 and certified by the American
Board of Psychiatry and Neurology or eligible for board certification in psychiatry;
deleted text end

deleted text begin (6) in marriage and family therapy, the mental health professional must be a marriage
and family therapist licensed under sections 148B.29 to 148B.39, with at least two years of
post-master's supervised experience in the delivery of clinical services in the treatment of
mental illness; and
deleted text end

deleted text begin (7) in licensed professional clinical counseling, the mental health professional shall be
a licensed professional clinical counselor under section 148B.5301 with at least 4,000 hours
of post-master's supervised experience in the delivery of clinical services in the treatment
of mental illness.
deleted text end

Sec. 41.

Minnesota Statutes 2018, section 256P.01, is amended by adding a subdivision
to read:

new text begin Subd. 6a. new text end

new text begin Qualified professional. new text end

new text begin (a) For illness, injury, or incapacity, a "qualified
professional" means a licensed physician, physician assistant, nurse practitioner, physical
therapist, occupational therapist, or licensed chiropractor, according to their scope of practice.
new text end

new text begin (b) For developmental disability, learning disability, and intelligence testing, a "qualified
professional" means a licensed physician, physician assistant, nurse practitioner, licensed
independent clinical social worker, licensed psychologist, certified school psychologist, or
certified psychometrist working under the supervision of a licensed psychologist.
new text end

new text begin (c) For mental health, a "qualified professional" means a licensed physician, nurse
practitioner, or qualified mental health professional under section 245.462, subdivision 18,
clauses (1) to (6).
new text end

new text begin (d) For substance use disorder, a "qualified professional" means an individual as defined
in section 245G.11, subdivision 3, 4, or 5.
new text end

Sec. 42. new text begin DIRECTION TO THE COMMISSIONER; EVALUATION OF
CONTINUOUS LICENSES.
new text end

new text begin By January 1, 2021, the commissioner of human services shall consult with family child
care license holders and county agencies to determine whether family child care licenses
should automatically renew instead of requiring license holders to reapply for licensure. If
the commissioner determines that family child care licenses should automatically renew,
the commissioner must propose legislation for the 2021 legislative session to make the
required amendments to statutes and administrative rules, as necessary.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 43. new text begin REVISOR INSTRUCTION; CORRECTING TERMINOLOGY.
new text end

new text begin In Minnesota Statutes, sections 256.01, subdivisions 2 and 24; 256.975, subdivision 7;
256B.0911, subdivisions 1a, 3b, and 4d; and 256B.439, subdivision 4, the revisor of statutes
must substitute the term "Disability Linkage Line" or similar terms for "Disability Hub" or
similar terms. The revisor must also make grammatical changes related to the changes in
terms.
new text end

Sec. 44. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2018, section 245F.02, subdivision 20, new text end new text begin is repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

ARTICLE 7

CIVIL COMMITMENT

Section 1.

Minnesota Statutes 2018, section 253B.02, subdivision 4b, is amended to read:

Subd. 4b.

Community-based treatment new text begin program new text end .

"Community-based treatment new text begin
program new text end " means new text begin treatment and services provided at the community level, including but not
limited to new text end community support services programs defined in section 245.462, subdivision 6;
day treatment services defined in section 245.462, subdivision 8; outpatient services defined
in section 245.462, subdivision 21; new text begin mental health crisis services under section 245.462,
subdivision 14c; outpatient services defined in section 245.462, subdivision 21; assertive
community treatment services under section 256B.0622; adult rehabilitation mental health
services under section 256B.0623; home and community-based waivers; supportive housing;
new text end and residential treatment services as defined in section 245.462, subdivision 23. new text begin
Community-based treatment program excludes services provided by a state-operated
treatment program.
new text end

Sec. 2.

Minnesota Statutes 2018, section 253B.02, subdivision 7, is amended to read:

Subd. 7.

Examiner.

"Examiner" means a person who is knowledgeable, trained, and
practicing in the diagnosis and assessment or in the treatment of the alleged impairment,
and who is deleted text begin : deleted text end new text begin a licensed physician, a mental health professional as defined in section 245.462,
subdivision 18, clauses (1) to (6), a licensed physician assistant, or an advanced practice
registered nurse (APRN) as defined in section 148.171, subdivision 3, who is practicing in
the emergency room of a hospital, so long as the hospital has a process for credentialing
and recredentialing any APRN acting as an examiner in an emergency room.
new text end

deleted text begin (1) a licensed physician;
deleted text end

deleted text begin (2) a licensed psychologist who has a doctoral degree in psychology or who became a
licensed consulting psychologist before July 2, 1975; or
deleted text end

deleted text begin (3) an advanced practice registered nurse certified in mental health or a licensed physician
assistant, except that only a physician or psychologist meeting these requirements may be
appointed by the court as described by sections 253B.07, subdivision 3; 253B.092,
subdivision 8, paragraph (b); 253B.17, subdivision 3; 253B.18, subdivision 2; and 253B.19,
subdivisions 1 and 2, and only a physician or psychologist may conduct an assessment as
described by Minnesota Rules of Criminal Procedure, rule 20.
deleted text end

Sec. 3.

Minnesota Statutes 2018, section 253B.02, is amended by adding a subdivision to
read:

new text begin Subd. 7a. new text end

new text begin Court examiner. new text end

new text begin "Court examiner" means a person appointed to serve the
court, and who is a physician or licensed psychologist who has a doctoral degree in
psychology.
new text end

Sec. 4.

Minnesota Statutes 2018, section 253B.02, subdivision 8, is amended to read:

Subd. 8.

Head of the deleted text begin treatment deleted text end facility new text begin or program new text end .

"Head of the deleted text begin treatment deleted text end facility new text begin
or program new text end " means the person who is charged with overall responsibility for the professional
program of care and treatment of the deleted text begin facility or the person's designee deleted text end new text begin treatment facility,
state-operated treatment program, or community-based treatment program new text end .

Sec. 5.

Minnesota Statutes 2018, section 253B.02, subdivision 9, is amended to read:

Subd. 9.

Health officer.

"Health officer" means:

(1) a licensed physician;

(2) deleted text begin a licensed psychologist deleted text end new text begin a mental health professional as defined in section 245.462,
subdivision 18, clauses (1) to (6) new text end ;

(3) a licensed social worker;

(4) a registered nurse working in an emergency room of a hospital;

deleted text begin (5) a psychiatric or public health nurse as defined in section 145A.02, subdivision 18;
deleted text end

deleted text begin (6) deleted text end new text begin (5) new text end an advanced practice registered nurse (APRN) as defined in section 148.171,
subdivision 3;

deleted text begin (7) deleted text end new text begin (6) new text end a mental health deleted text begin professional deleted text end new text begin practitioner as defined in section 245.462, subdivision
17, new text end providing mental health mobile crisis intervention services as described under section
256B.0624 new text begin with the consultation and approval by a mental health professional new text end ; or

deleted text begin (8) deleted text end new text begin (7) new text end a formally designated member of a prepetition screening unit established by
section 253B.07.

Sec. 6.

Minnesota Statutes 2018, section 253B.02, subdivision 10, is amended to read:

Subd. 10.

Interested person.

"Interested person" means:

(1) an adult new text begin who has a specific interest in the patient or proposed patient new text end , including but
not limited to deleted text begin , deleted text end a public official, including a local welfare agency acting under section
626.5561 deleted text begin , and deleted text end new text begin ; a health care or mental health provider or the provider's employee or agent; new text end
the legal guardian, spouse, parent, legal counsel, adult child, new text begin or new text end next of kin deleted text begin , deleted text end new text begin ; new text end or other person
designated by a new text begin patient or new text end proposed patient; or

(2) a health plan company that is providing coverage for a proposed patient.

Sec. 7.

Minnesota Statutes 2018, section 253B.02, subdivision 13, is amended to read:

Subd. 13.

Person who deleted text begin is mentally ill deleted text end new text begin poses a risk of harm due to a mental illness new text end .

(a)
A "person who deleted text begin is mentally ill deleted text end new text begin poses a risk of harm due to a mental illness new text end " means any person
who has an organic disorder of the brain or a substantial psychiatric disorder of thought,
mood, perception, orientation, or memory deleted text begin which deleted text end new text begin that new text end grossly impairs judgment, behavior,
capacity to recognize reality, or to reason or understand, deleted text begin which deleted text end new text begin that new text end is manifested by instances
of grossly disturbed behavior or faulty perceptions and new text begin who, due to this impairment, new text end poses
a substantial likelihood of physical harm to self or others as demonstrated by:

(1) a failure to obtain necessary food, clothing, shelter, or medical care as a result of the
impairment;

(2) an inability for reasons other than indigence to obtain necessary food, clothing,
shelter, or medical care as a result of the impairment and it is more probable than not that
the person will suffer substantial harm, significant psychiatric deterioration or debilitation,
or serious illness, unless appropriate treatment and services are provided;

(3) a recent attempt or threat to physically harm self or others; or

(4) recent and volitional conduct involving significant damage to substantial property.

(b) A person deleted text begin is not mentally ill deleted text end new text begin does not pose a risk of harm due to mental illness new text end under
this section if the new text begin person's new text end impairment is solely due to:

(1) epilepsy;

(2) developmental disability;

(3) brief periods of intoxication caused by alcohol, drugs, or other mind-altering
substances; or

(4) dependence upon or addiction to any alcohol, drugs, or other mind-altering substances.

Sec. 8.

Minnesota Statutes 2018, section 253B.02, subdivision 16, is amended to read:

Subd. 16.

Peace officer.

"Peace officer" means a sheriff new text begin or deputy sheriff new text end , or municipal
or other local police officer, or a State Patrol officer when engaged in the authorized duties
of office.

Sec. 9.

Minnesota Statutes 2018, section 253B.02, subdivision 17, is amended to read:

Subd. 17.

Person who deleted text begin is mentally ill deleted text end new text begin has a mental illness new text end and new text begin is new text end dangerous to the
public.

deleted text begin (a) deleted text end A "person who deleted text begin is mentally ill deleted text end new text begin has a mental illness new text end and new text begin is new text end dangerous to the public"
is a person:

(1) who deleted text begin is mentally ill deleted text end new text begin has an organic disorder of the brain or a substantial psychiatric
disorder of thought, mood, perception, orientation, or memory that grossly impairs judgment,
behavior, capacity to recognize reality, or to reason or understand, and is manifested by
instances of grossly disturbed behavior or faulty perceptions new text end ; and

(2) who as a result of that deleted text begin mental illness deleted text end new text begin impairment new text end presents a clear danger to the safety
of others as demonstrated by the facts that (i) the person has engaged in an overt act causing
or attempting to cause serious physical harm to another and (ii) there is a substantial
likelihood that the person will engage in acts capable of inflicting serious physical harm on
another.

deleted text begin (b) A person committed as a sexual psychopathic personality or sexually dangerous
person as defined in subdivisions 18a and 18b is subject to the provisions of this chapter
that apply to persons who are mentally ill and dangerous to the public.
deleted text end

Sec. 10.

Minnesota Statutes 2018, section 253B.02, subdivision 18, is amended to read:

Subd. 18.

deleted text begin Regional deleted text end new text begin State-operated new text end treatment deleted text begin center deleted text end new text begin program new text end .

" deleted text begin Regional deleted text end new text begin State-operated new text end
treatment deleted text begin center deleted text end new text begin program new text end " deleted text begin means any state-operated facility for persons who are mentally
ill, developmentally disabled, or chemically dependent under the direct administrative
authority of the commissioner deleted text end new text begin means any state-operated program including community
behavioral health hospitals, crisis centers, residential facilities, outpatient services, and other
community-based services developed and operated by the state and under the commissioner's
control for a person who has a mental illness, developmental disability, or chemical
dependency new text end .

Sec. 11.

Minnesota Statutes 2018, section 253B.02, subdivision 19, is amended to read:

Subd. 19.

Treatment facility.

"Treatment facility" means a new text begin non-state-operated new text end hospital,
deleted text begin community mental health center, or other treatment provider deleted text end new text begin residential treatment provider,
crisis residential withdrawal management center, or corporate foster care home new text end qualified
to provide care and treatment for persons deleted text begin who are mentally ill, developmentally disabled,
or chemically dependent deleted text end new text begin who have a mental illness, developmental disability, or chemical
dependency new text end .

Sec. 12.

Minnesota Statutes 2018, section 253B.02, subdivision 21, is amended to read:

Subd. 21.

Pass.

"Pass" means any authorized temporary, unsupervised absence from a
new text begin state-operated new text end treatment deleted text begin facility deleted text end new text begin program new text end .

Sec. 13.

Minnesota Statutes 2018, section 253B.02, subdivision 22, is amended to read:

Subd. 22.

Pass plan.

"Pass plan" means the part of a treatment plan for a deleted text begin person deleted text end new text begin patient new text end
who has been committed as deleted text begin mentally ill and deleted text end new text begin a person who has a mental illness and is new text end
dangerous new text begin to the public new text end that specifies the terms and conditions under which the patient may
be released on a pass.

Sec. 14.

Minnesota Statutes 2018, section 253B.02, subdivision 23, is amended to read:

Subd. 23.

Pass-eligible status.

"Pass-eligible status" means the status under which a
deleted text begin person deleted text end new text begin patient new text end committed as deleted text begin mentally ill and deleted text end new text begin a person who has a mental illness and is new text end
dangerous new text begin to the public new text end may be released on passes after approval of a pass plan by the head
of a new text begin state-operated new text end treatment deleted text begin facility deleted text end new text begin program new text end .

Sec. 15.

Minnesota Statutes 2018, section 253B.03, subdivision 1, is amended to read:

Subdivision 1.

Restraints.

(a) A patient has the right to be free from restraints. Restraints
shall not be applied to a patient in a treatment facility new text begin or state-operated treatment program
new text end unless the head of the treatment facility, new text begin head of the state-operated treatment program, new text end a
member of the medical staff, or a licensed peace officer who has custody of the patient
determines that deleted text begin they deleted text end new text begin restraints new text end are necessary for the safety of the patient or others.

(b) Restraints shall not be applied to patients with developmental disabilities except as
permitted under section 245.825 and rules of the commissioner of human services. Consent
must be obtained from the deleted text begin person deleted text end new text begin patient new text end or deleted text begin person's deleted text end new text begin patient's new text end guardian except for emergency
procedures as permitted under rules of the commissioner adopted under section 245.825.

(c) Each use of a restraint and reason for it shall be made part of the clinical record of
the patient under the signature of the head of the treatment facility.

Sec. 16.

Minnesota Statutes 2018, section 253B.03, subdivision 2, is amended to read:

Subd. 2.

Correspondence.

A patient has the right to correspond freely without censorship.
The head of the treatment facility new text begin or head of the state-operated treatment program new text end may
restrict correspondence if the patient's medical welfare requires this restriction. For deleted text begin patients deleted text end new text begin
a patient new text end in deleted text begin regional deleted text end new text begin a state-operated new text end treatment deleted text begin centers deleted text end new text begin program new text end , that determination may be
reviewed by the commissioner. Any limitation imposed on the exercise of a patient's
correspondence rights and the reason for it shall be made a part of the clinical record of the
patient. Any communication which is not delivered to a patient shall be immediately returned
to the sender.

Sec. 17.

Minnesota Statutes 2018, section 253B.03, subdivision 3, is amended to read:

Subd. 3.

Visitors and phone calls.

Subject to the general rules of the treatment facility new text begin
or state-operated treatment program new text end , a patient has the right to receive visitors and make
phone calls. The head of the treatment facility new text begin or head of the state-operated treatment program
new text end may restrict visits and phone calls on determining that the medical welfare of the patient
requires it. Any limitation imposed on the exercise of the patient's visitation and phone call
rights and the reason for it shall be made a part of the clinical record of the patient.

Sec. 18.

Minnesota Statutes 2018, section 253B.03, subdivision 4a, is amended to read:

Subd. 4a.

Disclosure of patient's admission.

Upon admission to a new text begin treatment new text end facility new text begin or
state-operated treatment program new text end where federal law prohibits unauthorized disclosure of
patient or resident identifying information to callers and visitors, the patient or resident, or
the legal guardian of the patient or resident, shall be given the opportunity to authorize
disclosure of the patient's or resident's presence in the facility to callers and visitors who
may seek to communicate with the patient or resident. To the extent possible, the legal
guardian of a patient or resident shall consider the opinions of the patient or resident regarding
the disclosure of the patient's or resident's presence in the facility.

Sec. 19.

Minnesota Statutes 2018, section 253B.03, subdivision 5, is amended to read:

Subd. 5.

Periodic assessment.

A patient has the right to periodic medical assessment,
including assessment of the medical necessity of continuing care and, if the treatment facility new text begin ,
state-operated treatment program, or community-based treatment program new text end declines to provide
continuing care, the right to receive specific written reasons why continuing care is declined
at the time of the assessment. The treatment facility new text begin , state-operated treatment program, or
community-based treatment program new text end shall assess the physical and mental condition of every
patient as frequently as necessary, but not less often than annually. If the patient refuses to
be examined, the new text begin treatment new text end facility new text begin , state-operated treatment program, or community-based
treatment program new text end shall document in the patient's chart its attempts to examine the patient.
If a deleted text begin person deleted text end new text begin patient new text end is committed as developmentally disabled for an indeterminate period
of time, the three-year judicial review must include the annual reviews for each year deleted text begin as
outlined in Minnesota Rules, part 9525.0075, subpart 6 deleted text end new text begin regarding the patient's need for
continued commitment new text end .

Sec. 20.

Minnesota Statutes 2018, section 253B.03, subdivision 6, is amended to read:

Subd. 6.

Consent for medical procedure.

new text begin (a) new text end A patient has the right to new text begin give new text end prior consent
to any medical or surgical treatment, other than treatment for chemical dependency or
nonintrusive treatment for mental illness.

new text begin (b) new text end The following procedures shall be used to obtain consent for any treatment necessary
to preserve the life or health of any committed patient:

deleted text begin (a) deleted text end new text begin (1) new text end the written, informed consent of a competent adult patient for the treatment is
sufficient deleted text begin . deleted text end new text begin ;
new text end

deleted text begin (b) deleted text end new text begin (2) new text end if the patient is subject to guardianship which includes the provision of medical
care, the written, informed consent of the guardian for the treatment is sufficient deleted text begin . deleted text end new text begin ;
new text end

deleted text begin (c) deleted text end new text begin (3) new text end if the head of the treatment facility new text begin or state-operated treatment program new text end determines
that the patient is not competent to consent to the treatment and the patient has not been
adjudicated incompetent, written, informed consent for the surgery or medical treatment
shall be obtained from the new text begin person appointed the health care power of attorney, the patient's
agent under the health care directive, or the new text end nearest proper relative. For this purpose, the
following persons are proper relatives, in the order listed: the patient's spouse, parent, adult
child, or adult sibling. If the nearest proper relatives cannot be located, refuse to consent to
the procedure, or are unable to consent, the head of the treatment facility new text begin or state-operated
treatment program new text end or an interested person may petition the committing court for approval
for the treatment or may petition a court of competent jurisdiction for the appointment of a
guardian. The determination that the patient is not competent, and the reasons for the
determination, shall be documented in the patient's clinical record deleted text begin . deleted text end new text begin ;
new text end

deleted text begin (d) deleted text end new text begin (4) new text end consent to treatment of any minor patient shall be secured in accordance with
sections 144.341 to 144.346. A minor 16 years of age or older may consent to hospitalization,
routine diagnostic evaluation, and emergency or short-term acute care deleted text begin . deleted text end new text begin ; and
new text end

deleted text begin (e) deleted text end new text begin (5) new text end in the case of an emergency when the persons ordinarily qualified to give consent
cannot be located new text begin in sufficient time to address the emergency need new text end , the head of the treatment
facility new text begin or state-operated treatment program new text end may give consent.

new text begin (c) new text end No person who consents to treatment pursuant to the provisions of this subdivision
shall be civilly or criminally liable for the performance or the manner of performing the
treatment. No person shall be liable for performing treatment without consent if written,
informed consent was given pursuant to this subdivision. This provision shall not affect any
other liability which may result from the manner in which the treatment is performed.

Sec. 21.

Minnesota Statutes 2018, section 253B.03, subdivision 6b, is amended to read:

Subd. 6b.

Consent for mental health treatment.

A competent deleted text begin person deleted text end new text begin patient new text end admitted
voluntarily to a treatment facility new text begin or state-operated treatment program new text end may be subjected to
intrusive mental health treatment only with the deleted text begin person's deleted text end new text begin patient's new text end written informed consent.
For purposes of this section, "intrusive mental health treatment" means deleted text begin electroshock deleted text end new text begin
electroconvulsive new text end therapy and neuroleptic medication and does not include treatment for a
developmental disability. An incompetent deleted text begin person deleted text end new text begin patient new text end who has prepared a directive under
subdivision 6d regarding new text begin intrusive mental health new text end treatment deleted text begin with intrusive therapies deleted text end must be
treated in accordance with this section, except in cases of emergencies.

Sec. 22.

Minnesota Statutes 2018, section 253B.03, subdivision 6d, is amended to read:

Subd. 6d.

Adult mental health treatment.

(a) A competent adult new text begin patient new text end may make a
declaration of preferences or instructions regarding intrusive mental health treatment. These
preferences or instructions may include, but are not limited to, consent to or refusal of these
treatments. new text begin A declaration of preferences or instructions may include a health care directive
under chapter 145C or a psychiatric directive.
new text end

(b) A declaration may designate a proxy to make decisions about intrusive mental health
treatment. A proxy designated to make decisions about intrusive mental health treatments
and who agrees to serve as proxy may make decisions on behalf of a declarant consistent
with any desires the declarant expresses in the declaration.

(c) A declaration is effective only if it is signed by the declarant and two witnesses. The
witnesses must include a statement that they believe the declarant understands the nature
and significance of the declaration. A declaration becomes operative when it is delivered
to the declarant's physician or other mental health treatment provider. The physician or
provider must comply with deleted text begin it deleted text end new text begin the declaration new text end to the fullest extent possible, consistent with
reasonable medical practice, the availability of treatments requested, and applicable law.
The physician or provider shall continue to obtain the declarant's informed consent to all
intrusive mental health treatment decisions if the declarant is capable of informed consent.
A treatment provider deleted text begin may deleted text end new text begin must new text end not require a deleted text begin person deleted text end new text begin patient new text end to make a declaration under
this subdivision as a condition of receiving services.

(d) The physician or other provider shall make the declaration a part of the declarant's
medical record. If the physician or other provider is unwilling at any time to comply with
the declaration, the physician or provider must promptly notify the declarant and document
the notification in the declarant's medical record. deleted text begin If the declarant has been committed as a
patient under this chapter, the physician or provider may subject a declarant to intrusive
treatment in a manner contrary to the declarant's expressed wishes, only upon order of the
committing court. If the declarant is not a committed patient under this chapter, deleted text end The physician
or provider may subject the declarant to intrusive treatment in a manner contrary to the
declarant's expressed wishes, only if the declarant is committed as deleted text begin mentally ill deleted text end new text begin a person who
poses a risk of harm due to mental illness new text end or deleted text begin mentally ill deleted text end new text begin as a person who has a mental illness new text end
and new text begin is new text end dangerous to the public and a court order authorizing the treatment has been issued new text begin
or an emergency has been declared under section 253B.092, subdivision 3 new text end .

(e) A declaration under this subdivision may be revoked in whole or in part at any time
and in any manner by the declarant if the declarant is competent at the time of revocation.
A revocation is effective when a competent declarant communicates the revocation to the
attending physician or other provider. The attending physician or other provider shall note
the revocation as part of the declarant's medical record.

(f) A provider who administers intrusive mental health treatment according to and in
good faith reliance upon the validity of a declaration under this subdivision is held harmless
from any liability resulting from a subsequent finding of invalidity.

(g) In addition to making a declaration under this subdivision, a competent adult may
delegate parental powers under section 524.5-211 or may nominate a guardian under sections
524.5-101 to 524.5-502.

Sec. 23.

Minnesota Statutes 2018, section 253B.03, subdivision 7, is amended to read:

Subd. 7.

deleted text begin Program deleted text end new text begin Treatment new text end plan.

A deleted text begin person deleted text end new text begin patient new text end receiving services under this
chapter has the right to receive proper care and treatment, best adapted, according to
contemporary professional standards, to rendering further supervision unnecessary. The
treatment facility new text begin , state-operated treatment program, or community-based treatment program new text end
shall devise a written deleted text begin program deleted text end new text begin treatment new text end plan for each deleted text begin person deleted text end new text begin patient new text end which describes in
behavioral terms the case problems, the precise goals, including the expected period of time
for treatment, and the specific measures to be employed. deleted text begin Each plan shall be reviewed at
least quarterly to determine progress toward the goals, and to modify the program plan as
necessary. deleted text end new text begin The development and review of treatment plans must be conducted as required
under the license or certification of the treatment facility, state-operated treatment program,
or community-based treatment program. If there are no review requirements under the
license or certification, the treatment plan must be reviewed quarterly. new text end The deleted text begin program deleted text end new text begin treatment new text end
plan shall be devised and reviewed with the designated agency and with the patient. The
clinical record shall reflect the deleted text begin program deleted text end new text begin treatment new text end plan review. If the designated agency or
the patient does not participate in the planning and review, the clinical record shall include
reasons for nonparticipation and the plans for future involvement. The commissioner shall
monitor the deleted text begin program deleted text end new text begin treatment new text end plan and review process for deleted text begin regional centers deleted text end new text begin state-operated
treatment programs new text end to deleted text begin insure deleted text end new text begin ensure new text end compliance with the provisions of this subdivision.

Sec. 24.

Minnesota Statutes 2018, section 253B.03, subdivision 10, is amended to read:

Subd. 10.

Notification.

new text begin (a) new text end All deleted text begin persons deleted text end new text begin patients new text end admitted or committed to a treatment
facility new text begin or state-operated treatment program, or temporarily confined under section 253B.045,
new text end shall be notified in writing of their rights regarding hospitalization and other treatment deleted text begin at
the time of admission deleted text end .

new text begin (b) new text end This notification must include:

(1) patient rights specified in this section and section 144.651, including nursing home
discharge rights;

(2) the right to obtain treatment and services voluntarily under this chapter;

(3) the right to voluntary admission and release under section 253B.04;

(4) rights in case of an emergency admission under section deleted text begin 253B.05 deleted text end , including
the right to documentation in support of an emergency hold and the right to a summary
hearing before a judge if the patient believes an emergency hold is improper;

(5) the right to request expedited review under section 62M.05 if additional days of
inpatient stay are denied;

(6) the right to continuing benefits pending appeal and to an expedited administrative
hearing under section 256.045 if the patient is a recipient of medical assistance or
MinnesotaCare; and

(7) the right to an external appeal process under section 62Q.73, including the right to
a second opinion.

Sec. 25.

Minnesota Statutes 2018, section 253B.04, subdivision 1, is amended to read:

Subdivision 1.

Voluntary admission and treatment.

(a) Voluntary admission is preferred
over involuntary commitment and treatment. Any person 16 years of age or older may
request to be admitted to a treatment facility new text begin or state-operated treatment program new text end as a
voluntary patient for observation, evaluation, diagnosis, care and treatment without making
formal written application. Any person under the age of 16 years may be admitted as a
patient with the consent of a parent or legal guardian if it is determined by independent
examination that there is reasonable evidence that (1) the proposed patient has a mental
illness, deleted text begin or is developmentally disabled deleted text end new text begin developmental disability, new text end or deleted text begin chemically dependent deleted text end new text begin
chemical dependency new text end ; and (2) the proposed patient is suitable for treatment. The head of
the treatment facility new text begin or head of the state-operated treatment program new text end shall not arbitrarily
refuse any person seeking admission as a voluntary patient. In making decisions regarding
admissions, the new text begin treatment new text end facility new text begin or state-operated treatment program new text end shall use clinical
admission criteria consistent with the current applicable inpatient admission standards
established by new text begin professional organizations including new text end the American Psychiatric Association
deleted text begin or deleted text end new text begin , new text end the American Academy of Child and Adolescent Psychiatry new text begin , the Joint Commission, and
the American Society of Addiction Medicine new text end . These criteria must be no more restrictive
than, and must be consistent with, the requirements of section 62Q.53. The new text begin treatment new text end facility
new text begin or head of the state-operated treatment program new text end may not refuse to admit a person voluntarily
solely because the person does not meet the criteria for involuntary holds under section
deleted text begin 253B.05 deleted text end or the definition of new text begin a person who poses a risk of harm due to new text end mental
illness under section 253B.02, subdivision 13.

(b) In addition to the consent provisions of paragraph (a), a person who is 16 or 17 years
of age who refuses to consent personally to admission may be admitted as a patient for
mental illness or chemical dependency treatment with the consent of a parent or legal
guardian if it is determined by an independent examination that there is reasonable evidence
that the proposed patient is chemically dependent or has a mental illness and is suitable for
treatment. The person conducting the examination shall notify the proposed patient and the
parent or legal guardian of this determination.

(c) A person who is voluntarily participating in treatment for a mental illness is not
subject to civil commitment under this chapter if the person:

(1) has given informed consent or, if lacking capacity, is a person for whom legally valid
substitute consent has been given; and

(2) is participating in a medically appropriate course of treatment, including clinically
appropriate and lawful use of neuroleptic medication and electroconvulsive therapy. The
limitation on commitment in this paragraph does not apply if, based on clinical assessment,
the court finds that it is unlikely that the deleted text begin person deleted text end new text begin patient new text end will remain in and cooperate with
a medically appropriate course of treatment absent commitment and the standards for
commitment are otherwise met. This paragraph does not apply to a person for whom
commitment proceedings are initiated pursuant to rule 20.01 or 20.02 of the Rules of Criminal
Procedure, or a person found by the court to meet the requirements under section 253B.02,
subdivision 17.

new text begin (d) new text end Legally valid substitute consent may be provided by a proxy under a health care
directive, a guardian or conservator with authority to consent to mental health treatment,
or consent to admission under subdivision 1a or 1b.

Sec. 26.

Minnesota Statutes 2018, section 253B.04, subdivision 1a, is amended to read:

Subd. 1a.

Voluntary treatment or admission for persons with new text begin a new text end mental illness.

(a)
A person with a mental illness may seek or voluntarily agree to accept treatment or admission
to a new text begin state-operated treatment program or treatment new text end facility. If the mental health provider
determines that the person lacks the capacity to give informed consent for the treatment or
admission, and in the absence of a health care deleted text begin power of attorney deleted text end new text begin directive or health care
power of attorney new text end that authorizes consent, the designated agency or its designee may give
informed consent for mental health treatment or admission to a treatment facility new text begin or
state-operated treatment program new text end on behalf of the person.

(b) The designated agency shall apply the following criteria in determining the person's
ability to give informed consent:

(1) whether the person demonstrates an awareness of the person's illness, and the reasons
for treatment, its risks, benefits and alternatives, and the possible consequences of refusing
treatment; and

(2) whether the person communicates verbally or nonverbally a clear choice concerning
treatment that is a reasoned one, not based on delusion, even though it may not be in the
person's best interests.

(c) The basis for the designated agency's decision that the person lacks the capacity to
give informed consent for treatment or admission, and that the patient has voluntarily
accepted treatment or admission, must be documented in writing.

(d) A deleted text begin mental health provider deleted text end new text begin treatment facility or state-operated treatment program new text end that
provides treatment in reliance on the written consent given by the designated agency under
this subdivision or by a substitute decision maker appointed by the court is not civilly or
criminally liable for performing treatment without consent. This paragraph does not affect
any other liability that may result from the manner in which the treatment is performed.

(e) A deleted text begin person deleted text end new text begin patient new text end who receives treatment or is admitted to a new text begin treatment new text end facility new text begin or
state-operated treatment program new text end under this subdivision or subdivision 1b has the right to
refuse treatment at any time or to be released from a new text begin treatment new text end facility new text begin or state-operated
treatment program new text end as provided under subdivision 2. The deleted text begin person deleted text end new text begin patient new text end or any interested
person acting on the deleted text begin person's deleted text end new text begin patient's new text end behalf may seek court review within five days for a
determination of whether the deleted text begin person's deleted text end new text begin patient's new text end agreement to accept treatment or admission
is voluntary. At the time a deleted text begin person deleted text end new text begin patient new text end agrees to treatment or admission to a new text begin treatment
new text end facility new text begin or state-operated treatment program new text end under this subdivision, the designated agency
or its designee shall inform the deleted text begin person deleted text end new text begin patient new text end in writing of the deleted text begin person's deleted text end new text begin patient's new text end rights under
this paragraph.

deleted text begin (f) This subdivision does not authorize the administration of neuroleptic medications.
Neuroleptic medications may be administered only as provided in section 253B.092.
deleted text end

Sec. 27.

Minnesota Statutes 2018, section 253B.04, subdivision 2, is amended to read:

Subd. 2.

Release.

Every patient admitted for mental illness or developmental disability
under this section shall be informed in writing at the time of admission that the patient has
a right to leave the new text begin treatment new text end facility new text begin or state-operated treatment program new text end within 12 hours
of making a request, unless held under another provision of this chapter. Every patient
admitted for chemical dependency under this section shall be informed in writing at the
time of admission that the patient has a right to leave the new text begin treatment new text end facility new text begin or state-operated
treatment program new text end within 72 hours, exclusive of Saturdays, Sundays, and new text begin legal new text end holidays,
of making a request, unless held under another provision of this chapter. The request shall
be submitted in writing to the head of the treatment facility new text begin or state-operated treatment
program new text end or the person's designee.

Sec. 28.

new text begin [253B.041] SERVICES FOR ENGAGEMENT IN TREATMENT.
new text end

new text begin Subdivision 1. new text end

new text begin Eligibility. new text end

new text begin (a) The purpose of engagement services is to avoid the need
for commitment and to enable the proposed patient to voluntarily engage in needed treatment.
An interested person may apply to the county where a proposed patient resides to request
engagement services.
new text end

new text begin (b) To be eligible for engagement services, the proposed patient must be at least 18 years
of age, have a mental illness, and either:
new text end

new text begin (1) be exhibiting symptoms of serious mental illness including hallucinations, mania,
delusional thoughts, or be unable to obtain necessary food, clothing, shelter, medical care,
or provide necessary hygiene due to the patient's mental illness; or
new text end

new text begin (2) have a history of failing to adhere to treatment for mental illness, in that:
new text end

new text begin (i) the proposed patient's mental illness has been a substantial factor in necessitating
hospitalization, or incarceration in a state or local correctional facility, not including any
period during which the person was hospitalized or incarcerated immediately preceding
filing the application for engagement; or
new text end

new text begin (ii) the proposed patient is exhibiting symptoms or behavior that may lead to
hospitalization, incarceration, or court-ordered treatment.
new text end

new text begin Subd. 2. new text end

new text begin Administration. new text end

new text begin (a) Upon receipt of a request for engagement services, the
county's prepetition screening team shall conduct an investigation to determine whether the
proposed patient is eligible. In making this determination, the screening team shall seek any
relevant information from an interested person.
new text end

new text begin (b) If the screening team determines that the proposed patient is eligible, engagement
services must begin and include, but are not limited to:
new text end

new text begin (1) assertive attempts to engage the patient in voluntary treatment for mental illness for
at least 90 days. Engagement services must be person-centered and continue even if the
patient is an inmate in a non-state-operated correctional facility;
new text end

new text begin (2) efforts to engage the patient's existing systems of support, including interested persons,
unless the engagement provider determines that involvement is not helpful to the patient.
This includes education on restricting means of harm, suicide prevention, and engagement;
and
new text end

new text begin (3) collaboration with the patient to meet immediate needs including access to housing,
food, income, disability verification, medications, and treatment for medical conditions.
new text end

new text begin (c) Engagement services regarding potential treatment options must take into account
the patient's preferences for services and supports. The county may offer engagement services
through the designated agency or another agency under contract. Engagement services staff
must have training in person-centered care. Engagement services staff may include but are
not limited to mobile crisis teams under section 245.462, certified peer specialists under
section 256B.0615, community-based treatment programs, and homeless outreach workers.
new text end

new text begin (d) If the patient voluntarily consents to receive mental health treatment, the engagement
services staff must facilitate the referral to an appropriate mental health treatment provider
including support obtaining health insurance if the proposed patient is currently or may
become uninsured. If the proposed patient initially consents to treatment, but fails to initiate
or continue treatment, the engagement services team must continue outreach efforts to the
patient.
new text end

new text begin Subd. 3. new text end

new text begin Commitment. new text end

new text begin Engagement services for a patient to seek treatment may be
stopped if the proposed patient is in need of commitment and satisfies the commitment
criteria under section 253B.09, subdivision 1. In such a case, the engagement services team
must immediately notify the designated agency, initiate the prepetition screening process
under section 253B.07, or seek an emergency hold if necessary to ensure the safety of the
patient or others.
new text end

new text begin Subd. 4. new text end

new text begin Evaluation. new text end

new text begin Counties may, but are not required to, provide engagement services.
The commissioner may conduct a pilot project evaluating the impact of engagement services
in decreasing commitments, increasing engagement in treatment, and other measures.
new text end

Sec. 29.

Minnesota Statutes 2018, section 253B.045, subdivision 2, is amended to read:

Subd. 2.

Facilities.

(a) Each county or a group of counties shall maintain or provide by
contract a facility for confinement of persons held temporarily for observation, evaluation,
diagnosis, treatment, and care. When the temporary confinement is provided at a deleted text begin regional deleted text end
new text begin state-operated new text end treatment deleted text begin center deleted text end new text begin program new text end , the commissioner shall charge the county of
financial responsibility for the costs of confinement of deleted text begin persons deleted text end new text begin patients new text end hospitalized under
deleted text begin section 253B.05, subdivisions 1 and 2, deleted text end new text begin sections 253B.051 new text end and deleted text begin section deleted text end 253B.07, subdivision
2b, except that the commissioner shall bill the responsible health plan first. Any charges
not covered, including co-pays and deductibles shall be the responsibility of the county. If
the deleted text begin person deleted text end new text begin patient new text end has health plan coverage, but the hospitalization does not meet the criteria
in subdivision 6 or section 62M.07, 62Q.53, or 62Q.535, the county is responsible. deleted text begin When
a person is temporarily confined in a Department of Corrections facility solely under
subdivision 1a, and not based on any separate correctional authority:
deleted text end

deleted text begin (1) the commissioner of corrections may charge the county of financial responsibility
for the costs of confinement; and
deleted text end

deleted text begin (2) the Department of Human Services shall use existing appropriations to fund all
remaining nonconfinement costs. The funds received by the commissioner for the
confinement and nonconfinement costs are appropriated to the department for these purposes.
deleted text end

(b) For the purposes of this subdivision, "county of financial responsibility" has the
meaning specified in section 253B.02, subdivision 4c, or, if the deleted text begin person deleted text end new text begin patient new text end has no
residence in this state, the county which initiated the confinement. The charge for
confinement in a facility operated by the commissioner deleted text begin of human services deleted text end shall be based
on the commissioner's determination of the cost of care pursuant to section 246.50,
subdivision 5. When there is a dispute as to which county is the county of financial
responsibility, the county charged for the costs of confinement shall pay for them pending
final determination of the dispute over financial responsibility.

Sec. 30.

Minnesota Statutes 2018, section 253B.045, subdivision 3, is amended to read:

Subd. 3.

Cost of care.

Notwithstanding subdivision 2, a county shall be responsible for
the cost of care as specified under section 246.54 for deleted text begin persons deleted text end new text begin a patient new text end hospitalized at a
deleted text begin regional deleted text end new text begin state-operated new text end treatment deleted text begin center deleted text end new text begin program new text end in accordance with section 253B.09 and
the deleted text begin person's deleted text end new text begin patient's new text end legal status has been changed to a court hold under section 253B.07,
subdivision 2b, pending a judicial determination regarding continued commitment pursuant
to sections 253B.12 and 253B.13.

Sec. 31.

Minnesota Statutes 2018, section 253B.045, subdivision 5, is amended to read:

Subd. 5.

Health plan company; definition.

For purposes of this section, "health plan
company" has the meaning given it in section 62Q.01, subdivision 4, and also includes a
demonstration provider as defined in section 256B.69, subdivision 2, paragraph (b) deleted text begin , deleted text end new text begin ; and new text end a
county or group of counties participating in county-based purchasing according to section
256B.692 deleted text begin , and a children's mental health collaborative under contract to provide medical
assistance for individuals enrolled in the prepaid medical assistance and MinnesotaCare
programs according to sections 245.493 to 245.495 deleted text end .

Sec. 32.

Minnesota Statutes 2018, section 253B.045, subdivision 6, is amended to read:

Subd. 6.

Coverage.

(a) For purposes of this section, "mental health services" means all
covered services that are intended to treat or ameliorate an emotional, behavioral, or
psychiatric condition and that are covered by the policy, contract, or certificate of coverage
of the enrollee's health plan company or by law.

(b) All health plan companies that provide coverage for mental health services must
cover or provide mental health services ordered by a court of competent jurisdiction deleted text begin under
a court order that is issued on the basis of a behavioral care evaluation performed by a
licensed psychiatrist or a doctoral level licensed psychologist, which includes a diagnosis
and an individual treatment plan for care in the most appropriate, least restrictive
environment. The health plan company must be given a copy of the court order and the
behavioral care evaluation. The health plan company shall be financially liable for the
evaluation if performed by a participating provider of the health plan company and shall be
financially liable for the care included in the court-ordered individual treatment plan if the
care is covered by the health plan company and ordered to be provided by a participating
provider or another provider as required by rule or law deleted text end . This court-ordered coverage must
not be subject to a separate medical necessity determination by a health plan company under
its utilization procedures.

Sec. 33.

new text begin [253B.051] EMERGENCY ADMISSION.
new text end

new text begin Subdivision 1. new text end

new text begin Peace officer or health officer authority. new text end

new text begin (a) If a peace officer or health
officer has reason to believe, either through direct observation of the person's behavior or
upon reliable information of the person's recent behavior and, if available, knowledge or
reliable information concerning the person's past behavior or treatment that the person:
new text end

new text begin (1) has a mental illness or developmental disability and is in danger of harming self or
others if the officer does not immediately detain the patient, the peace officer or health
officer may take the person into custody and transport the person to an examiner or a
treatment facility, state-operated treatment program, or community-based treatment program;
new text end

new text begin (2) is chemically dependent or intoxicated in public and in danger of harming self or
others if the officer does not immediately detain the patient, the peace officer or health
officer may take the person into custody and transport the person to a treatment facility,
state-operated treatment program, or community-based treatment program; or
new text end

new text begin (3) is chemically dependent or intoxicated in public and not in danger of harming self,
others, or property, the peace officer or health officer may take the person into custody and
transport the person to the person's home.
new text end

new text begin (b) An examiner's written statement or a health officer's written statement in compliance
with the requirements of subdivision 2 is sufficient authority for a peace officer or health
officer to take the person into custody and transport the person to a treatment facility,
state-operated treatment program, or community-based treatment program.
new text end

new text begin (c) A peace officer or health officer who takes a person into custody and transports the
person to a treatment facility, state-operated treatment program, or community-based
treatment program under this subdivision shall make written application for admission of
the person containing:
new text end

new text begin (1) the officer's statement specifying the reasons and circumstances under which the
person was taken into custody;
new text end

new text begin (2) identifying information on specific individuals to the extent practicable, if danger to
those individuals is a basis for the emergency hold; and
new text end

new text begin (3) the officer's name, the agency that employs the officer, and the telephone number or
other contact information for purposes of receiving notice under subdivision 3.
new text end

new text begin (d) A copy of the examiner's written statement and officer's application shall be made
available to the person taken into custody.
new text end

new text begin (e) The officer may provide the transportation personally or may arrange to have the
person transported by a suitable medical or mental health transportation provider. As far as
practicable, a peace officer who provides transportation for a person placed in a treatment
facility, state-operated treatment program, or community-based treatment program under
this subdivision must not be in uniform and must not use a vehicle visibly marked as a law
enforcement vehicle.
new text end

new text begin Subd. 2. new text end

new text begin Emergency hold. new text end

new text begin (a) A treatment facility, state-operated treatment program,
or community-based treatment program, other than a facility operated by the Minnesota sex
offender program, may admit or hold a patient, including a patient transported under
subdivision 1, for emergency care and treatment if the head of the facility or program
consents to holding the patient and an examiner provides a written statement in support of
holding the patient.
new text end

new text begin (b) The written statement must indicate that:
new text end

new text begin (1) the examiner examined the patient not more than 15 days prior to admission;
new text end

new text begin (2) the examiner interviewed the patient, or if not, the specific reasons why the examiner
did not interview the patient;
new text end

new text begin (3) the examiner has the opinion that the patient has a mental illness or developmental
disability, or is chemically dependent and is in danger of causing harm to self or others if
a facility or program does not immediately detain the patient. The statement must include
observations of the patient's behavior and avoid conclusory language. The statement must
be specific enough to provide an adequate record for review. If danger to specific individuals
is a basis for the emergency hold, the statement must identify those individuals to the extent
practicable; and
new text end

new text begin (4) the facility or program cannot obtain a court order in time to prevent the anticipated
injury.
new text end

new text begin (c) Prior to an examiner writing a statement, if another person brought the patient to the
treatment facility, state-operated treatment program, or community-based treatment program,
the examiner shall make a good-faith effort to obtain information from that person, which
the examiner must consider in deciding whether to place the patient on an emergency hold.
To the extent available, the statement must include direct observations of the patient's
behaviors, reliable knowledge of the patient's recent and past behavior, and information
regarding the patient's psychiatric history, past treatment, and current mental health providers.
The examiner shall also inquire about health care directives under chapter 145C and advance
psychiatric directives under section 253B.03, subdivision 6d.
new text end

new text begin (d) The facility or program must give a copy of the examiner's written statement to the
patient immediately upon initiating the emergency hold. The treatment facility, state-operated
treatment program, or community-based treatment program shall maintain a copy of the
examiner's written statement. The program or facility must inform the patient in writing of
the right to (1) leave after 72 hours, (2) have a medical examination within 48 hours, and
(3) request a change to voluntary status. The facility or program shall assist the patient in
exercising the rights granted in this subdivision.
new text end

new text begin (e) The facility or program must not allow the patient nor require the patient's consent
to participate in a clinical drug trial during an emergency admission or hold under this
subdivision. If a patient gives consent to participate in a drug trial during a period of an
emergency admission or hold, it is void and unenforceable. This paragraph does not prohibit
a patient from continuing participation in a clinical drug trial if the patient was participating
in the clinical drug trial at the time of the emergency admission or hold.
new text end

new text begin Subd. 3. new text end

new text begin Duration of hold, release procedures, and change of status. new text end

new text begin (a) If a peace
officer or health officer transports a person to a treatment facility, state-operated treatment
program, or community-based treatment program under subdivision 1, an examiner at the
facility or program must examine the patient and make a determination about the need for
an emergency hold as soon as possible and within 12 hours of the person's arrival. The peace
officer or health officer hold ends upon whichever occurs first: (1) initiation of an emergency
hold on the person under subdivision 2; (2) the person's voluntary admission; (3) the
examiner's decision not to admit the person; or (4) 12 hours after the person's arrival.
new text end

new text begin (b) Under this section, the facility or program may hold a patient up to 72 hours, exclusive
of Saturdays, Sundays, and legal holidays, after the examiner signs the written statement
for an emergency hold of the patient. The facility or program must release a patient when
the emergency hold expires unless the facility or program obtains a court order to hold the
patient. The facility or program may not place the patient on a consecutive emergency hold
under this section.
new text end

new text begin (c) If the interested person files a petition to civilly commit the patient, the court may
issue a judicial hold order pursuant to section 253B.07, subdivision 2b.
new text end

new text begin (d) During the 72-hour hold, a court must not release a patient under this section unless
the court received a written petition for the patient's release and the court has held a summary
hearing regarding the patient's release.
new text end

new text begin (e) The written petition for the patient's release must include the patient's name, the basis
for the hold, the location of the hold, and a statement explaining why the hold is improper.
The petition must also include copies of any written documentation under subdivision 1 or
2 that support the hold, unless the facility or program holding the patient refuses to supply
the documentation. Upon receipt of a petition, the court must comply with the following:
new text end

new text begin (1) the court must hold the hearing as soon as practicable and the court may conduct the
hearing by telephone conference call, interactive video conference, or similar method by
which the participants are able to simultaneously hear each other;
new text end

new text begin (2) before deciding to release the patient, the court shall make every reasonable effort
to provide notice of the proposed release and reasonable opportunity to be heard to:
new text end

new text begin (i) any specific individuals identified in a statement under subdivision 1 or 2 or individuals
identified in the record who might be endangered if the person is not held;
new text end

new text begin (ii) the examiner whose written statement was the basis for the hold under subdivision
2; and
new text end

new text begin (iii) the peace officer or health officer who applied for a hold under subdivision 1; and
new text end

new text begin (3) if the court decides to release the patient, the court shall direct the patient's release
and shall issue written findings supporting the decision. The facility or program must not
delay the patient's release pending the written order.
new text end

new text begin (f) Notwithstanding section 144.293, subdivisions 2 and 4, if a treatment facility,
state-operated treatment program, or community-based treatment program releases or
discharges a patient during the 72-hour hold; the examiner refuses to admit the patient; or
the patient leaves without the consent of the treating health care provider, the head of the
treatment facility, state-operated treatment program, or community-based treatment program
shall immediately notify the agency that employs the peace officer or health officer who
initiated the transport hold. This paragraph does not apply to the extent that the notice would
violate federal law governing the confidentiality of alcohol and drug abuse patient records
under Code of Federal Regulations, title 42, part 2.
new text end

new text begin (g) If a patient is intoxicated in public and a facility or program holds the patient under
this section for detoxification, a treatment facility, state-operated treatment program, or
community-based treatment program may release the patient without providing notice under
paragraph (f) as soon as the treatment facility, state-operated treatment program, or
community-based treatment program determines that the person is no longer in danger of
causing harm to self or others. The facility or program must provide notice to the peace
officer or health officer who transported the person, or to the appropriate law enforcement
agency, if the officer or agency requests notification.
new text end

new text begin (h) A treatment facility or state-operated treatment program must change a patient's
status to voluntary status as provided in section 253B.04 upon the patient's request in writing
if the head of the facility or program consents to the change.
new text end

Sec. 34.

Minnesota Statutes 2018, section 253B.06, subdivision 1, is amended to read:

Subdivision 1.

Persons deleted text begin who are mentally ill or developmentally disabled deleted text end new text begin with mental
illness or developmental disability new text end .

new text begin A physician must examine new text end every patient hospitalized
deleted text begin as mentally ill or developmentally disabled deleted text end new text begin due to mental illness or developmental disability new text end
pursuant to section 253B.04 or deleted text begin 253B.05 must be examined by a physician deleted text end new text begin 253B.051 new text end as soon
as possible but no more than 48 hours following new text begin the patient's new text end admission. The physician deleted text begin shall deleted text end new text begin
must new text end be knowledgeable and trained in deleted text begin the diagnosis of deleted text end new text begin diagnosing new text end the deleted text begin alleged disability
related to the need for deleted text end new text begin patient's mental illness or developmental disability, forming the basis
of the patient's new text end admission deleted text begin as a person who is mentally ill or developmentally disabled deleted text end .

Sec. 35.

Minnesota Statutes 2018, section 253B.06, subdivision 2, is amended to read:

Subd. 2.

Chemically dependent persons.

deleted text begin Patients hospitalized deleted text end new text begin A treatment facility,
state-operated treatment program, or community-based treatment program must examine a
patient hospitalized new text end as chemically dependent pursuant to section 253B.04 or deleted text begin 253B.05 shall
also be examined deleted text end new text begin 253B.051 new text end within 48 hours of admission. At a minimum, deleted text begin the examination
shall consist of a physical evaluation by facility staff deleted text end new text begin the facility or program must physically
examine the patient new text end according to procedures established by a physician new text begin , new text end and deleted text begin an evaluation
by deleted text end staff new text begin examining the patient must be new text end knowledgeable and trained in the diagnosis of the
alleged disability deleted text begin related to the need for deleted text end new text begin forming the basis of the patient's new text end admission as a
chemically dependent person.

Sec. 36.

Minnesota Statutes 2018, section 253B.06, subdivision 3, is amended to read:

Subd. 3.

Discharge.

At the end of a 48-hour period, deleted text begin any deleted text end new text begin the facility or program shall
discharge a new text end patient admitted pursuant to section deleted text begin 253B.05 shall be discharged deleted text end new text begin 253B.051 new text end if
an examination has not been held or if the examiner or evaluation staff person fails to notify
the head of the deleted text begin treatment deleted text end facility new text begin or program new text end in writing that in the examiner's or staff person's
opinion the patient is deleted text begin apparently deleted text end in need of care, treatment, and evaluation as a deleted text begin mentally ill,
developmentally disabled, or chemically dependent deleted text end person new text begin who has a mental illness,
developmental disability, or chemical dependency new text end .

Sec. 37.

Minnesota Statutes 2018, section 253B.07, subdivision 1, is amended to read:

Subdivision 1.

Prepetition screening.

(a) Prior to filing a petition for commitment of
deleted text begin or early intervention for deleted text end a proposed patient, an interested person shall apply to the designated
agency in the county of financial responsibility or the county where the proposed patient is
present for conduct of a preliminary investigation new text begin as provided in section 253B.23, subdivision
1b new text end , except when the proposed patient has been acquitted of a crime under section 611.026
and the county attorney is required to file a petition for commitment. The designated agency
shall appoint a screening team to conduct an investigation. The petitioner may not be a
member of the screening team. The investigation must include:

(1) deleted text begin a personal deleted text end new text begin an new text end interview with the proposed patient and other individuals who appear
to have knowledge of the condition of the proposed patient new text begin , if practicable new text end . new text begin In-person
interviews with the proposed patient are preferred. new text end If the proposed patient is not interviewed,
specific reasons must be documented;

(2) identification and investigation of specific alleged conduct which is the basis for
application;

(3) identification, exploration, and listing of the specific reasons for rejecting or
recommending alternatives to involuntary placement;

(4) in the case of a commitment based on mental illness, deleted text begin the following deleted text end information deleted text begin , if
it is known or available, deleted text end that may be relevant to the administration of neuroleptic medications,
including the existence of a declaration under section 253B.03, subdivision 6d, or a health
care directive under chapter 145C or a guardian, conservator, proxy, or agent with authority
to make health care decisions for the proposed patient; information regarding the capacity
of the proposed patient to make decisions regarding administration of neuroleptic medication;
and whether the proposed patient is likely to consent or refuse consent to administration of
the medication;

(5) seeking input from the proposed patient's health plan company to provide the court
with information about deleted text begin services the enrollee needs and the least restrictive alternatives deleted text end new text begin the
patient's relevant treatment history and current treatment providers new text end ; and

(6) in the case of a commitment based on mental illness, information listed in clause (4)
for other purposes relevant to treatment.

(b) In conducting the investigation required by this subdivision, the screening team shall
have access to all relevant medical records of proposed patients currently in treatment
facilities new text begin , state-operated treatment programs, or community-based treatment programs new text end . The
interviewer shall inform the proposed patient that any information provided by the proposed
patient may be included in the prepetition screening report and may be considered in the
commitment proceedings. Data collected pursuant to this clause shall be considered private
data on individuals. The prepetition screening report is not admissible as evidence except
by agreement of counsel or as permitted by this chapter or the rules of court and is not
admissible in any court proceedings unrelated to the commitment proceedings.

(c) The prepetition screening team shall provide a notice, written in easily understood
language, to the proposed patient, the petitioner, persons named in a declaration under
chapter 145C or section 253B.03, subdivision 6d, and, with the proposed patient's consent,
other interested parties. The team shall ask the patient if the patient wants the notice read
and shall read the notice to the patient upon request. The notice must contain information
regarding the process, purpose, and legal effects of civil commitment deleted text begin and early intervention deleted text end .
The notice must inform the proposed patient that:

(1) if a petition is filed, the patient has certain rights, including the right to a
court-appointed attorney, the right to request a second new text begin court new text end examiner, the right to attend
hearings, and the right to oppose the proceeding and to present and contest evidence; and

(2) if the proposed patient is committed to a deleted text begin state regional treatment center or group
home deleted text end new text begin state-operated treatment program new text end , the patient may be billed for the cost of care and
the state has the right to make a claim against the patient's estate for this cost.

The ombudsman for mental health and developmental disabilities shall develop a form
for the notice which includes the requirements of this paragraph.

(d) When the prepetition screening team recommends commitment, a written report
shall be sent to the county attorney for the county in which the petition is to be filed. The
statement of facts contained in the written report must meet the requirements of subdivision
2, paragraph (b).

(e) The prepetition screening team shall refuse to support a petition if the investigation
does not disclose evidence sufficient to support commitment. Notice of the prepetition
screening team's decision shall be provided to the prospective petitioner new text begin , any specific
individuals identified in the examiner's statement, new text end and to the proposed patient.

(f) If the interested person wishes to proceed with a petition contrary to the
recommendation of the prepetition screening team, application may be made directly to the
county attorney, who shall determine whether or not to proceed with the petition. Notice of
the county attorney's determination shall be provided to the interested party.

(g) If the proposed patient has been acquitted of a crime under section 611.026, the
county attorney shall apply to the designated county agency in the county in which the
acquittal took place for a preliminary investigation unless substantially the same information
relevant to the proposed patient's current mental condition, as could be obtained by a
preliminary investigation, is part of the court record in the criminal proceeding or is contained
in the report of a mental examination conducted in connection with the criminal proceeding.
If a court petitions for commitment pursuant to the Rules of Criminal or Juvenile Procedure
or a county attorney petitions pursuant to acquittal of a criminal charge under section 611.026,
the prepetition investigation, if required by this section, shall be completed within seven
days after the filing of the petition.

Sec. 38.

Minnesota Statutes 2018, section 253B.07, subdivision 2, is amended to read:

Subd. 2.

The petition.

(a) Any interested person, except a member of the prepetition
screening team, may file a petition for commitment in the district court of the county of
financial responsibility or the county where the proposed patient is present. If the head of
the treatment facility new text begin , state-operated treatment program, or community-based treatment
program new text end believes that commitment is required and no petition has been filed, deleted text begin the head of
the treatment facility deleted text end new text begin that person new text end shall petition for the commitment of the deleted text begin person deleted text end new text begin proposed
patient new text end .

(b) The petition shall set forth the name and address of the proposed patient, the name
and address of the patient's nearest relatives, and the reasons for the petition. The petition
must contain factual descriptions of the proposed patient's recent behavior, including a
description of the behavior, where it occurred, and the time period over which it occurred.
Each factual allegation must be supported by observations of witnesses named in the petition.
Petitions shall be stated in behavioral terms and shall not contain judgmental or conclusory
statements.

(c) The petition shall be accompanied by a written statement by an examiner stating that
the examiner has examined the proposed patient within the 15 days preceding the filing of
the petition and is of the opinion that the proposed patient deleted text begin is suffering deleted text end new text begin has new text end a designated
disability and should be committed to a treatment facility new text begin , state-operated treatment program,
or community-based treatment program new text end . The statement shall include the reasons for the
opinion. In the case of a commitment based on mental illness, the petition and the examiner's
statement shall include deleted text begin , to the extent this information is available, deleted text end a statement and opinion
regarding the proposed patient's need for treatment with neuroleptic medication and the
patient's capacity to make decisions regarding the administration of neuroleptic medications,
and the reasons for the opinion. If use of neuroleptic medications is recommended by the
treating deleted text begin physician deleted text end new text begin medical practitioner or other qualified medical provider new text end , the petition for
commitment must, if applicable, include or be accompanied by a request for proceedings
under section 253B.092. Failure to include the required information regarding neuroleptic
medications in the examiner's statement, or to include a request for an order regarding
neuroleptic medications with the commitment petition, is not a basis for dismissing the
commitment petition. If a petitioner has been unable to secure a statement from an examiner,
the petition shall include documentation that a reasonable effort has been made to secure
the supporting statement.

Sec. 39.

Minnesota Statutes 2018, section 253B.07, subdivision 2a, is amended to read:

Subd. 2a.

Petition originating from criminal proceedings.

(a) If criminal charges are
pending against a defendant, the court shall order simultaneous competency and civil
commitment examinations in accordance with Minnesota Rules of Criminal Procedure, rule
20.04, when the following conditions are met:

(1) the prosecutor or defense counsel doubts the defendant's competency and a motion
is made challenging competency, or the court on its initiative raises the issue under rule
20.01; and

(2) the prosecutor and defense counsel agree simultaneous examinations are appropriate.

No additional examination under subdivision 3 is required in a subsequent civil commitment
proceeding unless a second examination is requested by defense counsel appointed following
the filing of any petition for commitment.

new text begin (b) Only a court examiner may conduct an assessment as described in Minnesota Rules
of Criminal Procedure, rules 20.01, subdivision 4, and 20.02, subdivision 2.
new text end

new text begin (c) Where a county is ordered to consider civil commitment following a determination
of incompetency under Minnesota Rules of Criminal Procedure, rule 20.01, the county in
which the criminal matter is pending is responsible to conduct prepetition screening and, if
statutory conditions for commitment are satisfied, to file the commitment petition in that
county. By agreement between county attorneys, prepetition screening and filing the petition
may be handled in the county of financial responsibility or the county where the proposed
patient is present.
new text end

deleted text begin (b) deleted text end new text begin (d) new text end Following an acquittal of a person of a criminal charge under section 611.026,
the petition shall be filed by the county attorney of the county in which the acquittal took
place and the petition shall be filed with the court in which the acquittal took place, and that
court shall be the committing court for purposes of this chapter. When a petition is filed
pursuant to subdivision 2 with the court in which acquittal of a criminal charge took place,
the court shall assign the judge before whom the acquittal took place to hear the commitment
proceedings unless that judge is unavailable.

Sec. 40.

Minnesota Statutes 2018, section 253B.07, subdivision 2b, is amended to read:

Subd. 2b.

Apprehend and hold orders.

(a) The court may order the treatment facility
new text begin or state-operated treatment program new text end to hold the deleted text begin person in a treatment facility deleted text end new text begin proposed
patient new text end or direct a health officer, peace officer, or other person to take the proposed patient
into custody and transport the proposed patient to a treatment facility new text begin or state-operated
treatment program new text end for observation, evaluation, diagnosis, care, treatment, and, if necessary,
confinement, when:

(1) there has been a particularized showing by the petitioner that serious physical harm
to the proposed patient or others is likely unless the proposed patient is immediately
apprehended;

(2) the proposed patient has not voluntarily appeared for the examination or the
commitment hearing pursuant to the summons; or

(3) a person is held pursuant to section deleted text begin 253B.05 deleted text end and a request for a petition
for commitment has been filed.

(b) The order of the court may be executed on any day and at any time by the use of all
necessary means including the imposition of necessary restraint upon the proposed patient.
Where possible, a peace officer taking the proposed patient into custody pursuant to this
subdivision shall not be in uniform and shall not use a deleted text begin motor deleted text end vehicle visibly marked as a
deleted text begin police deleted text end new text begin law enforcement new text end vehicle. Except as provided in section 253D.10, subdivision 2, in
the case of an individual on a judicial hold due to a petition for civil commitment under
chapter 253D, assignment of custody during the hold is to the commissioner deleted text begin of human
services deleted text end . The commissioner is responsible for determining the appropriate placement within
a secure treatment facility under the authority of the commissioner.

(c) A proposed patient must not be allowed or required to consent to nor participate in
a clinical drug trial while an order is in effect under this subdivision. A consent given while
an order is in effect is void and unenforceable. This paragraph does not prohibit a patient
from continuing participation in a clinical drug trial if the patient was participating in the
new text begin clinical new text end drug trial at the time the order was issued under this subdivision.

Sec. 41.

Minnesota Statutes 2018, section 253B.07, subdivision 2d, is amended to read:

Subd. 2d.

Change of venue.

Either party may move to have the venue of the petition
changed to the district court of the Minnesota county where the person currently lives,
whether independently or pursuant to a placement. new text begin The county attorney of the proposed
county of venue must be notified of the motion and provided the opportunity to respond
before the court rules on the motion. new text end The court shall grant the motion if it determines that
the transfer is appropriate and is in the interests of justice. If the petition has been filed
pursuant to the Rules of Criminal or Juvenile Procedure, venue may not be changed without
the new text begin agreement of the county attorney of the proposed county of venue and the new text end approval of
the court in which the juvenile or criminal proceedings are pending.

Sec. 42.

Minnesota Statutes 2018, section 253B.07, subdivision 3, is amended to read:

Subd. 3.

new text begin Court-appointed new text end examiners.

After a petition has been filed, the court shall
appoint deleted text begin an deleted text end new text begin a court new text end examiner. Prior to the hearing, the court shall inform the proposed patient
of the right to an independent second examination. At the proposed patient's request, the
court shall appoint a second new text begin court new text end examiner of the patient's choosing to be paid for by the
county at a rate of compensation fixed by the court.

Sec. 43.

Minnesota Statutes 2018, section 253B.07, subdivision 5, is amended to read:

Subd. 5.

Prehearing examination; report.

The examination shall be held at a treatment
facility or other suitable place the court determines is not likely to harm the health of the
proposed patient. The county attorney and the patient's attorney may be present during the
examination. Either party may waive this right. Unless otherwise agreed by the parties, a
deleted text begin court-appointed deleted text end new text begin court new text end examiner shall file the report with the court not less than 48 hours
prior to the commitment hearing. The court shall ensure that copies of the new text begin court new text end examiner's
report are provided to the county attorney, the proposed patient, and the patient's counsel.

Sec. 44.

Minnesota Statutes 2018, section 253B.07, subdivision 7, is amended to read:

Subd. 7.

Preliminary hearing.

(a) No proposed patient may be held in a treatment
facility new text begin or state-operated treatment program new text end under a judicial hold pursuant to subdivision
2b longer than 72 hours, exclusive of Saturdays, Sundays, and legal holidays, unless the
court holds a preliminary hearing and determines that the standard is met to hold the deleted text begin person deleted text end new text begin
proposed patient new text end .

(b) The proposed patient, patient's counsel, the petitioner, the county attorney, and any
other persons as the court directs shall be given at least 24 hours written notice of the
preliminary hearing. The notice shall include the alleged grounds for confinement. The
proposed patient shall be represented at the preliminary hearing by counsel. The court may
admit reliable hearsay evidence, including written reports, for the purpose of the preliminary
hearing.

(c) The court, on its motion or on the motion of any party, may exclude or excuse a
proposed patient who is seriously disruptive or who is incapable of comprehending and
participating in the proceedings. In such instances, the court shall, with specificity on the
record, state the behavior of the proposed patient or other circumstances which justify
proceeding in the absence of the proposed patient.

(d) The court may continue the judicial hold of the proposed patient if it finds, by a
preponderance of the evidence, that serious physical harm to the proposed patient or others
is likely if the proposed patient is not immediately confined. If a proposed patient was
acquitted of a crime against the person under section 611.026 immediately preceding the
filing of the petition, the court may presume that serious physical harm to the patient or
others is likely if the proposed patient is not immediately confined.

(e) Upon a showing that a deleted text begin person deleted text end new text begin proposed patient new text end subject to a petition for commitment
may need treatment with neuroleptic medications and that the deleted text begin person deleted text end new text begin proposed patient new text end may
lack capacity to make decisions regarding that treatment, the court may appoint a substitute
decision-maker as provided in section 253B.092, subdivision 6. The substitute decision-maker
shall meet with the proposed patient and provider and make a report to the court at the
hearing under section 253B.08 regarding whether the administration of neuroleptic
medications is appropriate under the criteria of section 253B.092, subdivision 7. If the
substitute decision-maker consents to treatment with neuroleptic medications and the
proposed patient does not refuse the medication, neuroleptic medication may be administered
to the new text begin proposed new text end patient. If the substitute decision-maker does not consent or the new text begin proposed
new text end patient refuses, neuroleptic medication may not be administered without a court order, or
in an emergency as set forth in section 253B.092, subdivision 3.

Sec. 45.

Minnesota Statutes 2018, section 253B.08, subdivision 1, is amended to read:

Subdivision 1.

Time for commitment hearing.

(a) The hearing on the commitment
petition shall be held within 14 days from the date of the filing of the petition, except that
the hearing on a commitment petition pursuant to section 253D.07 shall be held within 90
days from the date of the filing of the petition. For good cause shown, the court may extend
the time of hearing up to an additional 30 days. The proceeding shall be dismissed if the
proposed patient has not had a hearing on a commitment petition within the allowed time.

(b) The proposed patient, or the head of the treatment facility new text begin or state-operated treatment
program new text end in which the deleted text begin person deleted text end new text begin patient new text end is held, may demand in writing at any time that the
hearing be held immediately. Unless the hearing is held within five days of the date of the
demand, exclusive of Saturdays, Sundays new text begin , new text end and legal holidays, the petition shall be
automatically dismissed if the patient is being held in a treatment facility new text begin or state-operated
treatment program new text end pursuant to court order. For good cause shown, the court may extend
the time of hearing on the demand for an additional ten days. This paragraph does not apply
to a commitment petition brought under section 253B.18 or chapter 253D.

Sec. 46.

Minnesota Statutes 2018, section 253B.08, subdivision 2a, is amended to read:

Subd. 2a.

Place of hearing.

The hearing shall be conducted in a manner consistent with
orderly procedure. The hearing shall be held at a courtroom meeting standards prescribed
by local court rule which may be at a treatment facility new text begin or state-operated treatment program new text end .
The hearing may be conducted by interactive video conference under General Rules of
Practice, rule 131, and Minnesota Rules of Civil Commitment, rule 14.

Sec. 47.

Minnesota Statutes 2018, section 253B.08, subdivision 5, is amended to read:

Subd. 5.

Absence permitted.

(a) The court may permit the proposed patient to waive
the right to attend the hearing if it determines that the waiver is freely given. At the time of
the hearing new text begin , new text end the new text begin proposed new text end patient shall not be so under the influence of drugs, medication,
or other treatment so as to be hampered in participating in the proceedings. When the deleted text begin licensed
physician or licensed psychologist attending the patient deleted text end new text begin professional responsible for the
proposed patient's treatment new text end is of the opinion that the discontinuance of deleted text begin drugs, deleted text end medication deleted text begin , deleted text end
or other treatment is not in the best interest of the new text begin proposed new text end patient, the court, at the time of
the hearing, shall be presented a record of all deleted text begin drugs, deleted text end medication or other treatment which
the new text begin proposed new text end patient has received during the 48 hours immediately prior to the hearing.

(b) The court, on its own motion or on the motion of any party, may exclude or excuse
a proposed patient who is seriously disruptive or who is incapable of comprehending and
participating in the proceedings. In such instances, the court shall, with specificity on the
record, state the behavior of the proposed patient or other circumstances justifying proceeding
in the absence of the proposed patient.

Sec. 48.

Minnesota Statutes 2018, section 253B.08, subdivision 5a, is amended to read:

Subd. 5a.

Witnesses.

The proposed patient or the patient's counsel and the county attorney
may present and cross-examine witnesses, including new text begin court new text end examiners, at the hearing. The
court may in its discretion receive the testimony of any other person. Opinions of
deleted text begin court-appointed deleted text end new text begin court new text end examiners may not be admitted into evidence unless the new text begin court new text end examiner
is present to testify, except by agreement of the parties.

Sec. 49.

Minnesota Statutes 2018, section 253B.09, subdivision 1, is amended to read:

Subdivision 1.

Standard of proof.

(a) If the court finds by clear and convincing evidence
that the proposed patient is a person deleted text begin who is mentally ill, developmentally disabled, or
chemically dependent deleted text end new text begin who poses a risk of harm due to mental illness, or is a person who
has a developmental disability or chemical dependency, new text end and after careful consideration of
reasonable alternative dispositions deleted text begin , deleted text end including but not limited to deleted text begin , deleted text end dismissal of petition deleted text begin , deleted text end new text begin ; new text end
voluntary outpatient care deleted text begin , deleted text end new text begin ; new text end voluntary admission to a treatment facility, new text begin state-operated
treatment program, or community-based treatment program; new text end appointment of a guardian or
conservator deleted text begin , deleted text end new text begin ; new text end or release before commitment as provided for in subdivision 4, it finds that
there is no suitable alternative to judicial commitment, the court shall commit the patient
to the least restrictive treatment program or alternative programs which can meet the patient's
treatment needs consistent with section 253B.03, subdivision 7.

(b) In deciding on the least restrictive program, the court shall consider a range of
treatment alternatives including deleted text begin , deleted text end but not limited to deleted text begin , deleted text end community-based nonresidential
treatment, community residential treatment, partial hospitalization, acute care hospital,
new text begin assertive community treatment teams, new text end and deleted text begin regional deleted text end new text begin state-operated new text end treatment deleted text begin center services deleted text end new text begin
programs new text end . The court shall also consider the proposed patient's treatment preferences and
willingness to participate voluntarily in the treatment ordered. The court may not commit
a patient to a facility or program that is not capable of meeting the patient's needs.

new text begin (c) If, after careful consideration of reasonable alternative dispositions, the court finds
no suitable alternative to judicial commitment and the court finds that the least restrictive
alternative as determined in paragraph (a) is a treatment facility or community-based
treatment program that is less restrictive or more community based than a state-operated
treatment program, and there is a treatment facility or a community-based treatment program
willing to accept the civilly committed patient, the court may commit the patient to both
the treatment facility or community-based treatment program and to the commissioner, in
the event that treatment in a state-operated treatment program becomes the least restrictive
alternative. If there is a change in the patient's level of care, then:
new text end

new text begin (1) if the patient needs a higher level of care requiring admission to a state-operated
treatment program, custody of the patient and authority and responsibility for the commitment
may be transferred to the commissioner for as long as the patient needs a higher level of
care; and
new text end

new text begin (2) when the patient no longer needs treatment in a state-operated treatment program,
the program may provisionally discharge the patient to an appropriate placement or release
the patient to the treatment facility or community-based treatment program if the program
continues to be willing and able to readmit the patient, in which case the commitment, its
authority, and responsibilities revert to the non-state-operated treatment program. Both
agencies accepting commitment shall coordinate admission and discharge planning to
facilitate timely access to the other's services to meet the patient's needs and shall coordinate
treatment planning consistent with section 253B.03, subdivision 7.
new text end

deleted text begin (c) deleted text end new text begin (d) new text end If deleted text begin the commitment as mentally ill, chemically dependent, or developmentally
disabled is to a service facility provided by the commissioner of human services deleted text end new text begin a person
is committed to a state-operated treatment program as a person who poses a risk of harm
due to mental illness or as a person who has a developmental disability or chemical
dependency new text end , the court shall order the commitment to the commissioner. The commissioner
shall designate the placement of the person to the court.

deleted text begin (d) deleted text end new text begin (e) new text end If the court finds a proposed patient to be a person who deleted text begin is mentally ill deleted text end new text begin poses a
risk of harm due to mental illness new text end under section 253B.02, subdivision 13, deleted text begin paragraph (a), deleted text end
clause deleted text begin (2) or deleted text end (4), the court shall commit new text begin the patient new text end to a new text begin treatment facility or new text end community-based
new text begin treatment new text end program that meets the proposed patient's needs. deleted text begin For purposes of this paragraph,
a community-based program may include inpatient mental health services at a community
hospital.
deleted text end

Sec. 50.

Minnesota Statutes 2018, section 253B.09, subdivision 2, is amended to read:

Subd. 2.

Findings.

new text begin (a) new text end The court shall find the facts specifically, and separately state its
conclusions of law. Where commitment is ordered, the findings of fact and conclusions of
law shall specifically state the proposed patient's conduct which is a basis for determining
that each of the requisites for commitment is met.

new text begin (b) new text end If commitment is ordered, the findings shall also identify less restrictive alternatives
considered and rejected by the court and the reasons for rejecting each alternative.

new text begin (c) new text end If the proceedings are dismissed, the court may direct that the person be transported
back to a suitable location new text begin including to the person's home new text end .

Sec. 51.

Minnesota Statutes 2018, section 253B.09, subdivision 3a, is amended to read:

Subd. 3a.

Reporting judicial commitments; private treatment program or
facility.

Notwithstanding section 253B.23, subdivision 9, when a court commits a patient
to a new text begin non-state-operated new text end treatment new text begin facility or new text end program deleted text begin or facility other than a state-operated
program or facility deleted text end , the court shall report the commitment to the commissioner through the
supreme court information system for purposes of providing commitment information for
firearm background checks under section 245.041. new text begin If the patient is committed to a
state-operated treatment program, the court shall send a copy of the commitment order to
the commissioner.
new text end

Sec. 52.

Minnesota Statutes 2018, section 253B.09, subdivision 5, is amended to read:

Subd. 5.

Initial commitment period.

The initial commitment begins on the date that
the court issues its order or warrant under section 253B.10, subdivision 1. For deleted text begin persons deleted text end new text begin a
person new text end committed as deleted text begin mentally ill, developmentally disabled, deleted text end new text begin a person who poses a risk of
harm due to mental illness, a developmental disability, new text end or deleted text begin chemically dependent deleted text end new text begin chemical
dependency, new text end the initial commitment shall not exceed six months.

Sec. 53.

Minnesota Statutes 2018, section 253B.092, is amended to read:

253B.092 ADMINISTRATION OF NEUROLEPTIC MEDICATION.

Subdivision 1.

General.

Neuroleptic medications may be administered, only as provided
in this section, to patients subject to deleted text begin early intervention or deleted text end civil commitment deleted text begin as mentally ill,
mentally ill and dangerous, a sexually dangerous person, or a person with a sexual
psychopathic personality deleted text end new text begin under this chapter or chapter 253D new text end . For purposes of this section,
"patient" includes a proposed patient who is the subject of a petition for deleted text begin early intervention
or deleted text end commitment and a committed person as defined in section 253D.02, subdivision 4.

Subd. 2.

Administration without judicial review.

new text begin (a) new text end Neuroleptic medications may be
administered without judicial review in the following circumstances:

(1) the patient has the capacity to make an informed decision under subdivision 4;

(2) the patient does not have the present capacity to consent to the administration of
neuroleptic medication, but prepared new text begin a health care power of attorney, new text end a health care directive
under chapter 145C new text begin , new text end or a declaration under section 253B.03, subdivision 6d, requesting
treatment or authorizing an agent or proxy to request treatment, and the agent or proxy has
requested the treatment;

(3) the patient has been prescribed neuroleptic medication prior to admission to a
treatment facility, but lacks the new text begin present new text end capacity to consent to the administration of that
neuroleptic medication; continued administration of the medication is in the patient's best
interest; and the patient does not refuse administration of the medication. In this situation,
the previously prescribed neuroleptic medication may be continued for up to 14 days while
the treating deleted text begin physician deleted text end new text begin medical practitioner new text end :

(i) is obtaining a substitute decision-maker appointed by the court under subdivision 6;
or

(ii) is requesting new text begin a court order authorizing administering neuroleptic medication or new text end an
amendment to a current court order authorizing administration of neuroleptic medication;

(4) a substitute decision-maker appointed by the court consents to the administration of
the neuroleptic medication and the patient does not refuse administration of the medication;
or

(5) the substitute decision-maker does not consent or the patient is refusing medication,
and the patient is in an emergency situation.

new text begin (b) For the purposes of paragraph (a), clause (3), if a person requests a substitute
decision-maker or requests a court order administering neuroleptic medication within 14
days, the treating medical practitioner may continue administering the medication to the
patient through the hearing date or until the court otherwise issues an order.
new text end

Subd. 3.

Emergency administration.

A treating deleted text begin physician deleted text end new text begin medical practitioner new text end may
administer neuroleptic medication to a patient who does not have capacity to make a decision
regarding administration of the medication if the patient is in an emergency situation.
Medication may be administered for so long as the emergency continues to exist, up to 14
days, if the treating deleted text begin physician deleted text end new text begin medical practitioner new text end determines that the medication is necessary
to prevent serious, immediate physical harm to the patient or to others. If a request for
authorization to administer medication is made to the court within the 14 days, the treating
deleted text begin physician deleted text end new text begin medical practitioner new text end may continue the medication through the date of the first
court hearing, if the emergency continues to exist. If the request for authorization to
administer medication is made to the court in conjunction with a petition for commitment
deleted text begin or early intervention deleted text end and the court makes a determination at the preliminary hearing under
section 253B.07, subdivision 7, that there is sufficient cause to continue the deleted text begin physician's deleted text end new text begin
medical practitioner's new text end order until the hearing under section 253B.08, the treating deleted text begin physician deleted text end new text begin
medical practitioner new text end may continue the medication until that hearing, if the emergency
continues to exist. The treatment facility new text begin , state-operated treatment program, or
community-based treatment program new text end shall document the emergency in the patient's medical
record in specific behavioral terms.

Subd. 4.

Patients with capacity to make informed decision.

A patient who has the
capacity to make an informed decision regarding the administration of neuroleptic medication
may consent or refuse consent to administration of the medication. The informed consent
of a patient must be in writing.

Subd. 5.

Determination of capacity.

(a) new text begin There is a rebuttable presumption that new text end a patient
deleted text begin is presumed to have deleted text end new text begin has the new text end capacity to make decisions regarding administration of
neuroleptic medication.

(b) deleted text begin In determining deleted text end A deleted text begin person's deleted text end new text begin patient has the new text end capacity to make decisions regarding the
administration of neuroleptic medication deleted text begin , the court shall consider deleted text end new text begin if the patient new text end :

(1) deleted text begin whether the person demonstrates deleted text end new text begin has new text end an awareness of the nature of the deleted text begin person's deleted text end new text begin
patient's new text end situation, including the reasons for hospitalization, and the possible consequences
of refusing treatment with neuroleptic medications;

(2) deleted text begin whether the person demonstrates deleted text end new text begin has new text end an understanding of treatment with neuroleptic
medications and the risks, benefits, and alternatives; and

(3) deleted text begin whether the person deleted text end communicates verbally or nonverbally a clear choice regarding
treatment with neuroleptic medications that is a reasoned one not based on deleted text begin delusion deleted text end new text begin a
symptom of the patient's mental illness new text end , even though it may not be in the deleted text begin person's deleted text end new text begin patient's
new text end best interests.

new text begin (c) new text end Disagreement with the deleted text begin physician's deleted text end new text begin medical practitioner's new text end recommendation new text begin alone new text end is
not evidence of an unreasonable decision.

Subd. 6.

Patients without capacity to make informed decision; substitute
decision-maker.

(a) Upon request of any person, and upon a showing that administration
of neuroleptic medications may be recommended and that the deleted text begin person deleted text end new text begin patient new text end may lack
capacity to make decisions regarding the administration of neuroleptic medication, the court
shall appoint a substitute decision-maker with authority to consent to the administration of
neuroleptic medication as provided in this section. A hearing is not required for an
appointment under this paragraph. The substitute decision-maker must be an individual or
a community or institutional multidisciplinary panel designated by the local mental health
authority. In appointing a substitute decision-maker, the court shall give preference to a
guardian deleted text begin or conservator deleted text end , proxy, or health care agent with authority to make health care
decisions for the patient. The court may provide for the payment of a reasonable fee to the
substitute decision-maker for services under this section or may appoint a volunteer.

(b) If the deleted text begin person's treating physician deleted text end new text begin patient's treating medical practitioner new text end recommends
treatment with neuroleptic medication, the substitute decision-maker may give or withhold
consent to the administration of the medication, based on the standards under subdivision
7. If the substitute decision-maker gives informed consent to the treatment and the deleted text begin person deleted text end new text begin
patient new text end does not refuse, the substitute decision-maker shall provide written consent to the
treating deleted text begin physician deleted text end new text begin medical practitioner new text end and the medication may be administered. The
substitute decision-maker shall also notify the court that consent has been given. If the
substitute decision-maker refuses or withdraws consent or the deleted text begin person deleted text end new text begin patient new text end refuses the
medication, neuroleptic medication deleted text begin may deleted text end new text begin must new text end not be administered to the deleted text begin person without deleted text end new text begin
patient except with new text end a court order or in an emergency.

(c) A substitute decision-maker appointed under this section has access to the relevant
sections of the patient's health records on the past or present administration of medication.
The designated agency or a person involved in the patient's physical or mental health care
may disclose information to the substitute decision-maker for the sole purpose of performing
the responsibilities under this section. The substitute decision-maker may not disclose health
records obtained under this paragraph except to the extent necessary to carry out the duties
under this section.

(d) At a hearing under section 253B.08, the petitioner has the burden of proving incapacity
by a preponderance of the evidence. If a substitute decision-maker has been appointed by
the court, the court shall make findings regarding the patient's capacity to make decisions
regarding the administration of neuroleptic medications and affirm or reverse its appointment
of a substitute decision-maker. If the court affirms the appointment of the substitute
decision-maker, and if the substitute decision-maker has consented to the administration of
the medication and the patient has not refused, the court shall make findings that the substitute
decision-maker has consented and the treatment is authorized. If a substitute decision-maker
has not yet been appointed, upon request the court shall make findings regarding the patient's
capacity and appoint a substitute decision-maker if appropriate.

(e) If an order for civil commitment deleted text begin or early intervention deleted text end did not provide for the
appointment of a substitute decision-maker or for the administration of neuroleptic
medication, deleted text begin the deleted text end new text begin a new text end treatment facility new text begin , state-operated treatment program, or community-based
treatment program new text end may later request the appointment of a substitute decision-maker upon
a showing that administration of neuroleptic medications is recommended and that the
deleted text begin person deleted text end new text begin patient new text end lacks capacity to make decisions regarding the administration of neuroleptic
medications. A hearing is not required in order to administer the neuroleptic medication
unless requested under subdivision 10 or if the substitute decision-maker withholds or
refuses consent or the deleted text begin person deleted text end new text begin patient new text end refuses the medication.

(f) The substitute decision-maker's authority to consent to treatment lasts for the duration
of the court's order of appointment or until modified by the court.

deleted text begin If the substitute decision-maker withdraws consent or the patient refuses consent,
neuroleptic medication may not be administered without a court order.
deleted text end

(g) If there is no hearing after the preliminary hearing, then the court shall, upon the
request of any interested party, review the reasonableness of the substitute decision-maker's
decision based on the standards under subdivision 7. The court shall enter an order upholding
or reversing the decision within seven days.

Subd. 7.

When deleted text begin person deleted text end new text begin patient new text end lacks capacity to make decisions about medication.

(a)
When a deleted text begin person deleted text end new text begin patient new text end lacks capacity to make decisions regarding the administration of
neuroleptic medication, the substitute decision-maker or the court shall use the standards
in this subdivision in making a decision regarding administration of the medication.

(b) If the deleted text begin person deleted text end new text begin patient new text end clearly stated what the deleted text begin person deleted text end new text begin patient new text end would choose to do in this
situation when the deleted text begin person deleted text end new text begin patient new text end had the capacity to make a reasoned decision, the deleted text begin person's deleted text end new text begin
patient's new text end wishes must be followed. Evidence of the deleted text begin person's deleted text end new text begin patient's new text end wishes may include
written instruments, including a durable power of attorney for health care under chapter
145C or a declaration under section 253B.03, subdivision 6d.

(c) If evidence of the deleted text begin person's deleted text end new text begin patient's new text end wishes regarding the administration of neuroleptic
medications is conflicting or lacking, the decision must be based on what a reasonable
person would do, taking into consideration:

(1) the deleted text begin person's deleted text end new text begin patient's new text end family, community, moral, religious, and social values;

(2) the medical risks, benefits, and alternatives to the proposed treatment;

(3) past efficacy and any extenuating circumstances of past use of neuroleptic
medications; and

(4) any other relevant factors.

Subd. 8.

Procedure when patient refuses new text begin neuroleptic new text end medication.

(a) If the substitute
decision-maker or the patient refuses to consent to treatment with neuroleptic medications,
and absent an emergency as set forth in subdivision 3, neuroleptic medications may not be
administered without a court order. Upon receiving a written request for a hearing, the court
shall schedule the hearing within 14 days of the request. The matter may be heard as part
of any other district court proceeding under this chapter. By agreement of the parties or for
good cause shown, the court may extend the time of hearing an additional 30 days.

(b) The patient must be examined by a court examiner prior to the hearing. If the patient
refuses to participate in an examination, the new text begin court new text end examiner may rely on the patient's medical
records to reach an opinion as to the appropriateness of neuroleptic medication. The patient
is entitled to counsel and a second new text begin court new text end examiner, if requested by the patient or patient's
counsel.

(c) The court may base its decision on relevant and admissible evidence, including the
testimony of a treating deleted text begin physician deleted text end new text begin medical practitioner new text end or other qualified physician, a member
of the patient's treatment team, a deleted text begin court-appointed deleted text end new text begin court new text end examiner, witness testimony, or the
patient's medical records.

(d) If the court finds that the patient has the capacity to decide whether to take neuroleptic
medication or that the patient lacks capacity to decide and the standards for making a decision
to administer the medications under subdivision 7 are not met, the deleted text begin treating deleted text end new text begin treatment new text end facility new text begin ,
state-operated treatment program, or community-based treatment program new text end may not administer
medication without the patient's informed written consent or without the declaration of an
emergency, or until further review by the court.

(e) If the court finds that the patient lacks capacity to decide whether to take neuroleptic
medication and has applied the standards set forth in subdivision 7, the court may authorize
the deleted text begin treating deleted text end new text begin treatment new text end facility new text begin , state-operated treatment program, or community-based
treatment program new text end and any other deleted text begin community or treatment deleted text end facility new text begin or program new text end to which the
patient may be transferred or provisionally discharged, to involuntarily administer the
medication to the patient. A copy of the order must be given to the patient, the patient's
attorney, the county attorney, and the treatment facility new text begin , state-operated treatment program,
or community-based treatment program new text end . The treatment facility new text begin , state-operated treatment
program, or community-based treatment program new text end may not begin administration of the
neuroleptic medication until it notifies the patient of the court's order authorizing the
treatment.

(f) A finding of lack of capacity under this section must not be construed to determine
the patient's competence for any other purpose.

(g) The court may authorize the administration of neuroleptic medication until the
termination of a determinate commitment. If the patient is committed for an indeterminate
period, the court may authorize treatment of neuroleptic medication for not more than two
years, subject to the patient's right to petition the court for review of the order. The treatment
facility new text begin , state-operated treatment program, or community-based treatment program new text end must
submit annual reports to the court, which shall provide copies to the patient and the respective
attorneys.

(h) The court may limit the maximum dosage of neuroleptic medication that may be
administered.

(i) If physical force is required to administer the neuroleptic medication, new text begin the facility or
program may only use injectable medications. If physical new text end force new text begin is needed to administer the
medication, medication new text end may only deleted text begin take place deleted text end new text begin be administered new text end in a deleted text begin treatment facility or
therapeutic deleted text end setting where the person's condition can be reassessed and deleted text begin appropriate deleted text end medical
deleted text begin staff deleted text end new text begin personnel qualified to administer medication new text end are available new text begin , including in the community,
a county jail, or a correctional facility. The facility or program may not use a nasogastric
tube to administer neuroleptic medication involuntarily new text end .

Subd. 9.

Immunity.

A substitute decision-maker who consents to treatment is not civilly
or criminally liable for the performance of or the manner of performing the treatment. A
person is not liable for performing treatment without consent if the substitute decision-maker
has given written consent. This provision does not affect any other liability that may result
from the manner in which the treatment is performed.

Subd. 10.

Review.

A patient or other person may petition the court under section 253B.17
for review of any determination under this section or for a decision regarding the
administration of neuroleptic medications, appointment of a substitute decision-maker, or
the patient's capacity to make decisions regarding administration of neuroleptic medications.

Sec. 54.

Minnesota Statutes 2018, section 253B.0921, is amended to read:

253B.0921 ACCESS TO MEDICAL RECORDS.

A treating deleted text begin physician deleted text end new text begin medical practitioner new text end who makes medical decisions regarding the
prescription and administration of medication for treatment of a mental illness has access
to the relevant sections of a patient's health records on past administration of medication at
any deleted text begin treatment deleted text end facility new text begin , program, or treatment provider new text end , if the patient lacks the capacity to
authorize the release of records. Upon request of a treating deleted text begin physician deleted text end new text begin medical practitioner new text end
under this section, a deleted text begin treatment deleted text end facility new text begin , program, or treatment provider new text end shall supply complete
information relating to the past records on administration of medication of a patient subject
to this chapter. A patient who has the capacity to authorize the release of data retains the
right to make decisions regarding access to medical records as provided by sections 144.291
to 144.298.

Sec. 55.

Minnesota Statutes 2018, section 253B.095, subdivision 3, is amended to read:

Subd. 3.

Duration.

The maximum duration of a stayed order under this section is six
months. The court may continue the order for a maximum of an additional 12 months if,
after notice and hearing, under sections 253B.08 and 253B.09 the court finds that (1) the
person continues to deleted text begin be mentally ill, chemically dependent, or developmentally disabled, deleted text end new text begin
have a mental illness, developmental disability, or chemical dependency, new text end and (2) an order
is needed deleted text begin to protect the patient or others deleted text end new text begin because the person is likely to attempt to physically
harm self or others or fail to obtain necessary food, clothing, shelter, or medical care unless
the person is under the supervision of a stayed commitment new text end .

Sec. 56.

Minnesota Statutes 2018, section 253B.097, subdivision 1, is amended to read:

Subdivision 1.

Findings.

In addition to the findings required under section 253B.09,
subdivision 2, an order committing a person to new text begin a new text end community-based treatment new text begin program new text end must
include:

(1) a written plan for services to the patient;

(2) a finding that the proposed treatment is available and accessible to the patient and
that public or private financial resources are available to pay for the proposed treatment;

(3) conditions the patient must meet in order to obtain an early release from commitment
or to avoid a hearing for further commitment; and

(4) consequences of the patient's failure to follow the commitment order. Consequences
may include commitment to another setting for treatment.

Sec. 57.

Minnesota Statutes 2018, section 253B.097, subdivision 2, is amended to read:

Subd. 2.

Case manager.

When a court commits a patient with mental illness to new text begin a
new text end community-based treatment new text begin program new text end , the court shall appoint a case manager from the county
agency or other entity under contract with the county agency to provide case management
services.

Sec. 58.

Minnesota Statutes 2018, section 253B.097, subdivision 3, is amended to read:

Subd. 3.

Reports.

The case manager shall report to the court at least once every 90 days.
The case manager shall immediately report new text begin to the court new text end a substantial failure of the patient
or provider to comply with the conditions of the commitment.

Sec. 59.

Minnesota Statutes 2018, section 253B.097, subdivision 6, is amended to read:

Subd. 6.

Immunity from liability.

No new text begin treatment new text end facility new text begin , community-based treatment
program, new text end or person is financially liable, personally or otherwise, for new text begin the patient's new text end actions deleted text begin of
the patient deleted text end if the facility or person follows accepted community standards of professional
practice in the management, supervision, and treatment of the patient. For purposes of this
subdivision, "person" means official, staff, employee of the new text begin treatment new text end facility new text begin ,
community-based treatment program new text end , physician, or other individual who is responsible for
deleted text begin the deleted text end new text begin a patient's new text end management, supervision, or treatment deleted text begin of a patient's community-based
treatment deleted text end under this section.

Sec. 60.

Minnesota Statutes 2018, section 253B.10, is amended to read:

253B.10 PROCEDURES UPON COMMITMENT.

Subdivision 1.

Administrative requirements.

(a) When a person is committed, the
court shall issue a warrant or an order committing the patient to the custody of the head of
the treatment facility new text begin , state-operated treatment program, or community-based treatment
program new text end . The warrant or order shall state that the patient meets the statutory criteria for
civil commitment.

(b) The commissioner shall prioritize patients being admitted from jail or a correctional
institution who are:

(1) ordered confined in a deleted text begin state hospital deleted text end new text begin state-operated treatment program new text end for an
examination under Minnesota Rules of Criminal Procedure, rules 20.01, subdivision 4,
paragraph (a), and 20.02, subdivision 2;

(2) under civil commitment for competency treatment and continuing supervision under
Minnesota Rules of Criminal Procedure, rule 20.01, subdivision 7;

(3) found not guilty by reason of mental illness under Minnesota Rules of Criminal
Procedure, rule 20.02, subdivision 8, and under civil commitment or are ordered to be
detained in a deleted text begin state hospital or other facility deleted text end new text begin state-operated treatment program new text end pending
completion of the civil commitment proceedings; or

(4) committed under this chapter to the commissioner after dismissal of the patient's
criminal charges.

Patients described in this paragraph must be admitted to a deleted text begin service operated by the
commissioner deleted text end new text begin state-operated treatment program new text end within 48 hours. The commitment must be
ordered by the court as provided in section 253B.09, subdivision 1, paragraph deleted text begin (c) deleted text end new text begin (d) new text end .

(c) Upon the arrival of a patient at the designated treatment facility new text begin , state-operated
treatment program, or community-based treatment program new text end , the head of the facility new text begin or
program new text end shall retain the duplicate of the warrant and endorse receipt upon the original
warrant or acknowledge receipt of the order. The endorsed receipt or acknowledgment must
be filed in the court of commitment. After arrival, the patient shall be under the control and
custody of the head of the deleted text begin treatment deleted text end facility new text begin or program new text end .

(d) Copies of the petition for commitment, the court's findings of fact and conclusions
of law, the court order committing the patient, the report of the new text begin court new text end examiners, and the
prepetition report, and any medical and behavioral information available shall be provided
at the time of admission of a patient to the designated treatment facility new text begin or program to which
the patient is committed. Upon a patient's referral to the commissioner of human services
for admission pursuant to subdivision 1, paragraph (b), any inpatient hospital, treatment
facility, jail, or correctional facility that has provided care or supervision to the patient in
the previous two years shall, when requested by the treatment facility or commissioner,
provide copies of the patient's medical and behavioral records to the Department of Human
Services for purposes of preadmission planning. This information shall be provided by the
head of the treatment facility to treatment facility staff in a consistent and timely manner
and pursuant to all applicable laws new text end . deleted text begin This information shall also be provided by the head of
the treatment facility to treatment facility staff in a consistent and timely manner and pursuant
to all applicable laws.
deleted text end

Subd. 2.

Transportation.

new text begin (a) new text end When a patient is about to be placed in a treatment facility new text begin ,
state-operated treatment program, or community-based treatment program new text end , the court may
order the designated agency, the treatment facility new text begin , state-operated treatment program, or
community-based treatment program new text end , or any responsible adult to transport the patient deleted text begin to
the treatment facility deleted text end . new text begin A protected transport provider may transport the patient according to
section 256B.0625, subdivision 17. new text end Whenever possible, a peace officer who provides the
transportation shall not be in uniform and shall not use a vehicle visibly marked as a deleted text begin police deleted text end new text begin
law enforcement new text end vehicle. The proposed patient may be accompanied by one or more
interested persons.

new text begin (b) new text end When a patient who is at a deleted text begin regional deleted text end new text begin state-operated new text end treatment deleted text begin center deleted text end new text begin program new text end requests
a hearing for adjudication of a patient's status pursuant to section 253B.17, the commissioner
shall provide transportation.

Subd. 3.

Notice of admission.

Whenever a committed person has been admitted to a
treatment facility new text begin , state-operated treatment program, or community-based treatment program new text end
under the provisions of section 253B.09 or 253B.18, the head of the deleted text begin treatment deleted text end facility new text begin or
program new text end shall immediately notify the patient's spouse, health care agent, or parent and the
county of financial responsibility if the county may be liable for a portion of the cost of
treatment. If the committed person was admitted upon the petition of a spouse, health care
agent, or parent new text begin , new text end the head of the treatment facility new text begin , state-operated treatment program, or
community-based treatment program new text end shall notify an interested person other than the
petitioner.

new text begin Subd. 3a. new text end

new text begin Interim custody and treatment of committed person. new text end

new text begin When the patient is
present in a treatment facility or state-operated treatment program at the time of the court's
commitment order, unless the court orders otherwise, the commitment order constitutes
authority for that facility or program to confine and provide treatment to the patient until
the patient is transferred to the facility or program to which the patient has been committed.
new text end

Subd. 4.

Private treatment.

Patients or other responsible persons are required to pay
the necessary charges for patients committed or transferred to deleted text begin private deleted text end treatment facilities new text begin
or community-based treatment programs new text end . deleted text begin Private deleted text end Treatment facilities new text begin or community-based
treatment programs new text end may not refuse to accept a committed person solely based on the person's
court-ordered status. Insurers must provide treatment and services as ordered by the court
under section 253B.045, subdivision 6, or as required under chapter 62M.

Subd. 5.

Transfer to voluntary status.

At any time prior to the expiration of the initial
commitment period, a patient who has not been committed as deleted text begin mentally ill deleted text end new text begin a person who has
a mental illness new text end and new text begin is new text end dangerous to the public or deleted text begin as deleted text end a sexually dangerous person or deleted text begin as deleted text end a
sexual psychopathic personality may be transferred to voluntary status upon the patient's
application in writing with the consent of the head of the facility new text begin or program to which the
person is committed new text end . Upon transfer, the head of the treatment facility new text begin , state-operated treatment
program, or community-based treatment program new text end shall immediately notify the court in
writing and the court shall terminate the proceedings.

Sec. 61.

Minnesota Statutes 2018, section 253B.12, subdivision 1, is amended to read:

Subdivision 1.

Reports.

(a) If a patient who was committed as a person deleted text begin who is mentally
ill, developmentally disabled, or chemically dependent deleted text end new text begin who poses a risk of harm due to a
mental illness, or as a person who has a developmental disability or chemical dependency,
new text end is discharged from commitment within the first 60 days after the date of the initial
commitment order, the head of the treatment facility new text begin , state-operated treatment program, or
community-based treatment program new text end shall file a written report with the committing court
describing the patient's need for further treatment. A copy of the report must be provided
to the county attorney, the patient, and the patient's counsel.

(b) If a patient who was committed as a person deleted text begin who is mentally ill, developmentally
disabled, or chemically dependent deleted text end new text begin who poses a risk of harm due to a mental illness, or as a
person who has a developmental disability or chemical dependency, new text end remains in treatment
more than 60 days after the date of the commitment, then at least 60 days, but not more than
90 days, after the date of the order, the head of the facility new text begin or program new text end that has custody of
the patient shall file a written report with the committing court and provide a copy to the
county attorney, the patient, and the patient's counsel. The report must set forth in detailed
narrative form at least the following:

(1) the diagnosis of the patient with the supporting data;

(2) the anticipated discharge date;

(3) an individualized treatment plan;

(4) a detailed description of the discharge planning process with suggested after care
plan;

(5) whether the patient is in need of further care and treatment, the treatment facility
deleted text begin which deleted text end new text begin , state-operated treatment program, or community-based treatment program that new text end is
needed, and evidence to support the response;

(6) whether the patient satisfies the statutory requirement for continued commitment deleted text begin to
a treatment facility, deleted text end with documentation to support the opinion; deleted text begin and
deleted text end

new text begin (7) a statement from the patient related to accepting treatment, if possible; and
new text end

deleted text begin (7) deleted text end new text begin (8) new text end whether the administration of neuroleptic medication is clinically indicated,
whether the patient is able to give informed consent to that medication, and the basis for
these opinions.

(c) Prior to the termination of the initial commitment order or final discharge of the
patient, the head of the deleted text begin treatment deleted text end facility new text begin or program new text end that has custody or care of the patient
shall file a written report with the committing court with a copy to the county attorney, the
patient, and the patient's counsel that sets forth the information required in paragraph (b).

(d) If the patient has been provisionally discharged from a deleted text begin treatment deleted text end facility new text begin or program new text end ,
the report shall be filed by the designated agency, which may submit the discharge report
as part of its report.

(e) deleted text begin If no written report is filed within the required time, or deleted text end If a report describes the patient
as not in need of further deleted text begin institutional care and deleted text end new text begin court-ordered new text end treatment, the proceedings must
be terminated by the committing court and the patient discharged from the treatment facility new text begin ,
state-operated treatment program, or community-based treatment program, unless the patient
chooses to voluntarily receive services new text end .

new text begin (f) If no written report is filed within the required time, the court must notify the county,
facility or program to which the person is committed, and designated agency and require a
report be filed within five business days. If a report is not filed within five business days a
hearing must be held within three business days.
new text end

Sec. 62.

Minnesota Statutes 2018, section 253B.12, subdivision 3, is amended to read:

Subd. 3.

Examination.

Prior to the review hearing, the court shall inform the patient of
the right to an independent examination by deleted text begin an deleted text end new text begin a court new text end examiner chosen by the patient and
appointed in accordance with provisions of section 253B.07, subdivision 3. The report of
the new text begin court new text end examiner may be submitted at the hearing.

Sec. 63.

Minnesota Statutes 2018, section 253B.12, subdivision 4, is amended to read:

Subd. 4.

Hearing; standard of proof.

new text begin (a) new text end The committing court shall not make a final
determination of the need to continue commitment unless the court finds by clear and
convincing evidence that (1) the deleted text begin person deleted text end new text begin patient new text end continues to deleted text begin be mentally ill, developmentally
disabled, or chemically dependent deleted text end new text begin have a mental illness, developmental disability, or chemical
dependency new text end ; (2) involuntary commitment is necessary for the protection of the patient or
others; and (3) there is no alternative to involuntary commitment.

new text begin (b) new text end In determining whether a deleted text begin person deleted text end new text begin patient new text end continues to deleted text begin be mentally ill, chemically
dependent, or developmentally disabled, deleted text end new text begin require commitment due to mental illness,
developmental disability, or chemical dependency, new text end the court need not find that there has
been a recent attempt or threat to physically harm self or others, or a recent failure to provide
necessary deleted text begin personal deleted text end food, clothing, shelter, or medical care. Instead, the court must find that
the patient is likely to attempt to physically harm self or others, or to fail to deleted text begin provide deleted text end new text begin obtain new text end
necessary deleted text begin personal deleted text end food, clothing, shelter, or medical care unless involuntary commitment
is continued.

Sec. 64.

Minnesota Statutes 2018, section 253B.12, subdivision 7, is amended to read:

Subd. 7.

Record required.

Where continued commitment is ordered, the findings of
fact and conclusions of law shall specifically state the conduct of the proposed patient which
is the basis for the final determination, that the statutory criteria of commitment continue
to be met, and that less restrictive alternatives have been considered and rejected by the
court. Reasons for rejecting each alternative shall be stated. A copy of the final order for
continued commitment shall be forwarded to the head of the deleted text begin treatment deleted text end facility new text begin or program
to which the person is committed and, if the patient has been provisionally discharged, to
the designated agency responsible for monitoring the provisional discharge new text end .

Sec. 65.

Minnesota Statutes 2018, section 253B.13, subdivision 1, is amended to read:

Subdivision 1.

deleted text begin Mentally ill or chemically dependent deleted text end Persons new text begin with mental illness or
chemical dependency new text end .

new text begin (a) new text end If at the conclusion of a review hearing the court finds that the
person continues to deleted text begin be mentally ill or chemically dependent deleted text end new text begin have mental illness or chemical
dependency new text end and deleted text begin in deleted text end need deleted text begin of deleted text end treatment or supervision, the court shall determine the length of
continued commitment. No period of commitment shall exceed this length of time or 12
months, whichever is less.

new text begin (b) new text end At the conclusion of the prescribed period new text begin under paragraph (a) new text end , commitment may
not be continued unless a new petition is filed pursuant to section 253B.07 and hearing and
determination made on it. new text begin If the petition was filed before the end of the previous commitment
and, for good cause shown, the court has not completed the hearing and the determination
by the end of the commitment period, the court may for good cause extend the previous
commitment for up to 14 days to allow the completion of the hearing and the issuance of
the determination. The standard of proof for the new petition is the standard specified in
section 253B.12, subdivision 4. new text end Notwithstanding the provisions of section 253B.09,
subdivision 5, the initial commitment period under the new petition shall be the probable
length of commitment necessary or 12 months, whichever is less. deleted text begin The standard of proof at
the hearing on the new petition shall be the standard specified in section 253B.12, subdivision
4.
deleted text end

Sec. 66.

Minnesota Statutes 2018, section 253B.14, is amended to read:

253B.14 TRANSFER OF COMMITTED PERSONS.

The commissioner may transfer any committed person, other than a person committed
as deleted text begin mentally ill and deleted text end new text begin a person who has a mental illness and is new text end dangerous to the public, deleted text begin or as deleted text end
a sexually dangerous person or deleted text begin as deleted text end a sexual psychopathic personality, from one deleted text begin regional deleted text end new text begin
state-operated new text end treatment deleted text begin center deleted text end new text begin program new text end to any other new text begin state-operated new text end treatment deleted text begin facility under
the commissioner's jurisdiction which is deleted text end new text begin program new text end capable of providing proper care and
treatment. When a committed person is transferred from one new text begin state-operated new text end treatment deleted text begin facility deleted text end
new text begin program new text end to another, written notice shall be given to the committing court, the county attorney,
the patient's counsel, and to the person's parent, health care agent, or spouse or, if none is
known, to an interested person, and the designated agency.

Sec. 67.

Minnesota Statutes 2018, section 253B.141, is amended to read:

253B.141 AUTHORITY TO DETAIN AND TRANSPORT A MISSING PATIENT.

Subdivision 1.

Report of absence.

(a) If a patient committed under this chapter or
detained new text begin in a treatment facility or state-operated treatment program new text end under a judicial hold is
absent without authorization, and either: (1) does not return voluntarily within 72 hours of
the time the unauthorized absence began; or (2) is considered by the head of the deleted text begin treatment deleted text end
facility new text begin or program new text end to be a danger to self or others, then the head of the deleted text begin treatment deleted text end facility new text begin
or program new text end shall report the absence to the local law enforcement agency. The head of the
deleted text begin treatment deleted text end facility new text begin or program new text end shall also notify the committing court that the patient is absent
and that the absence has been reported to the local law enforcement agency. The committing
court may issue an order directing the law enforcement agency to transport the patient to
an appropriate new text begin treatment new text end facility new text begin , state-operated treatment program, or community-based
treatment program new text end .

(b) Upon receiving a report that a patient subject to this section is absent without
authorization, the local law enforcement agency shall enter information on the patient into
the missing persons file of the National Crime Information Center computer according to
the missing persons practices.

Subd. 2.

Apprehension; return to facility new text begin or program new text end .

(a) Upon receiving the report
of absence from the head of the treatment facility new text begin , state-operated treatment program, or
community-based treatment program new text end or the committing court, a patient may be apprehended
and held by a peace officer in any jurisdiction pending return to the facility new text begin or program new text end from
which the patient is absent without authorization. A patient may also be returned to any
deleted text begin facility operated by the commissioner deleted text end new text begin state-operated treatment program or any other treatment
facility or community-based treatment program willing to accept the person new text end . A person who
deleted text begin is mentally ill deleted text end new text begin has a mental illness new text end and new text begin is new text end dangerous new text begin to the public new text end and detained under this
subdivision may be held in a jail or lockup only if:

(1) there is no other feasible place of detention for the patient;

(2) the detention is for less than 24 hours; and

(3) there are protections in place, including segregation of the patient, to ensure the
safety of the patient.

(b) If a patient is detained under this subdivision, the head of the deleted text begin treatment deleted text end facility new text begin or
program new text end from which the patient is absent shall arrange to pick up the patient within 24 hours
of the time detention was begun and shall be responsible for securing transportation for the
patient to the facility new text begin or program new text end . The expense of detaining and transporting a patient shall
be the responsibility of the deleted text begin treatment deleted text end facility new text begin or program new text end from which the patient is absent.
The expense of detaining and transporting a patient to a new text begin state-operated new text end treatment deleted text begin facility
operated by the Department of Human Services deleted text end new text begin program new text end shall be paid by the commissioner
unless paid by the patient or persons on behalf of the patient.

Subd. 3.

Notice of apprehension.

Immediately after an absent patient is located, the
head of the deleted text begin treatment deleted text end facility new text begin or program new text end from which the patient is absent, or the law
enforcement agency that located or returned the absent patient, shall notify the law
enforcement agency that first received the absent patient report under this section and that
agency shall cancel the missing persons entry from the National Crime Information Center
computer.

Sec. 68.

Minnesota Statutes 2018, section 253B.15, subdivision 1, is amended to read:

Subdivision 1.

Provisional discharge.

new text begin (a) new text end The head of the treatment facility new text begin ,
state-operated treatment program, or community-based treatment program new text end may provisionally
discharge any patient without discharging the commitment, unless the patient was found
by the committing court to be a person who deleted text begin is mentally ill and deleted text end new text begin has a mental illness and is new text end
dangerous to the public, deleted text begin or deleted text end a sexually dangerous person new text begin , new text end or a sexual psychopathic personality.

new text begin (b) When a patient committed to the commissioner becomes ready for provisional
discharge before being placed in a state-operated treatment program, the head of the treatment
facility or community-based treatment program where the patient is placed pending transfer
to the commissioner may provisionally discharge the patient pursuant to this subdivision.
new text end

new text begin (c) new text end Each patient released on provisional discharge shall have a written deleted text begin aftercare deleted text end new text begin
provisional discharge new text end plan developed new text begin with input from the patient and the designated agency
new text end which specifies the services and treatment to be provided as part of the deleted text begin aftercare deleted text end new text begin provisional
discharge new text end plan, the financial resources available to pay for the services specified, the expected
period of provisional discharge, the precise goals for the granting of a final discharge, and
conditions or restrictions on the patient during the period of the provisional discharge. The
deleted text begin aftercare deleted text end new text begin provisional discharge new text end plan shall be provided to the patient, the patient's attorney,
and the designated agency.

new text begin (d) new text end The deleted text begin aftercare deleted text end new text begin provisional discharge new text end plan shall be reviewed on a quarterly basis by
the patient, designated agency and other appropriate persons. The deleted text begin aftercare deleted text end new text begin provisional
discharge new text end plan shall contain the grounds upon which a provisional discharge may be revoked.
The provisional discharge shall terminate on the date specified in the plan unless specific
action is taken to revoke or extend it.

Sec. 69.

Minnesota Statutes 2018, section 253B.15, subdivision 1a, is amended to read:

Subd. 1a.

Representative of designated agency.

Before a provisional discharge is
granted, a representative of the designated agency must be identified to ensure continuity
of care by being involved with the treatment facility new text begin , state-operated treatment program, or
community-based treatment program new text end and the patient prior to the provisional discharge. The
representative of the designated agency shall coordinate plans for and monitor the patient's
aftercare program. When the patient is on a provisional discharge, the representative of the
designated agency shall provide the treatment report to the court required under section
253B.12, subdivision 1.

Sec. 70.

Minnesota Statutes 2018, section 253B.15, subdivision 2, is amended to read:

Subd. 2.

Revocation of provisional discharge.

new text begin (a) new text end The designated agency may deleted text begin revoke deleted text end new text begin
initiate with the court a revocation of new text end a provisional discharge if new text begin revocation is the least
restrictive alternative and either new text end :

(1) the patient has violated material conditions of the provisional discharge, and the
violation creates the need to return the patient to a more restrictive setting new text begin or more intensive
community services new text end ; or

(2) there exists a serious likelihood that the safety of the patient or others will be
jeopardized, in that either the patient's need for food, clothing, shelter, or medical care are
not being met, or will not be met in the near future, or the patient has attempted or threatened
to seriously physically harm self or others deleted text begin ; and deleted text end new text begin .
new text end

deleted text begin (3) revocation is the least restrictive alternative available.
deleted text end

new text begin (b) new text end Any interested person may request that the designated agency revoke the patient's
provisional discharge. Any person making a request shall provide the designated agency
with a written report setting forth the specific facts, including witnesses, dates and locations,
supporting a revocation, demonstrating that every effort has been made to avoid revocation
and that revocation is the least restrictive alternative available.

Sec. 71.

Minnesota Statutes 2018, section 253B.15, subdivision 3, is amended to read:

Subd. 3.

Procedure; notice.

Revocation shall be commenced by the designated agency's
written notice of intent to revoke provisional discharge given or sent to the patient, the
patient's attorney, deleted text begin and deleted text end the deleted text begin treatment deleted text end facility new text begin or program from which the patient was
provisionally discharged, and the current community services provider new text end . The notice shall set
forth the grounds upon which the intention to revoke is based, and shall inform the patient
of the rights of a patient under this chapter.

Sec. 72.

Minnesota Statutes 2018, section 253B.15, subdivision 3a, is amended to read:

Subd. 3a.

Report to the court.

Within 48 hours, excluding weekends and new text begin legal new text end holidays,
of giving notice to the patient, the designated agency shall file with the court a copy of the
notice and a report setting forth the specific facts, including witnesses, dates and locations,
which (1) support revocation, (2) demonstrate that revocation is the least restrictive alternative
available, and (3) show that specific efforts were made to avoid revocation. The designated
agency shall provide copies of the report to the patient, the patient's attorney, the county
attorney, and the treatment facility new text begin or program from which the patient was provisionally
discharged new text end within 48 hours of giving notice to the patient under subdivision 3.

Sec. 73.

Minnesota Statutes 2018, section 253B.15, subdivision 3b, is amended to read:

Subd. 3b.

Review.

The patient or patient's attorney may request judicial review of the
intended revocation by filing a petition for review and an affidavit with the committing
court. The affidavit shall state specific grounds for opposing the revocation. If the patient
does not file a petition for review within five days of receiving the notice under subdivision
3, revocation of the provisional discharge is final and the court, without hearing, may order
the patient into a deleted text begin treatment deleted text end facility new text begin or program from which the patient was provisionally
discharged, another treatment facility, state-operated treatment program, or community-based
treatment program that consents to receive the patient, or more intensive community
treatment new text end . If the patient files a petition for review, the court shall review the petition and
determine whether a genuine issue exists as to the propriety of the revocation. The burden
of proof is on the designated agency to show that no genuine issue exists as to the propriety
of the revocation. If the court finds that no genuine issue exists as to the propriety of the
revocation, the revocation of the provisional discharge is final.

Sec. 74.

Minnesota Statutes 2018, section 253B.15, subdivision 3c, is amended to read:

Subd. 3c.

Hearing.

new text begin (a) new text end If the court finds under subdivision 3b that a genuine issue exists
as to the propriety of the revocation, the court shall hold a hearing on the petition within
three days after the patient files the petition. The court may continue the review hearing for
an additional five days upon any party's showing of good cause. At the hearing, the burden
of proof is on the designated agency to show a factual basis for the revocation. At the
conclusion of the hearing, the court shall make specific findings of fact. The court shall
affirm the revocation if it finds:

(1) a factual basis for revocation due to:

(i) a violation of the material conditions of the provisional discharge that creates a need
for the patient to return to a more restrictive setting new text begin or more intensive community services new text end ;
or

(ii) a probable danger of harm to the patient or others if the provisional discharge is not
revoked; and

(2) that revocation is the least restrictive alternative available.

new text begin (b) new text end If the court does not affirm the revocation, the court shall order the patient returned
to provisional discharge status.

Sec. 75.

Minnesota Statutes 2018, section 253B.15, subdivision 5, is amended to read:

Subd. 5.

Return to facility.

When the designated agency gives or sends notice of the
intent to revoke a patient's provisional discharge, it may also apply to the committing court
for an order directing that the patient be returned to deleted text begin a deleted text end new text begin the new text end facility new text begin or program from which
the patient was provisionally discharged or another treatment facility, state-operated treatment
program, or community-based treatment program that consents to receive the patient new text end . The
court may order the patient returned to a facility new text begin or program new text end prior to a review hearing only
upon finding that immediate return deleted text begin to a facility deleted text end is necessary because there is a serious
likelihood that the safety of the patient or others will be jeopardized, in that (1) the patient's
need for food, clothing, shelter, or medical care is not being met, or will not be met in the
near future, or (2) the patient has attempted or threatened to seriously harm self or others.
If a voluntary return is not arranged, the head of the treatment facility new text begin , state-operated
treatment program, or community-based treatment program new text end may request a health officer or
a peace officer to return the patient to the deleted text begin treatment deleted text end facility new text begin or program new text end from which the
patient was released or to any other treatment facility deleted text begin which deleted text end new text begin , state-operated treatment
program, or community-based treatment program that new text end consents to receive the patient. If
necessary, the head of the treatment facility new text begin , state-operated treatment program, or
community-based treatment program new text end may request the committing court to direct a health
new text begin officer new text end or peace officer in the county where the patient is located to return the patient to the
deleted text begin treatment deleted text end facility new text begin or program new text end or to another treatment facility deleted text begin which deleted text end new text begin , state-operated treatment
program, or community-based treatment program that new text end consents to receive the patient. The
expense of returning the patient to a deleted text begin regional deleted text end new text begin state-operated new text end treatment deleted text begin center deleted text end new text begin program new text end shall
be paid by the commissioner unless paid by the patient or the patient's relatives. If the court
orders the patient to return to the deleted text begin treatment deleted text end facility new text begin or program new text end , or if a health new text begin officer new text end or peace
officer returns the patient to the deleted text begin treatment deleted text end facility new text begin or program new text end , and the patient wants judicial
review of the revocation, the patient or the patient's attorney must file the petition for review
and affidavit required under subdivision 3b within 14 days of receipt of the notice of the
intent to revoke.

Sec. 76.

Minnesota Statutes 2018, section 253B.15, subdivision 7, is amended to read:

Subd. 7.

Modification and extension of provisional discharge.

(a) A provisional
discharge may be modified upon agreement of the parties.

(b) A provisional discharge may be extended only in those circumstances where the
patient has not achieved the goals set forth in the provisional discharge plan or continues
to need the supervision or assistance provided by an extension of the provisional discharge.
In determining whether the provisional discharge is to be extended, the deleted text begin head of the facility deleted text end new text begin
designated agency new text end shall consider the willingness and ability of the patient to voluntarily
obtain needed care and treatment.

deleted text begin (c) The designated agency shall recommend extension of a provisional discharge only
after a preliminary conference with the patient and other appropriate persons. The patient
shall be given the opportunity to object or make suggestions for alternatives to extension.
deleted text end

deleted text begin (d) deleted text end new text begin (c) The designated agency must provide new text end any deleted text begin recommendation for deleted text end new text begin proposed new text end extension
deleted text begin shall be made deleted text end in writing deleted text begin to the head of the facility and deleted text end to the patient new text begin and the patient's attorney
new text end at least 30 days prior to the expiration of the provisional discharge new text begin unless the patient cannot
be located or is unavailable to receive the notice new text end . The deleted text begin written recommendation submitted deleted text end new text begin
proposal for extension new text end shall include: the specific grounds for deleted text begin recommending deleted text end new text begin proposing new text end the
extension, deleted text begin the date of the preliminary conference and results, deleted text end the anniversary date of the
provisional discharge, the termination date of the provisional discharge, and the proposed
length of extension. If the grounds for deleted text begin recommending deleted text end new text begin proposing new text end the extension occur less
than 30 days before its expiration, the new text begin designated agency must submit the new text end written
deleted text begin recommendation shall occur deleted text end new text begin proposal for extension new text end as soon as practicable.

deleted text begin (e) The head of the facility deleted text end new text begin (d) The designated agency shall extend a provisional discharge
only after providing the patient an opportunity for a meeting to object or make suggestions
for alternatives to an extension. The designated agency new text end shall deleted text begin issue deleted text end new text begin provide new text end a written decision
new text begin to the patient and the patient's attorney new text end regarding extension within five days after receiving
deleted text begin the recommendation from the designated agency deleted text end new text begin the patient's input or after holding a meeting
with the patient or after the patient has declined to provide input or participate in the meeting.
The designated agency may seek input from the community-based treatment team or other
persons the patient chooses new text end .

Sec. 77.

Minnesota Statutes 2018, section 253B.15, is amended by adding a subdivision
to read:

new text begin Subd. 8a. new text end

new text begin Provisional discharge extension. new text end

new text begin If the provisional discharge extends until
the end of the period of commitment and, before the commitment expires, the court extends
the commitment under section 253B.12 or issues a new commitment order under section
253B.13, the provisional discharge shall continue for the duration of the new or extended
period of commitment ordered unless the commitment order provides otherwise or the
designated agency revokes the patient's provisional discharge pursuant to this section. To
continue the patient's provisional discharge under this subdivision, the designated agency
is not required to comply with the procedures in subdivision 7.
new text end

Sec. 78.

Minnesota Statutes 2018, section 253B.15, subdivision 9, is amended to read:

Subd. 9.

Expiration of provisional discharge.

new text begin (a) new text end Except as otherwise provided, a
provisional discharge is absolute when it expires. If, while on provisional discharge or
extended provisional discharge, a patient is discharged as provided in section 253B.16, the
discharge shall be absolute.

new text begin (b) The designated agency shall give new text end notice of the expiration of the provisional discharge
deleted text begin shall be given by the head of the treatment facility deleted text end to the committing court; the petitioner,
if known; the patient's attorney; the county attorney in the county of commitment; deleted text begin the
commissioner; deleted text end and the deleted text begin designated agency deleted text end new text begin facility or program that provisionally discharged
the patient new text end .

Sec. 79.

Minnesota Statutes 2018, section 253B.15, subdivision 10, is amended to read:

Subd. 10.

Voluntary return.

new text begin (a) new text end With the consent of the head of the treatment facility new text begin
or state-operated treatment program new text end , a patient may voluntarily return to inpatient status deleted text begin at
the treatment facility deleted text end as follows:

(1) as a voluntary patient, in which case the patient's commitment is discharged;

(2) as a committed patient, in which case the patient's provisional discharge is voluntarily
revoked; or

(3) on temporary return from provisional discharge, in which case both the commitment
and the provisional discharge remain in effect.

new text begin (b) new text end Prior to readmission, the patient shall be informed of status upon readmission.

Sec. 80.

Minnesota Statutes 2018, section 253B.16, is amended to read:

253B.16 DISCHARGE OF COMMITTED PERSONS.

Subdivision 1.

Date.

The head of a treatment facility new text begin , state-operated treatment program,
or community-based treatment program new text end shall discharge any patient admitted as a person
deleted text begin who is mentally ill or chemically dependent, or a person with a deleted text end new text begin who poses a risk of harm
due to mental illness, or a person who has a chemical dependency or a new text end developmental
disability deleted text begin admitted under Minnesota Rules of Criminal Procedure, deleted text end deleted text begin rules 20.01 deleted text end deleted text begin and deleted text end deleted text begin 20.02 deleted text end deleted text begin ,
to the secure bed component of the Minnesota extended treatment options deleted text end when the head
of the facility new text begin or program new text end certifies that the person is no longer in need of care and treatment
new text begin under commitment new text end or at the conclusion of any period of time specified in the commitment
order, whichever occurs first. The head of a deleted text begin treatment deleted text end facility new text begin or program new text end shall discharge
any person admitted as deleted text begin developmentally disabled, except those admitted under Minnesota
Rules of Criminal Procedure, deleted text end deleted text begin rules 20.01 deleted text end deleted text begin and deleted text end deleted text begin 20.02 deleted text end deleted text begin , to the secure bed component of the
Minnesota extended treatment options, deleted text end new text begin a person with a developmental disability new text end when that
person's screening team has determined, under section 256B.092, subdivision 8, that the
person's needs can be met by services provided in the community and a plan has been
developed in consultation with the interdisciplinary team to place the person in the available
community services.

Subd. 2.

Notification of discharge.

Prior to the discharge or provisional discharge of
any committed deleted text begin person deleted text end new text begin patient new text end , the head of the treatment facility new text begin , state-operated treatment
program, or community-based treatment program new text end shall notify the designated agency and
the patient's spouse or health care agent, or if there is no spouse or health care agent, then
an adult child, or if there is none, the next of kin of the patient, of the proposed discharge.
new text begin The facility or program shall send new text end the notice deleted text begin shall be sent to the last known address of the
person to be notified by certified mail with return receipt. The notice deleted text end new text begin in writing and new text end shall
include the following: (1) the proposed date of discharge or provisional discharge; (2) the
date, time and place of the meeting of the staff who have been treating the patient to discuss
discharge and discharge planning; (3) the fact that the patient will be present at the meeting;
and (4) the fact that the next of kin or health care agent may attend that staff meeting and
present any information relevant to the discharge of the patient. deleted text begin The notice shall be sent at
least one week prior to the date set for the meeting.
deleted text end

Sec. 81.

Minnesota Statutes 2018, section 253B.17, is amended to read:

253B.17 RELEASE; JUDICIAL DETERMINATION.

Subdivision 1.

Petition.

Any patient, except one committed as a sexually dangerous
person or a person with a sexual psychopathic personality or as a person who deleted text begin is mentally
ill and deleted text end new text begin has a mental illness and is new text end dangerous to the public as provided in section 253B.18,
subdivision 3, or any interested person may petition the committing court or the court to
which venue has been transferred for an order that the patient is not in need of continued
care and treatment new text begin under commitment new text end or for an order that an individual is no longer a person
deleted text begin who is mentally ill, developmentally disabled, or chemically dependent deleted text end new text begin who poses a risk
of harm due to mental illness, or a person who has a developmental disability or chemical
dependency new text end , or for any other relief. A patient committed as a person deleted text begin who is mentally ill or
mentally ill and deleted text end new text begin who poses a risk of harm due to mental illness, a person who has a mental
illness and is new text end dangerous deleted text begin or deleted text end new text begin to the public, new text end a sexually dangerous person new text begin , new text end or new text begin a new text end person with a
sexual psychopathic personality may petition the committing court or the court to which
venue has been transferred for a hearing concerning the administration of neuroleptic
medication.

Subd. 2.

Notice of hearing.

Upon the filing of the petition, the court shall fix the time
and place for the hearing on it. Ten days' notice of the hearing shall be given to the county
attorney, the patient, patient's counsel, the person who filed the initial commitment petition,
the head of the deleted text begin treatment deleted text end facility new text begin or program to which the person is committed new text end , and other
persons as the court directs. Any person may oppose the petition.

Subd. 3.

new text begin Court new text end examiners.

The court shall appoint deleted text begin an deleted text end new text begin a court new text end examiner and, at the
patient's request, shall appoint a second new text begin court new text end examiner of the patient's choosing to be paid
for by the county at a rate of compensation to be fixed by the court. Unless otherwise agreed
by the parties, deleted text begin the examiners deleted text end new text begin a court examiner new text end shall file a report with the court not less than
48 hours prior to the hearing under this section.

Subd. 4.

Evidence.

The patient, patient's counsel, the petitioner new text begin , new text end and the county attorney
shall be entitled to be present at the hearing and to present and cross-examine witnesses,
including new text begin court new text end examiners. The court may hear any relevant testimony and evidence deleted text begin which
is deleted text end offered at the hearing.

Subd. 5.

Order.

Upon completion of the hearing, the court shall enter an order stating
its findings and decision and mail deleted text begin it deleted text end new text begin the order new text end to the head of the treatment facility new text begin ,
state-operated treatment program, or community-based treatment program new text end .

Sec. 82.

Minnesota Statutes 2018, section 253B.18, subdivision 1, is amended to read:

Subdivision 1.

Procedure.

(a) Upon the filing of a petition alleging that a proposed
patient is a person who deleted text begin is mentally ill and deleted text end new text begin has a mental illness and is new text end dangerous to the public,
the court shall hear the petition as provided in sections 253B.07 and 253B.08. If the court
finds by clear and convincing evidence that the proposed patient is a person who deleted text begin is mentally
ill and deleted text end new text begin has a mental illness and is new text end dangerous to the public, it shall commit the person to a
secure treatment facility or to a treatment facility new text begin or state-operated treatment program new text end willing
to accept the patient under commitment. The court shall commit the patient to a secure
treatment facility unless the patient deleted text begin establishes deleted text end new text begin or others establish new text end by clear and convincing
evidence that a less restrictive new text begin state-operated treatment program or new text end treatment deleted text begin program deleted text end new text begin facility new text end
is available that is consistent with the patient's treatment needs and the requirements of
public safety. In any case where the petition was filed immediately following the acquittal
of the proposed patient for a crime against the person pursuant to a verdict of not guilty by
reason of mental illness, the verdict constitutes evidence that the proposed patient is a person
who deleted text begin is mentally ill and deleted text end new text begin has a mental illness and is new text end dangerous new text begin to the public new text end within the meaning
of this section. The proposed patient has the burden of going forward in the presentation of
evidence. The standard of proof remains as required by this chapter. Upon commitment,
admission procedures shall be carried out pursuant to section 253B.10.

(b) Once a patient is admitted to a treatment facility new text begin or state-operated treatment program new text end
pursuant to a commitment under this subdivision, treatment must begin regardless of whether
a review hearing will be held under subdivision 2.

Sec. 83.

Minnesota Statutes 2018, section 253B.18, subdivision 2, is amended to read:

Subd. 2.

Review; hearing.

(a) A written treatment report shall be filed by the treatment
facility new text begin or state-operated treatment program new text end with the committing court within 60 days after
commitment. If the person is in the custody of the commissioner of corrections when the
initial commitment is ordered under subdivision 1, the written treatment report must be filed
within 60 days after the person is admitted to deleted text begin a secure deleted text end new text begin the state-operated treatment program
or new text end treatment facility. The court shall hold a hearing to make a final determination as to
whether the deleted text begin person deleted text end new text begin patient new text end should remain committed as a person who deleted text begin is mentally ill and deleted text end new text begin
has a mental illness and is new text end dangerous to the public. The hearing shall be held within the
earlier of 14 days of the court's receipt of the written treatment report, or within 90 days of
the date of initial commitment or admission, unless otherwise agreed by the parties.

(b) The court may, with agreement of the county attorney and new text begin the patient's new text end attorney deleted text begin for
the patient deleted text end :

(1) waive the review hearing under this subdivision and immediately order an
indeterminate commitment under subdivision 3; or

(2) continue the review hearing for up to one year.

(c) If the court finds that the patient should be committed as a person deleted text begin who is mentally
ill deleted text end new text begin who poses a risk of harm due to mental illness new text end , but not as a person who deleted text begin is mentally ill
and deleted text end new text begin has a mental illness and is new text end dangerous to the public, the court may commit the deleted text begin person deleted text end new text begin
patient new text end as a person deleted text begin who is mentally ill deleted text end new text begin who poses a risk of harm due to mental illness new text end and
the deleted text begin person shall be deemed deleted text end new text begin court shall deem the patient new text end not to deleted text begin have been found to deleted text end be
dangerous to the public for the purposes of subdivisions 4a to 15. Failure of the treatment
facility new text begin or state-operated treatment program new text end to provide the required new text begin treatment new text end report at the
end of the 60-day period shall not result in automatic discharge of the patient.

Sec. 84.

Minnesota Statutes 2018, section 253B.18, subdivision 3, is amended to read:

Subd. 3.

Indeterminate commitment.

If the court finds at the final determination hearing
held pursuant to subdivision 2 that the patient continues to be a person who deleted text begin is mentally ill
and deleted text end new text begin has a mental illness and is new text end dangerous new text begin to the public new text end , then the court shall order commitment
of the proposed patient for an indeterminate period of time. After a final determination that
a patient is a person who deleted text begin is mentally ill and deleted text end new text begin has a mental illness and is new text end dangerous to the
public, the patient shall be transferred, provisionally discharged or discharged, only as
provided in this section.

Sec. 85.

Minnesota Statutes 2018, section 253B.18, subdivision 4a, is amended to read:

Subd. 4a.

Release on pass; notification.

A patient who has been committed as a person
who deleted text begin is mentally ill and deleted text end new text begin has a mental illness and is new text end dangerous new text begin to the public new text end and who is confined
at a secure treatment facility or has been transferred out of a deleted text begin state-operated services deleted text end new text begin secure
treatment new text end facility according to section 253B.18, subdivision 6, shall not be released on a
pass unless the pass is part of a pass plan that has been approved by the medical director of
the secure treatment facility. The pass plan must have a specific therapeutic purpose
consistent with the treatment plan, must be established for a specific period of time, and
must have specific levels of liberty delineated. The county case manager must be invited
to participate in the development of the pass plan. At least ten days prior to a determination
on the plan, the medical director shall notify the designated agency, the committing court,
the county attorney of the county of commitment, an interested person, the local law
enforcement agency where the facility is located, the county attorney and the local law
enforcement agency in the location where the pass is to occur, the petitioner, and the
petitioner's counsel of the plan, the nature of the passes proposed, and their right to object
to the plan. If any notified person objects prior to the proposed date of implementation, the
person shall have an opportunity to appear, personally or in writing, before the medical
director, within ten days of the objection, to present grounds for opposing the plan. The
pass plan shall not be implemented until the objecting person has been furnished that
opportunity. Nothing in this subdivision shall be construed to give a patient an affirmative
right to a pass plan.

Sec. 86.

Minnesota Statutes 2018, section 253B.18, subdivision 4b, is amended to read:

Subd. 4b.

Pass-eligible status; notification.

new text begin (a) new text end The following patients committed to a
secure treatment facility shall not be placed on pass-eligible status unless that status has
been approved by the medical director of the secure treatment facility:

deleted text begin (a) deleted text end new text begin (1) new text end a patient who has been committed as a person who deleted text begin is mentally ill and deleted text end new text begin has a mental
illness and is new text end dangerous new text begin to the public new text end and who:

deleted text begin (1) deleted text end new text begin (i) new text end was found incompetent to proceed to trial for a felony or was found not guilty by
reason of mental illness of a felony immediately prior to the filing of the commitment
petition;

deleted text begin (2) deleted text end new text begin (ii) new text end was convicted of a felony immediately prior to or during commitment as a person
who deleted text begin is mentally ill and deleted text end new text begin has a mental illness and is new text end dangerous new text begin to the public new text end ; or

deleted text begin (3) deleted text end new text begin (iii) new text end is subject to a commitment to the commissioner of corrections; and

deleted text begin (b) deleted text end new text begin (2) new text end a patient who has been committed as a psychopathic personality, a sexually
psychopathic personality, or a sexually dangerous person.

new text begin (b) new text end At least ten days prior to a determination on the status, the medical director shall
notify the committing court, the county attorney of the county of commitment, the designated
agency, an interested person, the petitioner, and the petitioner's counsel of the proposed
status, and their right to request review by the special review board. If within ten days of
receiving notice any notified person requests review by filing a notice of objection with the
commissioner and the head of the new text begin secure new text end treatment facility, a hearing shall be held before
the special review board. The proposed status shall not be implemented unless it receives
a favorable recommendation by a majority of the board and approval by the commissioner.
The order of the commissioner is appealable as provided in section 253B.19.

new text begin (c) new text end Nothing in this subdivision shall be construed to give a patient an affirmative right
to seek pass-eligible status from the special review board.

Sec. 87.

Minnesota Statutes 2018, section 253B.18, subdivision 4c, is amended to read:

Subd. 4c.

Special review board.

(a) The commissioner shall establish one or more
panels of a special review board. The board shall consist of three members experienced in
the field of mental illness. One member of each special review board panel shall be a
psychiatrist or a doctoral level psychologist with forensic experience and one member shall
be an attorney. No member shall be affiliated with the Department of Human Services. The
special review board shall meet at least every six months and at the call of the commissioner.
It shall hear and consider all petitions for a reduction in custody or to appeal a revocation
of provisional discharge. A "reduction in custody" means transfer from a secure treatment
facility, discharge, and provisional discharge. Patients may be transferred by the
commissioner between secure treatment facilities without a special review board hearing.

Members of the special review board shall receive compensation and reimbursement
for expenses as established by the commissioner.

(b) The special review board must review each denied petition under subdivision 5 for
barriers and obstacles preventing the patient from progressing in treatment. Based on the
cases before the board in the previous year, the special review board shall provide to the
commissioner an annual summation of the barriers to treatment progress, and
recommendations to achieve the common goal of making progress in treatment.

(c) A petition filed by a person committed as deleted text begin mentally ill and deleted text end new text begin a person who has a mental
illness and is new text end dangerous to the public under this section must be heard as provided in
subdivision 5 and, as applicable, subdivision 13. A petition filed by a person committed as
a sexual psychopathic personality or as a sexually dangerous person under chapter 253D,
or committed as both deleted text begin mentally ill and deleted text end new text begin a person who has a mental illness and is new text end dangerous
to the public under this section and as a sexual psychopathic personality or as a sexually
dangerous person must be heard as provided in section 253D.27.

Sec. 88.

Minnesota Statutes 2018, section 253B.18, subdivision 5, is amended to read:

Subd. 5.

Petition; notice of hearing; attendance; order.

(a) A petition for a reduction
in custody or revocation of provisional discharge shall be filed with the commissioner and
may be filed by the patient or by the head of the treatment facility new text begin or state-operated treatment
program to which the person was committed or has been transferred new text end . A patient may not
petition the special review board for six months following commitment under subdivision
3 or following the final disposition of any previous petition and subsequent appeal by the
patient. The head of the new text begin state-operated treatment program or head of the new text end treatment facility
must schedule a hearing before the special review board for any patient who has not appeared
before the special review board in the previous three years, and schedule a hearing at least
every three years thereafter. The medical director may petition at any time.

(b) Fourteen days prior to the hearing, the committing court, the county attorney of the
county of commitment, the designated agency, interested person, the petitioner, and the
petitioner's counsel shall be given written notice by the commissioner of the time and place
of the hearing before the special review board. Only those entitled to statutory notice of the
hearing or those administratively required to attend may be present at the hearing. The
patient may designate interested persons to receive notice by providing the names and
addresses to the commissioner at least 21 days before the hearing. The board shall provide
the commissioner with written findings of fact and recommendations within 21 days of the
hearing. The commissioner shall issue an order no later than 14 days after receiving the
recommendation of the special review board. A copy of the order shall be mailed to every
person entitled to statutory notice of the hearing within five days after deleted text begin it deleted text end new text begin the order new text end is signed.
No order by the commissioner shall be effective sooner than 30 days after the order is signed,
unless the county attorney, the patient, and the commissioner agree that it may become
effective sooner.

(c) The special review board shall hold a hearing on each petition prior to making its
recommendation to the commissioner. The special review board proceedings are not contested
cases as defined in chapter 14. Any person or agency receiving notice that submits
documentary evidence to the special review board prior to the hearing shall also provide
copies to the patient, the patient's counsel, the county attorney of the county of commitment,
the case manager, and the commissioner.

(d) Prior to the final decision by the commissioner, the special review board may be
reconvened to consider events or circumstances that occurred subsequent to the hearing.

(e) In making their recommendations and order, the special review board and
commissioner must consider any statements received from victims under subdivision 5a.

Sec. 89.

Minnesota Statutes 2018, section 253B.18, subdivision 5a, is amended to read:

Subd. 5a.

Victim notification of petition and release; right to submit statement.

(a)
As used in this subdivision:

(1) "crime" has the meaning given to "violent crime" in section 609.1095, and includes
criminal sexual conduct in the fifth degree and offenses within the definition of "crime
against the person" in section 253B.02, subdivision 4a, and also includes offenses listed in
section 253D.02, subdivision 8, paragraph (b), regardless of whether they are sexually
motivated;

(2) "victim" means a person who has incurred loss or harm as a result of a crime the
behavior for which forms the basis for a commitment under this section or chapter 253D;
and

(3) "convicted" and "conviction" have the meanings given in section 609.02, subdivision
5, and also include juvenile court adjudications, findings under Minnesota Rules of Criminal
Procedure, rule 20.02, that the elements of a crime have been proved, and findings in
commitment cases under this section or chapter 253D that an act or acts constituting a crime
occurred.

(b) A county attorney who files a petition to commit a person under this section or chapter
253D shall make a reasonable effort to provide prompt notice of filing the petition to any
victim of a crime for which the person was convicted. In addition, the county attorney shall
make a reasonable effort to promptly notify the victim of the resolution of the petition.

(c) Before provisionally discharging, discharging, granting pass-eligible status, approving
a pass plan, or otherwise permanently or temporarily releasing a person committed under
this section from a new text begin state-operated treatment program or new text end treatment facility, the head of the
new text begin state-operated treatment program or head of the new text end treatment facility shall make a reasonable
effort to notify any victim of a crime for which the person was convicted that the person
may be discharged or released and that the victim has a right to submit a written statement
regarding decisions of the medical director, special review board, or commissioner with
respect to the person. To the extent possible, the notice must be provided at least 14 days
before any special review board hearing or before a determination on a pass plan.
Notwithstanding section 611A.06, subdivision 4, the commissioner shall provide the judicial
appeal panel with victim information in order to comply with the provisions of this section.
The judicial appeal panel shall ensure that the data on victims remains private as provided
for in section 611A.06, subdivision 4.

(d) This subdivision applies only to victims who have requested notification through
the Department of Corrections electronic victim notification system, or by contacting, in
writing, the county attorney in the county where the conviction for the crime occurred. A
request for notice under this subdivision received by the commissioner of corrections through
the Department of Corrections electronic victim notification system shall be promptly
forwarded to the prosecutorial authority with jurisdiction over the offense to which the
notice relates or, following commitment, the head of the new text begin state-operated treatment program
or head of the new text end treatment facility. A county attorney who receives a request for notification
under this paragraph following commitment shall promptly forward the request to the
commissioner of human services.

(e) The rights under this subdivision are in addition to rights available to a victim under
chapter 611A. This provision does not give a victim all the rights of a "notified person" or
a person "entitled to statutory notice" under subdivision 4a, 4b, or 5 or section 253D.14.

Sec. 90.

Minnesota Statutes 2018, section 253B.18, subdivision 6, is amended to read:

Subd. 6.

Transfer.

new text begin (a) new text end A patient who is deleted text begin mentally ill and deleted text end new text begin a person who has a mental
illness and is new text end dangerous new text begin to the public new text end shall not be transferred out of a secure treatment facility
unless it appears to the satisfaction of the commissioner, after a hearing and favorable
recommendation by a majority of the special review board, that the transfer is appropriate.
Transfer may be to deleted text begin other regional centers under the commissioner's control deleted text end new text begin another
state-operated treatment program new text end . In those instances where a commitment also exists to the
Department of Corrections, transfer may be to a facility designated by the commissioner of
corrections.

new text begin (b) new text end The following factors must be considered in determining whether a transfer is
appropriate:

(1) the person's clinical progress and present treatment needs;

(2) the need for security to accomplish continuing treatment;

(3) the need for continued institutionalization;

(4) which facility can best meet the person's needs; and

(5) whether transfer can be accomplished with a reasonable degree of safety for the
public.

Sec. 91.

Minnesota Statutes 2018, section 253B.18, subdivision 7, is amended to read:

Subd. 7.

Provisional discharge.

new text begin (a) new text end A patient who is deleted text begin mentally ill and deleted text end new text begin a person who has
a mental illness and is new text end dangerous new text begin to the public new text end shall not be provisionally discharged unless
it appears to the satisfaction of the commissioner, after a hearing and a favorable
recommendation by a majority of the special review board, that the patient is capable of
making an acceptable adjustment to open society.

new text begin (b) new text end The following factors are to be considered in determining whether a provisional
discharge shall be recommended: (1) whether the patient's course of hospitalization and
present mental status indicate there is no longer a need for treatment and supervision in the
patient's current treatment setting; and (2) whether the conditions of the provisional discharge
plan will provide a reasonable degree of protection to the public and will enable the patient
to adjust successfully to the community.

Sec. 92.

Minnesota Statutes 2018, section 253B.18, subdivision 8, is amended to read:

Subd. 8.

Provisional discharge plan.

A provisional discharge plan shall be developed,
implemented new text begin , new text end and monitored by the designated agency in conjunction with the patient, the
treatment facility new text begin or state-operated treatment program to which the person is committed, new text end
and other appropriate persons. The designated agency shall, at least quarterly, review the
new text begin provisional discharge new text end plan with the patient and submit a written report to deleted text begin the commissioner
and deleted text end the deleted text begin treatment deleted text end facility new text begin or program new text end concerning the patient's status and compliance with
each term of the new text begin provisional discharge new text end plan.

Sec. 93.

Minnesota Statutes 2018, section 253B.18, subdivision 10, is amended to read:

Subd. 10.

Provisional discharge; revocation.

new text begin (a) new text end The head of the treatment facility new text begin or
state-operated treatment program from which the person was provisionally discharged new text end may
revoke a provisional discharge if any of the following grounds exist:

(i) the patient has departed from the conditions of the provisional discharge plan;

(ii) the patient is exhibiting signs of a mental illness which may require in-hospital
evaluation or treatment; or

(iii) the patient is exhibiting behavior which may be dangerous to self or others.

new text begin (b) new text end Revocation shall be commenced by a notice of intent to revoke provisional discharge,
which shall be served upon the patient, patient's counsel, and the designated agency. The
notice shall set forth the grounds upon which the intention to revoke is based, and shall
inform the patient of the rights of a patient under this chapter.

new text begin (c) new text end In all nonemergency situations, prior to revoking a provisional discharge, the head
of the deleted text begin treatment deleted text end facility new text begin or program new text end shall obtain a new text begin revocation new text end report from the designated
agency outlining the specific reasons for recommending the revocation, including but not
limited to the specific facts upon which the revocation recommendation is based.

new text begin (d) new text end The patient must be provided a copy of the revocation report and informed orally
and in writing of the rights of a patient under this section.

Sec. 94.

Minnesota Statutes 2018, section 253B.18, subdivision 11, is amended to read:

Subd. 11.

Exceptions.

If an emergency exists, the head of the treatment facility new text begin or
state-operated treatment program new text end may revoke the provisional discharge and, either orally
or in writing, order that the patient be immediately returned to the deleted text begin treatment deleted text end facility new text begin or
program new text end . In emergency cases, a new text begin revocation new text end report deleted text begin documenting reasons for revocation deleted text end shall
be submitted by the designated agency within seven days after the patient is returned to the
deleted text begin treatment deleted text end facility new text begin or program new text end .

Sec. 95.

Minnesota Statutes 2018, section 253B.18, subdivision 12, is amended to read:

Subd. 12.

Return of patient.

After revocation of a provisional discharge or if the patient
is absent without authorization, the head of the treatment facility new text begin or state-operated treatment
program new text end may request the patient to return to the deleted text begin treatment deleted text end facility new text begin or program new text end voluntarily.
The head of the new text begin treatment new text end facility new text begin or state-operated treatment program new text end may request a health
officer deleted text begin , a welfare officer, deleted text end or a peace officer to return the patient to the deleted text begin treatment deleted text end facility new text begin or
program new text end . If a voluntary return is not arranged, the head of the treatment facility new text begin or
state-operated treatment program new text end shall inform the committing court of the revocation or
absence and the court shall direct a health or peace officer in the county where the patient
is located to return the patient to the deleted text begin treatment deleted text end facility new text begin or program new text end or to another new text begin state-operated
treatment program or to another new text end treatment facility new text begin willing to accept the patient new text end . The expense
of returning the patient to a deleted text begin regional deleted text end new text begin state-operated new text end treatment deleted text begin center deleted text end new text begin program new text end shall be paid
by the commissioner unless paid by the patient or other persons on the patient's behalf.

Sec. 96.

Minnesota Statutes 2018, section 253B.18, subdivision 14, is amended to read:

Subd. 14.

Voluntary readmission.

(a) With the consent of the head of the treatment
facility new text begin or state-operated treatment program new text end , a patient may voluntarily return from provisional
discharge for a period of up to 30 days, or up to 60 days with the consent of the designated
agency. If the patient is not returned to provisional discharge status within 60 days, the
provisional discharge is revoked. Within 15 days of receiving notice of the change in status,
the patient may request a review of the matter before the special review board. The board
may recommend a return to a provisional discharge status.

(b) The treatment facility new text begin or state-operated treatment program new text end is not required to petition
for a further review by the special review board unless the patient's return to the community
results in substantive change to the existing provisional discharge plan. All the terms and
conditions of the provisional discharge order shall remain unchanged if the patient is released
again.

Sec. 97.

Minnesota Statutes 2018, section 253B.18, subdivision 15, is amended to read:

Subd. 15.

Discharge.

new text begin (a) new text end A patient who is deleted text begin mentally ill and deleted text end new text begin a person who has a mental
illness and is new text end dangerous new text begin to the public new text end shall not be discharged unless it appears to the
satisfaction of the commissioner, after a hearing and a favorable recommendation by a
majority of the special review board, that the patient is capable of making an acceptable
adjustment to open society, is no longer dangerous to the public, and is no longer in need
of treatment and supervision.

new text begin (b) new text end In determining whether a discharge shall be recommended, the special review board
and commissioner shall consider whether specific conditions exist to provide a reasonable
degree of protection to the public and to assist the patient in adjusting to the community. If
the desired conditions do not exist, the discharge shall not be granted.

Sec. 98.

Minnesota Statutes 2018, section 253B.19, subdivision 2, is amended to read:

Subd. 2.

Petition; hearing.

(a) A deleted text begin person deleted text end new text begin patient new text end committed as deleted text begin mentally ill and deleted text end new text begin a person
who has a mental illness and is new text end dangerous to the public under section 253B.18, or the county
attorney of the county from which the deleted text begin person deleted text end new text begin patient new text end was committed or the county of financial
responsibility, may petition the judicial appeal panel for a rehearing and reconsideration of
a decision by the commissioner under section 253B.18, subdivision 5. The judicial appeal
panel must not consider petitions for relief other than those considered by the commissioner
from which the appeal is taken. The petition must be filed with the supreme court within
30 days after the decision of the commissioner is signed. The hearing must be held within
45 days of the filing of the petition unless an extension is granted for good cause.

(b) For an appeal under paragraph (a), the supreme court shall refer the petition to the
chief judge of the judicial appeal panel. The chief judge shall notify the patient, the county
attorney of the county of commitment, the designated agency, the commissioner, the head
of the deleted text begin treatment deleted text end facility new text begin or program to which the patient was committed new text end , any interested
person, and other persons the chief judge designates, of the time and place of the hearing
on the petition. The notice shall be given at least 14 days prior to the date of the hearing.

(c) Any person may oppose the petition. The patient, the patient's counsel, the county
attorney of the committing county or the county of financial responsibility, and the
commissioner shall participate as parties to the proceeding pending before the judicial appeal
panel and shall, except when the patient is committed solely as deleted text begin mentally ill and deleted text end new text begin a person
who has a mental illness and is new text end dangerous new text begin to the public new text end , no later than 20 days before the
hearing on the petition, inform the judicial appeal panel and the opposing party in writing
whether they support or oppose the petition and provide a summary of facts in support of
their position. The judicial appeal panel may appoint new text begin court new text end examiners and may adjourn the
hearing from time to time. It shall hear and receive all relevant testimony and evidence and
make a record of all proceedings. The patient, the patient's counsel, and the county attorney
of the committing county or the county of financial responsibility have the right to be present
and may present and cross-examine all witnesses and offer a factual and legal basis in
support of their positions. The petitioning party seeking discharge or provisional discharge
bears the burden of going forward with the evidence, which means presenting a prima facie
case with competent evidence to show that the person is entitled to the requested relief. If
the petitioning party has met this burden, the party opposing discharge or provisional
discharge bears the burden of proof by clear and convincing evidence that the discharge or
provisional discharge should be denied. A party seeking transfer under section 253B.18,
subdivision 6, must establish by a preponderance of the evidence that the transfer is
appropriate.

Sec. 99.

Minnesota Statutes 2018, section 253B.20, subdivision 1, is amended to read:

Subdivision 1.

Notice to court.

When a committed person is discharged, provisionally
discharged, new text begin or new text end transferred to another treatment facility, deleted text begin or partially hospitalized deleted text end new text begin state-operated
treatment program, or community-based treatment program new text end , or when the deleted text begin person deleted text end new text begin patient new text end
dies, is absent without authorization, or is returned, the treatment facility new text begin , state-operated
treatment program, or community-based treatment program new text end having custody of the patient
shall notify the committing court, the county attorney, and the patient's attorney.

Sec. 100.

Minnesota Statutes 2018, section 253B.20, subdivision 2, is amended to read:

Subd. 2.

Necessities.

The deleted text begin head of the deleted text end new text begin state-operated new text end treatment deleted text begin facility deleted text end new text begin program new text end shall
make necessary arrangements at the expense of the state to insure that no patient is discharged
or provisionally discharged without suitable clothing. The head of the new text begin state-operated new text end treatment
deleted text begin facility deleted text end new text begin program new text end shall, if necessary, provide the patient with a sufficient sum of money to
secure transportation home, or to another destination of the patient's choice, if the destination
is located within a reasonable distance of the new text begin state-operated new text end treatment deleted text begin facility deleted text end new text begin program new text end . The
commissioner shall establish procedures by rule to help the patient receive all public
assistance benefits provided by state or federal law to which the patient is entitled by
residence and circumstances. The rule shall be uniformly applied in all counties. All counties
shall provide temporary relief whenever necessary to meet the intent of this subdivision.

Sec. 101.

Minnesota Statutes 2018, section 253B.20, subdivision 3, is amended to read:

Subd. 3.

Notice to designated agency.

The head of the treatment facility new text begin , state-operated
treatment program, or community-based treatment program new text end , upon the provisional discharge
of any committed person, shall notify the designated agency before the patient leaves the
deleted text begin treatment deleted text end facility new text begin or program new text end . Whenever possible the notice shall be given at least one week
before the patient is to leave the facility new text begin or program new text end .

Sec. 102.

Minnesota Statutes 2018, section 253B.20, subdivision 4, is amended to read:

Subd. 4.

Aftercare services.

Prior to the date of discharge or provisional discharge of
any committed person, the designated agency of the county of financial responsibility, in
cooperation with the head of the treatment facility new text begin , state-operated treatment program, or
community-based treatment program new text end , and the patient's deleted text begin physician deleted text end new text begin mental health professional new text end ,
if notified pursuant to subdivision 6, shall establish a continuing plan of aftercare services
for the patient including a plan for medical and psychiatric treatment, nursing care, vocational
assistance, and other assistance the patient needs. The designated agency shall provide case
management services, supervise and assist the patient in finding employment, suitable
shelter, and adequate medical and psychiatric treatment, and aid in the patient's readjustment
to the community.

Sec. 103.

Minnesota Statutes 2018, section 253B.20, subdivision 6, is amended to read:

Subd. 6.

Notice to deleted text begin physician deleted text end new text begin mental health professional new text end .

The head of the treatment
facility new text begin , state-operated treatment program, or community-based treatment program new text end shall
notify the deleted text begin physician deleted text end new text begin mental health professional new text end of any committed person at the time of the
patient's discharge or provisional discharge, unless the patient objects to the notice.

Sec. 104.

Minnesota Statutes 2018, section 253B.21, subdivision 1, is amended to read:

Subdivision 1.

Administrative procedures.

If the patient is entitled to care by any
agency of the United States in this state, the commitment warrant shall be in triplicate,
committing the patient to the joint custody of the head of the treatment facility new text begin , state-operated
treatment program, or community-based treatment program new text end and the federal agency. If the
federal agency is unable or unwilling to receive the patient at the time of commitment, the
patient may subsequently be transferred to it upon its request.

Sec. 105.

Minnesota Statutes 2018, section 253B.21, subdivision 2, is amended to read:

Subd. 2.

Applicable regulations.

Any person, when admitted to an institution of a
federal agency within or without this state, shall be subject to the rules and regulations of
the federal agency, except that nothing in this section shall deprive any person of rights
secured to patients of deleted text begin state deleted text end new text begin state-operated treatment programs, new text end treatment facilities new text begin , and
community-based treatment programs new text end by this chapter.

Sec. 106.

Minnesota Statutes 2018, section 253B.21, subdivision 3, is amended to read:

Subd. 3.

Powers.

The chief officer of any treatment facility operated by a federal agency
to which any person is admitted shall have the same powers as the heads of deleted text begin treatment
facilities deleted text end new text begin state-operated treatment programs new text end within this state with respect to admission,
retention of custody, transfer, parole, or discharge of the committed person.

Sec. 107.

Minnesota Statutes 2018, section 253B.212, subdivision 1, is amended to read:

Subdivision 1.

Cost of care; commitment by tribal court order; Red Lake Band of
Chippewa Indians.

The commissioner of human services may contract with and receive
payment from the Indian Health Service of the United States Department of Health and
Human Services for the care and treatment of those members of the Red Lake Band of
Chippewa Indians who have been committed by tribal court order to the Indian Health
Service for care and treatment of mental illness, developmental disability, or chemical
dependency. The contract shall provide that the Indian Health Service may not transfer any
person for admission to a deleted text begin regional center deleted text end new text begin state-operated treatment program new text end unless the
commitment procedure utilized by the tribal court provided due process protections similar
to those afforded by sections deleted text begin 253B.05 deleted text end to 253B.10.

Sec. 108.

Minnesota Statutes 2018, section 253B.212, subdivision 1a, is amended to read:

Subd. 1a.

Cost of care; commitment by tribal court order; White Earth Band of
Ojibwe Indians.

The commissioner of human services may contract with and receive
payment from the Indian Health Service of the United States Department of Health and
Human Services for the care and treatment of those members of the White Earth Band of
Ojibwe Indians who have been committed by tribal court order to the Indian Health Service
for care and treatment of mental illness, developmental disability, or chemical dependency.
The tribe may also contract directly with the commissioner for treatment of those members
of the White Earth Band who have been committed by tribal court order to the White Earth
Department of Health for care and treatment of mental illness, developmental disability, or
chemical dependency. The contract shall provide that the Indian Health Service and the
White Earth Band shall not transfer any person for admission to a deleted text begin regional center deleted text end new text begin
state-operated treatment program new text end unless the commitment procedure utilized by the tribal
court provided due process protections similar to those afforded by sections deleted text begin 253B.05 deleted text end to 253B.10.

Sec. 109.

Minnesota Statutes 2018, section 253B.212, subdivision 1b, is amended to read:

Subd. 1b.

Cost of care; commitment by tribal court order; any federally recognized
Indian tribe within the state of Minnesota.

The commissioner of human services may
contract with and receive payment from the Indian Health Service of the United States
Department of Health and Human Services for the care and treatment of those members of
any federally recognized Indian tribe within the state, who have been committed by tribal
court order to the Indian Health Service for care and treatment of mental illness,
developmental disability, or chemical dependency. The tribe may also contract directly with
the commissioner for treatment of those members of any federally recognized Indian tribe
within the state who have been committed by tribal court order to the respective tribal
Department of Health for care and treatment of mental illness, developmental disability, or
chemical dependency. The contract shall provide that the Indian Health Service and any
federally recognized Indian tribe within the state shall not transfer any person for admission
to a deleted text begin regional center deleted text end new text begin state-operated treatment program new text end unless the commitment procedure
utilized by the tribal court provided due process protections similar to those afforded by
sections deleted text begin 253B.05 deleted text end to 253B.10.

Sec. 110.

Minnesota Statutes 2018, section 253B.212, subdivision 2, is amended to read:

Subd. 2.

Effect given to tribal commitment order.

new text begin (a) new text end When, under an agreement
entered into pursuant to subdivision 1, 1a, or 1b, the Indian Health Service or the placing
tribe applies to a deleted text begin regional center deleted text end new text begin state-operated treatment program new text end for admission of a person
committed to the jurisdiction of the health service by the tribal court deleted text begin as a person who is
mentally ill, developmentally disabled, or chemically dependent deleted text end new text begin due to mental illness,
developmental disability, or chemical dependency new text end , the commissioner may treat the patient
with the consent of the Indian Health Service or the placing tribe.

new text begin (b) new text end A person admitted to a deleted text begin regional center deleted text end new text begin state-operated treatment program new text end pursuant to
this section has all the rights accorded by section 253B.03. In addition, treatment reports,
prepared in accordance with the requirements of section 253B.12, subdivision 1, shall be
filed with the Indian Health Service or the placing tribe within 60 days of commencement
of the patient's stay at the deleted text begin facility deleted text end new text begin program new text end . A subsequent treatment report shall be filed with
the Indian Health Service or the placing tribe within six months of the patient's admission
to the deleted text begin facility deleted text end new text begin program new text end or prior to discharge, whichever comes first. Provisional discharge
or transfer of the patient may be authorized by the head of the deleted text begin treatment facility deleted text end new text begin program new text end
only with the consent of the Indian Health Service or the placing tribe. Discharge from the
deleted text begin facility deleted text end new text begin program new text end to the Indian Health Service or the placing tribe may be authorized by the
head of the deleted text begin treatment facility deleted text end new text begin program new text end after notice to and consultation with the Indian Health
Service or the placing tribe.

Sec. 111.

Minnesota Statutes 2018, section 253B.22, subdivision 1, is amended to read:

Subdivision 1.

Establishment.

The commissioner shall establish a review board of three
or more persons for deleted text begin each regional center deleted text end new text begin the Anoka-Metro Regional Treatment Center,
Minnesota Security Hospital, and Minnesota sex offender program new text end to review the admission
and retention of deleted text begin its deleted text end patients new text begin of that program new text end receiving services under this chapter. One
member shall be qualified in the diagnosis of mental illness, developmental disability, or
chemical dependency, and one member shall be an attorney. The commissioner may, upon
written request from the appropriate federal authority, establish a review panel for any
federal treatment facility within the state to review the admission and retention of patients
hospitalized under this chapter. For any review board established for a federal treatment
facility, one of the persons appointed by the commissioner shall be the commissioner of
veterans affairs or the commissioner's designee.

Sec. 112.

Minnesota Statutes 2018, section 253B.22, subdivision 2, is amended to read:

Subd. 2.

Right to appear.

Each deleted text begin treatment facility deleted text end new text begin program specified in subdivision 1 new text end
shall be visited by the review board at least once every six months. Upon request each
patient in the deleted text begin treatment facility deleted text end new text begin program new text end shall have the right to appear before the review
board during the visit.

Sec. 113.

Minnesota Statutes 2018, section 253B.22, subdivision 3, is amended to read:

Subd. 3.

Notice.

The head of deleted text begin the treatment facility deleted text end new text begin each program specified in subdivision
1 new text end shall notify each patient at the time of admission by a simple written statement of the
patient's right to appear before the review board and the next date when the board will visit
deleted text begin the treatment facility deleted text end new text begin that program new text end . A request to appear before the board need not be in
writing. Any employee of the deleted text begin treatment facility deleted text end new text begin program new text end receiving a patient's request to
appear before the board shall notify the head of the deleted text begin treatment facility deleted text end new text begin program new text end of the request.

Sec. 114.

Minnesota Statutes 2018, section 253B.22, subdivision 4, is amended to read:

Subd. 4.

Review.

The board shall review the admission and retention of patients at deleted text begin its
respective treatment facility deleted text end new text begin the program new text end . The board may examine the records of all patients
admitted and may examine personally at its own instigation all patients who from the records
or otherwise appear to justify reasonable doubt as to continued need of confinement in deleted text begin a
treatment facility deleted text end new text begin the program new text end . The review board shall report its findings to the commissioner
and to the head of the deleted text begin treatment facility deleted text end new text begin program new text end . The board may also receive reports from
patients, interested persons, and deleted text begin treatment facility deleted text end employees new text begin of the program new text end , and investigate
conditions affecting the care of patients.

Sec. 115.

Minnesota Statutes 2018, section 253B.23, subdivision 1, is amended to read:

Subdivision 1.

Costs of hearings.

(a) In each proceeding under this chapter the court
shall allow and order paid to each witness subpoenaed the fees and mileage prescribed by
law; to each examiner a reasonable sum for services and for travel; to persons conveying
the patient to the place of detention, disbursements for the travel, board, and lodging of the
patient and of themselves and their authorized assistants; and to the patient's counsel, when
appointed by the court, a reasonable sum for travel and for the time spent in court or in
preparing for the hearing. Upon the court's order, the county auditor shall issue a warrant
on the county treasurer for payment of the amounts allowed, excluding the costs of the new text begin court
new text end examiner, which must be paid by the state courts.

(b) Whenever venue of a proceeding has been transferred under this chapter, the costs
of the proceedings shall be reimbursed to the county where the proceedings were conducted
by the county of financial responsibility.

Sec. 116.

Minnesota Statutes 2018, section 253B.23, subdivision 1b, is amended to read:

Subd. 1b.

Responsibility for conducting prepetition screening and filing commitment
deleted text begin and early intervention deleted text end petitions.

(a) The county of financial responsibility is responsible
to conduct prepetition screening pursuant to section 253B.07, subdivision 1, and, if statutory
conditions for deleted text begin early intervention or deleted text end commitment are satisfied, to file a petition pursuant to
section deleted text begin 253B.064, subdivision 1, paragraph (a); deleted text end 253B.07, deleted text begin subdivision 1 deleted text end new text begin subdivision 2 new text end ,
paragraph (a) deleted text begin ; deleted text end new text begin , new text end or 253D.07.

(b) Except in cases under chapter 253D, if the county of financial responsibility refuses
or fails to conduct prepetition screening or file a petition, or if it is unclear which county is
the county of financial responsibility, the county where the proposed patient is present is
responsible to conduct the prepetition screening and, if statutory conditions for deleted text begin early
intervention or deleted text end commitment are satisfied, file the petition.

(c) In cases under chapter 253D, if the county of financial responsibility refuses or fails
to file a petition, or if it is unclear which county is the county of financial responsibility,
then (1) the county where the conviction for which the person is incarcerated was entered,
or (2) the county where the proposed patient is present, if the person is not currently
incarcerated based on conviction, is responsible to file the petition if statutory conditions
for commitment are satisfied.

(d) When a proposed patient is an inmate confined to an adult correctional facility under
the control of the commissioner of corrections and commitment proceedings are initiated
or proposed to be initiated pursuant to section 241.69, the county where the correctional
facility is located may agree to perform the responsibilities specified in paragraph (a).

(e) Any dispute concerning financial responsibility for the costs of the proceedings and
treatment will be resolved pursuant to chapter 256G.

(f) This subdivision and the sections of law cited in this subdivision address venue only.
Nothing in this chapter is intended to limit the statewide jurisdiction of district courts over
civil commitment matters.

Sec. 117.

Minnesota Statutes 2018, section 253B.23, subdivision 2, is amended to read:

Subd. 2.

Legal results of commitment status.

(a) Except as otherwise provided in this
chapter and in sections 246.15 and 246.16, no person by reason of commitment or treatment
pursuant to this chapter shall be deprived of any legal right, including but not limited to the
right to dispose of property, sue and be sued, execute instruments, make purchases, enter
into contractual relationships, vote, and hold a driver's license. Commitment or treatment
of any patient pursuant to this chapter is not a judicial determination of legal incompetency
except to the extent provided in section 253B.03, subdivision 6.

(b) Proceedings for determination of legal incompetency and the appointment of a
guardian for a person subject to commitment under this chapter may be commenced before,
during, or after commitment proceedings have been instituted and may be conducted jointly
with the commitment proceedings. The court shall notify the head of the deleted text begin treatment deleted text end facility new text begin
or program new text end to which the patient is committed of a finding that the patient is incompetent.

(c) Where the person to be committed is a minor or owns property of value and it appears
to the court that the person is not competent to manage a personal estate, the court shall
appoint a general conservator of the person's estate as provided by law.

Sec. 118.

Minnesota Statutes 2018, section 253B.24, is amended to read:

253B.24 TRANSMITTAL OF DATA TO NATIONAL INSTANT CRIMINAL
BACKGROUND CHECK SYSTEM.

When a court:

(1) commits a person under this chapter deleted text begin as being mentally ill, developmentally disabled,
mentally ill and dangerous, or chemically dependent deleted text end new text begin due to mental illness, developmental
disability, or chemical dependency, or as a person who has a mental illness and is dangerous
to the public new text end ;

(2) determines in a criminal case that a person is incompetent to stand trial or not guilty
by reason of mental illness; or

(3) restores a person's ability to possess a firearm under section 609.165, subdivision
1d, or 624.713, subdivision 4,

the court shall ensure that this information is electronically transmitted within three business
days to the National Instant Criminal Background Check System.

Sec. 119.

Minnesota Statutes 2018, section 253D.02, subdivision 6, is amended to read:

Subd. 6.

new text begin Court new text end examiner.

" new text begin Court new text end examiner" has the meaning given in section 253B.02,
subdivision deleted text begin 7 deleted text end new text begin 7a new text end .

Sec. 120.

Minnesota Statutes 2018, section 253D.07, subdivision 2, is amended to read:

Subd. 2.

Petition.

Upon the filing of a petition alleging that a proposed respondent is a
sexually dangerous person or a person with a sexual psychopathic personality, deleted text begin the court
shall hear the petition as provided deleted text end new text begin all of the applicable procedures contained new text end in sections
253B.07 and 253B.08 new text begin apply to the commitment proceeding new text end .

Sec. 121.

Minnesota Statutes 2018, section 253D.10, subdivision 2, is amended to read:

Subd. 2.

Correctional facilities.

(a) A person who is being petitioned for commitment
under this chapter and who is placed under a judicial hold order under section 253B.07,
subdivision 2b or 7, may be confined at a Department of Corrections or a county correctional
or detention facility, rather than a secure treatment facility, until a determination of the
commitment petition as specified in this subdivision.

(b) A court may order that a person who is being petitioned for commitment under this
chapter be confined in a Department of Corrections facility pursuant to the judicial hold
order under the following circumstances and conditions:

(1) The person is currently serving a sentence in a Department of Corrections facility
and the court determines that the person has made a knowing and voluntary (i) waiver of
the right to be held in a secure treatment facility and (ii) election to be held in a Department
of Corrections facility. The order confining the person in the Department of Corrections
facility shall remain in effect until the court vacates the order or the person's criminal sentence
and conditional release term expire.

In no case may the person be held in a Department of Corrections facility pursuant only
to this subdivision, and not pursuant to any separate correctional authority, for more than
210 days.

(2) A person who has elected to be confined in a Department of Corrections facility
under this subdivision may revoke the election by filing a written notice of intent to revoke
the election with the court and serving the notice upon the Department of Corrections and
the county attorney. The court shall order the person transferred to a secure treatment facility
within 15 days of the date that the notice of revocation was filed with the court, except that,
if the person has additional time to serve in prison at the end of the 15-day period, the person
shall not be transferred to a secure treatment facility until the person's prison term expires.
After a person has revoked an election to remain in a Department of Corrections facility
under this subdivision, the court may not adopt another election to remain in a Department
of Corrections facility without the agreement of both parties and the Department of
Corrections.

(3) Upon petition by the commissioner of corrections, after notice to the parties and
opportunity for hearing and for good cause shown, the court may order that the person's
place of confinement be changed from the Department of Corrections to a secure treatment
facility.

(4) While at a Department of Corrections facility pursuant to this subdivision, the person
shall remain subject to all rules and practices applicable to correctional inmates in the facility
in which the person is placed including deleted text begin , deleted text end but not limited to deleted text begin , deleted text end the powers and duties of the
commissioner of corrections under section 241.01, powers relating to use of force under
section 243.52, and the right of the commissioner of corrections to determine the place of
confinement in a prison, reformatory, or other facility.

(5) A person may not be confined in a Department of Corrections facility under this
provision beyond the end of the person's executed sentence or the end of any applicable
conditional release period, whichever is later. If a person confined in a Department of
Corrections facility pursuant to this provision reaches the person's supervised release date
and is subject to a period of conditional release, the period of conditional release shall
commence on the supervised release date even though the person remains in the Department
of Corrections facility pursuant to this provision. At the end of the later of the executed
sentence or any applicable conditional release period, the person shall be transferred to a
secure treatment facility.

(6) Nothing in this section may be construed to establish a right of an inmate in a state
correctional facility to participate in sex offender treatment. This section must be construed
in a manner consistent with the provisions of section 244.03.

new text begin (c) When a person is temporarily confined in a Department of Corrections facility solely
under this subdivision and not based on any separate correctional authority, the commissioner
of corrections may charge the county of financial responsibility for the costs of confinement,
and the Department of Human Services shall use existing appropriations to fund all remaining
nonconfinement costs. The funds received by the commissioner for the confinement and
nonconfinement costs are appropriated to the department for these purposes.
new text end

deleted text begin (c) deleted text end new text begin (d) new text end The committing county may offer a person who is being petitioned for commitment
under this chapter and who is placed under a judicial hold order under section 253B.07,
subdivision 2b or 7, the option to be held in a county correctional or detention facility rather
than a secure treatment facility, under such terms as may be agreed to by the county, the
commitment petitioner, and the commitment respondent. If a person makes such an election
under this paragraph, the court hold order shall specify the terms of the agreement, including
the conditions for revoking the election.

Sec. 122.

Minnesota Statutes 2018, section 253D.28, subdivision 2, is amended to read:

Subd. 2.

Procedure.

(a) The supreme court shall refer a petition for rehearing and
reconsideration to the chief judge of the judicial appeal panel. The chief judge shall notify
the committed person, the county attorneys of the county of commitment and county of
financial responsibility, the commissioner, the executive director, any interested person,
and other persons the chief judge designates, of the time and place of the hearing on the
petition. The notice shall be given at least 14 days prior to the date of the hearing. The
hearing may be conducted by interactive video conference under General Rules of Practice,
rule 131, and Minnesota Rules of Civil Commitment, rule 14.

(b) Any person may oppose the petition. The committed person, the committed person's
counsel, the county attorneys of the committing county and county of financial responsibility,
and the commissioner shall participate as parties to the proceeding pending before the
judicial appeal panel and shall, no later than 20 days before the hearing on the petition,
inform the judicial appeal panel and the opposing party in writing whether they support or
oppose the petition and provide a summary of facts in support of their position.

(c) The judicial appeal panel may appoint new text begin court new text end examiners and may adjourn the hearing
from time to time. It shall hear and receive all relevant testimony and evidence and make
a record of all proceedings. The committed person, the committed person's counsel, and the
county attorney of the committing county or the county of financial responsibility have the
right to be present and may present and cross-examine all witnesses and offer a factual and
legal basis in support of their positions.

(d) The petitioning party seeking discharge or provisional discharge bears the burden
of going forward with the evidence, which means presenting a prima facie case with
competent evidence to show that the person is entitled to the requested relief. If the petitioning
party has met this burden, the party opposing discharge or provisional discharge bears the
burden of proof by clear and convincing evidence that the discharge or provisional discharge
should be denied.

(e) A party seeking transfer under section 253D.29 must establish by a preponderance
of the evidence that the transfer is appropriate.

Sec. 123. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall renumber Minnesota Statutes, section 253B.02, so that the
subdivisions are alphabetical. The revisor shall correct any cross-references that arise as a
result of the renumbering.
new text end

Sec. 124. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2018, sections 253B.02, subdivisions 6 and 12a; 253B.05, subdivisions
1, 2, 2b, 3, and 4; 253B.064; 253B.065; 253B.066; 253B.09, subdivision 3; 253B.12,
subdivision 2; 253B.15, subdivision 11; and 253B.20, subdivision 7, new text end new text begin are repealed.
new text end

APPENDIX

Repealed Minnesota Statutes: S3322-1

245F.02 DEFINITIONS.

Subd. 20.

Qualified medical professional.

"Qualified medical professional" means an individual licensed in Minnesota as a doctor of osteopathic medicine or physician, or an individual licensed in Minnesota as an advanced practice registered nurse by the Board of Nursing and certified to practice as a clinical nurse specialist or nurse practitioner by a national nurse organization acceptable to the board.

253B.02 DEFINITIONS.

Subd. 6.

Emergency treatment.

"Emergency treatment" means the treatment of a patient pursuant to section 253B.05 which is necessary to protect the patient or others from immediate harm.

Subd. 12a.

Mental illness.

"Mental illness" has the meaning given in section 245.462, subdivision 20.

253B.05 EMERGENCY ADMISSION.

Subdivision 1.

Emergency hold.

(a) Any person may be admitted or held for emergency care and treatment in a treatment facility, except to a facility operated by the Minnesota sex offender program, with the consent of the head of the treatment facility upon a written statement by an examiner that:

(1) the examiner has examined the person not more than 15 days prior to admission;

(2) the examiner is of the opinion, for stated reasons, that the person is mentally ill, developmentally disabled, or chemically dependent, and is in danger of causing injury to self or others if not immediately detained; and

(3) an order of the court cannot be obtained in time to prevent the anticipated injury.

(b) If the proposed patient has been brought to the treatment facility by another person, the examiner shall make a good faith effort to obtain a statement of information that is available from that person, which must be taken into consideration in deciding whether to place the proposed patient on an emergency hold. The statement of information must include, to the extent available, direct observations of the proposed patient's behaviors, reliable knowledge of recent and past behavior, and information regarding psychiatric history, past treatment, and current mental health providers. The examiner shall also inquire into the existence of health care directives under chapter 145, and advance psychiatric directives under section 253B.03, subdivision 6d.

(c) The examiner's statement shall be: (1) sufficient authority for a peace or health officer to transport a patient to a treatment facility, (2) stated in behavioral terms and not in conclusory language, and (3) of sufficient specificity to provide an adequate record for review. If danger to specific individuals is a basis for the emergency hold, the statement must identify those individuals, to the extent practicable. A copy of the examiner's statement shall be personally served on the person immediately upon admission and a copy shall be maintained by the treatment facility.

(d) A patient must not be allowed or required to consent to nor participate in a clinical drug trial during an emergency admission or hold under this subdivision or subdivision 2. A consent given during a period of an emergency admission or hold is void and unenforceable. This paragraph does not prohibit a patient from continuing participation in a clinical drug trial if the patient was participating in the drug trial at the time of the emergency admission or hold.

Subd. 2.

Peace or health officer authority.

(a) A peace or health officer may take a person into custody and transport the person to a licensed physician or treatment facility if the officer has reason to believe, either through direct observation of the person's behavior, or upon reliable information of the person's recent behavior and knowledge of the person's past behavior or psychiatric treatment, that the person is mentally ill or developmentally disabled and in danger of injuring self or others if not immediately detained. A peace or health officer or a person working under such officer's supervision, may take a person who is believed to be chemically dependent or is intoxicated in public into custody and transport the person to a treatment facility. If the person is intoxicated in public or is believed to be chemically dependent and is not in danger of causing self-harm or harm to any person or property, the peace or health officer may transport the person home. The peace or health officer shall make written application for admission of the person to the treatment facility. The application shall contain the peace or health officer's statement specifying the reasons for and circumstances under which the person was taken into custody. If danger to specific individuals is a basis for the emergency hold, the statement must include identifying information on those individuals, to the extent practicable. A copy of the statement shall be made available to the person taken into custody. The peace or health officer who makes the application shall provide the officer's name, the agency that employs the officer, and the telephone number or other contact information for purposes of receiving notice under subdivision 3, paragraph (d).

(b) As far as is practicable, a peace officer who provides transportation for a person placed in a facility under this subdivision may not be in uniform and may not use a vehicle visibly marked as a law enforcement vehicle.

(c) A person may be admitted to a treatment facility for emergency care and treatment under this subdivision with the consent of the head of the facility under the following circumstances: (1) a written statement shall only be made by the following individuals who are knowledgeable, trained, and practicing in the diagnosis and treatment of mental illness or developmental disability; the medical officer, or the officer's designee on duty at the facility, including a licensed physician, a licensed physician assistant, or an advanced practice registered nurse who after preliminary examination has determined that the person has symptoms of mental illness or developmental disability and appears to be in danger of harming self or others if not immediately detained; or (2) a written statement is made by the institution program director or the director's designee on duty at the facility after preliminary examination that the person has symptoms of chemical dependency and appears to be in danger of harming self or others if not immediately detained or is intoxicated in public.

Subd. 2b.

Notice.

Every person held pursuant to this section must be informed in writing at the time of admission of the right to leave after 72 hours, to a medical examination within 48 hours, and to request a change to voluntary status. The treatment facility shall, upon request, assist the person in exercising the rights granted in this subdivision.

Subd. 3.

Duration of hold.

(a) Any person held pursuant to this section may be held up to 72 hours, exclusive of Saturdays, Sundays, and legal holidays after admission. If a petition for the commitment of the person is filed in the district court in the county of financial responsibility or of the county in which the treatment facility is located, the court may issue a judicial hold order pursuant to section 253B.07, subdivision 2b.

(b) During the 72-hour hold period, a court may not release a person held under this section unless the court has received a written petition for release and held a summary hearing regarding the release. The petition must include the name of the person being held, the basis for and location of the hold, and a statement as to why the hold is improper. The petition also must include copies of any written documentation under subdivision 1 or 2 in support of the hold, unless the person holding the petitioner refuses to supply the documentation. The hearing must be held as soon as practicable and may be conducted by means of a telephone conference call or similar method by which the participants are able to simultaneously hear each other. If the court decides to release the person, the court shall direct the release and shall issue written findings supporting the decision. The release may not be delayed pending the written order. Before deciding to release the person, the court shall make every reasonable effort to provide notice of the proposed release to:

(1) any specific individuals identified in a statement under subdivision 1 or 2 or individuals identified in the record who might be endangered if the person was not held;

(2) the examiner whose written statement was a basis for a hold under subdivision 1; and

(3) the peace or health officer who applied for a hold under subdivision 2.

(c) If a person is intoxicated in public and held under this section for detoxification, a treatment facility may release the person without providing notice under paragraph (d) as soon as the treatment facility determines the person is no longer a danger to themselves or others. Notice must be provided to the peace officer or health officer who transported the person, or the appropriate law enforcement agency, if the officer or agency requests notification.

(d) Notwithstanding section 144.293, subdivisions 2 and 4, if a treatment facility releases or discharges a person during the 72-hour hold period or if the person leaves the facility without the consent of the treating health care provider, the head of the treatment facility shall immediately notify the agency which employs the peace or health officer who transported the person to the treatment facility under this section. This paragraph does not apply to the extent that the notice would violate federal law governing the confidentiality of alcohol and drug abuse patient records under Code of Federal Regulations, title 42, part 2.

(e) A person held under a 72-hour emergency hold must be released by the facility within 72 hours unless a court order to hold the person is obtained. A consecutive emergency hold order under this section may not be issued.

Subd. 4.

Change of status.

Any person admitted pursuant to this section shall be changed to voluntary status provided by section 253B.04 upon the person's request in writing and with the consent of the head of the treatment facility.

253B.064 COURT-ORDERED EARLY INTERVENTION; PRELIMINARY PROCEDURES.

Subdivision 1.

General.

(a) An interested person may apply to the designated agency for early intervention of a proposed patient in the county of financial responsibility or the county where the patient is present. If the designated agency determines that early intervention may be appropriate, a prepetition screening report must be prepared pursuant to section 253B.07, subdivision 1. The county attorney may file a petition for early intervention following the procedures of section 253B.07, subdivision 2.

(b) The proposed patient is entitled to representation by counsel, pursuant to section 253B.07, subdivision 2c. The proposed patient shall be examined by an examiner, and has the right to a second independent examiner, pursuant to section 253B.07, subdivisions 3 and 5.

Subd. 2.

Prehearing examination; failure to appear.

If a proposed patient fails to appear for the examination, the court may:

(1) reschedule the examination; or

(2) deem the failure to appear as a waiver of the proposed patient's right to an examination and consider the failure to appear when deciding the merits of the petition for early intervention.

Subd. 3.

County option.

Nothing in sections 253B.064 to 253B.066 requires a county to use early intervention procedures.

253B.065 COURT-ORDERED EARLY INTERVENTION; HEARING PROCEDURES.

Subdivision 1.

Time for early intervention hearing.

The hearing on the petition for early intervention shall be held within 14 days from the date of the filing of the petition. For good cause shown, the court may extend the time of hearing up to an additional 30 days. When any proposed patient has not had a hearing on a petition filed for early intervention within the allowed time, the proceedings shall be dismissed.

Subd. 2.

Notice of hearing.

The proposed patient, the patient's counsel, the petitioner, the county attorney, and any other persons as the court directs shall be given at least five days' notice that a hearing will be held and at least two days' notice of the time and date of the hearing, except that any person may waive notice. Notice to the proposed patient may be waived by patient's counsel.

Subd. 3.

Failure to appear.

If a proposed patient fails to appear at the hearing, the court may reschedule the hearing within five days and direct a health officer, peace officer, or other person to take the proposed patient to an appropriate treatment facility designated by the court and transport the person to the hearing.

Subd. 4.

Procedures.

The hearing must be conducted pursuant to section 253B.08, subdivisions 3 to 8.

Subd. 5.

Early intervention criteria.

(a) A court shall order early intervention treatment of a proposed patient who meets the criteria under paragraph (b) or (c). The early intervention treatment must be less intrusive than long-term inpatient commitment and must be the least restrictive treatment program available that can meet the patient's treatment needs.

(b) The court shall order early intervention treatment if the court finds all of the elements of the following factors by clear and convincing evidence:

(1) the proposed patient is mentally ill;

(2) the proposed patient refuses to accept appropriate mental health treatment; and

(3) the proposed patient's mental illness is manifested by instances of grossly disturbed behavior or faulty perceptions and either:

(i) the grossly disturbed behavior or faulty perceptions significantly interfere with the proposed patient's ability to care for self and the proposed patient, when competent, would have chosen substantially similar treatment under the same circumstances; or

(ii) due to the mental illness, the proposed patient received court-ordered inpatient treatment under section 253B.09 at least two times in the previous three years; the patient is exhibiting symptoms or behavior substantially similar to those that precipitated one or more of the court-ordered treatments; and the patient is reasonably expected to physically or mentally deteriorate to the point of meeting the criteria for commitment under section 253B.09 unless treated.

For purposes of this paragraph, a proposed patient who was released under section 253B.095 and whose release was not revoked is not considered to have received court-ordered inpatient treatment under section 253B.09.

(c) The court may order early intervention treatment if the court finds by clear and convincing evidence that a pregnant woman is a chemically dependent person. A chemically dependent person for purposes of this section is a woman who has during pregnancy engaged in excessive use, for a nonmedical purpose, of controlled substances or their derivatives, alcohol, or inhalants that will pose a substantial risk of damage to the brain or physical development of the fetus.

(d) For purposes of paragraphs (b) and (c), none of the following constitute a refusal to accept appropriate mental health treatment:

(1) a willingness to take medication but a reasonable disagreement about type or dosage;

(2) a good faith effort to follow a reasonable alternative treatment plan, including treatment as specified in a valid advance directive under chapter 145C or section 253B.03, subdivision 6d;

(3) an inability to obtain access to appropriate treatment because of inadequate health care coverage or an insurer's refusal or delay in providing coverage for the treatment; or

(4) an inability to obtain access to needed mental health services because the provider will only accept patients who are under a court order or because the provider gives persons under a court order a priority over voluntary patients in obtaining treatment and services.

253B.066 COURT-ORDERED EARLY INTERVENTION; DECISION; TREATMENT ALTERNATIVES; DURATION.

Subdivision 1.

Treatment alternatives.

If the court orders early intervention under section 253B.065, subdivision 5, the court may include in its order a variety of treatment alternatives including, but not limited to, day treatment, medication compliance monitoring, assertive community treatment, crisis assessment and stabilization, partial hospitalization, and short-term hospitalization not to exceed 21 days.

If the court orders short-term hospitalization and the proposed patient will not go voluntarily, the court may direct a health officer, peace officer, or other person to take the person into custody and transport the person to the hospital.

Subd. 2.

Findings.

The court shall find the facts specifically and separately state its conclusions of law in its order. Where early intervention is ordered, the findings of fact and conclusions of law shall specifically state the proposed patient's conduct which is a basis for determining that each of the requisites for early intervention is met.

The court shall also determine the nature and extent of the property of the patient and of the persons who are liable for the patient's care.

Subd. 3.

Duration.

The order for early intervention shall not exceed 90 days.

253B.09 DECISION; STANDARD OF PROOF; DURATION.

Subd. 3.

Financial determination.

The court shall determine the nature and extent of the property of the patient and of the persons who are liable for the patient's care. If the patient is committed to a regional treatment center, the court shall send a copy of the commitment order to the commissioner.

253B.12 TREATMENT REPORT; REVIEW; HEARING.

Subd. 2.

Basis for discharge.

If no written report is filed within the required time or if the written statement describes the patient as not in need of further institutional care and treatment, the proceedings shall be terminated by the committing court, and the patient shall be discharged from the treatment facility.

253B.15 PROVISIONAL DISCHARGE; PARTIAL INSTITUTIONALIZATION.

Subd. 11.

Partial institutionalization.

The head of a treatment facility may place any committed person on a status of partial institutionalization. The status shall allow the patient to be absent from the facility for certain fixed periods of time. The head of the facility may terminate the status at any time.

253B.20 DISCHARGE; ADMINISTRATIVE PROCEDURE.

Subd. 7.

Services.

A committed person may at any time after discharge, provisional discharge or partial treatment, apply to the head of the treatment facility within whose district the committed person resides for treatment. The head of the treatment facility, on determining that the applicant requires service, may provide needed services related to mental illness, developmental disability, or chemical dependency to the applicant. The services shall be provided in regional centers under terms and conditions established by the commissioner.

Repealed Minnesota Session Laws: S3322-1

Laws 2005, First Special Session chapter 4, article 7, section 50

Sec. 50. new text begin CONSUMER-DIRECTED COMMUNITY SUPPORTS METHODOLOGY. new text end

new text begin (a) Effective upon federal approval, for persons using the home and community-based waiver for persons with developmental disabilities whose consumer-directed community supports budgets were reduced by the October 2004, state-set budget methodology, the commissioner of human services must allow exceptions to exceed the state-set budget formula up to the daily average cost during calendar year 2004 or for persons who graduated from school during 2004, the average daily cost during July through December 2004, less one-half of case management and home modifications over $5,000 when the individual's county of financial responsibility determines that: new text end

new text begin (1) necessary alternative services will cost the same or more than the person's current budget; and new text end

new text begin (2) administrative expenses or provider rates will result in fewer hours of needed staffing for the person than under the consumer-directed community supports option. Any exceptions the county grants must be within the county's allowable aggregate amount for the home and community-based waiver for persons with developmental disabilities. new text end

new text begin (b) This section expires on the date the commissioner of human services implements a new consumer-directed community supports budget methodology that is based on information about the services and supports intensity needs of persons using the option and that adequately accounts for the increased costs of adults who graduate from school and need services funded by the waiver during the day. new text end

Laws 2005, First Special Session chapter 4, article 7, section 51

Sec. 51. new text begin COSTS ASSOCIATED WITH PHYSICAL ACTIVITIES. new text end

new text begin Effective upon federal approval, the expenses allowed for adults under the consumer-directed community supports option shall include the costs at the lowest rate available considering daily, monthly, semi-annual, annual, or membership rates, including transportation, associated with physical exercise or other physical activities to maintain or improve the person's health and functioning. new text end

Laws 2012, chapter 247, article 4, section 47, as amended by Laws 2014, chapter 312, article 27, section 72; as amended by Laws 2015, chapter 71, article 7, section 58; as amended by Laws 2016, chapter 144, section 1; as amended by Laws 2017, First Special Session chapter 6, article 1, section 54

Sec. 72.

Laws 2012, chapter 247, article 4, section 47, is amended to read:

Sec. 47. COMMISSIONER TO SEEK AMENDMENT FOR EXCEPTION TO CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET METHODOLOGY.

By July 1, 2014, if necessary, the commissioner shall request an amendment to the home and community-based services waivers authorized under Minnesota Statutes, sections 256B.092 and 256B.49, to establish an exception to the consumer-directed community supports budget methodology to provide up to 20 percent more funds for those participants who have their 21st birthday and graduate from high school between 2013 to 2015 and are authorized for more services under consumer-directed community supports prior to graduation than the amount they are eligible to receive under the current consumer-directed community supports budget methodology. The exception is limited to those who can demonstrate that they will have to leave consumer-directed community supports and use other waiver services because their need for day or employment supports cannot be met within the consumer-directed community supports budget limits. The commissioner shall consult with the stakeholder group authorized under Minnesota Statutes, section 256B.0657, subdivision 11, to implement this provision. The exception process shall be effective upon federal approval for persons eligible through June 30, 2017.

Laws 2015, chapter 71, article 7, section 54, as amended by Laws 2017, First Special Session chapter 6, article 1, section 54

Sec. 54. CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET METHODOLOGY EXCEPTION.

(a) No later than September 30, 2015, if necessary, the commissioner of human services shall submit an amendment to the Centers for Medicare and Medicaid Services for the home and community-based services waivers authorized under Minnesota Statutes, sections 256B.092 and 256B.49, to establish an exception to the consumer-directed community supports budget methodology to provide up to 20 percent more funds for:

(1) consumer-directed community supports participants who have graduated from high school and have a coordinated service and support plan which identifies the need for more services under consumer-directed community supports, either prior to graduation or in order to increase the amount of time a person works or to improve their employment opportunities, than the amount they are eligible to receive under the current consumer-directed community supports budget methodology; and

(2) home and community-based waiver participants who are currently using licensed services for employment supports or services during the day which cost more annually than the person would spend under a consumer-directed community supports plan for individualized employment supports or services during the day.

(b) The exception under paragraph (a) is limited to those persons who can demonstrate either that they will have to leave consumer-directed community supports and use other waiver services because their need for day or employment supports cannot be met within the consumer-directed community supports budget limits or they will move to consumer-directed community supports and their services will cost less than services currently being used.

EFFECTIVE DATE.

The exception under this section is effective October 1, 2015, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when this occurs.

Laws 2017, First Special Session chapter 6, article 1, section 44, as amended by Laws 2019, First Special Session chapter 9, article 5, section 80

Sec. 80.

Laws 2017, First Special Session chapter 6, article 1, section 44, is amended to read:

Sec. 44. EXPANSION OF CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET METHODOLOGY EXCEPTION.

(a) No later than September 30, 2017, if necessary, the commissioner of human services shall submit an amendment to the Centers for Medicare and Medicaid Services for the home and community-based services waivers authorized under Minnesota Statutes, sections 256B.092 and 256B.49, to expand the exception to the consumer-directed community supports budget methodology under Laws 2015, chapter 71, article 7, section 54, to provide up to 30 percent more funds for either:

(1) consumer-directed community supports participants who have a coordinated service and support plan which identifies the need for an increased amount of services or supports under consumer-directed community supports than the amount they are currently receiving under the consumer-directed community supports budget methodology:

(i) to increase the amount of time a person works or otherwise improves employment opportunities;

(ii) to plan a transition to, move to, or live in a setting described in Minnesota Statutes, section 256D.44, subdivision 5, paragraph (g), clause (1), item (iii); or

(iii) to develop and implement a positive behavior support plan; or

(2) home and community-based waiver participants who are currently using licensed providers for (i) employment supports or services during the day; or (ii) residential services, either of which cost more annually than the person would spend under a consumer-directed community supports plan for any or all of the supports needed to meet the goals identified in paragraph (a), clause (1), items (i), (ii), and (iii).

(b) The exception under paragraph (a), clause (1), is limited to those persons who can demonstrate that they will have to discontinue using consumer-directed community supports and accept other non-self-directed waiver services because their supports needed for the goals described in paragraph (a), clause (1), items (i), (ii), and (iii), cannot be met within the consumer-directed community supports budget limits.

(c) The exception under paragraph (a), clause (2), is limited to those persons who can demonstrate that, upon choosing to become a consumer-directed community supports participant, the total cost of services, including the exception, will be less than the cost of current waiver services.

Laws 2017, First Special Session chapter 6, article 1, section 45, as amended by Laws 2019, First Special Session chapter 9, article 5, section 81

Sec. 81.

Laws 2017, First Special Session chapter 6, article 1, section 45, is amended to read:

Sec. 45.

CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET METHODOLOGY.

Subdivision 1.

Exception for persons leaving institutions and crisis residential settings.

(a) By September 30, 2017, the commissioner shall establish an institutional and crisis bed consumer-directed community supports budget exception process in the home and community-based services waivers under Minnesota Statutes, sections 256B.092 and 256B.49. This budget exception process shall be available for any individual who:

(1) is not offered available and appropriate services within 60 days since approval for discharge from the individual's current institutional setting; and

(2) requires services that are more expensive than appropriate services provided in a noninstitutional setting using the consumer-directed community supports option.

(b) Institutional settings for purposes of this exception include intermediate care facilities for persons with developmental disabilities; nursing facilities; acute care hospitals; Anoka Metro Regional Treatment Center; Minnesota Security Hospital; and crisis beds. The budget exception shall be limited to no more than the amount of appropriate services provided in a noninstitutional setting as determined by the lead agency managing the individual's home and community-based services waiver. The lead agency shall notify the Department of Human Services of the budget exception.

Subd. 2.

Shared services.

(a) Medical assistance payments for shared services under consumer-directed community supports are limited to this subdivision.

(b) For purposes of this subdivision, "shared services" means services provided at the same time by the same direct care worker for individuals who have entered into an agreement to share consumer-directed community support services.

(c) Shared services may include services in the personal assistance category as outlined in the consumer-directed community supports community support plan and shared services agreement, except:

(1) services for more than three individuals provided by one worker at one time;

(2) use of more than one worker for the shared services; and

(3) a child care program licensed under chapter 245A or operated by a local school district or private school.

(d) The individuals or, as needed, their representatives shall develop the plan for shared services when developing or amending the consumer-directed community supports plan, and must follow the consumer-directed community supports process for approval of the plan by the lead agency. The plan for shared services in an individual's consumer-directed community supports plan shall include the intention to utilize shared services based on individuals' needs and preferences.

(e) Individuals sharing services must use the same financial management services provider.

(f) Individuals whose consumer-directed community supports community support plans include the intention to utilize shared services must also jointly develop, with the support of their representatives as needed, a shared services agreement. This agreement must include:

(1) the names of the individuals receiving shared services;

(2) the individuals' representative, if identified in their consumer-directed community supports plans, and their duties;

(3) the names of the case managers;

(4) the financial management services provider;

(5) the shared services that must be provided;

(6) the schedule for shared services;

(7) the location where shared services must be provided;

(8) the training specific to each individual served;

(9) the training specific to providing shared services to the individuals identified in the agreement;

(10) instructions to follow all required documentation for time and services provided;

(11) a contingency plan for each of the individuals that accounts for service provision and billing in the absence of one of the individuals in a shared services setting due to illness or other circumstances;

(12) signatures of all parties involved in the shared services; and

(13) agreement by each of the individuals who are sharing services on the number of shared hours for services provided.

(g) Any individual or any individual's representative may withdraw from participating in a shared services agreement at any time.

(h) The lead agency for each individual must authorize the use of the shared services option based on the criteria that the shared service is appropriate to meet the needs, health, and safety of each individual for whom they provide case management or care coordination.

(i) Nothing in this subdivision must be construed to reduce the total authorized consumer-directed community supports budget for an individual.

(j) No later than September 30, 2019, the commissioner of human services shall:

(1) submit an amendment to the Centers for Medicare and Medicaid Services for the home and community-based services waivers authorized under Minnesota Statutes, sections 256B.0913, 256B.0915, 256B.092, and 256B.49, to allow for a shared services option under consumer-directed community supports; and

(2) with stakeholder input, develop guidance for shared services in consumer-directed community-supports within the Community Based Services Manual. Guidance must include:

(i) recommendations for negotiating payment for one-to-two and one-to-three services; and

(ii) a template of the shared services agreement.

EFFECTIVE DATE.

This section is effective October 1, 2019, or upon federal approval, whichever is later, except for subdivision 2, paragraph (j), which is effective the day following final enactment. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained.