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Capital IconMinnesota Legislature

SF 4410

3rd Engrossment - 92nd Legislature (2021 - 2022) Posted on 05/06/2022 08:12am

KEY: stricken = removed, old language.
underscored = added, new language.

Bill Text Versions

Engrossments
Introduction Posted on 03/30/2022
1st Engrossment Posted on 04/07/2022
2nd Engrossment Posted on 04/21/2022
3rd Engrossment Posted on 04/27/2022
Unofficial Engrossments
1st Unofficial Engrossment Posted on 04/28/2022
2nd Unofficial Engrossment Posted on 05/03/2022

Current Version - 3rd Engrossment

Line numbers 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 1.26 1.27 1.28 1.29 1.30 1.31 1.32 1.33 1.34 1.35 1.36 1.37 1.38 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 2.28 2.29 2.30 2.31 2.32 2.33 2.34 2.35 2.36 2.37 2.38 2.39 2.40 2.41 2.42 2.43 2.44 2.45 2.46 2.47 2.48 2.49 2.50 2.51 2.52 2.53 2.54 2.55 2.56 2.57 2.58 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16
3.17 3.18
3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31
3.32
3.33 3.34 3.35 3.36 3.37 3.38 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21
4.22
4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 4.32 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10
5.11 5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22
5.23 5.24 5.25 5.26 5.27 5.28 5.29 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14 6.15 6.16 6.17 6.18 6.19 6.20 6.21 6.22 6.23 6.24 6.25 6.26 6.27 6.28 6.29 6.30 6.31 6.32 7.1 7.2 7.3 7.4
7.5
7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13 7.14 7.15 7.16 7.17 7.18 7.19 7.20 7.21 7.22 7.23 7.24 7.25 7.26 7.27 7.28 7.29 7.30 7.31 7.32 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18 8.19 8.20 8.21 8.22 8.23 8.24 8.25 8.26 8.27 8.28 8.29 8.30 8.31 8.32 8.33
9.1 9.2 9.3
9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14 9.15 9.16 9.17 9.18 9.19 9.20 9.21 9.22 9.23 9.24 9.25 9.26 9.27 9.28 9.29
10.1 10.2 10.3
10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13 10.14
10.15 10.16 10.17 10.18 10.19 10.20 10.21 10.22 10.23 10.24 10.25 10.26 10.27 10.28 10.29 10.30 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8 11.9 11.10 11.11 11.12 11.13 11.14 11.15 11.16 11.17 11.18 11.19 11.20 11.21 11.22 11.23 11.24 11.25 11.26 11.27 11.28 11.29 11.30 11.31 12.1 12.2 12.3 12.4
12.5 12.6 12.7
12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20 12.21 12.22 12.23 12.24 12.25 12.26 12.27 12.28 12.29 12.30 12.31 13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 13.10 13.11 13.12 13.13
13.14 13.15 13.16
13.17 13.18 13.19 13.20 13.21 13.22 13.23 13.24 13.25 13.26 13.27 13.28 13.29 13.30 13.31 14.1 14.2 14.3 14.4 14.5 14.6 14.7 14.8 14.9 14.10 14.11 14.12 14.13 14.14 14.15 14.16 14.17 14.18 14.19 14.20 14.21 14.22 14.23 14.24 14.25 14.26 14.27 14.28 14.29 14.30 14.31 14.32 14.33 15.1 15.2 15.3 15.4 15.5 15.6 15.7 15.8
15.9 15.10 15.11 15.12 15.13 15.14 15.15 15.16 15.17 15.18 15.19 15.20 15.21 15.22 15.23 15.24 15.25 15.26 15.27 15.28 15.29 15.30 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9 16.10 16.11 16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21 16.22 16.23 16.24 16.25 16.26 16.27 16.28 16.29 16.30 16.31 16.32 17.1 17.2 17.3 17.4 17.5 17.6
17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16 17.17 17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25 17.26 17.27 17.28 17.29 17.30 17.31 17.32 17.33 17.34 18.1 18.2 18.3 18.4 18.5 18.6 18.7 18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16 18.17 18.18 18.19 18.20 18.21 18.22 18.23 18.24 18.25 18.26 18.27 18.28 18.29 18.30 18.31 18.32 18.33 19.1 19.2
19.3 19.4 19.5 19.6 19.7 19.8 19.9 19.10 19.11 19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29 19.30 19.31 20.1 20.2 20.3 20.4 20.5 20.6 20.7 20.8 20.9 20.10 20.11 20.12 20.13 20.14 20.15 20.16 20.17 20.18 20.19 20.20 20.21 20.22 20.23 20.24 20.25 20.26 20.27
20.28 20.29 20.30 20.31 20.32 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 21.10 21.11 21.12 21.13 21.14 21.15 21.16 21.17 21.18 21.19 21.20 21.21 21.22 21.23 21.24 21.25
21.26 21.27 21.28
21.29 21.30 21.31 21.32 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11 22.12 22.13 22.14 22.15 22.16 22.17 22.18 22.19 22.20 22.21 22.22 22.23 22.24 22.25 22.26 22.27
22.28 22.29 22.30
23.1 23.2 23.3 23.4 23.5 23.6 23.7 23.8 23.9 23.10 23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18 23.19 23.20 23.21 23.22 23.23 23.24 23.25 23.26 23.27 23.28
23.29 23.30 23.31
24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8 24.9 24.10 24.11 24.12 24.13 24.14 24.15 24.16 24.17 24.18 24.19 24.20 24.21 24.22 24.23 24.24 24.25 24.26 24.27 24.28
25.1 25.2 25.3
25.4 25.5 25.6 25.7 25.8 25.9 25.10 25.11 25.12 25.13 25.14 25.15 25.16 25.17 25.18 25.19 25.20 25.21 25.22 25.23 25.24 25.25 25.26 25.27 25.28 25.29 26.1 26.2 26.3 26.4 26.5 26.6 26.7 26.8 26.9 26.10 26.11 26.12 26.13 26.14 26.15 26.16 26.17 26.18
26.19 26.20 26.21
26.22 26.23 26.24 26.25 26.26 26.27 26.28 26.29 26.30 26.31 26.32 26.33 27.1 27.2 27.3 27.4 27.5 27.6 27.7
27.8 27.9 27.10
27.11 27.12 27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21 27.22 27.23 27.24 27.25 27.26 27.27 27.28 27.29 28.1 28.2 28.3 28.4 28.5 28.6 28.7 28.8 28.9 28.10 28.11 28.12 28.13 28.14 28.15 28.16 28.17 28.18 28.19 28.20 28.21 28.22 28.23 28.24 28.25 28.26 28.27 28.28 28.29 28.30 29.1 29.2 29.3 29.4 29.5 29.6 29.7 29.8 29.9 29.10 29.11
29.12 29.13 29.14
29.15 29.16 29.17 29.18 29.19 29.20 29.21 29.22 29.23 29.24 29.25 29.26 29.27 29.28 29.29 29.30 30.1 30.2 30.3 30.4 30.5 30.6 30.7 30.8 30.9 30.10 30.11 30.12 30.13 30.14 30.15 30.16 30.17 30.18 30.19 30.20 30.21 30.22 30.23 30.24 30.25 30.26 30.27 30.28 30.29 30.30 30.31 31.1 31.2 31.3 31.4 31.5
31.6 31.7 31.8
31.9 31.10 31.11 31.12 31.13 31.14 31.15 31.16 31.17 31.18 31.19 31.20 31.21 31.22 31.23 31.24 31.25 31.26 31.27 31.28 31.29 31.30 31.31 32.1 32.2 32.3 32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15
32.16 32.17 32.18
32.19 32.20 32.21 32.22 32.23 32.24 32.25 32.26 32.27 32.28 32.29 32.30 32.31 33.1 33.2 33.3 33.4 33.5 33.6 33.7 33.8 33.9 33.10 33.11 33.12 33.13 33.14 33.15 33.16 33.17 33.18 33.19 33.20 33.21 33.22 33.23 33.24 33.25 33.26 33.27 33.28 33.29 33.30 33.31 33.32
34.1 34.2 34.3
34.4 34.5 34.6 34.7 34.8 34.9 34.10 34.11 34.12 34.13 34.14 34.15 34.16 34.17 34.18 34.19 34.20 34.21 34.22 34.23 34.24 34.25 34.26
34.27 34.28 34.29
35.1 35.2 35.3 35.4 35.5 35.6 35.7 35.8 35.9 35.10 35.11 35.12 35.13 35.14 35.15 35.16 35.17 35.18 35.19 35.20 35.21 35.22 35.23 35.24 35.25 35.26 35.27 35.28 35.29 35.30 35.31 35.32 36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 36.9 36.10 36.11 36.12 36.13 36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23 36.24 36.25 36.26 36.27 36.28
36.29 36.30 36.31
37.1 37.2 37.3 37.4 37.5 37.6 37.7 37.8 37.9 37.10 37.11 37.12 37.13 37.14 37.15 37.16 37.17 37.18 37.19 37.20 37.21 37.22 37.23 37.24 37.25 37.26 37.27 37.28 37.29 37.30 37.31 38.1 38.2 38.3 38.4 38.5 38.6 38.7 38.8 38.9 38.10 38.11 38.12
38.13 38.14 38.15 38.16 38.17 38.18 38.19 38.20 38.21 38.22
38.23 38.24 38.25 38.26 38.27 38.28 38.29 38.30 38.31
39.1 39.2 39.3 39.4 39.5 39.6 39.7 39.8 39.9 39.10 39.11 39.12 39.13 39.14 39.15 39.16
39.17 39.18 39.19 39.20 39.21 39.22 39.23
39.24 39.25 39.26 39.27 39.28 39.29 39.30
40.1 40.2 40.3 40.4 40.5 40.6 40.7
40.8 40.9 40.10
40.11 40.12 40.13 40.14 40.15 40.16 40.17
40.18 40.19 40.20
40.21 40.22 40.23 40.24 40.25 40.26 40.27 40.28 40.29 40.30 41.1 41.2 41.3 41.4 41.5 41.6 41.7 41.8 41.9 41.10 41.11 41.12 41.13 41.14 41.15 41.16 41.17 41.18 41.19 41.20
41.21 41.22 41.23 41.24 41.25 41.26 41.27 41.28 41.29 41.30 41.31 41.32 41.33 42.1 42.2 42.3 42.4 42.5 42.6 42.7 42.8 42.9 42.10 42.11 42.12 42.13 42.14 42.15 42.16 42.17 42.18 42.19 42.20 42.21 42.22 42.23
42.24 42.25 42.26
42.27 42.28 42.29 42.30 42.31 42.32 43.1 43.2 43.3 43.4
43.5 43.6 43.7 43.8 43.9 43.10 43.11 43.12 43.13 43.14 43.15 43.16 43.17 43.18 43.19 43.20 43.21 43.22 43.23
43.24 43.25 43.26
43.27 43.28 43.29 43.30 43.31 44.1 44.2 44.3 44.4 44.5 44.6 44.7 44.8 44.9 44.10 44.11 44.12 44.13 44.14
44.15 44.16 44.17
44.18 44.19 44.20 44.21 44.22 44.23 44.24 44.25 44.26 44.27 44.28 44.29 44.30 45.1 45.2 45.3 45.4 45.5 45.6 45.7 45.8 45.9 45.10 45.11 45.12 45.13 45.14 45.15 45.16 45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25 45.26 45.27 45.28 45.29 45.30 45.31 45.32 45.33 45.34 45.35 46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13 46.14 46.15
46.16 46.17 46.18 46.19 46.20 46.21 46.22 46.23 46.24
46.25
46.26 46.27 46.28 46.29 46.30 46.31 46.32 47.1 47.2 47.3 47.4 47.5 47.6 47.7 47.8 47.9 47.10 47.11 47.12 47.13 47.14 47.15 47.16 47.17 47.18 47.19 47.20 47.21 47.22 47.23 47.24 47.25 47.26 47.27 47.28 47.29 47.30 48.1 48.2 48.3 48.4 48.5 48.6 48.7 48.8 48.9 48.10 48.11 48.12 48.13 48.14 48.15 48.16 48.17 48.18 48.19 48.20 48.21 48.22 48.23 48.24 48.25 48.26 48.27 48.28 48.29 48.30 49.1 49.2 49.3 49.4 49.5 49.6 49.7 49.8 49.9 49.10 49.11 49.12 49.13 49.14 49.15 49.16 49.17 49.18 49.19 49.20 49.21 49.22 49.23 49.24 49.25 49.26 49.27 49.28 49.29 49.30 49.31 49.32 50.1 50.2 50.3 50.4 50.5 50.6 50.7 50.8 50.9 50.10 50.11 50.12 50.13 50.14 50.15 50.16 50.17 50.18 50.19 50.20 50.21 50.22 50.23 50.24 50.25 50.26 50.27 50.28 50.29 50.30 50.31 50.32
51.1 51.2 51.3 51.4 51.5 51.6 51.7 51.8 51.9 51.10 51.11 51.12 51.13 51.14 51.15 51.16 51.17 51.18 51.19 51.20 51.21 51.22 51.23 51.24 51.25 51.26 51.27 51.28 51.29 51.30 52.1 52.2 52.3 52.4 52.5 52.6 52.7 52.8 52.9 52.10 52.11 52.12 52.13 52.14 52.15 52.16 52.17 52.18 52.19 52.20 52.21 52.22 52.23 52.24 52.25 52.26 52.27 52.28 52.29 52.30 52.31 52.32 53.1 53.2 53.3 53.4 53.5 53.6 53.7 53.8 53.9 53.10 53.11 53.12 53.13 53.14 53.15 53.16 53.17 53.18 53.19 53.20 53.21 53.22 53.23 53.24 53.25 53.26 53.27 53.28 53.29 53.30 53.31 53.32 54.1 54.2 54.3 54.4 54.5 54.6 54.7 54.8 54.9 54.10 54.11 54.12 54.13 54.14 54.15 54.16 54.17 54.18 54.19 54.20 54.21 54.22 54.23 54.24 54.25 54.26
54.27 54.28 54.29
54.30 54.31 54.32 55.1 55.2 55.3 55.4 55.5 55.6 55.7 55.8 55.9 55.10 55.11 55.12 55.13 55.14 55.15 55.16 55.17 55.18 55.19 55.20 55.21 55.22 55.23 55.24 55.25 55.26 55.27 55.28 55.29 55.30 55.31 55.32 55.33 56.1 56.2 56.3 56.4 56.5 56.6 56.7 56.8 56.9 56.10 56.11 56.12 56.13 56.14 56.15 56.16 56.17 56.18 56.19 56.20 56.21 56.22 56.23 56.24 56.25 56.26 56.27 56.28 56.29 56.30 56.31 56.32
57.1 57.2 57.3
57.4 57.5 57.6 57.7 57.8 57.9 57.10 57.11 57.12 57.13 57.14 57.15 57.16 57.17 57.18
57.19 57.20 57.21
57.22 57.23 57.24 57.25 57.26
57.27 57.28 57.29
58.1 58.2 58.3 58.4 58.5
58.6 58.7 58.8
58.9 58.10 58.11 58.12 58.13 58.14 58.15 58.16 58.17 58.18 58.19 58.20 58.21 58.22 58.23 58.24 58.25 58.26 58.27 58.28 58.29 58.30 58.31 58.32 59.1 59.2 59.3 59.4 59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12
59.13 59.14 59.15
59.16 59.17 59.18 59.19 59.20 59.21 59.22 59.23 59.24 59.25 59.26
59.27 59.28 59.29
59.30 59.31 59.32 60.1 60.2 60.3 60.4 60.5 60.6 60.7 60.8 60.9 60.10 60.11 60.12 60.13 60.14 60.15
60.16 60.17 60.18
60.19 60.20 60.21 60.22 60.23 60.24 60.25 60.26 60.27 60.28 60.29 60.30 60.31 60.32 61.1 61.2 61.3 61.4 61.5 61.6 61.7 61.8 61.9 61.10 61.11 61.12 61.13 61.14 61.15 61.16 61.17 61.18 61.19 61.20 61.21 61.22 61.23 61.24 61.25 61.26 61.27 61.28 61.29 61.30 61.31 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13 62.14 62.15 62.16 62.17 62.18 62.19 62.20 62.21 62.22 62.23 62.24 62.25 62.26 62.27 62.28 63.1 63.2
63.3 63.4 63.5 63.6 63.7 63.8 63.9 63.10 63.11 63.12 63.13
63.14 63.15 63.16
63.17 63.18 63.19 63.20 63.21 63.22 63.23 63.24 63.25 63.26 63.27 63.28 63.29 63.30 63.31 63.32 63.33 64.1 64.2 64.3 64.4 64.5 64.6 64.7 64.8 64.9 64.10 64.11 64.12 64.13 64.14 64.15 64.16 64.17 64.18 64.19 64.20 64.21 64.22 64.23 64.24 64.25 64.26 64.27
64.28 64.29 64.30 64.31 64.32 64.33 65.1 65.2 65.3 65.4 65.5 65.6 65.7 65.8 65.9 65.10 65.11 65.12 65.13 65.14 65.15 65.16 65.17 65.18 65.19 65.20 65.21 65.22 65.23 65.24 65.25 65.26 65.27 65.28 65.29 65.30 65.31 65.32 65.33 66.1 66.2 66.3 66.4 66.5 66.6 66.7 66.8 66.9 66.10
66.11 66.12 66.13 66.14 66.15 66.16 66.17
66.18 66.19 66.20 66.21 66.22 66.23
66.24 66.25 66.26
66.27 66.28 66.29 66.30 66.31 67.1 67.2 67.3 67.4
67.5 67.6 67.7 67.8 67.9 67.10 67.11 67.12 67.13 67.14 67.15 67.16 67.17 67.18 67.19 67.20 67.21 67.22 67.23 67.24 67.25 67.26 67.27 67.28 67.29 67.30 67.31 68.1 68.2
68.3 68.4 68.5 68.6 68.7 68.8 68.9 68.10 68.11 68.12 68.13 68.14 68.15 68.16 68.17 68.18 68.19 68.20 68.21 68.22 68.23 68.24 68.25 68.26 68.27 68.28 68.29 68.30 68.31 68.32 69.1 69.2 69.3 69.4 69.5 69.6 69.7 69.8 69.9 69.10 69.11 69.12 69.13
69.14 69.15 69.16 69.17 69.18 69.19 69.20 69.21 69.22 69.23 69.24 69.25 69.26 69.27 69.28 69.29 69.30 69.31 69.32
70.1
70.2 70.3
70.4 70.5 70.6
70.7 70.8
70.9 70.10 70.11 70.12 70.13 70.14
70.15 70.16 70.17
70.18 70.19 70.20 70.21 70.22 70.23
70.24 70.25 70.26
70.27 70.28 70.29 71.1 71.2
71.3 71.4 71.5
71.6 71.7 71.8 71.9 71.10
71.11 71.12 71.13
71.14 71.15 71.16 71.17 71.18 71.19
71.20 71.21 71.22
71.23 71.24 71.25 71.26 71.27
71.28 71.29 71.30
72.1 72.2 72.3 72.4 72.5
72.6 72.7 72.8
72.9 72.10 72.11 72.12 72.13 72.14 72.15
72.16 72.17 72.18
72.19 72.20 72.21 72.22 72.23 72.24
72.25 72.26 72.27
72.28 72.29 72.30 73.1 73.2
73.3 73.4 73.5
73.6 73.7 73.8 73.9 73.10 73.11
73.12 73.13 73.14
73.15 73.16 73.17 73.18
73.19 73.20 73.21
73.22 73.23 73.24 73.25
73.26 73.27 73.28
74.1 74.2 74.3 74.4 74.5 74.6 74.7 74.8 74.9 74.10 74.11 74.12 74.13 74.14 74.15 74.16 74.17 74.18 74.19 74.20 74.21 74.22 74.23 74.24 74.25 74.26 74.27 74.28 74.29 74.30 74.31 75.1 75.2 75.3 75.4 75.5 75.6 75.7 75.8
75.9 75.10 75.11
75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21 75.22 75.23 75.24
75.25 75.26 75.27 75.28 75.29 75.30 75.31 76.1 76.2 76.3 76.4 76.5 76.6 76.7 76.8 76.9 76.10 76.11 76.12 76.13 76.14 76.15 76.16 76.17 76.18 76.19 76.20 76.21 76.22 76.23 76.24 76.25 76.26 76.27 76.28 76.29 76.30 76.31 76.32 77.1 77.2 77.3 77.4 77.5 77.6 77.7 77.8 77.9 77.10 77.11 77.12 77.13 77.14 77.15 77.16 77.17 77.18 77.19
77.20 77.21 77.22 77.23
77.24 77.25 77.26 77.27 77.28 77.29 77.30 77.31 77.32 78.1 78.2 78.3 78.4 78.5 78.6 78.7 78.8 78.9 78.10 78.11 78.12 78.13 78.14 78.15 78.16 78.17 78.18 78.19 78.20 78.21 78.22 78.23 78.24 78.25 78.26 78.27 78.28 78.29 78.30 78.31 78.32 78.33 79.1 79.2 79.3 79.4 79.5 79.6 79.7
79.8 79.9 79.10
79.11 79.12 79.13 79.14 79.15 79.16 79.17 79.18 79.19 79.20 79.21 79.22 79.23 79.24 79.25 79.26 79.27 79.28 79.29 79.30 79.31 80.1 80.2 80.3 80.4 80.5 80.6 80.7 80.8 80.9 80.10 80.11 80.12 80.13 80.14 80.15 80.16 80.17 80.18 80.19 80.20 80.21 80.22 80.23 80.24 80.25 80.26 80.27 80.28 80.29 80.30 80.31 80.32 80.33 80.34 80.35 81.1 81.2 81.3 81.4 81.5
81.6 81.7 81.8 81.9 81.10 81.11 81.12 81.13 81.14 81.15 81.16 81.17 81.18 81.19 81.20 81.21 81.22 81.23 81.24 81.25 81.26 81.27 81.28 81.29 81.30 81.31
81.32 81.33 82.1 82.2 82.3 82.4
82.5 82.6 82.7 82.8 82.9
82.10 82.11 82.12
82.13 82.14
82.15 82.16 82.17 82.18 82.19 82.20 82.21 82.22 82.23 82.24 82.25 82.26 82.27 82.28 82.29 82.30 82.31 82.32 83.1 83.2 83.3 83.4 83.5 83.6 83.7 83.8 83.9 83.10 83.11 83.12 83.13 83.14 83.15 83.16 83.17 83.18 83.19 83.20 83.21 83.22 83.23 83.24 83.25 83.26 83.27 83.28 83.29 83.30 84.1 84.2 84.3 84.4 84.5 84.6 84.7 84.8 84.9 84.10 84.11 84.12 84.13 84.14 84.15 84.16 84.17 84.18 84.19 84.20 84.21 84.22 84.23 84.24 84.25 84.26 84.27 84.28 84.29 84.30 84.31 84.32 85.1 85.2 85.3 85.4 85.5 85.6 85.7 85.8 85.9 85.10 85.11 85.12 85.13 85.14 85.15 85.16 85.17 85.18 85.19 85.20 85.21 85.22 85.23 85.24 85.25 85.26 85.27 85.28 85.29 85.30 85.31 85.32 86.1 86.2 86.3 86.4 86.5 86.6 86.7 86.8
86.9
86.10 86.11 86.12 86.13 86.14 86.15 86.16 86.17 86.18 86.19 86.20 86.21 86.22 86.23 86.24 86.25 86.26 86.27 86.28 86.29 86.30 86.31 86.32 87.1 87.2 87.3 87.4 87.5 87.6 87.7 87.8 87.9 87.10 87.11
87.12 87.13 87.14 87.15 87.16 87.17 87.18 87.19 87.20 87.21 87.22 87.23 87.24 87.25 87.26 87.27 87.28 87.29 87.30 87.31 87.32 88.1 88.2 88.3 88.4 88.5 88.6 88.7 88.8 88.9 88.10 88.11 88.12 88.13 88.14 88.15 88.16 88.17 88.18 88.19 88.20 88.21 88.22 88.23 88.24 88.25 88.26 88.27 88.28 88.29 88.30 89.1 89.2 89.3 89.4 89.5 89.6 89.7 89.8 89.9 89.10 89.11 89.12 89.13 89.14 89.15 89.16 89.17 89.18 89.19 89.20 89.21 89.22 89.23 89.24 89.25 89.26 89.27 89.28 89.29 89.30 89.31 89.32 89.33 89.34 90.1 90.2 90.3 90.4
90.5 90.6 90.7 90.8 90.9 90.10 90.11 90.12 90.13 90.14
90.15 90.16 90.17
90.18 90.19 90.20 90.21 90.22 90.23 90.24 90.25 90.26 90.27 90.28 90.29 90.30 90.31 91.1 91.2 91.3 91.4 91.5 91.6 91.7 91.8 91.9 91.10 91.11 91.12 91.13 91.14 91.15 91.16 91.17 91.18 91.19 91.20 91.21 91.22 91.23 91.24 91.25 91.26 91.27 91.28 91.29 91.30 91.31 91.32 92.1 92.2 92.3 92.4 92.5 92.6 92.7 92.8 92.9 92.10 92.11 92.12 92.13 92.14 92.15 92.16 92.17 92.18 92.19 92.20 92.21 92.22 92.23 92.24 92.25 92.26 92.27 92.28 92.29 92.30 92.31 92.32 92.33 92.34 93.1 93.2 93.3 93.4 93.5 93.6 93.7 93.8 93.9 93.10 93.11 93.12 93.13 93.14 93.15 93.16 93.17 93.18 93.19 93.20 93.21 93.22 93.23 93.24 93.25 93.26 93.27 93.28 93.29 93.30 93.31 93.32 94.1 94.2 94.3 94.4 94.5 94.6 94.7 94.8 94.9 94.10 94.11 94.12 94.13 94.14 94.15 94.16 94.17 94.18 94.19 94.20 94.21 94.22 94.23 94.24 94.25 94.26 94.27 94.28 94.29 94.30 95.1 95.2 95.3 95.4 95.5 95.6 95.7 95.8 95.9 95.10 95.11
95.12 95.13 95.14 95.15 95.16 95.17 95.18 95.19 95.20 95.21 95.22 95.23 95.24 95.25 95.26 95.27 95.28 95.29 95.30 95.31 95.32 95.33 96.1 96.2
96.3 96.4 96.5 96.6 96.7 96.8 96.9 96.10 96.11 96.12 96.13 96.14
96.15 96.16 96.17
96.18 96.19 96.20 96.21 96.22 96.23 96.24 96.25 96.26 96.27 96.28 96.29 96.30 96.31 96.32 97.1 97.2 97.3 97.4 97.5 97.6 97.7 97.8 97.9 97.10 97.11 97.12 97.13
97.14 97.15 97.16 97.17 97.18 97.19
97.20
97.21 97.22 97.23 97.24 97.25 97.26 97.27 97.28
97.29 97.30 98.1 98.2
98.3 98.4 98.5 98.6 98.7 98.8 98.9 98.10 98.11 98.12 98.13 98.14 98.15 98.16 98.17 98.18 98.19 98.20 98.21 98.22 98.23 98.24 98.25 98.26 98.27 98.28 98.29 98.30 98.31 98.32
99.1 99.2 99.3 99.4 99.5 99.6 99.7 99.8 99.9 99.10 99.11 99.12 99.13 99.14 99.15 99.16 99.17 99.18 99.19 99.20 99.21 99.22 99.23 99.24 99.25 99.26 99.27 99.28 99.29 99.30 99.31
100.1 100.2 100.3 100.4 100.5 100.6 100.7 100.8 100.9 100.10 100.11 100.12 100.13 100.14 100.15
100.16 100.17 100.18 100.19 100.20 100.21
100.22
100.23 100.24 100.25 100.26 100.27
100.28
101.1 101.2
101.3 101.4 101.5 101.6 101.7 101.8 101.9 101.10 101.11 101.12 101.13 101.14 101.15 101.16 101.17 101.18 101.19 101.20 101.21 101.22 101.23 101.24 101.25 101.26 101.27 101.28 101.29 101.30 101.31 101.32 102.1 102.2 102.3 102.4 102.5 102.6 102.7 102.8 102.9 102.10 102.11 102.12 102.13 102.14 102.15 102.16 102.17 102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25 102.26 102.27
102.28 102.29 102.30 102.31 102.32 103.1 103.2
103.3
103.4 103.5 103.6 103.7 103.8
103.9
103.10 103.11 103.12 103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 103.31 103.32 104.1 104.2 104.3 104.4 104.5 104.6 104.7 104.8 104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20 104.21 104.22 104.23 104.24 104.25 104.26 104.27 104.28 104.29 104.30 104.31 104.32 104.33 104.34 105.1 105.2 105.3 105.4 105.5 105.6 105.7
105.8
105.9 105.10 105.11 105.12 105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20 105.21 105.22 105.23 105.24 105.25 105.26 105.27 105.28 105.29
105.30 105.31 105.32 106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9 106.10 106.11 106.12 106.13 106.14 106.15 106.16
106.17
106.18 106.19 106.20 106.21 106.22 106.23 106.24 106.25 106.26 106.27 106.28 106.29 106.30 106.31 106.32 107.1 107.2 107.3 107.4 107.5 107.6
107.7
107.8 107.9 107.10 107.11 107.12 107.13 107.14 107.15 107.16 107.17 107.18 107.19 107.20 107.21 107.22 107.23 107.24 107.25 107.26 107.27 107.28 107.29 107.30 108.1 108.2 108.3 108.4 108.5 108.6 108.7 108.8 108.9 108.10 108.11 108.12 108.13 108.14 108.15 108.16 108.17 108.18 108.19 108.20 108.21 108.22 108.23 108.24 108.25
108.26
108.27 108.28 108.29 108.30 109.1 109.2 109.3 109.4 109.5 109.6 109.7 109.8 109.9 109.10 109.11 109.12
109.13
109.14 109.15 109.16 109.17 109.18 109.19 109.20 109.21 109.22 109.23
109.24
109.25 109.26 109.27 109.28 109.29 109.30 109.31 110.1 110.2 110.3 110.4 110.5 110.6 110.7 110.8 110.9 110.10 110.11 110.12 110.13 110.14 110.15 110.16 110.17 110.18 110.19 110.20 110.21 110.22 110.23 110.24 110.25 110.26 110.27 110.28 110.29 110.30
110.31
111.1 111.2 111.3 111.4 111.5 111.6 111.7 111.8 111.9 111.10 111.11 111.12 111.13 111.14 111.15 111.16 111.17 111.18 111.19 111.20 111.21 111.22 111.23 111.24 111.25 111.26 111.27 111.28 111.29 111.30 111.31 111.32 112.1 112.2 112.3 112.4 112.5 112.6 112.7 112.8 112.9 112.10 112.11 112.12 112.13
112.14
112.15 112.16 112.17 112.18 112.19 112.20 112.21 112.22 112.23
112.24 112.25 112.26 112.27 112.28
112.29
113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9 113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17 113.18 113.19 113.20 113.21 113.22 113.23 113.24 113.25 113.26 113.27 113.28 113.29 113.30
113.31
114.1 114.2 114.3 114.4 114.5 114.6 114.7 114.8 114.9 114.10 114.11 114.12 114.13 114.14 114.15 114.16 114.17 114.18 114.19 114.20 114.21 114.22 114.23 114.24 114.25 114.26 114.27 114.28 114.29 114.30 114.31 114.32 114.33 114.34 114.35 115.1 115.2 115.3
115.4
115.5 115.6 115.7 115.8 115.9 115.10 115.11 115.12 115.13 115.14 115.15 115.16 115.17 115.18 115.19 115.20 115.21 115.22 115.23 115.24 115.25 115.26 115.27 115.28 115.29 116.1 116.2 116.3 116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13 116.14 116.15 116.16 116.17 116.18 116.19 116.20 116.21 116.22 116.23 116.24 116.25 116.26 116.27 116.28 116.29 116.30 116.31 116.32 117.1 117.2 117.3 117.4 117.5 117.6 117.7 117.8
117.9
117.10 117.11 117.12 117.13 117.14 117.15 117.16 117.17 117.18 117.19
117.20
117.21 117.22 117.23 117.24 117.25 117.26 117.27 117.28 117.29 117.30 118.1 118.2 118.3 118.4 118.5 118.6 118.7 118.8 118.9 118.10 118.11 118.12 118.13 118.14 118.15 118.16 118.17 118.18 118.19 118.20 118.21 118.22
118.23
118.24 118.25 118.26 118.27 118.28 118.29 118.30 118.31 118.32 119.1 119.2
119.3
119.4 119.5 119.6 119.7 119.8 119.9 119.10 119.11
119.12
119.13 119.14 119.15 119.16 119.17 119.18 119.19
119.20
119.21 119.22 119.23 119.24
119.25
119.26 119.27 119.28 119.29
119.30
120.1 120.2 120.3 120.4 120.5 120.6
120.7
120.8 120.9 120.10
120.11
120.12 120.13 120.14 120.15 120.16
120.17
120.18 120.19 120.20 120.21 120.22 120.23
120.24 120.25 120.26
120.27
121.1 121.2 121.3 121.4 121.5
121.6
121.7 121.8 121.9 121.10 121.11
121.12
121.13 121.14 121.15 121.16 121.17 121.18
121.19
121.20 121.21 121.22 121.23 121.24 121.25
121.26
121.27 121.28 121.29 121.30 122.1 122.2 122.3 122.4
122.5
122.6 122.7 122.8 122.9 122.10 122.11
122.12
122.13 122.14 122.15 122.16 122.17 122.18 122.19 122.20 122.21 122.22 122.23 122.24 122.25 122.26 122.27 122.28 122.29 122.30 122.31 122.32 123.1 123.2 123.3 123.4 123.5 123.6
123.7
123.8 123.9 123.10 123.11 123.12 123.13 123.14 123.15 123.16 123.17 123.18 123.19 123.20 123.21 123.22 123.23 123.24 123.25 123.26 123.27 123.28 123.29 123.30 123.31 123.32 123.33 124.1 124.2 124.3 124.4 124.5 124.6 124.7 124.8 124.9 124.10 124.11 124.12 124.13 124.14 124.15 124.16 124.17 124.18 124.19 124.20 124.21 124.22 124.23 124.24 124.25 124.26 124.27
124.28
124.29 124.30 124.31 124.32 125.1 125.2
125.3
125.4 125.5 125.6 125.7 125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16 125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26 125.27 125.28 125.29 125.30 125.31 126.1 126.2 126.3 126.4 126.5 126.6 126.7 126.8 126.9 126.10 126.11 126.12 126.13 126.14 126.15 126.16 126.17 126.18 126.19 126.20
126.21
126.22 126.23 126.24 126.25 126.26 126.27 126.28 126.29 126.30 126.31 126.32
127.1
127.2 127.3 127.4 127.5 127.6 127.7 127.8 127.9 127.10 127.11 127.12 127.13 127.14 127.15 127.16 127.17 127.18 127.19 127.20 127.21 127.22 127.23 127.24 127.25 127.26 127.27 127.28 127.29 127.30 127.31 128.1 128.2 128.3 128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12 128.13 128.14 128.15 128.16 128.17 128.18 128.19 128.20 128.21 128.22 128.23 128.24 128.25 128.26 128.27 128.28 128.29 128.30 128.31 128.32 129.1 129.2 129.3 129.4 129.5 129.6 129.7 129.8 129.9 129.10 129.11 129.12 129.13 129.14 129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22 129.23 129.24 129.25 129.26 129.27 129.28 129.29 129.30 130.1 130.2 130.3 130.4 130.5 130.6 130.7 130.8 130.9 130.10 130.11 130.12 130.13 130.14 130.15 130.16 130.17 130.18
130.19
130.20 130.21 130.22 130.23 130.24 130.25
130.26
130.27 130.28 130.29 130.30 130.31
131.1
131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14 131.15 131.16 131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24 131.25 131.26 131.27 131.28 131.29 131.30 132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9 132.10 132.11 132.12 132.13 132.14 132.15 132.16 132.17 132.18
132.19
132.20 132.21 132.22 132.23
132.24
132.25 132.26 132.27 132.28 132.29
132.30
133.1 133.2 133.3 133.4 133.5 133.6 133.7 133.8 133.9 133.10 133.11
133.12 133.13 133.14 133.15 133.16 133.17 133.18 133.19 133.20 133.21 133.22 133.23 133.24 133.25 133.26 133.27 133.28 133.29 133.30 133.31 133.32 134.1 134.2 134.3 134.4 134.5 134.6 134.7 134.8 134.9 134.10 134.11 134.12 134.13 134.14 134.15 134.16 134.17 134.18 134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27 134.28 134.29 134.30 134.31 134.32 135.1 135.2 135.3 135.4 135.5 135.6 135.7 135.8 135.9 135.10 135.11 135.12 135.13 135.14 135.15 135.16 135.17 135.18 135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28 135.29 135.30 135.31 135.32 136.1 136.2 136.3 136.4 136.5 136.6 136.7 136.8 136.9 136.10 136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19 136.20 136.21 136.22 136.23 136.24 136.25 136.26 136.27 136.28 136.29 136.30 136.31
137.1 137.2 137.3
137.4 137.5 137.6 137.7
137.8 137.9 137.10 137.11 137.12 137.13 137.14 137.15 137.16 137.17 137.18 137.19 137.20 137.21 137.22 137.23 137.24 137.25 137.26 137.27
137.28 137.29 137.30
138.1 138.2 138.3 138.4 138.5 138.6 138.7 138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16 138.17 138.18 138.19 138.20 138.21 138.22 138.23 138.24 138.25 138.26 138.27 138.28 138.29 138.30 138.31 139.1 139.2 139.3 139.4 139.5
139.6 139.7 139.8 139.9 139.10 139.11 139.12 139.13 139.14 139.15 139.16 139.17 139.18 139.19 139.20 139.21 139.22 139.23 139.24 139.25 139.26 139.27 139.28 139.29 139.30 139.31
140.1 140.2 140.3 140.4 140.5
140.6 140.7 140.8 140.9 140.10 140.11 140.12 140.13 140.14 140.15 140.16 140.17 140.18 140.19 140.20 140.21 140.22 140.23 140.24 140.25 140.26 140.27 140.28 140.29 140.30 140.31 140.32 140.33 140.34 141.1 141.2 141.3 141.4 141.5 141.6 141.7
141.8 141.9 141.10 141.11 141.12 141.13 141.14 141.15 141.16 141.17 141.18 141.19 141.20 141.21 141.22 141.23 141.24 141.25 141.26 141.27 141.28 141.29 141.30 141.31 141.32 142.1 142.2 142.3 142.4 142.5 142.6 142.7 142.8 142.9 142.10 142.11 142.12 142.13 142.14
142.15 142.16 142.17 142.18 142.19 142.20 142.21 142.22 142.23 142.24 142.25 142.26 142.27 142.28 142.29 142.30 142.31 142.32 142.33 142.34 143.1 143.2 143.3 143.4 143.5 143.6 143.7 143.8 143.9 143.10 143.11 143.12 143.13 143.14 143.15 143.16 143.17 143.18 143.19 143.20 143.21 143.22 143.23 143.24 143.25 143.26 143.27 143.28 143.29 143.30 143.31 143.32 143.33 143.34 143.35 144.1 144.2 144.3 144.4 144.5 144.6 144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20 144.21 144.22 144.23 144.24 144.25
144.26 144.27 144.28 144.29 144.30 144.31 144.32 144.33 145.1 145.2 145.3 145.4 145.5 145.6 145.7 145.8 145.9 145.10 145.11 145.12 145.13 145.14 145.15 145.16 145.17 145.18 145.19 145.20 145.21 145.22 145.23
145.24 145.25 145.26 145.27 145.28 145.29 145.30 145.31 145.32 145.33 146.1 146.2 146.3 146.4 146.5 146.6 146.7 146.8 146.9 146.10 146.11 146.12 146.13 146.14 146.15 146.16 146.17 146.18 146.19 146.20 146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 146.31
147.1 147.2 147.3 147.4 147.5 147.6 147.7 147.8 147.9 147.10 147.11 147.12 147.13 147.14 147.15 147.16 147.17 147.18 147.19 147.20 147.21
147.22 147.23 147.24 147.25 147.26 147.27 147.28 147.29 147.30 148.1 148.2
148.3 148.4 148.5 148.6 148.7 148.8 148.9 148.10
148.11 148.12 148.13 148.14 148.15 148.16 148.17 148.18 148.19
148.20 148.21 148.22 148.23
148.24 148.25 148.26 148.27 148.28 148.29
149.1 149.2 149.3 149.4 149.5 149.6 149.7
149.8 149.9 149.10 149.11
149.12 149.13 149.14 149.15 149.16 149.17 149.18 149.19
149.20 149.21 149.22 149.23 149.24 149.25 149.26 149.27 149.28
150.1 150.2
150.3 150.4 150.5 150.6 150.7 150.8 150.9 150.10 150.11 150.12
150.13 150.14 150.15
150.16 150.17 150.18 150.19 150.20 150.21 150.22 150.23 150.24 150.25 150.26 150.27 150.28 150.29 151.1 151.2 151.3 151.4 151.5 151.6 151.7 151.8 151.9
151.10 151.11 151.12 151.13 151.14 151.15 151.16 151.17 151.18 151.19 151.20
151.21 151.22
151.23 151.24 151.25 151.26 151.27 151.28 151.29 152.1 152.2 152.3 152.4 152.5 152.6 152.7 152.8 152.9 152.10 152.11 152.12 152.13 152.14 152.15 152.16 152.17 152.18 152.19 152.20 152.21 152.22 152.23 152.24 152.25
152.26 152.27 152.28 152.29 152.30 152.31 152.32 152.33 153.1 153.2 153.3 153.4 153.5 153.6 153.7 153.8 153.9 153.10 153.11 153.12 153.13 153.14 153.15 153.16 153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24 153.25 153.26 153.27 153.28 153.29 153.30 153.31 154.1 154.2 154.3 154.4 154.5 154.6 154.7 154.8 154.9 154.10 154.11 154.12 154.13 154.14 154.15 154.16 154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24 154.25 154.26 154.27 154.28 154.29 154.30 154.31 154.32 154.33 155.1 155.2 155.3 155.4 155.5 155.6 155.7 155.8 155.9 155.10 155.11 155.12 155.13 155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21 155.22 155.23 155.24 155.25 155.26 155.27 155.28 155.29 155.30 155.31 155.32 155.33 156.1 156.2 156.3 156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18 156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27 156.28 156.29 156.30 156.31 156.32 157.1 157.2 157.3 157.4
157.5 157.6 157.7 157.8 157.9 157.10 157.11
157.12 157.13 157.14 157.15 157.16 157.17 157.18 157.19 157.20 157.21 157.22 157.23 157.24 157.25 157.26 157.27 157.28 157.29 157.30 157.31 157.32 158.1 158.2 158.3 158.4 158.5 158.6 158.7
158.8 158.9 158.10 158.11 158.12 158.13
158.14 158.15 158.16 158.17 158.18 158.19
158.20 158.21 158.22 158.23 158.24 158.25 158.26 158.27 158.28 158.29 158.30 158.31 158.32 159.1 159.2 159.3 159.4 159.5 159.6 159.7 159.8 159.9 159.10 159.11 159.12 159.13 159.14 159.15 159.16 159.17 159.18 159.19 159.20 159.21 159.22 159.23 159.24 159.25 159.26 159.27 159.28 159.29 159.30 159.31 160.1 160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12 160.13 160.14 160.15 160.16 160.17 160.18 160.19 160.20 160.21 160.22 160.23 160.24 160.25 160.26 160.27 160.28 160.29 160.30 160.31 160.32 161.1 161.2 161.3 161.4 161.5 161.6 161.7 161.8 161.9 161.10 161.11 161.12 161.13 161.14 161.15 161.16 161.17
161.18 161.19 161.20
161.21 161.22 161.23 161.24 161.25 161.26 161.27 161.28 161.29 161.30 161.31 161.32 162.1 162.2 162.3 162.4 162.5 162.6 162.7 162.8 162.9 162.10 162.11 162.12 162.13 162.14 162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24
162.25 162.26 162.27 162.28
162.29 162.30 162.31 162.32 162.33
163.1 163.2 163.3 163.4 163.5 163.6 163.7 163.8 163.9 163.10 163.11 163.12 163.13 163.14 163.15 163.16 163.17 163.18 163.19 163.20 163.21 163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 163.30 163.31 163.32
164.1 164.2 164.3
164.4 164.5 164.6 164.7 164.8 164.9
164.10 164.11 164.12 164.13 164.14 164.15 164.16
164.17 164.18 164.19 164.20 164.21 164.22 164.23 164.24 164.25 164.26 164.27 164.28 164.29 164.30 164.31 164.32 165.1 165.2 165.3 165.4 165.5 165.6 165.7 165.8 165.9 165.10 165.11 165.12 165.13 165.14 165.15
165.16 165.17 165.18
165.19 165.20
165.21 165.22 165.23 165.24 165.25 165.26 165.27 165.28 165.29 165.30 165.31 165.32
166.1
166.2 166.3 166.4 166.5 166.6 166.7 166.8 166.9 166.10 166.11 166.12
166.13
166.14 166.15 166.16 166.17 166.18 166.19 166.20 166.21 166.22 166.23 166.24 166.25 166.26 166.27 166.28 166.29 166.30 167.1 167.2 167.3 167.4 167.5 167.6 167.7 167.8 167.9 167.10 167.11
167.12
167.13 167.14 167.15 167.16 167.17 167.18 167.19 167.20 167.21 167.22 167.23 167.24 167.25 167.26 167.27 167.28 167.29 168.1 168.2 168.3 168.4 168.5 168.6 168.7 168.8 168.9 168.10 168.11 168.12 168.13
168.14
168.15 168.16 168.17 168.18 168.19 168.20 168.21 168.22 168.23 168.24
168.25
168.26 168.27 168.28 168.29 168.30 169.1 169.2 169.3 169.4 169.5 169.6 169.7 169.8 169.9 169.10 169.11 169.12 169.13 169.14
169.15
169.16 169.17 169.18 169.19 169.20 169.21
169.22
169.23 169.24
169.25 169.26 169.27 169.28 169.29 169.30 170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10 170.11 170.12 170.13 170.14 170.15 170.16 170.17 170.18 170.19 170.20 170.21 170.22 170.23 170.24 170.25 170.26 170.27 170.28 170.29 170.30 170.31 170.32 170.33 170.34 171.1 171.2 171.3 171.4 171.5
171.6 171.7 171.8
171.9 171.10 171.11 171.12 171.13 171.14 171.15 171.16 171.17 171.18 171.19 171.20 171.21 171.22 171.23 171.24 171.25 171.26 171.27 171.28 171.29 171.30 171.31 171.32 171.33 171.34 172.1 172.2 172.3
172.4 172.5 172.6
172.7 172.8 172.9 172.10 172.11
172.12 172.13 172.14
172.15 172.16 172.17 172.18 172.19
172.20 172.21 172.22
172.23 172.24 172.25 172.26 172.27 172.28 172.29 172.30 172.31 173.1 173.2 173.3 173.4 173.5 173.6 173.7
173.8 173.9 173.10
173.11 173.12 173.13 173.14 173.15 173.16 173.17 173.18 173.19 173.20 173.21 173.22
173.23 173.24 173.25
173.26 173.27 173.28 173.29 173.30 173.31 173.32 174.1 174.2
174.3 174.4 174.5
174.6 174.7 174.8 174.9 174.10 174.11 174.12 174.13 174.14 174.15 174.16 174.17 174.18 174.19 174.20 174.21 174.22 174.23 174.24 174.25 174.26 174.27 174.28 174.29 174.30 174.31 174.32 174.33 175.1 175.2 175.3 175.4 175.5 175.6 175.7 175.8 175.9 175.10 175.11 175.12 175.13 175.14 175.15 175.16 175.17 175.18 175.19 175.20 175.21 175.22 175.23 175.24 175.25 175.26 175.27 175.28 175.29 175.30 175.31 175.32 176.1 176.2 176.3 176.4 176.5 176.6 176.7 176.8 176.9 176.10 176.11 176.12 176.13 176.14 176.15 176.16 176.17 176.18 176.19 176.20 176.21 176.22 176.23 176.24 176.25 176.26 176.27 176.28 176.29 176.30 176.31 176.32 176.33 177.1 177.2 177.3 177.4 177.5 177.6 177.7 177.8 177.9 177.10 177.11 177.12 177.13 177.14 177.15
177.16 177.17 177.18
177.19 177.20 177.21 177.22 177.23 177.24 177.25 177.26 177.27 177.28 177.29 177.30 177.31 177.32 177.33 178.1 178.2 178.3 178.4 178.5 178.6 178.7 178.8 178.9 178.10 178.11 178.12 178.13 178.14 178.15 178.16 178.17 178.18 178.19 178.20 178.21 178.22 178.23 178.24 178.25 178.26 178.27 178.28 178.29 178.30 178.31 178.32 178.33 179.1 179.2 179.3 179.4 179.5 179.6 179.7 179.8 179.9 179.10 179.11 179.12 179.13 179.14 179.15 179.16 179.17 179.18 179.19 179.20 179.21 179.22 179.23 179.24 179.25 179.26 179.27 179.28 179.29 179.30 179.31 179.32 179.33 179.34 180.1 180.2 180.3 180.4 180.5 180.6 180.7 180.8 180.9 180.10 180.11 180.12 180.13 180.14 180.15 180.16 180.17 180.18 180.19 180.20 180.21 180.22 180.23 180.24 180.25 180.26 180.27 180.28 180.29 180.30 180.31 180.32 180.33 180.34 180.35 181.1 181.2 181.3 181.4 181.5 181.6 181.7 181.8 181.9 181.10 181.11 181.12 181.13 181.14 181.15 181.16 181.17
181.18
181.19 181.20 181.21 181.22 181.23 181.24 181.25 181.26 181.27 181.28 181.29 181.30 181.31 181.32 181.33 181.34 182.1 182.2 182.3 182.4 182.5 182.6 182.7
182.8 182.9
182.10 182.11 182.12 182.13 182.14 182.15 182.16 182.17 182.18 182.19 182.20 182.21 182.22 182.23 182.24 182.25 182.26 182.27 182.28 182.29 182.30 182.31 182.32 182.33 183.1 183.2 183.3 183.4 183.5 183.6 183.7 183.8 183.9 183.10 183.11 183.12 183.13 183.14 183.15 183.16 183.17 183.18 183.19 183.20 183.21 183.22 183.23 183.24 183.25 183.26 183.27 183.28 183.29 183.30 183.31 183.32 183.33 184.1 184.2 184.3 184.4 184.5 184.6
184.7 184.8
184.9 184.10 184.11 184.12 184.13 184.14 184.15 184.16 184.17 184.18 184.19 184.20 184.21
184.22 184.23
184.24 184.25 184.26 184.27 184.28 184.29 184.30 184.31 185.1 185.2 185.3 185.4 185.5 185.6 185.7 185.8 185.9 185.10 185.11 185.12 185.13 185.14 185.15 185.16
185.17 185.18 185.19 185.20 185.21 185.22 185.23 185.24 185.25 185.26 185.27 185.28 185.29 185.30 185.31 185.32 186.1 186.2 186.3 186.4 186.5 186.6 186.7 186.8 186.9 186.10 186.11 186.12 186.13 186.14 186.15 186.16 186.17 186.18 186.19 186.20 186.21 186.22 186.23 186.24 186.25 186.26 186.27 186.28 186.29 186.30 186.31 186.32 187.1 187.2 187.3 187.4 187.5 187.6 187.7 187.8 187.9 187.10 187.11 187.12 187.13 187.14 187.15 187.16 187.17 187.18 187.19 187.20 187.21 187.22 187.23 187.24 187.25 187.26 187.27 187.28 187.29 187.30 187.31 187.32 188.1 188.2 188.3 188.4 188.5 188.6 188.7 188.8 188.9 188.10 188.11 188.12 188.13 188.14 188.15 188.16 188.17 188.18 188.19 188.20 188.21 188.22 188.23 188.24 188.25 188.26 188.27 188.28 188.29 188.30 188.31 188.32
189.1 189.2 189.3 189.4 189.5 189.6 189.7 189.8 189.9 189.10 189.11 189.12 189.13 189.14 189.15 189.16 189.17 189.18 189.19 189.20 189.21 189.22
189.23
189.24 189.25 189.26 189.27 189.28 189.29 189.30 189.31 189.32
190.1 190.2 190.3 190.4 190.5 190.6 190.7
190.8 190.9 190.10 190.11 190.12 190.13 190.14 190.15 190.16 190.17 190.18 190.19 190.20 190.21 190.22 190.23 190.24 190.25 190.26 190.27 190.28 190.29 190.30 190.31 191.1 191.2 191.3 191.4 191.5
191.6 191.7 191.8 191.9 191.10 191.11 191.12 191.13 191.14
191.15 191.16 191.17 191.18 191.19 191.20 191.21 191.22 191.23
191.24 191.25 191.26 191.27 191.28 191.29
192.1 192.2 192.3
192.4 192.5 192.6 192.7 192.8 192.9 192.10 192.11 192.12 192.13 192.14 192.15 192.16 192.17 192.18 192.19 192.20 192.21 192.22 192.23 192.24 192.25 192.26 192.27 192.28 192.29 193.1 193.2 193.3 193.4 193.5 193.6 193.7 193.8 193.9 193.10 193.11 193.12
193.13 193.14 193.15
193.16 193.17 193.18 193.19 193.20 193.21 193.22 193.23 193.24 193.25 193.26 193.27 193.28 193.29 193.30 193.31 194.1 194.2 194.3 194.4 194.5 194.6 194.7 194.8 194.9 194.10 194.11 194.12 194.13 194.14 194.15 194.16 194.17 194.18 194.19 194.20 194.21 194.22 194.23 194.24 194.25 194.26 194.27 194.28 194.29 194.30 194.31 195.1 195.2 195.3 195.4
195.5 195.6 195.7
195.8 195.9 195.10 195.11 195.12 195.13 195.14 195.15 195.16 195.17 195.18 195.19 195.20 195.21 195.22 195.23 195.24 195.25 195.26 195.27 195.28 195.29 195.30
196.1 196.2 196.3
196.4 196.5 196.6 196.7 196.8 196.9 196.10 196.11 196.12
196.13 196.14 196.15
196.16 196.17 196.18 196.19 196.20 196.21 196.22 196.23 196.24 196.25 196.26 196.27 196.28 196.29 196.30 197.1 197.2 197.3 197.4 197.5 197.6 197.7 197.8 197.9 197.10 197.11 197.12 197.13 197.14 197.15 197.16 197.17 197.18 197.19 197.20 197.21 197.22 197.23 197.24 197.25 197.26 197.27 197.28 197.29 197.30 197.31 198.1 198.2 198.3 198.4 198.5 198.6
198.7 198.8 198.9
198.10 198.11 198.12 198.13 198.14 198.15 198.16 198.17 198.18 198.19 198.20 198.21 198.22 198.23 198.24 198.25 198.26 198.27 198.28 198.29 198.30 198.31 199.1 199.2 199.3 199.4 199.5 199.6 199.7 199.8 199.9 199.10 199.11 199.12 199.13 199.14 199.15 199.16 199.17 199.18 199.19 199.20 199.21 199.22 199.23 199.24 199.25 199.26 199.27 199.28 199.29 199.30 199.31 199.32 200.1 200.2 200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10 200.11 200.12 200.13 200.14 200.15 200.16 200.17
200.18 200.19 200.20
200.21 200.22 200.23 200.24 200.25 200.26 200.27 200.28 200.29 200.30 200.31 200.32 200.33 201.1 201.2 201.3 201.4 201.5
201.6 201.7 201.8 201.9 201.10 201.11 201.12 201.13 201.14 201.15 201.16
201.17 201.18 201.19
201.20 201.21 201.22 201.23 201.24 201.25
201.26
201.27 201.28 201.29 201.30 202.1 202.2 202.3 202.4 202.5 202.6 202.7 202.8 202.9 202.10 202.11 202.12 202.13 202.14 202.15 202.16 202.17 202.18 202.19 202.20 202.21 202.22 202.23 202.24 202.25 202.26 202.27 202.28 202.29 202.30 202.31 202.32 202.33
203.1
203.2 203.3 203.4 203.5 203.6 203.7 203.8 203.9 203.10 203.11 203.12 203.13 203.14 203.15 203.16 203.17 203.18 203.19 203.20 203.21 203.22 203.23 203.24 203.25 203.26 203.27 203.28 203.29 203.30 203.31 204.1 204.2 204.3 204.4 204.5 204.6 204.7 204.8 204.9 204.10 204.11 204.12 204.13 204.14 204.15 204.16 204.17 204.18 204.19 204.20 204.21 204.22 204.23 204.24 204.25 204.26 204.27 204.28 204.29 204.30 204.31 204.32 204.33 205.1 205.2 205.3 205.4 205.5 205.6 205.7 205.8 205.9 205.10 205.11 205.12 205.13 205.14
205.15 205.16 205.17 205.18 205.19 205.20 205.21 205.22 205.23 205.24 205.25 205.26 205.27 205.28 205.29 205.30 206.1 206.2 206.3 206.4 206.5 206.6 206.7 206.8 206.9 206.10 206.11 206.12 206.13 206.14 206.15 206.16 206.17 206.18 206.19 206.20 206.21 206.22 206.23 206.24 206.25 206.26 206.27 206.28 206.29 206.30 206.31 206.32 206.33 207.1 207.2 207.3 207.4 207.5 207.6 207.7 207.8 207.9 207.10 207.11 207.12 207.13 207.14 207.15 207.16 207.17 207.18 207.19 207.20 207.21 207.22 207.23 207.24 207.25 207.26 207.27 207.28 207.29 207.30 207.31 207.32 207.33 207.34 208.1 208.2 208.3 208.4 208.5 208.6 208.7 208.8 208.9 208.10 208.11 208.12 208.13 208.14 208.15 208.16
208.17 208.18 208.19 208.20 208.21 208.22 208.23 208.24 208.25 208.26 208.27 208.28 208.29 208.30 208.31 209.1 209.2 209.3 209.4 209.5 209.6 209.7 209.8 209.9 209.10 209.11 209.12 209.13 209.14 209.15 209.16 209.17 209.18 209.19
209.20 209.21 209.22
209.23 209.24 209.25 209.26 209.27 209.28 209.29 209.30 209.31 210.1 210.2 210.3 210.4 210.5 210.6 210.7 210.8 210.9 210.10 210.11 210.12 210.13 210.14 210.15 210.16 210.17 210.18 210.19 210.20 210.21 210.22 210.23 210.24 210.25 210.26 210.27 210.28 210.29 210.30 210.31 210.32 211.1 211.2 211.3 211.4 211.5 211.6 211.7 211.8 211.9 211.10 211.11 211.12 211.13 211.14 211.15 211.16 211.17 211.18 211.19 211.20 211.21 211.22 211.23 211.24 211.25 211.26 211.27 211.28 211.29
211.30 211.31 211.32
212.1 212.2 212.3 212.4 212.5 212.6 212.7 212.8 212.9 212.10 212.11 212.12 212.13 212.14 212.15 212.16 212.17 212.18 212.19 212.20 212.21 212.22 212.23 212.24 212.25 212.26 212.27 212.28 212.29 212.30 212.31 213.1 213.2 213.3 213.4 213.5 213.6 213.7 213.8 213.9 213.10 213.11 213.12 213.13 213.14 213.15 213.16 213.17
213.18 213.19 213.20 213.21 213.22 213.23 213.24 213.25 213.26 213.27 213.28 213.29 213.30 213.31 214.1 214.2 214.3 214.4 214.5 214.6 214.7 214.8 214.9 214.10 214.11 214.12 214.13 214.14 214.15 214.16 214.17 214.18 214.19 214.20 214.21 214.22 214.23 214.24 214.25 214.26 214.27 214.28 214.29 214.30 215.1 215.2 215.3 215.4 215.5 215.6 215.7 215.8 215.9 215.10 215.11 215.12 215.13 215.14 215.15 215.16 215.17 215.18
215.19 215.20 215.21
215.22 215.23 215.24 215.25 215.26 215.27 215.28 215.29 215.30 215.31 216.1 216.2
216.3 216.4 216.5 216.6 216.7 216.8 216.9 216.10
216.11 216.12 216.13 216.14 216.15 216.16 216.17 216.18 216.19 216.20 216.21 216.22 216.23 216.24 216.25
216.26 216.27 216.28 216.29 216.30 217.1 217.2 217.3 217.4 217.5 217.6 217.7 217.8 217.9 217.10
217.11 217.12 217.13 217.14 217.15 217.16 217.17 217.18 217.19 217.20
217.21 217.22 217.23 217.24 217.25 217.26 217.27 217.28 217.29 217.30 217.31 218.1 218.2 218.3 218.4 218.5 218.6 218.7 218.8 218.9 218.10 218.11 218.12 218.13 218.14 218.15 218.16 218.17 218.18 218.19 218.20 218.21 218.22 218.23 218.24 218.25 218.26 218.27 218.28 218.29 218.30 218.31 218.32 218.33 218.34 219.1 219.2 219.3 219.4 219.5 219.6 219.7 219.8 219.9 219.10 219.11 219.12 219.13 219.14 219.15 219.16 219.17 219.18 219.19 219.20 219.21 219.22 219.23 219.24 219.25 219.26 219.27 219.28 219.29 219.30 219.31 220.1 220.2 220.3 220.4 220.5 220.6 220.7 220.8 220.9 220.10 220.11 220.12 220.13 220.14 220.15 220.16 220.17 220.18 220.19 220.20 220.21 220.22 220.23 220.24 220.25 220.26 220.27 220.28 220.29 220.30 220.31 221.1 221.2 221.3 221.4 221.5 221.6 221.7 221.8 221.9 221.10 221.11 221.12 221.13 221.14 221.15 221.16 221.17 221.18 221.19 221.20 221.21 221.22 221.23 221.24 221.25 221.26 221.27 221.28 221.29 221.30 221.31 221.32 221.33 221.34 222.1 222.2 222.3 222.4 222.5 222.6 222.7 222.8 222.9 222.10 222.11 222.12 222.13 222.14 222.15 222.16 222.17 222.18 222.19 222.20 222.21 222.22 222.23 222.24 222.25 222.26 222.27 222.28 222.29 222.30 222.31 222.32 222.33 222.34 222.35 223.1 223.2 223.3 223.4 223.5 223.6 223.7 223.8 223.9 223.10 223.11
223.12 223.13 223.14 223.15 223.16 223.17 223.18 223.19 223.20 223.21 223.22 223.23 223.24 223.25 223.26 223.27 223.28 223.29 223.30 223.31 223.32 223.33 224.1 224.2 224.3 224.4
224.5 224.6 224.7 224.8 224.9 224.10 224.11 224.12 224.13 224.14 224.15 224.16 224.17 224.18 224.19 224.20 224.21 224.22 224.23 224.24 224.25 224.26 224.27 224.28 224.29 224.30 224.31 224.32 225.1 225.2 225.3 225.4 225.5 225.6 225.7 225.8 225.9 225.10 225.11 225.12 225.13 225.14 225.15 225.16 225.17 225.18 225.19 225.20
225.21 225.22 225.23 225.24 225.25 225.26 225.27 225.28 225.29 226.1 226.2 226.3 226.4 226.5 226.6 226.7 226.8 226.9 226.10 226.11 226.12 226.13 226.14 226.15 226.16 226.17 226.18 226.19 226.20 226.21 226.22 226.23 226.24 226.25 226.26 226.27 226.28 226.29 226.30 226.31 226.32 226.33 227.1 227.2 227.3 227.4 227.5 227.6 227.7 227.8 227.9
227.10 227.11 227.12
227.13 227.14 227.15 227.16 227.17 227.18 227.19 227.20 227.21 227.22 227.23 227.24 227.25 227.26 227.27 227.28 227.29 227.30 227.31 227.32 228.1 228.2 228.3 228.4 228.5 228.6 228.7 228.8 228.9 228.10 228.11 228.12 228.13 228.14 228.15 228.16 228.17 228.18 228.19 228.20 228.21 228.22 228.23 228.24 228.25 228.26 228.27 228.28 228.29 228.30 228.31 228.32 229.1 229.2 229.3 229.4 229.5 229.6 229.7 229.8 229.9 229.10 229.11 229.12 229.13 229.14 229.15 229.16 229.17 229.18 229.19 229.20 229.21
229.22 229.23 229.24 229.25 229.26 229.27 229.28 229.29 229.30 229.31 229.32 230.1 230.2 230.3 230.4 230.5 230.6 230.7 230.8 230.9 230.10 230.11 230.12 230.13 230.14 230.15 230.16 230.17 230.18 230.19 230.20 230.21 230.22 230.23 230.24
230.25 230.26 230.27 230.28 230.29 230.30 230.31 230.32 230.33 231.1 231.2 231.3 231.4 231.5 231.6 231.7 231.8 231.9 231.10 231.11 231.12 231.13 231.14 231.15 231.16 231.17 231.18 231.19 231.20 231.21 231.22 231.23 231.24 231.25 231.26 231.27 231.28 231.29 231.30 231.31 232.1 232.2 232.3 232.4 232.5 232.6 232.7 232.8 232.9 232.10 232.11 232.12 232.13 232.14 232.15 232.16 232.17 232.18 232.19 232.20 232.21 232.22 232.23 232.24 232.25 232.26 232.27 232.28 232.29 232.30 232.31 232.32 232.33 233.1 233.2 233.3 233.4 233.5 233.6
233.7 233.8 233.9 233.10 233.11 233.12 233.13 233.14 233.15 233.16 233.17 233.18 233.19 233.20 233.21 233.22 233.23 233.24 233.25 233.26 233.27 233.28 233.29 233.30 233.31 234.1 234.2 234.3 234.4 234.5 234.6 234.7 234.8 234.9 234.10 234.11 234.12 234.13 234.14 234.15 234.16 234.17 234.18 234.19 234.20 234.21 234.22 234.23 234.24 234.25 234.26 234.27 234.28 234.29 234.30 234.31 234.32 234.33 235.1 235.2 235.3 235.4 235.5 235.6
235.7 235.8 235.9
235.10 235.11 235.12 235.13 235.14 235.15 235.16 235.17 235.18 235.19 235.20 235.21 235.22 235.23 235.24 235.25 235.26 235.27 235.28 235.29 235.30 235.31 235.32 235.33 236.1 236.2
236.3
236.4 236.5 236.6 236.7 236.8 236.9 236.10 236.11 236.12 236.13 236.14 236.15 236.16 236.17 236.18 236.19 236.20
236.21 236.22 236.23 236.24 236.25 236.26
236.27 236.28 236.29 236.30 237.1 237.2 237.3 237.4 237.5 237.6 237.7 237.8 237.9 237.10 237.11 237.12 237.13
237.14 237.15 237.16 237.17
237.18 237.19 237.20 237.21 237.22 237.23 237.24 237.25 237.26 237.27 237.28 237.29 237.30 237.31 238.1 238.2 238.3 238.4
238.5 238.6 238.7
238.8 238.9 238.10 238.11 238.12 238.13 238.14 238.15
238.16
238.17 238.18 238.19 238.20 238.21 238.22 238.23 238.24 238.25 238.26 238.27 238.28 238.29 238.30 238.31 239.1 239.2 239.3 239.4 239.5 239.6 239.7 239.8 239.9 239.10 239.11 239.12 239.13 239.14 239.15 239.16 239.17
239.18 239.19 239.20 239.21 239.22 239.23 239.24 239.25 239.26 239.27 239.28 239.29 239.30 239.31 240.1 240.2 240.3 240.4 240.5 240.6 240.7 240.8 240.9 240.10 240.11 240.12 240.13 240.14 240.15 240.16 240.17 240.18 240.19 240.20 240.21
240.22 240.23 240.24 240.25 240.26 240.27 240.28 240.29 240.30 240.31 240.32 240.33 240.34
241.1
241.2 241.3 241.4 241.5 241.6 241.7 241.8 241.9 241.10 241.11
241.12
241.13 241.14 241.15 241.16
241.17
241.18 241.19 241.20 241.21
241.22 241.23
241.24 241.25 241.26 241.27 241.28 241.29 241.30 242.1 242.2 242.3 242.4 242.5 242.6 242.7 242.8 242.9 242.10 242.11 242.12 242.13 242.14 242.15 242.16 242.17 242.18 242.19 242.20 242.21 242.22 242.23 242.24 242.25 242.26 242.27 242.28 242.29 242.30 242.31 243.1 243.2
243.3
243.4 243.5 243.6 243.7 243.8 243.9 243.10 243.11 243.12
243.13 243.14 243.15 243.16 243.17 243.18 243.19 243.20 243.21 243.22 243.23 243.24 243.25 243.26 243.27 243.28 243.29
244.1 244.2 244.3 244.4 244.5
244.6 244.7 244.8 244.9 244.10 244.11 244.12 244.13 244.14 244.15 244.16 244.17 244.18 244.19 244.20
244.21 244.22 244.23 244.24 244.25 244.26 244.27 244.28 244.29 244.30 244.31 245.1 245.2 245.3 245.4 245.5 245.6 245.7 245.8 245.9 245.10 245.11 245.12 245.13 245.14
245.15 245.16 245.17
245.18
245.19 245.20
245.21 245.22 245.23 245.24 245.25 245.26 245.27 245.28 245.29 245.30 246.1 246.2 246.3 246.4 246.5 246.6 246.7 246.8 246.9 246.10 246.11 246.12 246.13 246.14 246.15 246.16 246.17 246.18 246.19 246.20
246.21 246.22 246.23 246.24 246.25 246.26 246.27 246.28 246.29 246.30 246.31 246.32
247.1 247.2 247.3 247.4 247.5 247.6 247.7 247.8 247.9 247.10 247.11 247.12
247.13 247.14 247.15 247.16
247.17 247.18 247.19 247.20 247.21 247.22 247.23 247.24 247.25 247.26 247.27 247.28 247.29 247.30 248.1 248.2 248.3 248.4 248.5 248.6 248.7 248.8 248.9 248.10 248.11 248.12 248.13 248.14 248.15 248.16 248.17 248.18 248.19 248.20 248.21 248.22 248.23 248.24 248.25 248.26 248.27 248.28 248.29 248.30 248.31 249.1 249.2 249.3
249.4 249.5 249.6 249.7 249.8 249.9 249.10 249.11 249.12
249.13 249.14 249.15 249.16 249.17 249.18 249.19 249.20 249.21 249.22 249.23 249.24 249.25 249.26 249.27 249.28 249.29 249.30 250.1 250.2 250.3 250.4
250.5 250.6 250.7 250.8 250.9 250.10 250.11 250.12 250.13 250.14
250.15 250.16 250.17 250.18 250.19 250.20 250.21
250.22 250.23 250.24 250.25 250.26 250.27 250.28 250.29 250.30 250.31 251.1 251.2 251.3
251.4 251.5 251.6 251.7 251.8 251.9 251.10 251.11 251.12 251.13
251.14 251.15 251.16 251.17 251.18 251.19 251.20 251.21 251.22 251.23 251.24 251.25 251.26 251.27
251.28 251.29 251.30 251.31 251.32 252.1 252.2
252.3 252.4 252.5 252.6 252.7 252.8 252.9 252.10 252.11 252.12
252.13 252.14 252.15 252.16 252.17 252.18 252.19
252.20 252.21 252.22 252.23 252.24 252.25 252.26 252.27 252.28 252.29 252.30 253.1 253.2 253.3 253.4 253.5 253.6 253.7 253.8 253.9 253.10 253.11 253.12 253.13 253.14 253.15 253.16 253.17 253.18 253.19
253.20 253.21 253.22 253.23 253.24 253.25 253.26 253.27 253.28 253.29 253.30 254.1 254.2 254.3 254.4 254.5 254.6 254.7 254.8 254.9 254.10 254.11 254.12 254.13 254.14 254.15 254.16 254.17 254.18 254.19 254.20 254.21 254.22 254.23 254.24 254.25 254.26 254.27 254.28
255.1 255.2 255.3 255.4 255.5 255.6 255.7 255.8 255.9 255.10 255.11 255.12 255.13 255.14 255.15 255.16 255.17 255.18 255.19 255.20 255.21 255.22 255.23 255.24 255.25 255.26 255.27 255.28 255.29 255.30 255.31 255.32 256.1 256.2 256.3 256.4 256.5 256.6 256.7 256.8 256.9 256.10 256.11 256.12 256.13 256.14 256.15 256.16 256.17 256.18 256.19 256.20 256.21 256.22 256.23 256.24 256.25 256.26 256.27 256.28 256.29 256.30 256.31 256.32 257.1 257.2 257.3 257.4 257.5 257.6 257.7 257.8 257.9 257.10 257.11 257.12 257.13 257.14 257.15 257.16 257.17 257.18 257.19 257.20 257.21 257.22 257.23 257.24 257.25 257.26 257.27 257.28 257.29 257.30 257.31 257.32 257.33 257.34 258.1 258.2 258.3 258.4 258.5 258.6 258.7 258.8 258.9 258.10 258.11 258.12 258.13 258.14 258.15 258.16 258.17 258.18 258.19 258.20 258.21 258.22 258.23 258.24 258.25 258.26 258.27 258.28 258.29 258.30 259.1 259.2 259.3 259.4 259.5 259.6 259.7 259.8 259.9 259.10 259.11 259.12 259.13 259.14 259.15 259.16 259.17 259.18 259.19 259.20 259.21 259.22 259.23
259.24 259.25 259.26 259.27 259.28 259.29 259.30 259.31 259.32 260.1 260.2 260.3 260.4 260.5 260.6 260.7 260.8 260.9 260.10 260.11 260.12 260.13 260.14 260.15 260.16 260.17 260.18 260.19 260.20 260.21 260.22 260.23 260.24 260.25 260.26 260.27 260.28 260.29 260.30 260.31 260.32 260.33 260.34 260.35 261.1 261.2 261.3 261.4 261.5 261.6 261.7 261.8 261.9 261.10 261.11 261.12 261.13 261.14 261.15 261.16 261.17 261.18 261.19 261.20 261.21 261.22 261.23 261.24 261.25 261.26 261.27
261.28 261.29 261.30 261.31 262.1 262.2 262.3 262.4 262.5 262.6 262.7 262.8 262.9 262.10 262.11 262.12 262.13 262.14 262.15 262.16 262.17 262.18 262.19 262.20 262.21 262.22 262.23 262.24
262.25 262.26 262.27 262.28 262.29 262.30
263.1 263.2 263.3 263.4 263.5 263.6 263.7 263.8 263.9 263.10 263.11 263.12
263.13 263.14 263.15 263.16 263.17 263.18 263.19 263.20 263.21
263.22 263.23 263.24 263.25 263.26 263.27 263.28 263.29 263.30 263.31 263.32 264.1 264.2 264.3 264.4 264.5 264.6 264.7 264.8 264.9 264.10 264.11 264.12 264.13 264.14 264.15
264.16 264.17 264.18 264.19 264.20 264.21 264.22 264.23 264.24 264.25 264.26 264.27 264.28 264.29
264.30 264.31 264.32 264.33 265.1 265.2 265.3 265.4 265.5 265.6 265.7 265.8 265.9 265.10 265.11 265.12 265.13 265.14 265.15 265.16 265.17 265.18 265.19 265.20 265.21 265.22 265.23 265.24 265.25 265.26 265.27 265.28 265.29 265.30 265.31 265.32 265.33 265.34 266.1 266.2 266.3 266.4 266.5 266.6 266.7 266.8 266.9 266.10 266.11 266.12 266.13 266.14 266.15 266.16 266.17 266.18 266.19 266.20 266.21 266.22 266.23 266.24 266.25 266.26 266.27 266.28 266.29 266.30 266.31 266.32 266.33 267.1 267.2 267.3 267.4 267.5 267.6 267.7 267.8 267.9 267.10 267.11 267.12 267.13 267.14 267.15 267.16 267.17 267.18 267.19 267.20 267.21 267.22 267.23 267.24 267.25 267.26 267.27 267.28 267.29 267.30 267.31 267.32 267.33 268.1 268.2 268.3 268.4 268.5 268.6 268.7 268.8 268.9 268.10 268.11 268.12 268.13
268.14 268.15 268.16 268.17 268.18 268.19 268.20 268.21 268.22 268.23
268.24 268.25 268.26 268.27 268.28 268.29 268.30 268.31 268.32 268.33 269.1 269.2 269.3 269.4 269.5 269.6 269.7 269.8 269.9 269.10 269.11 269.12 269.13 269.14 269.15 269.16 269.17 269.18 269.19 269.20 269.21 269.22 269.23 269.24 269.25 269.26 269.27 269.28 269.29 269.30 269.31 269.32 269.33 269.34 270.1 270.2 270.3 270.4 270.5 270.6 270.7 270.8 270.9 270.10 270.11 270.12
270.13 270.14 270.15 270.16 270.17 270.18 270.19 270.20 270.21 270.22 270.23 270.24 270.25 270.26 270.27 270.28 270.29 270.30 270.31 271.1 271.2 271.3 271.4 271.5 271.6 271.7 271.8 271.9 271.10 271.11 271.12 271.13 271.14 271.15 271.16 271.17 271.18 271.19 271.20 271.21 271.22 271.23 271.24 271.25 271.26 271.27 271.28 271.29 271.30 271.31 271.32 271.33 271.34 272.1 272.2 272.3 272.4 272.5 272.6 272.7 272.8 272.9 272.10 272.11 272.12 272.13 272.14 272.15 272.16 272.17 272.18 272.19 272.20 272.21 272.22 272.23 272.24 272.25 272.26 272.27 272.28 272.29 272.30 272.31 272.32 272.33 272.34 273.1 273.2 273.3 273.4 273.5 273.6 273.7 273.8 273.9 273.10 273.11 273.12 273.13 273.14 273.15 273.16 273.17 273.18 273.19 273.20 273.21 273.22 273.23 273.24 273.25 273.26 273.27 273.28 273.29 273.30 273.31 273.32 273.33 274.1 274.2 274.3 274.4 274.5 274.6 274.7 274.8 274.9
274.10 274.11 274.12 274.13 274.14 274.15 274.16 274.17 274.18 274.19 274.20 274.21 274.22 274.23 274.24 274.25 274.26 274.27 274.28 274.29 274.30 274.31 274.32 274.33 275.1 275.2 275.3 275.4 275.5 275.6 275.7 275.8 275.9 275.10 275.11 275.12 275.13 275.14 275.15 275.16 275.17 275.18 275.19 275.20 275.21 275.22 275.23 275.24 275.25 275.26 275.27 275.28 275.29 275.30 275.31 275.32 275.33 276.1 276.2 276.3 276.4 276.5 276.6 276.7 276.8 276.9 276.10 276.11 276.12 276.13 276.14 276.15 276.16 276.17
276.18 276.19 276.20 276.21 276.22 276.23 276.24 276.25 276.26 276.27 276.28 276.29 276.30 276.31 276.32 276.33 277.1 277.2 277.3 277.4 277.5 277.6 277.7 277.8 277.9 277.10 277.11 277.12 277.13 277.14 277.15 277.16 277.17
277.18 277.19 277.20 277.21 277.22 277.23 277.24 277.25 277.26 277.27 277.28 277.29 277.30 277.31 277.32 277.33 278.1 278.2 278.3 278.4 278.5 278.6 278.7 278.8 278.9 278.10 278.11 278.12 278.13 278.14 278.15 278.16 278.17 278.18 278.19 278.20 278.21 278.22 278.23 278.24 278.25 278.26 278.27 278.28 278.29 278.30 278.31 278.32 279.1 279.2 279.3 279.4 279.5 279.6 279.7 279.8 279.9 279.10 279.11 279.12 279.13 279.14 279.15 279.16 279.17 279.18 279.19 279.20
279.21 279.22 279.23 279.24 279.25 279.26 279.27 279.28 279.29 279.30 280.1 280.2 280.3 280.4 280.5 280.6 280.7 280.8 280.9 280.10 280.11 280.12 280.13 280.14 280.15 280.16 280.17 280.18 280.19 280.20 280.21 280.22 280.23 280.24 280.25 280.26 280.27 280.28 280.29 280.30 280.31 280.32 281.1 281.2 281.3 281.4 281.5 281.6 281.7 281.8 281.9 281.10 281.11 281.12 281.13 281.14 281.15 281.16 281.17 281.18 281.19 281.20 281.21 281.22 281.23 281.24 281.25 281.26 281.27 281.28 281.29 281.30
282.1 282.2 282.3 282.4 282.5 282.6 282.7 282.8 282.9 282.10 282.11 282.12 282.13 282.14 282.15 282.16 282.17 282.18 282.19 282.20 282.21 282.22 282.23 282.24 282.25 282.26 282.27 282.28 282.29 282.30 282.31 282.32 282.33 282.34 283.1 283.2 283.3 283.4 283.5 283.6 283.7 283.8 283.9 283.10 283.11 283.12 283.13 283.14 283.15 283.16 283.17 283.18 283.19 283.20 283.21 283.22 283.23 283.24 283.25 283.26 283.27 283.28 283.29 283.30 283.31 283.32 283.33 284.1 284.2 284.3 284.4 284.5 284.6 284.7 284.8 284.9 284.10 284.11 284.12 284.13 284.14 284.15 284.16 284.17 284.18 284.19 284.20 284.21 284.22 284.23 284.24 284.25 284.26 284.27 284.28 284.29 284.30 284.31 284.32 284.33 285.1 285.2 285.3 285.4 285.5 285.6 285.7 285.8 285.9 285.10 285.11 285.12 285.13 285.14 285.15 285.16 285.17 285.18 285.19 285.20 285.21 285.22 285.23 285.24 285.25 285.26 285.27 285.28 285.29 285.30 285.31 286.1 286.2 286.3 286.4 286.5 286.6 286.7 286.8 286.9 286.10 286.11 286.12 286.13 286.14 286.15 286.16 286.17 286.18 286.19 286.20 286.21 286.22 286.23 286.24 286.25 286.26 286.27 286.28 286.29 286.30 286.31 287.1 287.2 287.3 287.4 287.5 287.6 287.7 287.8 287.9 287.10 287.11
287.12 287.13 287.14 287.15 287.16 287.17 287.18 287.19 287.20 287.21 287.22 287.23 287.24 287.25 287.26 287.27 287.28 287.29 287.30 287.31 287.32 288.1 288.2 288.3 288.4 288.5 288.6 288.7 288.8 288.9 288.10 288.11 288.12 288.13 288.14 288.15 288.16 288.17 288.18 288.19 288.20 288.21 288.22 288.23 288.24 288.25 288.26 288.27 288.28 288.29 288.30 288.31 288.32 289.1 289.2 289.3 289.4 289.5 289.6 289.7 289.8 289.9
289.10 289.11 289.12 289.13 289.14 289.15 289.16 289.17 289.18 289.19 289.20 289.21 289.22 289.23 289.24 289.25 289.26 289.27 289.28 289.29 289.30 289.31 289.32 290.1 290.2 290.3 290.4 290.5 290.6 290.7 290.8 290.9 290.10 290.11 290.12
290.13 290.14 290.15 290.16 290.17 290.18 290.19 290.20 290.21 290.22 290.23 290.24 290.25 290.26 290.27 290.28 290.29 290.30 290.31 290.32 290.33 291.1 291.2 291.3 291.4 291.5 291.6 291.7 291.8 291.9 291.10 291.11 291.12 291.13 291.14 291.15 291.16 291.17 291.18 291.19 291.20 291.21 291.22 291.23 291.24 291.25 291.26 291.27 291.28 291.29 291.30 291.31 291.32 291.33 291.34 292.1 292.2 292.3 292.4 292.5 292.6 292.7 292.8 292.9 292.10 292.11 292.12 292.13 292.14 292.15 292.16 292.17 292.18 292.19 292.20 292.21 292.22 292.23 292.24 292.25 292.26 292.27 292.28 292.29 292.30 292.31 292.32 292.33 292.34 293.1 293.2 293.3 293.4 293.5 293.6 293.7 293.8 293.9 293.10 293.11 293.12 293.13 293.14 293.15 293.16 293.17 293.18 293.19 293.20 293.21 293.22 293.23 293.24 293.25 293.26 293.27 293.28 293.29 293.30 293.31 294.1 294.2 294.3 294.4 294.5 294.6 294.7 294.8 294.9 294.10 294.11 294.12 294.13 294.14 294.15 294.16 294.17 294.18 294.19 294.20 294.21 294.22 294.23 294.24 294.25 294.26 294.27 294.28 294.29 294.30 294.31 294.32 295.1 295.2 295.3 295.4 295.5 295.6 295.7 295.8 295.9 295.10 295.11 295.12 295.13 295.14 295.15 295.16 295.17 295.18 295.19 295.20 295.21 295.22 295.23 295.24 295.25 295.26 295.27 295.28 295.29 295.30 295.31 295.32 296.1 296.2 296.3 296.4 296.5 296.6 296.7 296.8 296.9 296.10 296.11 296.12 296.13 296.14 296.15 296.16 296.17 296.18 296.19 296.20 296.21 296.22 296.23 296.24 296.25 296.26 296.27 296.28 296.29 296.30 296.31 296.32 296.33 296.34 297.1 297.2 297.3 297.4 297.5 297.6 297.7 297.8 297.9
297.10 297.11 297.12 297.13 297.14 297.15 297.16 297.17 297.18 297.19 297.20 297.21 297.22 297.23 297.24 297.25 297.26 297.27 297.28 297.29 297.30 297.31 297.32 297.33 297.34 298.1 298.2 298.3 298.4 298.5 298.6 298.7 298.8 298.9 298.10 298.11 298.12 298.13 298.14 298.15 298.16 298.17 298.18 298.19 298.20 298.21 298.22 298.23 298.24 298.25 298.26 298.27 298.28 298.29 298.30 298.31 298.32 298.33 299.1 299.2 299.3 299.4 299.5 299.6 299.7 299.8 299.9 299.10 299.11 299.12 299.13 299.14 299.15 299.16 299.17
299.18 299.19 299.20 299.21 299.22 299.23 299.24 299.25 299.26 299.27 299.28 299.29 299.30 299.31 299.32 299.33 300.1 300.2 300.3 300.4 300.5
300.6 300.7 300.8 300.9 300.10 300.11 300.12 300.13 300.14 300.15 300.16 300.17 300.18 300.19 300.20 300.21 300.22 300.23 300.24 300.25 300.26 300.27 300.28 300.29 300.30 300.31 301.1 301.2 301.3 301.4 301.5 301.6 301.7 301.8 301.9 301.10 301.11 301.12 301.13 301.14 301.15 301.16 301.17 301.18 301.19 301.20 301.21 301.22 301.23 301.24 301.25 301.26 301.27 301.28 301.29 301.30 302.1 302.2 302.3 302.4 302.5 302.6 302.7 302.8 302.9 302.10 302.11 302.12
302.13 302.14 302.15 302.16 302.17 302.18 302.19 302.20 302.21 302.22 302.23 302.24 302.25 302.26
302.27 302.28 302.29 302.30 303.1 303.2 303.3 303.4 303.5 303.6 303.7 303.8 303.9 303.10 303.11 303.12
303.13 303.14 303.15 303.16 303.17 303.18 303.19 303.20 303.21 303.22 303.23 303.24 303.25 303.26 303.27 303.28 303.29 303.30 303.31 303.32 303.33 304.1 304.2 304.3 304.4 304.5 304.6 304.7 304.8 304.9 304.10 304.11 304.12 304.13 304.14 304.15 304.16 304.17 304.18 304.19 304.20 304.21 304.22 304.23 304.24 304.25 304.26 304.27 304.28 304.29 304.30 304.31 305.1 305.2 305.3 305.4 305.5 305.6 305.7 305.8 305.9 305.10 305.11 305.12 305.13 305.14 305.15 305.16 305.17 305.18 305.19 305.20 305.21 305.22 305.23 305.24 305.25 305.26 305.27 305.28 305.29 305.30
305.31 305.32 305.33 306.1 306.2 306.3 306.4 306.5 306.6 306.7 306.8 306.9 306.10 306.11 306.12 306.13 306.14 306.15
306.16 306.17 306.18 306.19 306.20 306.21 306.22 306.23 306.24 306.25 306.26
306.27 306.28 306.29 306.30 306.31 306.32 306.33 307.1 307.2 307.3 307.4 307.5 307.6 307.7 307.8 307.9 307.10 307.11 307.12 307.13 307.14 307.15 307.16 307.17 307.18 307.19 307.20 307.21 307.22
307.23 307.24 307.25 307.26 307.27 307.28 307.29 307.30 307.31 308.1 308.2 308.3
308.4 308.5 308.6 308.7 308.8 308.9 308.10
308.11 308.12 308.13 308.14 308.15 308.16 308.17 308.18 308.19 308.20 308.21 308.22 308.23 308.24 308.25 308.26 308.27 308.28 308.29 308.30 308.31 309.1 309.2 309.3 309.4 309.5 309.6 309.7 309.8 309.9 309.10 309.11 309.12 309.13 309.14 309.15 309.16 309.17 309.18 309.19 309.20 309.21 309.22 309.23 309.24 309.25 309.26 309.27 309.28 309.29 309.30 309.31 309.32 309.33 310.1 310.2 310.3 310.4 310.5 310.6 310.7 310.8 310.9 310.10 310.11
310.12 310.13 310.14 310.15 310.16 310.17 310.18 310.19 310.20 310.21 310.22 310.23 310.24
310.25
310.26 310.27 310.28 310.29 310.30
310.31
311.1 311.2 311.3 311.4 311.5 311.6 311.7 311.8 311.9 311.10 311.11 311.12 311.13 311.14 311.15 311.16 311.17 311.18 311.19 311.20 311.21 311.22 311.23 311.24 311.25 311.26
311.27 311.28
311.29
312.1 312.2 312.3 312.4 312.5 312.6 312.7 312.8 312.9 312.10 312.11 312.12 312.13 312.14 312.15 312.16 312.17 312.18 312.19 312.20 312.21 312.22 312.23 312.24 312.25 312.26 312.27 312.28 312.29 312.30 312.31 313.1 313.2 313.3 313.4 313.5 313.6 313.7 313.8 313.9 313.10 313.11 313.12 313.13 313.14 313.15 313.16 313.17 313.18 313.19 313.20
313.21 313.22 313.23 313.24 313.25 313.26 313.27 313.28 313.29 313.30
314.1 314.2
314.3 314.4 314.5 314.6 314.7 314.8 314.9 314.10 314.11 314.12 314.13 314.14 314.15
314.16 314.17 314.18 314.19 314.20 314.21 314.22 314.23 314.24 314.25 314.26 314.27 314.28 314.29 314.30 314.31 315.1 315.2 315.3 315.4 315.5 315.6 315.7 315.8 315.9 315.10 315.11 315.12 315.13 315.14 315.15
315.16
315.17 315.18 315.19 315.20 315.21 315.22
315.23
315.24 315.25
315.26 315.27 315.28 315.29 315.30 316.1 316.2 316.3 316.4 316.5 316.6 316.7 316.8 316.9 316.10 316.11 316.12 316.13 316.14 316.15 316.16 316.17 316.18 316.19 316.20 316.21 316.22 316.23 316.24 316.25 316.26 316.27 316.28 316.29 316.30 316.31 316.32 317.1 317.2 317.3 317.4 317.5 317.6 317.7 317.8 317.9 317.10 317.11 317.12 317.13 317.14 317.15 317.16 317.17 317.18 317.19
317.20 317.21 317.22
317.23 317.24
317.25 317.26 317.27 317.28 317.29 317.30 317.31 317.32 318.1 318.2 318.3 318.4 318.5 318.6 318.7 318.8 318.9 318.10
318.11 318.12 318.13 318.14 318.15 318.16 318.17 318.18 318.19 318.20 318.21 318.22
318.23 318.24 318.25 318.26 318.27 318.28 318.29 318.30 319.1 319.2
319.3 319.4 319.5 319.6 319.7 319.8 319.9 319.10 319.11 319.12 319.13 319.14 319.15 319.16 319.17 319.18 319.19
319.20 319.21 319.22 319.23 319.24 319.25 319.26 319.27 319.28 319.29 319.30 319.31 319.32 320.1 320.2 320.3 320.4 320.5 320.6 320.7 320.8 320.9 320.10 320.11 320.12 320.13 320.14 320.15 320.16 320.17 320.18 320.19 320.20 320.21 320.22 320.23 320.24 320.25 320.26 320.27 320.28 320.29 320.30 320.31 320.32
320.33
321.1 321.2 321.3 321.4 321.5 321.6 321.7 321.8 321.9 321.10 321.11 321.12 321.13 321.14 321.15 321.16 321.17
321.18 321.19 321.20 321.21 321.22 321.23 321.24 321.25 321.26 321.27 321.28 321.29 321.30 322.1 322.2 322.3 322.4 322.5 322.6 322.7 322.8 322.9 322.10 322.11 322.12 322.13 322.14 322.15 322.16 322.17 322.18 322.19 322.20 322.21 322.22 322.23 322.24 322.25 322.26 322.27 322.28 322.29 322.30 322.31 322.32 322.33 322.34 323.1 323.2 323.3 323.4 323.5 323.6 323.7 323.8 323.9 323.10 323.11 323.12 323.13 323.14 323.15 323.16 323.17 323.18 323.19 323.20 323.21 323.22 323.23 323.24 323.25 323.26 323.27 323.28 323.29 323.30 323.31 323.32 323.33 324.1 324.2 324.3 324.4 324.5 324.6 324.7 324.8 324.9 324.10 324.11 324.12 324.13 324.14 324.15 324.16 324.17 324.18 324.19 324.20 324.21 324.22 324.23 324.24 324.25 324.26 324.27 324.28 324.29 324.30 324.31 324.32 325.1 325.2 325.3 325.4 325.5 325.6 325.7 325.8 325.9 325.10 325.11 325.12 325.13 325.14 325.15 325.16 325.17 325.18 325.19 325.20 325.21 325.22 325.23 325.24 325.25 325.26 325.27 325.28 325.29 325.30 325.31 325.32 325.33 326.1 326.2 326.3 326.4 326.5 326.6 326.7 326.8 326.9 326.10 326.11 326.12 326.13 326.14 326.15 326.16 326.17 326.18 326.19 326.20 326.21 326.22 326.23 326.24 326.25 326.26 326.27 326.28 326.29 326.30 326.31 326.32 326.33 326.34 327.1 327.2 327.3 327.4 327.5 327.6 327.7 327.8 327.9 327.10
327.11 327.12 327.13 327.14 327.15 327.16 327.17 327.18 327.19 327.20
327.21 327.22 327.23 327.24 327.25 327.26 327.27 327.28 327.29 327.30 327.31 327.32 327.33 328.1 328.2 328.3
328.4 328.5 328.6 328.7 328.8 328.9 328.10 328.11 328.12 328.13 328.14 328.15 328.16 328.17 328.18 328.19 328.20 328.21 328.22
328.23 328.24 328.25 328.26 328.27 328.28 328.29 328.30 328.31 328.32 328.33 329.1 329.2 329.3 329.4 329.5 329.6
329.7 329.8 329.9 329.10 329.11 329.12 329.13 329.14 329.15 329.16 329.17 329.18 329.19 329.20 329.21 329.22 329.23 329.24 329.25 329.26 329.27 329.28 329.29 329.30 329.31 329.32 329.33 329.34 330.1 330.2 330.3 330.4 330.5 330.6
330.7 330.8 330.9 330.10 330.11 330.12 330.13 330.14 330.15 330.16 330.17 330.18 330.19 330.20 330.21 330.22 330.23 330.24 330.25 330.26 330.27 330.28 330.29 330.30 331.1 331.2 331.3 331.4 331.5 331.6 331.7 331.8 331.9 331.10 331.11 331.12 331.13 331.14 331.15 331.16 331.17 331.18 331.19 331.20 331.21 331.22 331.23 331.24
331.25
331.26 331.27 331.28 331.29 331.30 331.31 331.32 331.33 332.1 332.2 332.3 332.4 332.5 332.6 332.7 332.8 332.9 332.10
332.11 332.12 332.13 332.14 332.15 332.16 332.17 332.18 332.19 332.20 332.21 332.22 332.23 332.24 332.25 332.26 332.27 332.28 332.29 332.30 332.31 332.32
332.33
333.1 333.2 333.3 333.4 333.5 333.6 333.7
333.8 333.9 333.10 333.11 333.12 333.13 333.14 333.15 333.16 333.17 333.18 333.19 333.20 333.21 333.22 333.23 333.24 333.25 333.26 333.27 333.28 333.29 333.30 333.31 333.32 333.33 333.34 334.1 334.2 334.3 334.4 334.5 334.6 334.7 334.8 334.9 334.10 334.11 334.12 334.13 334.14 334.15 334.16 334.17 334.18 334.19 334.20 334.21 334.22 334.23 334.24
334.25
334.26 334.27 334.28 334.29 334.30 334.31 334.32 334.33 335.1 335.2 335.3 335.4 335.5 335.6 335.7 335.8 335.9
335.10
335.11 335.12 335.13 335.14 335.15 335.16 335.17 335.18 335.19 335.20 335.21 335.22 335.23 335.24 335.25
335.26
335.27 335.28 335.29 335.30 335.31 336.1 336.2 336.3
336.4
336.5 336.6 336.7 336.8 336.9 336.10 336.11 336.12 336.13 336.14 336.15 336.16 336.17 336.18 336.19 336.20 336.21
336.22 336.23 336.24 336.25 336.26 336.27 336.28 336.29 336.30 336.31 336.32 337.1 337.2 337.3 337.4 337.5 337.6 337.7 337.8 337.9 337.10 337.11
337.12
337.13 337.14
337.15 337.16
337.17 337.18 337.19 337.20 337.21 337.22 337.23 337.24 337.25 337.26
337.27 337.28 337.29 337.30 337.31 338.1 338.2 338.3 338.4 338.5 338.6 338.7 338.8 338.9 338.10 338.11 338.12 338.13 338.14 338.15 338.16 338.17 338.18 338.19 338.20 338.21 338.22 338.23 338.24 338.25 338.26 338.27 338.28 338.29 338.30 338.31 339.1 339.2 339.3 339.4 339.5 339.6 339.7
339.8 339.9 339.10 339.11 339.12 339.13
339.14 339.15 339.16 339.17 339.18 339.19 339.20 339.21 339.22 339.23 339.24 339.25 339.26 339.27 339.28 339.29
340.1 340.2 340.3 340.4 340.5 340.6 340.7 340.8 340.9 340.10 340.11 340.12 340.13 340.14 340.15 340.16 340.17 340.18 340.19 340.20 340.21 340.22 340.23
340.24
340.25 340.26 340.27 341.1 341.2 341.3 341.4 341.5 341.6 341.7 341.8 341.9 341.10 341.11 341.12 341.13 341.14 341.15 341.16 341.17 341.18 341.19 341.20 341.21 341.22 341.23 341.24 341.25 341.26 341.27 341.28 341.29 341.30 341.31 341.32 342.1 342.2 342.3 342.4 342.5
342.6
342.7 342.8 342.9 342.10 342.11 342.12 342.13 342.14 342.15 342.16 342.17 342.18 342.19 342.20 342.21 342.22 342.23 342.24 342.25 342.26
342.27
343.1 343.2 343.3 343.4 343.5 343.6 343.7 343.8 343.9 343.10 343.11 343.12 343.13 343.14 343.15 343.16 343.17 343.18 343.19 343.20 343.21 343.22 343.23 343.24 343.25 343.26 343.27 343.28 343.29 343.30 343.31 343.32 344.1 344.2 344.3 344.4 344.5 344.6 344.7 344.8 344.9 344.10 344.11 344.12 344.13 344.14 344.15 344.16 344.17 344.18 344.19 344.20 344.21 344.22 344.23 344.24 344.25 344.26 344.27 344.28 344.29 344.30 344.31 345.1 345.2 345.3 345.4 345.5 345.6 345.7 345.8 345.9 345.10 345.11 345.12 345.13
345.14
345.15 345.16 345.17 345.18 345.19 345.20 345.21 345.22 345.23 345.24 345.25 345.26 345.27 345.28 345.29 345.30 345.31 345.32
346.1
346.2 346.3 346.4 346.5 346.6 346.7 346.8 346.9 346.10 346.11 346.12 346.13 346.14 346.15 346.16 346.17 346.18 346.19 346.20
346.21
346.22 346.23 346.24 346.25 346.26 346.27 346.28 347.1 347.2 347.3 347.4 347.5 347.6 347.7 347.8 347.9 347.10 347.11 347.12 347.13 347.14
347.15
347.16 347.17 347.18 347.19 347.20 347.21 347.22 347.23 347.24 347.25 347.26 347.27 347.28 347.29 348.1 348.2 348.3
348.4
348.5 348.6 348.7 348.8 348.9 348.10 348.11 348.12 348.13 348.14 348.15 348.16 348.17
348.18
348.19 348.20 348.21 348.22 348.23 348.24 348.25 348.26 348.27 348.28 348.29 348.30 349.1 349.2 349.3 349.4 349.5 349.6 349.7 349.8 349.9 349.10 349.11 349.12 349.13 349.14 349.15 349.16 349.17 349.18 349.19 349.20 349.21 349.22 349.23 349.24 349.25 349.26 349.27 349.28 349.29 349.30 349.31 349.32 350.1 350.2 350.3 350.4 350.5 350.6 350.7 350.8 350.9 350.10 350.11 350.12 350.13 350.14 350.15 350.16 350.17 350.18 350.19 350.20 350.21 350.22 350.23 350.24 350.25 350.26 350.27 350.28 350.29 350.30 350.31 350.32 351.1 351.2 351.3 351.4 351.5 351.6 351.7 351.8 351.9 351.10 351.11 351.12 351.13 351.14 351.15 351.16 351.17 351.18 351.19 351.20 351.21 351.22 351.23 351.24 351.25 351.26 351.27 351.28 351.29 351.30 351.31 351.32 351.33 352.1 352.2 352.3 352.4 352.5 352.6 352.7 352.8 352.9 352.10 352.11 352.12 352.13 352.14 352.15 352.16 352.17 352.18 352.19 352.20 352.21 352.22 352.23 352.24 352.25 352.26 352.27 352.28 352.29 352.30 352.31 352.32 352.33 353.1 353.2 353.3 353.4 353.5 353.6 353.7 353.8 353.9 353.10 353.11 353.12 353.13 353.14 353.15 353.16 353.17 353.18 353.19 353.20 353.21 353.22 353.23 353.24 353.25 353.26 353.27 353.28 353.29 353.30 353.31 353.32 353.33 354.1 354.2 354.3 354.4 354.5 354.6 354.7 354.8 354.9 354.10 354.11 354.12 354.13 354.14 354.15 354.16 354.17 354.18 354.19 354.20 354.21 354.22 354.23 354.24 354.25 354.26 354.27 354.28 354.29 354.30 354.31 354.32 355.1 355.2 355.3 355.4 355.5 355.6 355.7 355.8 355.9 355.10 355.11 355.12 355.13 355.14 355.15 355.16 355.17 355.18 355.19 355.20 355.21 355.22 355.23 355.24 355.25 355.26 355.27 355.28 355.29 355.30 355.31 356.1 356.2 356.3 356.4 356.5 356.6 356.7 356.8 356.9 356.10 356.11 356.12 356.13 356.14 356.15 356.16 356.17 356.18 356.19 356.20 356.21 356.22 356.23 356.24 356.25 356.26 356.27 356.28 356.29 356.30 357.1 357.2 357.3 357.4 357.5 357.6 357.7 357.8 357.9 357.10 357.11 357.12 357.13 357.14 357.15 357.16 357.17 357.18 357.19 357.20 357.21 357.22 357.23 357.24 357.25 357.26 357.27 357.28 357.29 357.30 357.31 358.1 358.2 358.3 358.4 358.5 358.6 358.7 358.8 358.9 358.10 358.11 358.12 358.13 358.14 358.15 358.16 358.17 358.18 358.19 358.20 358.21 358.22 358.23 358.24 358.25 358.26 358.27 358.28 358.29 358.30 358.31 359.1 359.2 359.3 359.4 359.5 359.6 359.7 359.8 359.9 359.10 359.11 359.12 359.13 359.14 359.15 359.16 359.17 359.18 359.19 359.20 359.21 359.22 359.23 359.24 359.25 359.26 359.27 359.28 359.29 359.30 359.31 359.32 360.1 360.2 360.3 360.4 360.5 360.6 360.7 360.8 360.9 360.10 360.11 360.12 360.13 360.14 360.15 360.16 360.17 360.18 360.19 360.20 360.21 360.22 360.23 360.24 360.25 360.26 360.27 360.28 360.29 360.30 360.31 360.32 360.33 361.1 361.2 361.3 361.4 361.5 361.6 361.7 361.8 361.9 361.10 361.11 361.12 361.13 361.14 361.15 361.16 361.17 361.18 361.19 361.20 361.21 361.22 361.23 361.24 361.25 361.26 361.27 361.28 361.29 361.30 361.31 362.1 362.2 362.3 362.4 362.5 362.6 362.7 362.8 362.9 362.10 362.11 362.12 362.13 362.14 362.15 362.16 362.17 362.18 362.19 362.20 362.21 362.22 362.23 362.24 362.25 362.26 362.27 362.28 362.29 362.30 362.31 362.32 363.1 363.2 363.3 363.4 363.5 363.6 363.7 363.8 363.9 363.10 363.11 363.12 363.13 363.14 363.15 363.16 363.17 363.18 363.19 363.20 363.21 363.22 363.23 363.24 363.25 363.26 363.27 363.28 363.29 363.30 363.31 363.32 363.33 364.1 364.2 364.3 364.4 364.5 364.6 364.7 364.8 364.9 364.10 364.11 364.12 364.13 364.14 364.15 364.16 364.17 364.18 364.19 364.20 364.21 364.22 364.23 364.24 364.25 364.26 364.27 364.28 364.29 364.30 364.31 365.1 365.2 365.3 365.4 365.5 365.6 365.7 365.8 365.9 365.10 365.11 365.12 365.13 365.14 365.15 365.16 365.17 365.18 365.19 365.20 365.21 365.22 365.23 365.24 365.25 365.26 365.27
365.28 365.29 365.30 366.1 366.2 366.3 366.4 366.5 366.6 366.7 366.8 366.9 366.10 366.11 366.12 366.13 366.14
366.15 366.16 366.17 366.18 366.19 366.20 366.21 366.22 366.23 366.24 366.25 366.26 366.27 366.28 366.29 366.30 366.31 366.32 367.1 367.2 367.3 367.4 367.5 367.6 367.7 367.8 367.9 367.10 367.11 367.12 367.13 367.14 367.15 367.16 367.17 367.18 367.19 367.20 367.21 367.22 367.23 367.24 367.25 367.26 367.27 367.28 367.29 367.30 367.31 368.1 368.2 368.3 368.4 368.5 368.6 368.7 368.8 368.9 368.10 368.11 368.12 368.13 368.14 368.15 368.16 368.17 368.18 368.19 368.20 368.21 368.22 368.23 368.24 368.25 368.26 368.27 368.28 368.29 368.30 368.31 368.32 369.1 369.2 369.3 369.4 369.5 369.6 369.7 369.8 369.9 369.10 369.11 369.12 369.13 369.14 369.15 369.16 369.17 369.18 369.19 369.20 369.21 369.22 369.23 369.24 369.25 369.26 369.27 369.28 369.29 369.30 369.31 369.32 369.33 370.1 370.2 370.3 370.4 370.5 370.6 370.7 370.8 370.9 370.10 370.11 370.12 370.13 370.14 370.15 370.16 370.17 370.18 370.19 370.20 370.21 370.22 370.23 370.24 370.25 370.26 370.27 370.28 370.29 370.30 370.31 371.1 371.2 371.3 371.4 371.5 371.6 371.7 371.8 371.9 371.10 371.11 371.12 371.13 371.14 371.15 371.16 371.17 371.18 371.19 371.20 371.21 371.22 371.23 371.24 371.25 371.26 371.27 371.28 371.29 371.30 371.31 371.32 372.1 372.2 372.3 372.4 372.5 372.6 372.7 372.8 372.9 372.10 372.11 372.12 372.13 372.14 372.15 372.16 372.17 372.18 372.19 372.20 372.21 372.22 372.23 372.24 372.25 372.26 372.27 372.28 372.29 372.30 372.31 372.32 373.1 373.2 373.3 373.4 373.5 373.6 373.7 373.8 373.9 373.10 373.11 373.12 373.13 373.14 373.15 373.16 373.17 373.18 373.19 373.20 373.21 373.22 373.23 373.24 373.25 373.26 373.27 373.28 373.29 373.30 373.31 374.1 374.2 374.3 374.4 374.5 374.6 374.7 374.8 374.9 374.10 374.11 374.12 374.13 374.14 374.15 374.16 374.17 374.18 374.19 374.20 374.21 374.22 374.23 374.24 374.25 374.26 374.27 374.28 374.29 374.30 374.31 375.1 375.2 375.3 375.4 375.5 375.6 375.7 375.8 375.9 375.10 375.11 375.12 375.13 375.14 375.15 375.16 375.17 375.18 375.19 375.20 375.21 375.22 375.23 375.24 375.25 375.26 375.27 375.28 375.29 375.30 375.31 375.32 376.1 376.2 376.3 376.4 376.5 376.6 376.7 376.8 376.9 376.10 376.11 376.12 376.13 376.14 376.15 376.16 376.17 376.18 376.19 376.20 376.21 376.22 376.23 376.24 376.25 376.26 376.27 376.28 376.29 376.30 376.31 377.1 377.2 377.3 377.4 377.5 377.6 377.7 377.8 377.9 377.10 377.11 377.12 377.13 377.14 377.15 377.16 377.17 377.18 377.19 377.20 377.21 377.22 377.23 377.24 377.25 377.26 377.27 377.28 377.29 377.30 378.1 378.2 378.3 378.4 378.5 378.6 378.7 378.8 378.9 378.10 378.11 378.12 378.13 378.14 378.15 378.16 378.17 378.18 378.19 378.20 378.21 378.22 378.23 378.24 378.25 378.26 378.27 378.28 379.1 379.2 379.3 379.4 379.5 379.6 379.7 379.8 379.9 379.10 379.11 379.12 379.13 379.14 379.15 379.16 379.17 379.18 379.19 379.20 379.21 379.22 379.23 379.24 379.25 379.26 379.27 379.28 379.29 379.30 379.31 379.32 379.33 380.1 380.2 380.3 380.4 380.5 380.6 380.7 380.8 380.9 380.10 380.11 380.12 380.13 380.14 380.15 380.16 380.17 380.18 380.19 380.20 380.21 380.22 380.23 380.24 380.25 380.26 380.27 380.28 380.29 380.30 380.31 380.32 380.33 381.1 381.2 381.3 381.4 381.5 381.6 381.7 381.8 381.9 381.10 381.11 381.12 381.13 381.14 381.15 381.16 381.17 381.18 381.19 381.20 381.21 381.22 381.23 381.24 381.25 381.26 381.27 381.28 381.29 381.30 381.31 381.32 382.1 382.2 382.3 382.4 382.5 382.6 382.7 382.8 382.9 382.10 382.11 382.12 382.13 382.14 382.15 382.16 382.17 382.18 382.19 382.20 382.21 382.22 382.23 382.24 382.25 382.26 382.27 382.28 382.29 382.30 383.1 383.2 383.3 383.4 383.5 383.6 383.7 383.8 383.9 383.10 383.11 383.12 383.13 383.14 383.15 383.16 383.17 383.18 383.19 383.20 383.21 383.22 383.23 383.24 383.25 383.26 383.27 383.28 383.29 383.30 383.31 383.32 384.1 384.2 384.3 384.4 384.5 384.6 384.7 384.8 384.9 384.10 384.11 384.12 384.13 384.14 384.15 384.16 384.17 384.18 384.19 384.20 384.21 384.22 384.23 384.24 384.25 384.26 384.27 384.28 384.29 384.30 384.31 384.32 384.33 385.1 385.2 385.3 385.4 385.5 385.6 385.7 385.8 385.9 385.10 385.11 385.12 385.13 385.14 385.15 385.16 385.17 385.18 385.19 385.20 385.21 385.22 385.23 385.24 385.25
385.26 385.27
385.28 385.29 385.30 385.31 385.32 386.1 386.2 386.3 386.4 386.5 386.6
386.7 386.8 386.9 386.10 386.11 386.12 386.13 386.14 386.15 386.16 386.17 386.18 386.19 386.20 386.21 386.22 386.23 386.24 386.25 386.26 386.27 386.28 386.29 386.30 386.31 387.1 387.2 387.3 387.4 387.5 387.6 387.7 387.8 387.9 387.10 387.11 387.12 387.13 387.14 387.15 387.16 387.17 387.18 387.19 387.20 387.21 387.22 387.23 387.24 387.25 387.26 387.27 387.28 387.29 387.30 388.1 388.2 388.3 388.4 388.5 388.6 388.7 388.8 388.9 388.10 388.11 388.12 388.13 388.14 388.15 388.16 388.17 388.18 388.19 388.20 388.21 388.22 388.23 388.24 388.25 388.26 388.27 388.28 388.29 388.30 389.1 389.2 389.3 389.4 389.5 389.6 389.7 389.8 389.9 389.10 389.11 389.12 389.13 389.14 389.15 389.16 389.17 389.18 389.19 389.20 389.21 389.22 389.23 389.24 389.25 389.26 389.27 389.28 389.29 389.30 390.1 390.2 390.3 390.4 390.5 390.6 390.7 390.8 390.9 390.10 390.11 390.12 390.13 390.14 390.15 390.16 390.17 390.18 390.19 390.20 390.21 390.22 390.23 390.24 390.25 390.26 390.27 390.28 390.29 390.30 390.31 391.1 391.2 391.3 391.4 391.5 391.6 391.7 391.8 391.9 391.10 391.11 391.12 391.13 391.14 391.15 391.16 391.17 391.18 391.19 391.20 391.21 391.22 391.23 391.24 391.25 391.26 391.27 391.28 391.29 391.30 391.31 392.1 392.2 392.3 392.4 392.5 392.6 392.7 392.8 392.9 392.10 392.11 392.12 392.13 392.14 392.15 392.16 392.17 392.18 392.19 392.20 392.21 392.22 392.23 392.24 392.25 392.26 392.27 392.28 392.29 392.30 392.31 393.1 393.2 393.3 393.4 393.5 393.6 393.7 393.8 393.9 393.10 393.11 393.12 393.13 393.14 393.15 393.16 393.17 393.18 393.19 393.20 393.21 393.22 393.23 393.24 393.25 393.26 393.27 393.28 393.29 393.30 393.31 394.1 394.2 394.3 394.4 394.5 394.6 394.7 394.8 394.9 394.10 394.11 394.12 394.13 394.14 394.15 394.16 394.17 394.18 394.19 394.20 394.21 394.22 394.23 394.24 394.25 394.26 394.27 394.28 394.29 394.30 394.31 394.32 395.1 395.2 395.3 395.4 395.5 395.6 395.7 395.8 395.9 395.10 395.11 395.12 395.13 395.14 395.15 395.16 395.17 395.18 395.19 395.20 395.21 395.22 395.23 395.24 395.25 395.26 395.27 395.28 395.29 395.30 396.1 396.2 396.3 396.4 396.5 396.6 396.7 396.8 396.9 396.10 396.11 396.12 396.13 396.14 396.15 396.16 396.17 396.18 396.19 396.20 396.21 396.22 396.23 396.24 396.25 396.26 396.27 396.28 396.29 396.30 397.1 397.2 397.3 397.4 397.5 397.6 397.7 397.8 397.9 397.10 397.11 397.12 397.13 397.14 397.15 397.16 397.17 397.18 397.19 397.20 397.21 397.22 397.23 397.24 397.25 397.26 397.27 397.28 397.29 397.30 397.31 398.1 398.2 398.3 398.4 398.5 398.6 398.7 398.8 398.9 398.10 398.11 398.12 398.13 398.14 398.15 398.16 398.17 398.18 398.19 398.20 398.21 398.22 398.23 398.24 398.25 398.26 398.27 398.28 398.29 399.1 399.2 399.3 399.4 399.5 399.6 399.7 399.8 399.9 399.10 399.11 399.12 399.13 399.14 399.15 399.16 399.17 399.18 399.19 399.20 399.21 399.22 399.23 399.24 399.25 399.26 399.27 399.28 399.29 399.30 399.31 399.32 400.1 400.2 400.3 400.4 400.5 400.6 400.7 400.8 400.9 400.10 400.11 400.12 400.13 400.14 400.15 400.16 400.17 400.18 400.19 400.20 400.21 400.22 400.23 400.24 400.25 400.26 400.27 400.28 400.29 400.30 400.31 400.32 400.33 401.1 401.2 401.3 401.4 401.5 401.6 401.7 401.8 401.9 401.10 401.11 401.12 401.13 401.14 401.15 401.16 401.17 401.18 401.19 401.20 401.21 401.22 401.23 401.24 401.25 401.26 401.27 401.28 401.29 401.30 402.1 402.2 402.3 402.4 402.5 402.6 402.7 402.8 402.9 402.10 402.11 402.12 402.13 402.14 402.15 402.16 402.17 402.18 402.19 402.20 402.21 402.22 402.23 402.24 402.25 402.26 402.27 402.28 402.29 402.30 402.31 403.1 403.2 403.3 403.4 403.5 403.6 403.7 403.8 403.9 403.10 403.11 403.12 403.13 403.14 403.15 403.16 403.17 403.18 403.19 403.20 403.21 403.22 403.23 403.24 403.25 403.26 403.27 403.28 403.29 403.30 403.31 404.1 404.2 404.3 404.4 404.5 404.6 404.7 404.8 404.9 404.10 404.11 404.12 404.13 404.14 404.15 404.16 404.17 404.18 404.19 404.20 404.21 404.22 404.23 404.24 404.25 404.26 404.27 404.28 404.29 404.30 405.1 405.2 405.3 405.4 405.5 405.6 405.7 405.8 405.9 405.10 405.11 405.12 405.13 405.14 405.15 405.16 405.17 405.18 405.19 405.20 405.21 405.22 405.23 405.24 405.25 405.26 405.27 405.28 405.29 405.30 405.31 405.32 406.1 406.2 406.3 406.4 406.5 406.6 406.7 406.8 406.9 406.10 406.11 406.12 406.13 406.14 406.15 406.16 406.17 406.18 406.19 406.20 406.21 406.22 406.23 406.24 406.25 406.26 406.27 406.28 406.29 406.30 406.31 406.32 407.1 407.2 407.3 407.4 407.5 407.6 407.7 407.8 407.9 407.10 407.11 407.12 407.13 407.14 407.15 407.16 407.17 407.18 407.19 407.20 407.21 407.22 407.23 407.24 407.25 407.26 407.27 407.28 407.29 407.30
408.1 408.2 408.3 408.4 408.5 408.6 408.7 408.8 408.9 408.10 408.11 408.12 408.13
408.14
408.15 408.16 408.17 408.18 408.19 408.20 408.21 408.22 408.23 408.24 408.25 408.26 408.27 408.28 408.29 408.30 408.31 408.32 408.33 409.1 409.2 409.3 409.4 409.5 409.6 409.7 409.8 409.9 409.10 409.11 409.12 409.13 409.14 409.15 409.16 409.17 409.18 409.19 409.20 409.21 409.22 409.23 409.24 409.25 409.26 409.27 409.28 409.29 409.30 409.31 409.32 409.33 410.1 410.2 410.3 410.4 410.5 410.6 410.7 410.8 410.9 410.10 410.11 410.12 410.13 410.14
410.15 410.16 410.17 410.18 410.19 410.20 410.21 410.22 410.23 410.24 410.25 410.26 410.27 410.28 410.29 410.30 410.31 411.1 411.2 411.3 411.4 411.5 411.6 411.7 411.8 411.9 411.10 411.11 411.12
411.13 411.14 411.15 411.16 411.17 411.18 411.19 411.20 411.21 411.22 411.23 411.24 411.25 411.26 411.27 411.28 411.29 411.30 411.31 411.32 412.1 412.2 412.3 412.4 412.5 412.6 412.7 412.8 412.9 412.10 412.11 412.12 412.13 412.14 412.15 412.16 412.17 412.18 412.19 412.20 412.21 412.22 412.23 412.24 412.25 412.26 412.27 412.28 412.29 412.30 413.1 413.2 413.3 413.4 413.5 413.6 413.7 413.8 413.9 413.10 413.11 413.12 413.13 413.14 413.15 413.16 413.17 413.18 413.19 413.20 413.21 413.22 413.23 413.24 413.25 413.26 413.27 413.28 413.29 413.30 413.31 413.32 414.1 414.2 414.3 414.4 414.5 414.6 414.7 414.8 414.9 414.10 414.11 414.12 414.13
414.14 414.15 414.16 414.17 414.18 414.19 414.20 414.21 414.22 414.23 414.24 414.25 414.26 414.27 414.28 414.29 415.1 415.2 415.3 415.4 415.5 415.6 415.7 415.8 415.9
415.10 415.11 415.12 415.13 415.14 415.15 415.16 415.17 415.18 415.19 415.20 415.21 415.22 415.23 415.24 415.25 415.26 415.27 416.1 416.2 416.3 416.4 416.5
416.6 416.7 416.8 416.9 416.10 416.11 416.12 416.13 416.14 416.15 416.16
416.17 416.18 416.19 416.20 416.21 416.22 416.23 416.24 416.25 416.26 416.27 416.28 416.29 416.30 417.1 417.2
417.3 417.4 417.5 417.6 417.7 417.8 417.9 417.10 417.11 417.12 417.13 417.14 417.15 417.16 417.17 417.18 417.19 417.20 417.21 417.22 417.23 417.24 417.25 417.26 417.27 417.28 417.29 417.30 417.31 417.32 418.1 418.2 418.3 418.4 418.5 418.6 418.7 418.8 418.9 418.10 418.11 418.12 418.13 418.14 418.15 418.16 418.17 418.18 418.19 418.20 418.21 418.22 418.23 418.24 418.25 418.26 418.27 418.28 418.29 418.30 418.31 418.32 418.33 418.34 419.1 419.2 419.3 419.4 419.5 419.6 419.7 419.8 419.9 419.10 419.11 419.12 419.13 419.14 419.15 419.16 419.17 419.18 419.19 419.20 419.21 419.22 419.23 419.24 419.25 419.26 419.27 419.28 419.29 419.30 419.31 419.32 419.33 420.1 420.2 420.3 420.4 420.5 420.6 420.7 420.8 420.9 420.10 420.11 420.12 420.13 420.14 420.15 420.16 420.17 420.18 420.19
420.20 420.21 420.22 420.23 420.24 420.25 420.26 420.27 420.28 420.29 420.30 420.31 420.32 421.1 421.2 421.3 421.4 421.5 421.6 421.7 421.8 421.9 421.10 421.11 421.12 421.13 421.14 421.15 421.16 421.17 421.18 421.19 421.20 421.21 421.22 421.23 421.24 421.25 421.26 421.27 421.28 421.29 421.30 421.31 421.32 422.1 422.2 422.3 422.4 422.5 422.6 422.7 422.8 422.9 422.10 422.11 422.12 422.13 422.14 422.15 422.16 422.17 422.18 422.19 422.20 422.21 422.22 422.23 422.24 422.25 422.26 422.27 422.28 422.29 422.30 422.31 423.1 423.2 423.3 423.4 423.5 423.6 423.7 423.8 423.9 423.10 423.11 423.12 423.13 423.14 423.15 423.16 423.17 423.18 423.19 423.20 423.21 423.22 423.23 423.24 423.25 423.26 423.27 423.28 423.29 423.30 423.31 423.32 423.33 424.1 424.2 424.3 424.4 424.5 424.6 424.7 424.8 424.9 424.10 424.11 424.12 424.13
424.14
424.15 424.16 424.17 424.18 424.19 424.20 424.21 424.22 424.23 424.24 424.25 424.26 424.27 424.28 424.29 424.30 424.31 424.32 425.1 425.2
425.3
425.4 425.5
425.6
425.7 425.8
425.9 425.10 425.11 425.12 425.13 425.14 425.15 425.16 425.17 425.18 425.19 425.20 425.21 425.22 425.23 425.24 425.25 425.26 425.27 425.28 425.29 425.30 425.31 425.32 426.1 426.2 426.3 426.4 426.5 426.6 426.7
426.8 426.9 426.10 426.11 426.12 426.13 426.14 426.15 426.16 426.17 426.18 426.19 426.20 426.21 426.22 426.23 426.24 426.25 426.26 426.27 426.28 426.29 426.30 427.1 427.2 427.3 427.4 427.5 427.6 427.7 427.8 427.9 427.10 427.11 427.12 427.13 427.14 427.15 427.16 427.17 427.18 427.19 427.20 427.21 427.22 427.23 427.24 427.25 427.26 427.27 427.28 427.29 428.1 428.2
428.3 428.4 428.5 428.6
428.7 428.8 428.9 428.10 428.11 428.12 428.13 428.14 428.15 428.16 428.17 428.18 428.19 428.20 428.21 428.22 428.23 428.24 428.25 428.26 428.27 428.28 428.29 428.30 428.31 428.32 429.1 429.2
429.3 429.4 429.5 429.6 429.7 429.8 429.9 429.10 429.11 429.12 429.13 429.14 429.15 429.16 429.17 429.18 429.19 429.20 429.21 429.22 429.23
429.24 429.25 429.26 429.27 429.28 429.29 429.30 429.31 429.32 429.33 430.1 430.2 430.3 430.4 430.5 430.6 430.7 430.8 430.9 430.10 430.11 430.12 430.13 430.14 430.15 430.16 430.17 430.18 430.19 430.20 430.21 430.22 430.23 430.24 430.25 430.26 430.27 430.28 430.29 430.30 430.31 430.32 430.33 430.34 430.35 431.1 431.2 431.3 431.4 431.5 431.6 431.7 431.8 431.9 431.10 431.11 431.12 431.13 431.14 431.15 431.16 431.17 431.18 431.19 431.20 431.21 431.22 431.23 431.24 431.25 431.26 431.27 431.28 431.29 431.30 431.31 431.32 431.33 431.34 432.1 432.2 432.3 432.4 432.5 432.6 432.7 432.8 432.9 432.10 432.11 432.12 432.13 432.14 432.15 432.16 432.17 432.18 432.19 432.20 432.21 432.22
432.23 432.24 432.25 432.26 432.27 432.28 432.29
432.30 432.31 432.32 432.33 433.1 433.2 433.3
433.4 433.5 433.6 433.7 433.8 433.9 433.10 433.11 433.12 433.13 433.14 433.15 433.16 433.17 433.18 433.19 433.20 433.21 433.22 433.23 433.24 433.25
433.26 433.27 433.28 433.29 433.30 433.31 433.32 434.1 434.2 434.3 434.4
434.5 434.6 434.7 434.8 434.9 434.10 434.11 434.12 434.13 434.14 434.15 434.16 434.17 434.18 434.19 434.20 434.21 434.22 434.23 434.24 434.25 434.26 434.27 434.28 434.29
434.30 434.31 434.32 434.33 434.34
435.1 435.2 435.3 435.4 435.5 435.6 435.7 435.8
435.9 435.10 435.11 435.12 435.13 435.14 435.15 435.16 435.17
435.18 435.19 435.20 435.21 435.22 435.23
435.24 435.25 435.26 435.27 435.28 435.29
436.1 436.2 436.3 436.4 436.5 436.6
436.7 436.8 436.9 436.10 436.11 436.12 436.13 436.14 436.15 436.16 436.17 436.18 436.19 436.20 436.21 436.22 436.23 436.24 436.25 436.26 436.27 436.28 436.29 436.30 436.31 437.1 437.2 437.3 437.4 437.5
437.6 437.7 437.8 437.9 437.10 437.11 437.12 437.13 437.14 437.15 437.16 437.17 437.18 437.19 437.20 437.21 437.22 437.23 437.24 437.25 437.26 437.27
437.28 437.29 437.30 437.31 437.32 437.33 438.1 438.2 438.3 438.4 438.5 438.6 438.7
438.8 438.9 438.10 438.11 438.12 438.13
438.14 438.15 438.16 438.17 438.18 438.19 438.20 438.21 438.22 438.23 438.24 438.25 438.26 438.27 438.28 438.29 438.30 438.31 438.32 439.1 439.2 439.3 439.4 439.5 439.6 439.7 439.8 439.9 439.10 439.11 439.12 439.13 439.14 439.15 439.16 439.17 439.18 439.19 439.20 439.21 439.22 439.23 439.24 439.25 439.26 439.27 439.28
439.29 439.30 439.31 439.32 439.33 439.34 439.35 440.1 440.2 440.3 440.4 440.5 440.6 440.7 440.8 440.9 440.10 440.11 440.12 440.13
440.14 440.15 440.16 440.17 440.18 440.19 440.20 440.21 440.22 440.23
440.24 440.25 440.26 440.27 440.28 440.29
440.30 440.31 440.32 441.1 441.2
441.3 441.4 441.5 441.6 441.7 441.8
441.9 441.10 441.11 441.12 441.13 441.14 441.15 441.16
441.17 441.18
441.19 441.20
441.21 441.22 441.23 441.24 441.25 441.26 441.27 441.28 441.29 441.30 442.1 442.2 442.3 442.4 442.5 442.6 442.7 442.8 442.9 442.10 442.11 442.12
442.13 442.14 442.15 442.16 442.17 442.18 442.19 442.20 442.21 442.22 442.23 442.24 442.25
442.26 442.27 442.28 442.29 442.30 442.31 443.1 443.2 443.3 443.4
443.5 443.6 443.7 443.8 443.9 443.10 443.11
443.12 443.13 443.14 443.15 443.16 443.17 443.18 443.19 443.20 443.21 443.22 443.23 443.24 443.25 443.26 443.27 443.28 443.29 443.30 443.31 443.32
444.1 444.2 444.3 444.4 444.5 444.6 444.7 444.8 444.9 444.10 444.11 444.12 444.13 444.14 444.15 444.16 444.17 444.18 444.19 444.20 444.21 444.22 444.23 444.24 444.25 444.26
444.27 444.28 444.29 444.30 444.31 445.1 445.2 445.3 445.4 445.5 445.6 445.7 445.8 445.9 445.10 445.11 445.12 445.13 445.14 445.15 445.16 445.17 445.18 445.19
445.20 445.21 445.22 445.23 445.24 445.25 445.26 445.27 445.28 445.29 445.30 445.31 445.32 446.1 446.2 446.3 446.4 446.5
446.6 446.7 446.8 446.9 446.10 446.11 446.12 446.13 446.14 446.15 446.16 446.17 446.18 446.19 446.20 446.21 446.22 446.23 446.24 446.25 446.26
446.27 446.28 446.29 446.30 446.31 447.1 447.2 447.3 447.4 447.5 447.6 447.7 447.8 447.9 447.10 447.11 447.12 447.13
447.14 447.15 447.16 447.17 447.18 447.19 447.20 447.21 447.22 447.23 447.24 447.25
447.26 447.27 447.28 447.29 447.30 447.31 447.32 448.1 448.2 448.3 448.4 448.5
448.6 448.7 448.8 448.9 448.10 448.11 448.12 448.13 448.14 448.15 448.16 448.17 448.18 448.19 448.20 448.21 448.22 448.23 448.24 448.25 448.26 448.27 448.28 448.29 448.30 448.31 448.32 449.1 449.2 449.3 449.4 449.5 449.6 449.7 449.8 449.9 449.10 449.11 449.12 449.13 449.14 449.15 449.16 449.17 449.18 449.19 449.20 449.21 449.22 449.23 449.24 449.25 449.26 449.27 449.28 449.29 449.30 449.31 449.32 449.33 450.1 450.2 450.3 450.4 450.5 450.6 450.7 450.8 450.9 450.10 450.11 450.12 450.13 450.14 450.15 450.16 450.17 450.18 450.19 450.20 450.21 450.22 450.23 450.24 450.25 450.26 450.27 450.28 450.29 450.30 450.31 450.32 450.33 450.34 451.1 451.2 451.3 451.4 451.5 451.6 451.7 451.8 451.9 451.10 451.11 451.12 451.13 451.14 451.15 451.16 451.17 451.18 451.19 451.20 451.21 451.22 451.23 451.24 451.25 451.26 451.27 451.28 451.29 451.30 451.31 451.32 451.33 451.34 451.35 452.1 452.2 452.3 452.4
452.5 452.6 452.7 452.8 452.9 452.10 452.11 452.12 452.13 452.14 452.15 452.16 452.17 452.18 452.19 452.20 452.21 452.22 452.23 452.24 452.25 452.26 452.27 452.28 452.29 452.30 452.31 453.1 453.2 453.3 453.4 453.5
453.6 453.7 453.8 453.9 453.10 453.11 453.12 453.13 453.14 453.15 453.16 453.17 453.18 453.19 453.20 453.21 453.22 453.23 453.24 453.25
453.26 453.27 453.28 453.29 453.30 453.31 453.32 454.1
454.2 454.3 454.4 454.5 454.6 454.7 454.8 454.9 454.10 454.11 454.12 454.13 454.14 454.15 454.16
454.17 454.18 454.19 454.20 454.21 454.22 454.23 454.24 454.25 454.26 454.27 454.28 454.29 454.30 454.31 454.32 455.1 455.2 455.3 455.4 455.5 455.6 455.7 455.8 455.9 455.10 455.11 455.12 455.13 455.14 455.15 455.16 455.17 455.18 455.19
455.20 455.21 455.22 455.23 455.24 455.25 455.26 455.27 455.28 455.29 455.30 455.31 455.32 455.33 456.1 456.2 456.3 456.4 456.5 456.6
456.7 456.8 456.9 456.10 456.11 456.12 456.13 456.14 456.15 456.16 456.17 456.18 456.19 456.20 456.21 456.22 456.23 456.24 456.25 456.26 456.27 456.28 456.29 456.30 456.31 456.32 457.1 457.2 457.3 457.4 457.5 457.6 457.7 457.8 457.9 457.10 457.11 457.12 457.13 457.14 457.15 457.16 457.17 457.18 457.19 457.20 457.21 457.22 457.23 457.24 457.25 457.26 457.27 457.28 457.29 457.30 457.31 458.1
458.2 458.3 458.4 458.5 458.6 458.7 458.8 458.9 458.10 458.11 458.12
458.13 458.14 458.15 458.16 458.17 458.18 458.19 458.20 458.21 458.22
458.23 458.24 458.25 458.26 458.27 458.28 458.29 458.30 458.31 458.32 459.1 459.2 459.3 459.4 459.5 459.6 459.7 459.8
459.9 459.10 459.11 459.12 459.13 459.14 459.15 459.16 459.17 459.18 459.19 459.20 459.21 459.22 459.23 459.24 459.25 459.26 459.27 459.28 459.29 459.30 459.31 459.32 459.33 460.1 460.2 460.3 460.4 460.5 460.6 460.7 460.8 460.9 460.10 460.11 460.12
460.13 460.14 460.15 460.16 460.17
460.18 460.19 460.20 460.21 460.22 460.23 460.24 460.25 460.26 460.27 460.28 460.29 460.30 460.31 460.32 460.33 461.1 461.2 461.3 461.4 461.5 461.6 461.7 461.8 461.9 461.10 461.11 461.12 461.13 461.14 461.15 461.16 461.17 461.18 461.19 461.20 461.21 461.22 461.23 461.24 461.25 461.26 461.27 461.28 461.29 461.30 461.31
462.1 462.2 462.3 462.4 462.5 462.6 462.7 462.8 462.9 462.10 462.11
462.12 462.13 462.14 462.15 462.16 462.17 462.18
462.19 462.20 462.21 462.22 462.23 462.24 462.25 462.26 462.27 462.28 462.29 462.30 462.31 463.1 463.2 463.3
463.4 463.5 463.6 463.7 463.8 463.9 463.10 463.11 463.12 463.13 463.14 463.15 463.16
463.17 463.18 463.19 463.20 463.21 463.22 463.23 463.24 463.25 463.26 463.27
463.28 463.29 463.30 463.31 464.1 464.2 464.3 464.4 464.5 464.6
464.7 464.8 464.9 464.10 464.11
464.12 464.13 464.14 464.15 464.16 464.17 464.18 464.19 464.20 464.21 464.22 464.23 464.24 464.25 464.26 464.27 464.28 464.29 464.30 464.31 464.32 465.1 465.2 465.3 465.4 465.5 465.6 465.7 465.8 465.9 465.10 465.11 465.12 465.13 465.14 465.15 465.16 465.17 465.18 465.19 465.20 465.21 465.22 465.23 465.24 465.25 465.26 465.27 465.28 465.29 465.30 465.31 466.1 466.2 466.3 466.4 466.5 466.6 466.7 466.8 466.9 466.10 466.11 466.12 466.13 466.14 466.15 466.16 466.17 466.18 466.19 466.20 466.21 466.22 466.23 466.24 466.25 466.26 466.27 466.28 466.29 466.30 466.31 467.1 467.2 467.3 467.4 467.5 467.6 467.7 467.8 467.9 467.10 467.11 467.12 467.13 467.14 467.15 467.16 467.17 467.18 467.19
467.20 467.21 467.22 467.23 467.24 467.25 467.26 467.27 467.28 467.29 467.30 467.31 467.32 467.33 468.1 468.2 468.3 468.4 468.5 468.6 468.7 468.8 468.9 468.10 468.11 468.12 468.13 468.14 468.15 468.16 468.17 468.18 468.19 468.20 468.21 468.22 468.23 468.24 468.25 468.26 468.27 468.28 468.29 468.30 468.31 468.32 469.1 469.2 469.3 469.4 469.5 469.6 469.7 469.8 469.9 469.10 469.11 469.12 469.13 469.14 469.15 469.16 469.17 469.18 469.19 469.20 469.21 469.22 469.23 469.24 469.25 469.26 469.27 469.28 469.29 469.30 469.31 469.32 469.33 469.34 470.1 470.2 470.3
470.4 470.5 470.6 470.7 470.8
470.9 470.10 470.11
470.12 470.13 470.14 470.15 470.16 470.17 470.18 470.19 470.20 470.21 470.22 470.23 470.24
470.25 470.26 470.27 470.28 470.29 470.30 470.31 470.32 470.33 471.1 471.2 471.3 471.4 471.5 471.6 471.7 471.8 471.9 471.10 471.11 471.12 471.13 471.14 471.15 471.16 471.17 471.18 471.19 471.20 471.21 471.22
471.23
471.24 471.25 471.26 471.27 471.28 471.29 471.30 471.31 472.1 472.2 472.3 472.4 472.5 472.6 472.7 472.8 472.9 472.10 472.11 472.12 472.13 472.14 472.15 472.16 472.17 472.18 472.19 472.20 472.21 472.22 472.23 472.24 472.25 472.26 472.27 472.28 472.29 472.30 472.31 472.32 472.33 472.34 472.35 473.1 473.2 473.3 473.4 473.5 473.6 473.7 473.8 473.9 473.10 473.11 473.12 473.13 473.14 473.15 473.16 473.17 473.18 473.19
473.20
473.21 473.22 473.23 473.24 473.25 473.26 473.27 473.28 473.29 473.30 473.31 473.32 473.33 473.34 474.1 474.2 474.3 474.4 474.5 474.6 474.7 474.8 474.9 474.10 474.11 474.12 474.13 474.14
474.15
474.16 474.17 474.18 474.19 474.20 474.21 474.22 474.23 474.24 474.25 474.26 474.27 474.28 474.29 474.30 474.31 474.32 474.33 474.34 474.35 475.1 475.2 475.3 475.4 475.5 475.6 475.7 475.8 475.9 475.10 475.11 475.12 475.13 475.14 475.15 475.16 475.17 475.18 475.19 475.20 475.21
475.22
475.23 475.24 475.25 475.26 475.27 475.28 475.29 475.30 475.31 475.32 475.33 476.1 476.2
476.3
476.4 476.5 476.6 476.7 476.8 476.9 476.10 476.11 476.12 476.13
476.14
476.15 476.16 476.17 476.18 476.19 476.20 476.21 476.22 476.23 476.24 476.25 476.26 476.27 476.28 476.29 476.30 477.1 477.2 477.3 477.4 477.5
477.6
477.7 477.8 477.9 477.10 477.11 477.12 477.13 477.14 477.15 477.16 477.17 477.18
477.19
477.20 477.21 477.22 477.23 477.24 477.25 477.26 477.27 477.28 477.29 477.30 478.1 478.2 478.3
478.4
478.5 478.6 478.7 478.8 478.9 478.10 478.11 478.12 478.13 478.14
478.15
478.16 478.17 478.18 478.19 478.20 478.21 478.22 478.23 478.24 478.25 478.26 478.27 478.28 478.29 478.30
479.1
479.2 479.3
479.4 479.5 479.6 479.7 479.8 479.9 479.10 479.11 479.12 479.13 479.14 479.15 479.16 479.17 479.18 479.19
479.20 479.21 479.22 479.23 479.24 479.25 479.26 479.27 479.28 479.29 479.30 479.31 479.32 480.1 480.2 480.3 480.4 480.5 480.6 480.7 480.8 480.9 480.10 480.11 480.12 480.13 480.14 480.15 480.16 480.17 480.18 480.19 480.20 480.21 480.22 480.23 480.24 480.25 480.26 480.27 480.28 480.29 480.30 480.31 480.32 480.33 481.1 481.2 481.3 481.4 481.5 481.6 481.7 481.8 481.9 481.10 481.11 481.12 481.13 481.14 481.15 481.16 481.17 481.18 481.19 481.20 481.21 481.22 481.23 481.24 481.25 481.26 481.27 481.28 481.29 481.30 481.31 481.32 481.33 481.34 482.1 482.2 482.3 482.4 482.5 482.6 482.7 482.8 482.9 482.10 482.11 482.12 482.13 482.14 482.15 482.16 482.17 482.18 482.19 482.20 482.21 482.22 482.23 482.24 482.25 482.26 482.27 482.28 482.29 482.30 482.31 482.32 482.33 482.34 482.35 483.1 483.2 483.3 483.4 483.5 483.6 483.7 483.8 483.9 483.10 483.11 483.12 483.13 483.14 483.15 483.16 483.17 483.18 483.19 483.20 483.21 483.22 483.23 483.24 483.25 483.26 483.27 483.28 483.29 483.30 483.31 483.32 483.33 483.34 483.35 484.1 484.2 484.3 484.4 484.5 484.6 484.7 484.8 484.9 484.10 484.11 484.12 484.13 484.14 484.15 484.16 484.17 484.18 484.19 484.20 484.21
484.22 484.23 484.24 484.25 484.26 484.27 484.28 484.29 484.30 484.31 484.32 484.33 484.34 485.1 485.2 485.3 485.4 485.5 485.6 485.7 485.8 485.9 485.10 485.11 485.12 485.13 485.14 485.15 485.16 485.17 485.18 485.19 485.20 485.21 485.22 485.23 485.24 485.25 485.26 485.27 485.28 485.29 485.30 485.31
485.32 485.33 486.1 486.2 486.3 486.4 486.5 486.6 486.7 486.8 486.9 486.10 486.11 486.12 486.13 486.14 486.15 486.16 486.17 486.18 486.19
486.20 486.21 486.22 486.23 486.24 486.25 486.26 486.27 486.28 486.29
486.30 486.31 486.33 486.32 487.1 487.2 487.4 487.3 487.5 487.6 487.7 487.8 487.9 487.10 487.11 487.12 487.13 487.14
487.15 487.16 487.17 487.18 487.19 487.20 487.21 487.22 487.23 487.24 487.25 487.26 487.27 487.28 487.29 487.30
487.31 487.32 487.34 487.33 488.1 488.2 488.3 488.4 488.5 488.6 488.7 488.8 488.9 488.10 488.11 488.12 488.13 488.14 488.15 488.16 488.17 488.18 488.19 488.20 488.21 488.22 488.23 488.24 488.25 488.26 488.27 488.28 488.29 488.30 488.31 488.32 488.33 488.34 489.1 489.2 489.3 489.4 489.5 489.6 489.7 489.8 489.9 489.10 489.11 489.12 489.13 489.14 489.15 489.16 489.17 489.18 489.19 489.20 489.21 489.22 489.23 489.24
489.25 489.26 489.27 489.28 489.29 489.30 489.31 489.32 489.33 490.1 490.2 490.3 490.4 490.5 490.6 490.7 490.8 490.9 490.10 490.11 490.12 490.13 490.14 490.15 490.16 490.17 490.18 490.19 490.20 490.21 490.22 490.23 490.24 490.25 490.26 490.27 490.28 490.29 490.30 490.31 490.32 490.33 490.34 491.1 491.2
491.3 491.4 491.5 491.6 491.7 491.8 491.9 491.10 491.11 491.12 491.13 491.14 491.15 491.16 491.17 491.18 491.19 491.20 491.21 491.22 491.23 491.24 491.25 491.26 491.27 491.28 491.29 491.30 491.31 491.32 491.33 491.34 492.1 492.2 492.3 492.4 492.5 492.6 492.7 492.8
492.9 492.10 492.11 492.12 492.13 492.14 492.15 492.16 492.17 492.18 492.19 492.20 492.21 492.22 492.23 492.24 492.25 492.26 492.27 492.28 492.29 492.30 492.31 492.32 492.33 493.1 493.2 493.3 493.4 493.5 493.6 493.7 493.8 493.9 493.10 493.11 493.12 493.13 493.14 493.15 493.16 493.17 493.18 493.19 493.20 493.21 493.22 493.23 493.24 493.25 493.26 493.27 493.28
493.29
494.1 494.2 494.3 494.4 494.5

A bill for an act
relating to health and human services; modifying provisions governing community
supports, continuing care for older adults, human services operations and licensing,
health care, behavioral health, children and family services, health, health-related
licensing boards, scope of practice, and background studies; establishing a
Department of Behavioral Health; establishing certain grants; establishing interstate
compacts for nurses, audiologists and speech language pathologists, and licensed
professional counselors; modifying the expiration dates and repealing certain
mandated reports; expanding and renaming the higher education facilities authority
to include nonprofit health care organizations; making human services forecast
adjustments; appropriating money; requiring reports; amending Minnesota Statutes
2020, sections 3.732, subdivision 1; 13.46, subdivision 7; 15A.0815, subdivision
2; 62J.692, subdivision 5; 62N.25, subdivision 5; 62Q.1055; 62Q.37, subdivision
7; 62Q.47; 103I.005, subdivisions 17a, 20a, by adding a subdivision; 136A.25;
136A.26; 136A.27; 136A.28; 136A.29, subdivisions 1, 3, 6, 9, 10, 14, 19, 20, 21,
22, by adding a subdivision; 136A.32, subdivision 4; 136A.33; 136A.34,
subdivisions 3, 4; 136A.36; 136A.38; 136A.41; 136A.42; 136F.67, subdivision
1; 137.68; 144.051, subdivision 6; 144.057, subdivision 1; 144.1222, subdivision
2d; 144.193; 144.294, subdivision 2; 144.4199, subdivision 8; 144.497; 144A.10,
subdivision 17; 144A.351, subdivision 1; 144A.483, subdivision 1; 144A.75,
subdivision 12; 144E.01, subdivisions 1, 4; 144E.35; 144G.45, subdivisions 6, 7;
145.4134; 145.4716, by adding a subdivision; 145.928, subdivision 13; 147.01,
subdivision 7; 147.03, subdivisions 1, 2; 147.037; 147A.28; 147C.15, subdivision
3; 147C.40, subdivision 5; 148.212, subdivision 1; 148F.11, by adding a
subdivision; 150A.10, subdivision 1a; 150A.105, subdivision 8; 151.01, subdivision
27; 151.065, subdivisions 1, 3, 7; 152.125; 169A.70, subdivisions 3, 4; 242.19,
subdivision 2; 245.4661, subdivision 10; 245.4889, subdivision 3, by adding a
subdivision; 245A.11, subdivisions 2, 2a, 7, 7a, by adding a subdivision; 245A.14,
subdivision 14; 245A.19; 245C.02, subdivision 17a, by adding a subdivision;
245C.04, subdivisions 1, 4a, by adding subdivisions; 245C.10, by adding
subdivisions; 245C.31, subdivisions 1, 2, by adding a subdivision; 245D.10,
subdivision 3a; 245D.12; 245F.03; 245F.04, subdivision 1; 245G.01, by adding a
subdivision; 245G.05, subdivision 2; 245G.06, subdivision 3, by adding a
subdivision; 245G.07, subdivision 1; 245G.08, subdivision 3; 245G.12; 245G.21,
by adding a subdivision; 245G.22, subdivision 2; 252.275, subdivisions 4c, 8;
253B.18, subdivision 6; 254A.19, subdivisions 1, 3, by adding subdivisions;
254B.01, subdivision 5, by adding subdivisions; 254B.03, subdivisions 1, 5;
254B.04, subdivision 2a, by adding subdivisions; 254B.05, subdivision 1; 256.01,
subdivision 29, by adding a subdivision; 256.021, subdivision 3; 256.042,
subdivision 5; 256.045, subdivision 3; 256.9657, subdivision 8; 256.975,
subdivisions 11, 12; 256B.0561, subdivision 4; 256B.057, subdivision 9;
256B.0625, subdivisions 17a, 39; 256B.0659, subdivisions 1, 12, 19, 24;
256B.0757, subdivisions 1, 2, 3, 4, 5, 8; 256B.0911, subdivision 5; 256B.0949,
subdivisions 8, 17; 256B.49, subdivisions 13, 15, 23; 256B.4911, subdivisions 3,
4, by adding a subdivision; 256B.4914, subdivisions 3, as amended, 4, as amended,
8, as amended, 9, as amended, 10, as amended, 10a, as amended, 12, as amended,
14, as amended; 256B.493, subdivisions 2, 4, 5, 6, by adding subdivisions;
256B.5012, by adding subdivisions; 256B.69, subdivision 9d; 256B.85, by adding
a subdivision; 256D.0515; 256D.09, subdivision 2a; 256E.28, subdivision 6;
256E.33, subdivisions 1, 2; 256E.35, subdivisions 1, 2, 4a, 6, 7; 256G.02,
subdivision 6; 256I.04, subdivision 3; 256I.05, by adding a subdivision; 256K.26,
subdivisions 2, 6, 7; 256K.45, subdivision 6, by adding subdivisions; 256L.12,
subdivision 8; 256N.26, subdivision 12; 256P.02, by adding a subdivision; 256P.03,
subdivision 2; 256P.04, subdivision 11; 256Q.06, by adding a subdivision; 256R.02,
subdivisions 16, 24, 26, 29, 34, by adding subdivisions; 256R.18; 256R.23,
subdivisions 2, 3; 256R.24, subdivision 1; 256R.25; 256S.16; 257.0725; 260.012;
260.775; 260B.157, subdivisions 1, 3; 260B.331, subdivision 1; 260C.001,
subdivision 3; 260C.007, subdivision 27; 260C.151, subdivision 6; 260C.152,
subdivision 5; 260C.175, subdivision 2; 260C.176, subdivision 2; 260C.178,
subdivision 1; 260C.181, subdivision 2; 260C.193, subdivision 3; 260C.201,
subdivisions 1, 2; 260C.202; 260C.203; 260C.204; 260C.212, subdivision 4a;
260C.221; 260C.331, subdivision 1; 260C.513; 260C.607, subdivisions 2, 5;
260C.613, subdivisions 1, 5; 260E.20, subdivision 1; 260E.22, subdivision 2;
260E.24, subdivisions 2, 6; 260E.38, subdivision 3; 268.19, subdivision 1;
297E.021, subdivision 3; 299A.299, subdivision 1; 354B.20, subdivision 7;
477A.0126, subdivision 7, by adding a subdivision; 518A.43, subdivision 1;
518A.77; 626.557, subdivision 12b; 626.5571, subdivision 1; Minnesota Statutes
2021 Supplement, sections 10A.01, subdivision 35; 15.01; 15.06, subdivision 1;
43A.08, subdivision 1a; 62A.673, subdivision 2; 144.551, subdivision 1; 144G.45,
subdivisions 4, 5; 144G.81, subdivision 3; 148F.11, subdivision 1; 245.467,
subdivisions 2, 3; 245.4871, subdivision 21; 245.4876, subdivisions 2, 3; 245.4889,
subdivision 1; 245.735, subdivision 3; 245A.03, subdivision 7; 245C.03, subdivision
5a, by adding subdivisions; 245C.05, subdivision 5; 245I.02, subdivisions 19, 36;
245I.03, subdivision 9; 245I.04, subdivision 4; 245I.05, subdivision 3; 245I.08,
subdivision 4; 245I.09, subdivision 2; 245I.10, subdivisions 2, 6; 245I.20,
subdivision 5; 245I.23, subdivision 22; 254A.03, subdivision 3; 254A.19,
subdivision 4; 254B.03, subdivision 2; 254B.04, subdivision 1; 254B.05,
subdivisions 4, 5; 256.01, subdivision 42; 256.042, subdivision 4; 256B.0371,
subdivision 4; 256B.0622, subdivision 2; 256B.0625, subdivisions 3b, 10, 17;
256B.0659, subdivision 17a; 256B.0671, subdivision 6; 256B.0911, subdivisions
3a, 3f; 256B.0946, subdivision 1; 256B.0947, subdivisions 2, 6; 256B.0949,
subdivisions 2, 13; 256B.49, subdivision 28; 256B.4914, subdivision 5, as amended;
256B.69, subdivision 9f; 256B.85, subdivisions 7, 7a; 256B.851, subdivision 5;
256L.03, subdivision 2; 256P.01, subdivision 6a; 256P.02, subdivisions 1a, 2;
256P.06, subdivision 3; 256S.205; 256S.2101; 260C.157, subdivision 3; 260C.212,
subdivisions 1, 2; 260C.605, subdivision 1; 260C.607, subdivision 6; 260E.20,
subdivision 2; 297E.02, subdivision 3; Laws 2009, chapter 79, article 13, section
3, subdivision 10, as amended; Laws 2014, chapter 312, article 27, section 75;
Laws 2020, First Special Session chapter 7, section 1, subdivision 1, as amended;
Laws 2021, First Special Session chapter 7, article 2, section 74, by adding a
subdivision; article 10, sections 1; 3; article 11, section 38; article 14, section 21,
subdivision 4; article 16, sections 2, subdivisions 1, 24, 29, 31, 33; 5; article 17,
sections 3; 6; 10; 11; 12; 14; 17, subdivision 3; 19; Laws 2021, First Special Session
chapter 8, article 6, section 1, subdivision 7; Laws 2022, chapter 33, section 1,
subdivisions 5a, 5b, 5c, 5d, 5e, 5f, 10c; by adding a subdivision; Laws 2022,
chapter 40, sections 6; 7; proposing coding for new law in Minnesota Statutes,
chapters 103I; 144G; 145; 147A; 148; 148B; 151; 245A; 245D; 254A; 256; 256B;
626; proposing coding for new law as Minnesota Statutes, chapter 256T; repealing
Minnesota Statutes 2020, sections 62U.10, subdivision 3; 136A.29, subdivision
4; 144.1911, subdivision 10; 144.564, subdivision 3; 144A.483, subdivision 2;
147.02, subdivision 2a; 169A.70, subdivision 6; 245.981; 245G.22, subdivision
19; 246.0136; 246.131; 246B.03, subdivision 2; 246B.035; 252.025, subdivision
7; 252.035; 254A.02, subdivision 8a; 254A.04; 254A.16, subdivision 6; 254A.19,
subdivisions 1a, 2; 254A.21; 254B.04, subdivisions 2b, 2c; 254B.041, subdivision
2; 254B.14, subdivisions 1, 2, 3, 4, 6; 256.01, subdivision 31; 256B.0638,
subdivision 7; Minnesota Statutes 2021 Supplement, sections 254A.19, subdivision
5; 254B.14, subdivision 5; Laws 1998, chapter 382, article 1, section 23; Laws
2022, chapter 33, section 1, subdivision 9a; Minnesota Rules, parts 9530.7000,
subparts 1, 2, 5, 6, 7, 8, 9, 10, 11, 13, 14, 15, 17a, 19, 20, 21; 9530.7005; 9530.7010;
9530.7012; 9530.7015, subparts 1, 2a, 4, 5, 6; 9530.7020, subparts 1, 1a, 2;
9530.7021; 9530.7022, subpart 1; 9530.7025; 9530.7030, subpart 1.

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

ARTICLE 1

COMMUNITY SUPPORTS

Section 1.

Minnesota Statutes 2020, section 252.275, subdivision 4c, is amended to read:


Subd. 4c.

Review of funds; reallocation.

new text begin(a) new text endAfter each quarter, the commissioner shall
review county program expenditures. The commissioner may reallocate unexpended money
at any time among those counties which have earned their full allocation.

new text begin (b) For each fiscal year, the commissioner shall determine if actual statewide expenditures
by county boards are less than the fiscal year appropriation to provide semi-independent
living services under this section. If actual statewide expenditures by county boards are less
than the fiscal year appropriation to provide semi-independent living services under this
section, the unexpended amount must be carried forward to the next fiscal year and allocated
to grants in equal amounts to the eight organizations defined in section 268A.01, subdivision
8, to expand services to support people with disabilities who are ineligible for medical
assistance to live in their own homes and communities by providing accessibility
modifications, independent living services, and public health program facilitation.
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.

Minnesota Statutes 2020, section 252.275, subdivision 8, is amended to read:


Subd. 8.

Use of federal funds and transfer of funds to medical assistance.

deleted text begin(a)deleted text end The
commissioner shall make every reasonable effort to maximize the use of federal funds for
semi-independent living services.

deleted text begin (b) The commissioner shall reduce the payments to be made under this section to each
county from January 1, 1994, to June 30, 1996, by the amount of the state share of medical
assistance reimbursement for services other than residential services provided under the
home and community-based waiver program under section 256B.092 from January 1, 1994
to June 30, 1996, for clients for whom the county is financially responsible and who have
been transferred by the county from the semi-independent living services program to the
home and community-based waiver program. Unless otherwise specified, all reduced amounts
shall be transferred to the medical assistance state account.
deleted text end

deleted text begin (c) For fiscal year 1997, the base appropriation available under this section shall be
reduced by the amount of the state share of medical assistance reimbursement for services
other than residential services provided under the home and community-based waiver
program authorized in section 256B.092 from January 1, 1995, to December 31, 1995, for
persons who have been transferred from the semi-independent living services program to
the home and community-based waiver program. The base appropriation for the medical
assistance state account shall be increased by the same amount.
deleted text end

deleted text begin (d) For purposes of calculating the guaranteed floor under subdivision 4b and to establish
the calendar year 1996 allocations, each county's original allocation for calendar year 1995
shall be reduced by the amount transferred to the state medical assistance account under
paragraph (b) during the six months ending on June 30, 1995. For purposes of calculating
the guaranteed floor under subdivision 4b and to establish the calendar year 1997 allocations,
each county's original allocation for calendar year 1996 shall be reduced by the amount
transferred to the state medical assistance account under paragraph (b) during the six months
ending on December 31, 1995.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 3.

new text begin [256.4791] COMMUNITY ORGANIZATIONS GRANT PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The commissioner of human services shall establish the
community organizations grant program to address violence prevention and provide street
outreach services.
new text end

new text begin Subd. 2. new text end

new text begin Applications. new text end

new text begin Organizations seeking grants under this section shall apply to
the commissioner. The grant applicant must include a description of the project that the
applicant is proposing, the amount of money that the applicant is seeking, and a proposed
budget describing how the applicant will spend the grant money.
new text end

new text begin Subd. 3. new text end

new text begin Eligible applicants. new text end

new text begin To be eligible for a grant under this section, applicants
must address violence prevention, connect with youth and community members, and provide
street outreach services. Applicants must also be focused on prevention, intervention, and
restorative practices within the community, which may include:
new text end

new text begin (1) providing trauma-responsive care; and
new text end

new text begin (2) access to individual and group therapy services or community healing.
new text end

new text begin Subd. 4. new text end

new text begin Use of grant money. new text end

new text begin Grant recipients must use the funds to address violence
prevention, connect with youth and community members, and provide street outreach
services.
new text end

new text begin Subd. 5. new text end

new text begin Reporting. new text end

new text begin Grant recipients must provide an annual report to the commissioner
in a manner specified by the commissioner on the activities and outcomes of the project
funded by the grant program.
new text end

Sec. 4.

new text begin [256.4792] EMPLOYMENT FOR PERSONS EXPERIENCING
HOMELESSNESS OR SUBSTANCE USE DISORDER.
new text end

new text begin (a) Nonprofit organizations, licensed providers, and other entities that receive funding
from the commissioner of human services to address homelessness or provide services to
individuals experiencing homelessness must incorporate into their program the facilitation
of full- or part-time employment and provide or make available employment services for
each client to the extent appropriate for each client.
new text end

new text begin (b) Nonprofit organizations, licensed providers, and other entities that receive funding
from the commissioner of human services to provide substance use disorder services or
treatment must incorporate into their program the facilitation of full- or part-time employment
and provide or make available employment services for each client to the extent appropriate
for each client.
new text end

Sec. 5.

new text begin [256.4795] RESIDENTIAL SETTING CLOSURE PREVENTION GRANTS.
new text end

new text begin Subdivision 1. new text end

new text begin Residential setting closure prevention grants established. new text end

new text begin The
commissioner of human services shall establish a grant program to reduce the risk of
residential settings in financial distress from closing. The commissioner shall limit
expenditures under this subdivision to the amount appropriated for this purpose.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) For the purposes of this section, the terms in this subdivision
have the meaning given them.
new text end

new text begin (b) "At risk of closure" or "at risk of closing" means a residential setting is in significant
financial distress, and, in the judgment of the commissioner, the setting will close without
additional funding from the commissioner.
new text end

new text begin (c) "Residential setting" means any of the following: a nursing facility; an assisted living
facility with a majority of residents receiving services funded by medical assistance; a setting
exempt from assisted living facility licensure under section 144G.08, subdivision 7, clauses
(10) to (13), with a majority of residents receiving services funded by medical assistance;
an intermediate care facility for persons with developmental disabilities; or an adult foster
care setting, a community residential setting, or an integrated community supports setting.
new text end

new text begin Subd. 3. new text end

new text begin Eligibility. new text end

new text begin (a) A license holder operating a residential setting in significant
financial distress may apply to the commissioner for a grant under this section to relieve its
immediate financial distress.
new text end

new text begin (b) Lead agencies that suspect a residential setting is in significant financial distress may
refer the license holder to the commissioner for consideration by the commissioner for grant
funding under this section. Upon a referral from a lead agency under this section, the
commissioner shall immediately solicit an application from the license holder, providing
individualized technical assistance to the license holder regarding the application process.
new text end

new text begin (c) The commissioner must give priority for closure prevention grants to residential
settings that are the most significantly at risk of closing in violation of the applicable notice
requirements prior to the termination of services.
new text end

new text begin Subd. 4. new text end

new text begin Criteria and limitations. new text end

new text begin (a) Within available appropriations for this purpose,
the commissioner must award sufficient funding to a residential setting at risk of closure to
ensure that the residential setting remains open long enough to comply with the applicable
termination of services notification requirements.
new text end

new text begin (b) The commissioner may award additional funding to a residential setting at risk of
closure if, in the judgment of the commissioner, the residential setting is likely to remain
open and financially viable after receiving time-limited additional funding from the
commissioner.
new text end

new text begin (c) Before receiving any additional funding under paragraph (b), grantees must work
with the commissioner to develop a business plan and corrective action plan to reduce the
risk of future financial distress. No residential setting may receive additional funding under
paragraph (b) more than once.
new text end

new text begin Subd. 5. new text end

new text begin Interagency coordination. new text end

new text begin The commissioner must coordinate the grant
activities under this section with any other impacted state agencies and lead agencies.
new text end

new text begin Subd. 6. new text end

new text begin Administrative funding. new text end

new text begin The commissioner may use up to 6.5 percent of the
grant amounts awarded for the commissioner's costs related to administration of this program.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 6.

Minnesota Statutes 2020, section 256B.0659, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

(a) For the purposes of this section, the terms defined in
paragraphs (b) to (r) have the meanings given unless otherwise provided in text.

(b) "Activities of daily living" means grooming, dressing, bathing, transferring, mobility,
positioning, eating, and toileting.

(c) "Behavior," effective January 1, 2010, means a category to determine the home care
rating and is based on the criteria found in this section. "Level I behavior" means physical
aggression deleted text begintowardsdeleted text endnew text begin towardnew text end self, others, or destruction of property that requires the immediate
response of another person.

(d) "Complex health-related needs," effective January 1, 2010, means a category to
determine the home care rating and is based on the criteria found in this section.

(e) "Critical activities of daily living," effective January 1, 2010, means transferring,
mobility, eating, and toileting.

(f) "Dependency in activities of daily living" means a person requires assistance to begin
and complete one or more of the activities of daily living.

(g) "Extended personal care assistance service" means personal care assistance services
included in a service plan under one of the home and community-based services waivers
authorized under chapter 256S and sections 256B.092, subdivision 5, and 256B.49, which
exceed the amount, duration, and frequency of the state plan personal care assistance services
for participants who:

(1) need assistance provided periodically during a week, but less than daily will not be
able to remain in their homes without the assistance, and other replacement services are
more expensive or are not available when personal care assistance services are to be reduced;
or

(2) need additional personal care assistance services beyond the amount authorized by
the state plan personal care assistance assessment in order to ensure that their safety, health,
and welfare are provided for in their homes.

(h) "Health-related procedures and tasks" means procedures and tasks that can be
delegated or assigned by a licensed health care professional under state law to be performed
by a personal care assistant.

(i) "Instrumental activities of daily living" means activities to include meal planning and
preparation; basic assistance with paying bills; shopping for food, clothing, and other
essential items; performing household tasks integral to the personal care assistance services;
communication by telephone and other media; and traveling, including to medical
appointments and to participate in the community.new text begin For purposes of this paragraph, traveling
includes driving and accompanying the recipient in the recipient's chosen mode of
transportation and according to the recipient's personal care assistance care plan.
new text end

(j) "Managing employee" has the same definition as Code of Federal Regulations, title
42, section 455.

(k) "Qualified professional" means a professional providing supervision of personal care
assistance services and staff as defined in section 256B.0625, subdivision 19c.

(l) "Personal care assistance provider agency" means a medical assistance enrolled
provider that provides or assists with providing personal care assistance services and includes
a personal care assistance provider organization, personal care assistance choice agency,
class A licensed nursing agency, and Medicare-certified home health agency.

(m) "Personal care assistant" or "PCA" means an individual employed by a personal
care assistance agency who provides personal care assistance services.

(n) "Personal care assistance care plan" means a written description of personal care
assistance services developed by the personal care assistance provider according to the
service plan.

(o) "Responsible party" means an individual who is capable of providing the support
necessary to assist the recipient to live in the community.

(p) "Self-administered medication" means medication taken orally, by injection, nebulizer,
or insertion, or applied topically without the need for assistance.

(q) "Service plan" means a written summary of the assessment and description of the
services needed by the recipient.

(r) "Wages and benefits" means wages and salaries, the employer's share of FICA taxes,
Medicare taxes, state and federal unemployment taxes, workers' compensation, mileage
reimbursement, health and dental insurance, life insurance, disability insurance, long-term
care insurance, uniform allowance, and contributions to employee retirement accounts.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective within 90 days following federal approval.
The commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

Sec. 7.

Minnesota Statutes 2020, section 256B.0659, subdivision 12, is amended to read:


Subd. 12.

Documentation of personal care assistance services provided.

(a) Personal
care assistance services for a recipient must be documented daily by each personal care
assistant, on a time sheet form approved by the commissioner. All documentation may be
web-based, electronic, or paper documentation. The completed form must be submitted on
a monthly basis to the provider and kept in the recipient's health record.

(b) The activity documentation must correspond to the personal care assistance care plan
and be reviewed by the qualified professional.

(c) The personal care assistant time sheet must be on a form approved by the
commissioner documenting time the personal care assistant provides services in the home.
The following criteria must be included in the time sheet:

(1) full name of personal care assistant and individual provider number;

(2) provider name and telephone numbers;

(3) full name of recipient and either the recipient's medical assistance identification
number or date of birth;

(4) consecutive dates, including month, day, and year, and arrival and departure times
with a.m. or p.m. notations;

(5) signatures of recipient or the responsible party;

(6) personal signature of the personal care assistant;

(7) any shared care provided, if applicable;

(8) a statement that it is a federal crime to provide false information on personal care
service billings for medical assistance payments; deleted text beginand
deleted text end

(9) dates and location of recipient stays in a hospital, care facility, or incarcerationnew text begin; and
new text end

new text begin (10) any time spent traveling, as described in subdivision 1, paragraph (i), including
start and stop times with a.m. and p.m. designations, the origination site, and the destination
site
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective within 90 days following federal approval.
The commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

Sec. 8.

Minnesota Statutes 2021 Supplement, section 256B.0659, subdivision 17a, is
amended to read:


Subd. 17a.

Enhanced rate.

An enhanced rate of deleted text begin107.5deleted text endnew text begin 143new text end percent of the rate paid for
personal care assistance services shall be paid for services provided to persons who qualify
for ten or more hours of personal care assistance services per day when provided by a
personal care assistant who meets the requirements of subdivision 11, paragraph (d). Any
change in the eligibility criteria for the enhanced rate for personal care assistance services
as described in this subdivision and referenced in subdivision 11, paragraph (d), does not
constitute a change in a term or condition for individual providers as defined in section
256B.0711, and is not subject to the state's obligation to meet and negotiate under chapter
179A.

Sec. 9.

Minnesota Statutes 2020, section 256B.0659, subdivision 19, is amended to read:


Subd. 19.

Personal care assistance choice option; qualifications; duties.

(a) Under
personal care assistance choice, the recipient or responsible party shall:

(1) recruit, hire, schedule, and terminate personal care assistants according to the terms
of the written agreement required under subdivision 20, paragraph (a);

(2) develop a personal care assistance care plan based on the assessed needs and
addressing the health and safety of the recipient with the assistance of a qualified professional
as needed;

(3) orient and train the personal care assistant with assistance as needed from the qualified
professional;

(4) deleted text begineffective January 1, 2010,deleted text end supervise and evaluate the personal care assistant with the
qualified professional, who is required to visit the recipient at least every 180 days;

(5) monitor and verify in writing and report to the personal care assistance choice agency
the number of hours worked by the personal care assistant and the qualified professional;

(6) engage in an annual face-to-face reassessment to determine continuing eligibility
and service authorization; deleted text beginand
deleted text end

(7) use the same personal care assistance choice provider agency if shared personal
assistance care is being usednew text begin; and
new text end

new text begin (8) ensure that a personal care assistant driving the recipient under subdivision 1,
paragraph (i), has a valid driver's license and the vehicle used is registered and insured
according to Minnesota law
new text end.

(b) The personal care assistance choice provider agency shall:

(1) meet all personal care assistance provider agency standards;

(2) enter into a written agreement with the recipient, responsible party, and personal
care assistants;

(3) not be related as a parent, child, sibling, or spouse to the recipient or the personal
care assistant; and

(4) ensure arm's-length transactions without undue influence or coercion with the recipient
and personal care assistant.

(c) The duties of the personal care assistance choice provider agency are to:

(1) be the employer of the personal care assistant and the qualified professional for
employment law and related regulations including, but not limited to, purchasing and
maintaining workers' compensation, unemployment insurance, surety and fidelity bonds,
and liability insurance, and submit any or all necessary documentation including, but not
limited to, workers' compensation, unemployment insurance, and labor market data required
under section 256B.4912, subdivision 1a;

(2) bill the medical assistance program for personal care assistance services and qualified
professional services;

(3) request and complete background studies that comply with the requirements for
personal care assistants and qualified professionals;

(4) pay the personal care assistant and qualified professional based on actual hours of
services provided;

(5) withhold and pay all applicable federal and state taxes;

(6) verify and keep records of hours worked by the personal care assistant and qualified
professional;

(7) make the arrangements and pay taxes and other benefits, if any, and comply with
any legal requirements for a Minnesota employer;

(8) enroll in the medical assistance program as a personal care assistance choice agency;
and

(9) enter into a written agreement as specified in subdivision 20 before services are
provided.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective within 90 days following federal approval.
The commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

Sec. 10.

Minnesota Statutes 2020, section 256B.0659, subdivision 24, is amended to read:


Subd. 24.

Personal care assistance provider agency; general duties.

A personal care
assistance provider agency shall:

(1) enroll as a Medicaid provider meeting all provider standards, including completion
of the required provider training;

(2) comply with general medical assistance coverage requirements;

(3) demonstrate compliance with law and policies of the personal care assistance program
to be determined by the commissioner;

(4) comply with background study requirements;

(5) verify and keep records of hours worked by the personal care assistant and qualified
professional;

(6) not engage in any agency-initiated direct contact or marketing in person, by phone,
or other electronic means to potential recipients, guardians, or family members;

(7) pay the personal care assistant and qualified professional based on actual hours of
services provided;

(8) withhold and pay all applicable federal and state taxes;

(9) document that the agency uses a minimum of 72.5 percent of the revenue generated
by the medical assistance rate for personal care assistance services for employee personal
care assistant wages and benefits. The revenue generated by the qualified professional and
the reasonable costs associated with the qualified professional shall not be used in making
this calculation;

(10) make the arrangements and pay unemployment insurance, taxes, workers'
compensation, liability insurance, and other benefits, if any;

(11) enter into a written agreement under subdivision 20 before services are provided;

(12) report suspected neglect and abuse to the common entry point according to section
256B.0651;

(13) provide the recipient with a copy of the home care bill of rights at start of service;

(14) request reassessments at least 60 days prior to the end of the current authorization
for personal care assistance services, on forms provided by the commissioner;

(15) comply with the labor market reporting requirements described in section 256B.4912,
subdivision 1a; deleted text beginand
deleted text end

(16) document that the agency uses the additional revenue due to the enhanced rate under
subdivision 17a for the wages and benefits of the PCAs whose services meet the requirements
under subdivision 11, paragraph (d)new text begin; and
new text end

new text begin (17) ensure that a personal care assistant driving a recipient under subdivision 1,
paragraph (i), has a valid driver's license and the vehicle used is registered and insured
according to Minnesota law
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective within 90 days following federal approval.
The commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

Sec. 11.

new text begin [256B.0909] LONG-TERM CARE DECISION REVIEWS.
new text end

new text begin Subdivision 1. new text end

new text begin Notice of intent to deny, reduce, suspend, or terminate required. new text end

new text begin At
least ten calendar days prior to issuing a written notice of action, a lead agency must provide
in a format accessible to the person or the person's legal representative, if any, a notice of
the lead agency's intent to deny, reduce, suspend, or terminate the person's access to or
eligibility for:
new text end

new text begin (1) home and community-based waivers, including level of care determinations, under
sections 256B.092 and 256B.49;
new text end

new text begin (2) specific home and community-based services available under sections 256B.092 and
256B.49;
new text end

new text begin (3) consumer-directed community supports;
new text end

new text begin (4) the following state plan services:
new text end

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

new text begin (ii) consumer support grants under section 256.476; or
new text end

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

new text begin (5) semi-independent living services under section 252.275;
new text end

new text begin (6) relocation targeted case management services available under section 256B.0621,
subdivision 2, clause (4);
new text end

new text begin (7) case management services targeted to vulnerable adults or people with developmental
disabilities under section 256B.0924;
new text end

new text begin (8) case management services targeted to people with developmental disabilities under
Minnesota Rules, part 9525.0016; and
new text end

new text begin (9) necessary diagnostic information to gain access to or determine eligibility under
clauses (5) to (8).
new text end

new text begin Subd. 2. new text end

new text begin Opportunity to respond required. new text end

new text begin A lead agency must provide the person,
or the person's legal representative, if any, the opportunity to respond to the agency's intent
to deny, reduce, suspend, or terminate eligibility or access to the services described in
subdivision 1. A lead agency must provide the person or the person's legal representative,
if any, ten days to respond. If the person or the person's legal representative, if any, responds,
the agency must initiate a decision review.
new text end

new text begin Subd. 3. new text end

new text begin Decision review. new text end

new text begin (a) A lead agency must initiate a decision review for any
person who responds under subdivision 2.
new text end

new text begin (b) The lead agency must conduct the decision review in a manner that allows an
opportunity for interactive communication between the person and a representative of the
lead agency who has specific knowledge of the proposed decision and the basis for the
decision. The interactive communication must be in a format that is accessible to the recipient,
and may include a phone call, written exchange, in-person meeting, or other format as
chosen by the person or the person's legal representative, if any.
new text end

new text begin (c) During the decision review, the representative of the lead agency must provide a
thorough explanation of the lead agency's intent to deny, reduce, suspend, or terminate
eligibility or access to the services described in subdivision 1 and provide the person or the
person's legal representative, if any, an opportunity to ask questions about the decision. If
the lead agency's explanation of the decision is based on a misunderstanding of the person's
circumstances, incomplete information, missing documentation, or similar missing or
inaccurate information, the lead agency must provide the person or the person's legal
representative, if any, an opportunity to provide clarifying or additional information.
new text end

new text begin (d) A person with a representative is not required to participate in the decision review.
A person may also have someone of the person's choosing participate in the decision review.
new text end

new text begin Subd. 4. new text end

new text begin Continuation of services. new text end

new text begin During the decision review and until the lead agency
issues a written notice of action to deny, reduce, suspend, or terminate the eligibility or
access, the person must continue to receive covered services.
new text end

new text begin Subd. 5. new text end

new text begin Notice of action. new text end

new text begin Following a decision review, a lead agency may issue a notice
of action to deny, reduce, suspend, or terminate the eligibility or access after considering
the discussions and information provided during the decision review.
new text end

new text begin Subd. 6. new text end

new text begin Appeal rights. new text end

new text begin Nothing in this section affects a person's appeal rights under
section 245.045.
new text end

Sec. 12.

Minnesota Statutes 2020, 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 person-centered written coordinated service and support plan within
the timelines established by the commissioner and section 256B.0911, subdivision 3a,
paragraph (e)new text begin. Prior to finalizing the portion of the written coordinated service and support
plan that identifies the amount and frequency of customized living component services to
be provided to the person, if any, the case manager must consider the recommendations of
the provider or proposed provider
new text end;

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

(3) assisting the recipient in the identification of potential service providers of chosen
services, including:

(i) available options for case management service and providers;

(ii) providers of services provided in a non-disability-specific setting;

(iii) employment service providers;

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

(v) providers of financial management services;

(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 person-centered coordinated service and support plan;

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

(3) adjustments to the person-centered 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.

(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 planningnew text begin and the commissioner's standards and documentation requirements
for determining the amount and frequency of customized living component services to be
provided to a person
new text end. For the purposes of this section, "person-centered planning" or
"person-centered" has the meaning given in section 256B.0911, subdivision 1a, paragraph
(f).

Sec. 13.

Minnesota Statutes 2020, section 256B.49, subdivision 15, is amended to read:


Subd. 15.

Coordinated service and support plan; comprehensive transitional service
plan; maintenance service plan.

(a) Each recipient of home and community-based waivered
services shall be provided a copy of the written coordinated service and support plan which
meets the requirements in section 256B.092, subdivision 1b.new text begin If the written coordinated
service and support plan departs from the recommendations of the provider or proposed
provider regarding the amount and frequency of customized living component services to
be provided to the person, the case manager must include in the written coordinated service
and support plan a written policy or clinical justification for the departure from the
recommendations. If a person believes that the amount and frequency of customized living
component services identified in the written coordinated service and support plan are not
based on the person's assessed needs, preferences, and available resources, the person may
appeal under section 256.045, subdivision 3, paragraph (a), clause (6), the amount and
frequency of customized living component services to be provided to the person.
new text end

(b) In developing the comprehensive transitional service plan, the individual receiving
services, the case manager, and the guardian, if applicable, will identify the transitional
service plan fundamental service outcome and anticipated timeline to achieve this outcome.
Within the first 20 days following a recipient's request for an assessment or reassessment,
the transitional service planning team must be identified. A team leader must be identified
who will be responsible for assigning responsibility and communicating with team members
to ensure implementation of the transition plan and ongoing assessment and communication
process. The team leader should be an individual, such as the case manager or guardian,
who has the opportunity to follow the recipient to the next level of service.

Within ten days following an assessment, a comprehensive transitional service plan must
be developed incorporating elements of a comprehensive functional assessment and including
short-term measurable outcomes and timelines for achievement of and reporting on these
outcomes. Functional milestones must also be identified and reported according to the
timelines agreed upon by the transitional service planning team. In addition, the
comprehensive transitional service plan must identify additional supports that may assist
in the achievement of the fundamental service outcome such as the development of greater
natural community support, increased collaboration among agencies, and technological
supports.

The timelines for reporting on functional milestones will prompt a reassessment of
services provided, the units of services, rates, and appropriate service providers. It is the
responsibility of the transitional service planning team leader to review functional milestone
reporting to determine if the milestones are consistent with observable skills and that
milestone achievement prompts any needed changes to the comprehensive transitional
service plan.

For those whose fundamental transitional service outcome involves the need to procure
housing, a plan for the recipient to seek the resources necessary to secure the least restrictive
housing possible should be incorporated into the plan, including employment and public
supports such as housing access and shelter needy funding.

(c) Counties and other agencies responsible for funding community placement and
ongoing community supportive services are responsible for the implementation of the
comprehensive transitional service plans. Oversight responsibilities include both ensuring
effective transitional service delivery and efficient utilization of funding resources.

(d) Following one year of transitional services, the transitional services planning team
will make a determination as to whether or not the individual receiving services requires
the current level of continuous and consistent support in order to maintain the recipient's
current level of functioning. Recipients who are determined to have not had a significant
change in functioning for 12 months must move from a transitional to a maintenance service
plan. Recipients on a maintenance service plan must be reassessed to determine if the
recipient would benefit from a transitional service plan at least every 12 months and at other
times when there has been a significant change in the recipient's functioning. This assessment
should consider any changes to technological or natural community supports.

(e) When a county is evaluating denials, reductions, or terminations of home and
community-based services under this section for an individual, the case manager shall offer
to meet with the individual or the individual's guardian in order to discuss the prioritization
of service needs within the coordinated service and support plan, comprehensive transitional
service plan, or maintenance service plan. The reduction in the authorized services for an
individual due to changes in funding for waivered services may not exceed the amount
needed to ensure medically necessary services to meet the individual's health, safety, and
welfare.

Sec. 14.

new text begin [256B.4909] HOME AND COMMUNITY-BASED SERVICES;
HOMEMAKER RATES.
new text end

new text begin Subdivision 1. new text end

new text begin Application. new text end

new text begin (a) Notwithstanding any law to the contrary, the payment
methodologies for homemaker services defined in this section apply to those homemaker
services offered under:
new text end

new text begin (1) home and community-based services waivers under sections 256B.092 and 256B.49;
new text end

new text begin (2) alternative care under section 256B.0913;
new text end

new text begin (3) essential community supports under section 256B.0922; and
new text end

new text begin (4) elderly waiver, elderly waiver customized living, and elderly waiver foster care under
chapter 256S.
new text end

new text begin (b) This section does not change existing waiver policies and procedures.
new text end

new text begin Subd. 2. new text end

new text begin Definition. new text end

new text begin For purposes of this section, "homemaker services" means
homemaker services and assistance with personal care, homemaker services and cleaning,
and homemaker services and home management under chapter 256S and similar services
offered under home and community-based services waivers under sections 256B.092 and
256B.49, alternative care under section 256B.0913, and essential community supports under
section 256B.0922.
new text end

new text begin Subd. 3. new text end

new text begin Rate methodology. new text end

new text begin (a) Beginning January 1, 2023, the rate methodology for
each homemaker service must be determined under sections 256S.211, subdivision 1, and
256S.212 to 256S.215, as adjusted by paragraph (b).
new text end

new text begin (b) As applicable to this section, on November 1, 2024, based on the most recently
available wage data by standard occupational classification (SOC) from the Bureau of Labor
Statistics, the commissioner shall update for each homemaker service the base wage index
in section 256S.212, publish these updated values, and load them into the appropriate rate
system.
new text end

new text begin Subd. 4. new text end

new text begin Spending requirements. new text end

new text begin (a) At least 80 percent of the marginal increase in
revenue for homemaker services resulting from the implementation of the new rate
methodology under this section, including any subsequent rate adjustments, for services
rendered on or after the day of implementation of the new rate methodology or applicable
rate adjustment must be used to increase compensation-related costs for employees directly
employed by the program.
new text end

new text begin (b) For the purposes of this subdivision, compensation-related costs include:
new text end

new text begin (1) wages and salaries;
new text end

new text begin (2) the employer's share of FICA taxes, Medicare taxes, state and federal unemployment
taxes, workers' compensation, and mileage reimbursement;
new text end

new text begin (3) the employer's paid share of health and dental insurance, life insurance, disability
insurance, long-term care insurance, uniform allowance, pensions, and contributions to
employee retirement accounts; and
new text end

new text begin (4) benefits that address direct support professional workforce needs above and beyond
what employees were offered prior to implementation of the new rate methodology or
applicable rate adjustment.
new text end

new text begin (c) Compensation-related costs for persons employed in the central office of a corporation
or entity that has an ownership interest in the provider or exercises control over the provider,
or for persons paid by the provider under a management contract, do not count toward the
80 percent requirement under this subdivision.
new text end

new text begin (d) A provider agency or individual provider that receives additional revenue subject to
the requirements of this subdivision shall prepare, and upon request submit to the
commissioner, a distribution plan that specifies the amount of money the provider expects
to receive that is subject to the requirements of this subdivision, including how that money
was or will be distributed to increase compensation-related costs for employees. Within 60
days of final implementation of the new rate methodology or any rate adjustment subject
to the requirements of this subdivision, the provider must post the distribution plan and
leave it posted for a period of at least six months in an area of the provider's operation to
which all direct support professionals have access. The posted distribution plan must include
instructions regarding how to contact the commissioner, or the commissioner's representative,
if an employee has not received the compensation-related increase described in the plan.
new text end

Sec. 15.

Minnesota Statutes 2020, section 256B.4911, subdivision 3, is amended to read:


Subd. 3.

Expansion and increase of budget exceptions.

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

(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:

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

(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

(iii) develop and implement a positive behavior support plan; or

(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 begin For people moving from
a community residential setting to their own home, this exception is no longer available
after June 30, 2023, or upon implementation of subdivision 4, paragraph (d), whichever is
later.
new text end

(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.

(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 begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 16.

Minnesota Statutes 2020, section 256B.4911, subdivision 4, is amended to read:


Subd. 4.

Budget exception for persons leaving institutions and crisis residential
settings.

(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:

(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 deleted text beginthis exceptiondeleted text endnew text begin paragraph (a)new text end 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.

(c) The budget exception new text beginunder paragraph (a) must be renewed each year as necessary
and consistent with the individual's needs and
new text endmust 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 deleted text beginDepartment of Human Servicesdeleted text endnew text begin commissionernew text end of the budget exception.

new text begin (d) Consistent with informed choice and informed decision making, the commissioner
must establish in the home and community-based services waivers under sections 256B.092
and 256B.49, a consumer-directed community supports budget exception process for
individuals living in licensed community residential settings whose cost of residential
services may otherwise exceed their available consumer-directed community supports
budget. The budget exception process must be available to individuals living in licensed
community residential settings who are moving to their own home. This exception is available
to people who move from a community residential setting on or after July 1, 2023.
new text end

new text begin (e) The budget exceptions under paragraph (d) must be renewed each year as necessary
and consistent with the individual's needs and must be limited to no more than the cost of
the community residential services previously authorized for the individual. The lead agency
must notify the commissioner of the budget exception.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 17.

Minnesota Statutes 2020, section 256B.4911, is amended by adding a subdivision
to read:


new text begin Subd. 6. new text end

new text begin Services provided by parents and spouses. new text end

new text begin (a) Upon federal approval, this
subdivision limits medical assistance payments under the consumer-directed community
supports option for personal assistance services provided by a parent to the parent's minor
child or by a spouse. This subdivision applies to the consumer-directed community supports
option available under all of the following:
new text end

new text begin (1) alternative care program;
new text end

new text begin (2) brain injury waiver;
new text end

new text begin (3) community alternative care waiver;
new text end

new text begin (4) community access for disability inclusion waiver;
new text end

new text begin (5) developmental disabilities waiver;
new text end

new text begin (6) elderly waiver; and
new text end

new text begin (7) Minnesota senior health option.
new text end

new text begin (b) For the purposes of this subdivision, "parent" means a parent, stepparent, or legal
guardian of a minor.
new text end

new text begin (c) If multiple parents are providing personal assistance services to their minor child or
children, each parent may provide up to 40 hours of personal assistance services in any
seven-day period regardless of the number of children served. The total number of hours
of personal assistance services provided by all of the parents must not exceed 80 hours in
a seven-day period regardless of the number of children served.
new text end

new text begin (d) If only one parent is providing personal assistance services to a minor child or
children, the parent may provide up to 60 hours of personal assistance services in a seven-day
period regardless of the number of children served.
new text end

new text begin (e) If a spouse is providing personal assistance services, the spouse may provide up to
60 hours of personal assistance services in a seven-day period.
new text end

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 18.

Minnesota Statutes 2020, section 256B.4914, subdivision 3, as amended by Laws
2022, chapter 33, section 1, is amended to read:


Subd. 3.

Applicable services.

Applicable services are those authorized under the state's
home and community-based services waivers under sections 256B.092 and 256B.49,
including the following, as defined in the federally approved home and community-based
services plan:

(1) 24-hour customized living;

(2) adult day services;

(3) adult day services bath;

(4) community residential services;

(5) customized living;

(6) day support services;

(7) employment development services;

(8) employment exploration services;

(9) employment support services;

(10) family residential services;

(11) individualized home supports;

(12) individualized home supports with family training;

(13) individualized home supports with training;

(14) integrated community supports;

(15) night supervision;

(16) positive support services;

(17) prevocational services;

(18) residential support services;

(19) deleted text beginrespite services;
deleted text end

deleted text begin (20)deleted text end transportation services; and

deleted text begin (21)deleted text endnew text begin (20)new text end other services as approved by the federal government in the state home and
community-based services waiver plan.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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 2020, section 256B.4914, subdivision 4, as amended by Laws
2022, chapter 33, section 1, is amended to read:


Subd. 4.

Data collection for rate determination.

(a) Rates for applicable home and
community-based waivered services, including customized rates under subdivision 12, are
set by the rates management system.

(b) Data and information in the rates management system must be used to calculate an
individual's rate.

(c) Service providers, with information from the coordinated service and support plan
and oversight by lead agencies, shall provide values and information needed to calculate
an individual's rate in the rates management system. The determination of service levels
must be part of a discussion with members of the support team as defined in section 245D.02,
subdivision 34
. This discussion must occur prior to the final establishment of each individual's
rate. The values and information include:

(1) shared staffing hours;

(2) individual staffing hours;

(3) direct registered nurse hours;

(4) direct licensed practical nurse hours;

(5) staffing ratios;

(6) information to document variable levels of service qualification for variable levels
of reimbursement in each framework;

(7) shared or individualized arrangements for unit-based services, including the staffing
ratio;

(8) number of trips and miles for transportation services; and

(9) service hours provided through monitoring technology.

(d) Updates to individual data must include:

(1) data for each individual that is updated annually when renewing service plans; and

(2) requests by individuals or lead agencies to update a rate whenever there is a change
in an individual's service needs, with accompanying documentation.

(e) Lead agencies shall review and approve all services reflecting each individual's needs,
and the values to calculate the final payment rate for services with variables under
subdivisions 6 to deleted text begin9adeleted text endnew text begin 9new text end for each individual. Lead agencies must notify the individual and the
service provider of the final agreed-upon values and rate, and provide information that is
identical to what was entered into the rates management system. If a value used was
mistakenly or erroneously entered and used to calculate a rate, a provider may petition lead
agencies to correct it. Lead agencies must respond to these requests. When responding to
the request, the lead agency must consider:

(1) meeting the health and welfare needs of the individual or individuals receiving
services by service site, identified in their coordinated service and support plan under section
245D.02, subdivision 4b, and any addendum under section 245D.02, subdivision 4c;

(2) meeting the requirements for staffing under subdivision 2, paragraphs (h), (n), and
(o); and meeting or exceeding the licensing standards for staffing required under section
245D.09, subdivision 1; and

(3) meeting the staffing ratio requirements under subdivision 2, paragraph (o), and
meeting or exceeding the licensing standards for staffing required under section 245D.31.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 20.

Minnesota Statutes 2021 Supplement, section 256B.4914, subdivision 5, as
amended by Laws 2022, chapter 33, section 1, is amended to read:


Subd. 5.

Base wage index; establishment and updates.

(a) The base wage index is
established to determine staffing costs associated with providing services to individuals
receiving home and community-based services. For purposes of calculating the base wage,
Minnesota-specific wages taken from job descriptions and standard occupational
classification (SOC) codes from the Bureau of Labor Statistics as defined in the Occupational
Handbook must be used.

(b) The commissioner shall update the base wage index in subdivision 5a, publish these
updated values, and load them into the rate management system as follows:

(1) on January 1, 2022, based on wage data by SOC from the Bureau of Labor Statistics
available as of December 31, 2019;

(2) new text beginon January 1, 2023, based on wage data by SOC from the Bureau of Labor Statistics
available as of December 31, 2020;
new text end

new text begin (3) new text endon deleted text beginNovember 1, 2024deleted text endnew text begin January 1, 2025new text end, based on wage data by SOC from the Bureau
of Labor Statistics available as of December 31, deleted text begin2021deleted text endnew text begin 2022new text end; and

deleted text begin (3)deleted text endnew text begin (4)new text end on deleted text beginJuly 1, 2026deleted text endnew text begin January 1, 2027new text end, and every two years thereafter, based on wage
data by SOC from the Bureau of Labor Statistics available deleted text begin30deleted text endnew text begin 24new text end months and one day prior
to the scheduled update.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 21.

Minnesota Statutes 2020, section 256B.4914, subdivision 8, as amended by Laws
2022, chapter 33, section 1, subdivision 8, is amended to read:


Subd. 8.

Unit-based services with programming; component values and calculation
of payment rates.

(a) For the purpose of this section, unit-based services with programming
include employment exploration services, employment development services, employment
support services, individualized home supports with family training, individualized home
supports with training, and positive support services provided to an individual outside of
any service plan for a day program or residential support service.

(b) Component values for unit-based services with programming are:

(1) competitive workforce factor: 4.7 percent;

(2) supervisory span of control ratio: 11 percent;

(3) employee vacation, sick, and training allowance ratio: 8.71 percent;

(4) employee-related cost ratio: 23.6 percent;

(5) program plan support ratio: 15.5 percent;

(6) client programming and support ratio: 4.7 percent, updated as specified in subdivision
5b;

(7) general administrative support ratio: 13.25 percent;

(8) program-related expense ratio: 6.1 percent; and

(9) absence and utilization factor ratio: 3.9 percent.

(c) A unit of service for unit-based services with programming is 15 minutesnew text begin, except for
individualized home supports with training where a unit of service is one hour or 15 minutes
new text end.

(d) Payments for unit-based services with programming must be calculated as follows,
unless the services are reimbursed separately as part of a residential support services or day
program payment rate:

(1) determine the number of units of service to meet a recipient's needs;

(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;

(4) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (3);

(5) multiply the number of direct staffing hours by the appropriate staff wage;

(6) multiply the number of direct staffing hours by the product of the supervisory span
of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);

(7) combine the results of clauses (5) and (6), and multiply the result by one plus the
employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
rate;

(8) for program plan support, multiply the result of clause (7) by one plus the program
plan support ratio;

(9) for employee-related expenses, multiply the result of clause (8) by one plus the
employee-related cost ratio;

(10) for client programming and supports, multiply the result of clause (9) by one plus
the client programming and support ratio;

(11) this is the subtotal rate;

(12) sum the standard general administrative support ratio, the program-related expense
ratio, and the absence and utilization factor ratio;

(13) divide the result of clause (11) by one minus the result of clause (12). This is the
total payment amount;

(14) for services provided in a shared manner, divide the total payment in clause (13)
as follows:

(i) for employment exploration services, divide by the number of service recipients, not
to exceed five;

(ii) for employment support services, divide by the number of service recipients, not to
exceed six; and

(iii) for individualized home supports with training and individualized home supports
with family training, divide by the number of service recipients, not to exceed deleted text begintwodeleted text endnew text begin threenew text end;
and

(15) adjust the result of clause (14) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, or upon federal approval,
whichever occurs later, except paragraph (c) is effective July 1, 2022. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 22.

Minnesota Statutes 2020, section 256B.4914, subdivision 9, as amended by Laws
2022, chapter 33, section 1, is amended to read:


Subd. 9.

Unit-based services without programming; component values and
calculation of payment rates.

(a) For the purposes of this section, unit-based services
without programming include individualized home supports without training and night
supervision provided to an individual outside of any service plan for a day program or
residential support service. Unit-based services without programming do not include respite.

(b) Component values for unit-based services without programming are:

(1) competitive workforce factor: 4.7 percent;

(2) supervisory span of control ratio: 11 percent;

(3) employee vacation, sick, and training allowance ratio: 8.71 percent;

(4) employee-related cost ratio: 23.6 percent;

(5) program plan support ratio: 7.0 percent;

(6) client programming and support ratio: 2.3 percent, updated as specified in subdivision
5b;

(7) general administrative support ratio: 13.25 percent;

(8) program-related expense ratio: 2.9 percent; and

(9) absence and utilization factor ratio: 3.9 percent.

(c) A unit of service for unit-based services without programming is 15 minutes.

(d) Payments for unit-based services without programming must be calculated as follows
unless the services are reimbursed separately as part of a residential support services or day
program payment rate:

(1) determine the number of units of service to meet a recipient's needs;

(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 to 5a;

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;

(4) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (3);

(5) multiply the number of direct staffing hours by the appropriate staff wage;

(6) multiply the number of direct staffing hours by the product of the supervisory span
of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);

(7) combine the results of clauses (5) and (6), and multiply the result by one plus the
employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
rate;

(8) for program plan support, multiply the result of clause (7) by one plus the program
plan support ratio;

(9) for employee-related expenses, multiply the result of clause (8) by one plus the
employee-related cost ratio;

(10) for client programming and supports, multiply the result of clause (9) by one plus
the client programming and support ratio;

(11) this is the subtotal rate;

(12) sum the standard general administrative support ratio, the program-related expense
ratio, and the absence and utilization factor ratio;

(13) divide the result of clause (11) by one minus the result of clause (12). This is the
total payment amount;

(14) for individualized home supports without training provided in a shared manner,
divide the total payment amount in clause (13) by the number of service recipients, not to
exceed deleted text begintwodeleted text endnew text begin threenew text end; and

(15) adjust the result of clause (14) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, or upon federal approval,
whichever occurs later. The commissioner of human services shall notify the revisor of
statutes when federal approval is obtained.
new text end

Sec. 23.

Minnesota Statutes 2020, section 256B.4914, subdivision 10, as amended by
Laws 2022, chapter 33, section 1, is amended to read:


Subd. 10.

Evaluation of information and data.

(a) The commissioner shall, within
available resources, conduct research and gather data and information from existing state
systems or other outside sources on the following items:

(1) differences in the underlying cost to provide services and care across the state;

(2) mileage, vehicle type, lift requirements, incidents of individual and shared rides, and
units of transportation for all day services, which must be collected from providers using
the rate management worksheet and entered into the rates management system; and

(3) the distinct underlying costs for services provided by a license holder under sections
245D.05, 245D.06, 245D.07, 245D.071, 245D.081, and 245D.09, and for services provided
by a license holder certified under section 245D.33.

(b) The commissioner, in consultation with stakeholders, shall review and evaluate the
following values already in subdivisions 6 to deleted text begin9adeleted text endnew text begin 9new text end, or issues that impact all services, including,
but not limited to:

(1) values for transportation rates;

(2) values for services where monitoring technology replaces staff time;

(3) values for indirect services;

(4) values for nursing;

(5) values for the facility use rate in day services, and the weightings used in the day
service ratios and adjustments to those weightings;

(6) values for workers' compensation as part of employee-related expenses;

(7) values for unemployment insurance as part of employee-related expenses;

(8) direct care workforce labor market measures;

(9) any changes in state or federal law with a direct impact on the underlying cost of
providing home and community-based services;

(10) outcome measures, determined by the commissioner, for home and community-based
services rates determined under this section; and

(11) different competitive workforce factors by service, as determined under subdivision
10b.

(c) The commissioner shall report to the chairs and the ranking minority members of
the legislative committees and divisions with jurisdiction over health and human services
policy and finance with the information and data gathered under paragraphs (a) and (b) on
January 15, 2021, with a full report, and a full report once every four years thereafter.

(d) Beginning July 1, 2022, the commissioner shall renew analysis and implement
changes to the regional adjustment factors once every six years. Prior to implementation,
the commissioner shall consult with stakeholders on the methodology to calculate the
adjustment.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 24.

Minnesota Statutes 2020, section 256B.4914, subdivision 10a, as amended by
Laws 2022, chapter 33, section 1, 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 deleted text begin9adeleted text endnew text begin 9new text end 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) vacancy rates; and

(11) 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.

(d) The commissioner shall analyze cost data submitted under 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 once every
four years beginning January 1, 2021. The commissioner shall make recommendations in
conjunction with reports submitted to the legislature according to subdivision 10, paragraph
(c).

(e) 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.

(f) 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).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 25.

Minnesota Statutes 2020, section 256B.4914, subdivision 12, as amended by
Laws 2022, chapter 33, section 1, is amended to read:


Subd. 12.

Customization of rates for individuals.

(a) For persons determined to have
higher needs based on being deaf or hard-of-hearing, the direct-care costs must be increased
by an adjustment factor prior to calculating the rate under subdivisions 6 to deleted text begin9adeleted text endnew text begin 9new text end. The
customization rate with respect to deaf or hard-of-hearing persons shall be $2.50 per hour
for waiver recipients who meet the respective criteria as determined by the commissioner.

(b) For the purposes of this section, "deaf and hard-of-hearing" means:

(1) the person has a developmental disability and:

(i) an assessment score which indicates a hearing impairment that is severe or that the
person has no useful hearing;

(ii) an expressive communications score that indicates the person uses single signs or
gestures, uses an augmentative communication aid, or does not have functional
communication, or the person's expressive communications is unknown; and

(iii) a communication score which indicates the person comprehends signs, gestures,
and modeling prompts or does not comprehend verbal, visual, or gestural communication,
or that the person's receptive communication score is unknown; or

(2) the person receives long-term care services and has an assessment score that indicates
the person hears only very loud sounds, the person has no useful hearing, or a determination
cannot be made; and the person receives long-term care services and has an assessment that
indicates the person communicates needs with sign language, symbol board, written
messages, gestures, or an interpreter; communicates with inappropriate content, makes
garbled sounds or displays echolalia, or does not communicate needs.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 26.

Minnesota Statutes 2020, section 256B.4914, subdivision 14, as amended by
Laws 2022, chapter 33, section 1, is amended to read:


Subd. 14.

Exceptions.

(a) In a format prescribed by the commissioner, lead agencies
must identify individuals with exceptional needs that cannot be met under the disability
waiver rate system. The commissioner shall use that information to evaluate and, if necessary,
approve an alternative payment rate for those individuals. Whether granted, denied, or
modified, the commissioner shall respond to all exception requests in writing. The
commissioner shall include in the written response the basis for the action and provide
notification of the right to appeal under paragraph (h).

(b) Lead agencies must act on an exception request within 30 days and notify the initiator
of the request of their recommendation in writing. A lead agency shall submit all exception
requests along with its recommendation to the commissioner.

(c) An application for a rate exception may be submitted for the following criteria:

(1) an individual has service needs that cannot be met through additional units of service;

(2) an individual's rate determined under subdivisions 6 to deleted text begin9adeleted text endnew text begin 9new text end is so insufficient that it
has resulted in an individual receiving a notice of discharge from the individual's provider;
or

(3) an individual's service needs, including behavioral changes, require a level of service
which necessitates a change in provider or which requires the current provider to propose
service changes beyond those currently authorized.

(d) Exception requests must include the following information:

(1) the service needs required by each individual that are not accounted for in subdivisions
6 to deleted text begin9adeleted text endnew text begin 9new text end;

(2) the service rate requested and the difference from the rate determined in subdivisions
6 to deleted text begin9adeleted text endnew text begin 9new text end;

(3) a basis for the underlying costs used for the rate exception and any accompanying
documentation; and

(4) any contingencies for approval.

(e) Approved rate exceptions shall be managed within lead agency allocations under
sections 256B.092 and 256B.49.

(f) Individual disability waiver recipients, an interested party, or the license holder that
would receive the rate exception increase may request that a lead agency submit an exception
request. A lead agency that denies such a request shall notify the individual waiver recipient,
interested party, or license holder of its decision and the reasons for denying the request in
writing no later than 30 days after the request has been made and shall submit its denial to
the commissioner in accordance with paragraph (b). The reasons for the denial must be
based on the failure to meet the criteria in paragraph (c).

(g) The commissioner shall determine whether to approve or deny an exception request
no more than 30 days after receiving the request. If the commissioner denies the request,
the commissioner shall notify the lead agency and the individual disability waiver recipient,
the interested party, and the license holder in writing of the reasons for the denial.

(h) The individual disability waiver recipient may appeal any denial of an exception
request by either the lead agency or the commissioner, pursuant to sections 256.045 and
256.0451. When the denial of an exception request results in the proposed demission of a
waiver recipient from a residential or day habilitation program, the commissioner shall issue
a temporary stay of demission, when requested by the disability waiver recipient, consistent
with the provisions of section 256.045, subdivisions 4a and 6, paragraph (c). The temporary
stay shall remain in effect until the lead agency can provide an informed choice of
appropriate, alternative services to the disability waiver.

(i) Providers may petition lead agencies to update values that were entered incorrectly
or erroneously into the rate management system, based on past service level discussions
and determination in subdivision 4, without applying for a rate exception.

(j) The starting date for the rate exception will be the later of the date of the recipient's
change in support or the date of the request to the lead agency for an exception.

(k) The commissioner shall track all exception requests received and their dispositions.
The commissioner shall issue quarterly public exceptions statistical reports, including the
number of exception requests received and the numbers granted, denied, withdrawn, and
pending. The report shall include the average amount of time required to process exceptions.

(l) Approved rate exceptions remain in effect in all cases until an individual's needs
change as defined in paragraph (c).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 27.

Minnesota Statutes 2020, section 256B.493, subdivision 4, is amended to read:


Subd. 4.

Review and approval process.

(a) To be considered fornew text begin conditionalnew text end approval,
an application must include:

(1) a description of the proposed closure plan, which must identify the home or homes
and occupied beds for which a planned closure rate adjustment is requested;

(2) the proposed timetable for any proposed closure, including the proposed dates for
notification to residents and the affected lead agencies, commencement of closure, and
completion of closure;

(3) the proposed relocation plan jointly developed by the counties of financial
responsibility, the residents and their legal representatives, if any, who wish to continue to
receive services from the provider, and the providers for current residents of any adult foster
care homenew text begin or community residential settingnew text end designated for closure; and

(4) documentation in a format approved by the commissioner that all the adult foster
care homesnew text begin or community residential settingsnew text end receiving a planned closure rate adjustment
under the plan have accepted joint and several liability for recovery of overpayments under
section 256B.0641, subdivision 2, for the facilities designated for closure under this plan.

(b) In reviewing and approving closure proposals, the commissioner shall give first
priority to proposals that:

(1) target counties and geographic areas which have:

(i) need for other types of services;

(ii) need for specialized services;

(iii) higher than average per capita use of foster care settings where the license holder
does not reside; or

(iv) residents not living in the geographic area of their choice;

(2) demonstrate savings of medical assistance expenditures; deleted text beginand
deleted text end

(3) demonstrate that alternative services are based on the recipient's choice of provider
and are consistent with federal law, state law, and federally approved waiver plansnew text begin;
new text end

new text begin (4) demonstrate alternative services based on the recipient's choices are available and
secured at time of closure application; and
new text end

new text begin (5) provide proof of referral to the regional Center for Independent Living for resident
transition support
new text end.

The commissioner shall deleted text beginalso considerdeleted text endnew text begin prioritize consideration ofnew text end any information provided
by service recipients, their legal representatives, family members, or the lead agency on the
impact of the planned closure on the recipients and the services they need.

(c) The commissioner shall select proposals that best meet the criteria established in this
subdivision for planned closure of adult foster carenew text begin or community residentialnew text end settings. The
commissioner shall notify license holders of the selectionsnew text begin conditionallynew text end approved by the
commissioner.new text begin Approval of closure is obtained following confirmation that every individual
impacted by the planned closure has an established plan to continue services in an equivalent
residential setting or in a less restrictive setting in the community of their choice.
new text end

(d) For each proposalnew text begin conditionallynew text end approved by the commissioner, a contract must be
established between the commissioner, the counties of financial responsibility, and the
participating license holder.

Sec. 28.

Minnesota Statutes 2020, section 256B.493, subdivision 5, is amended to read:


Subd. 5.

Notification ofnew text begin conditionallynew text end approved proposal.

(a) Once the license holder
receives notification from the commissioner that the proposal has beennew text begin conditionallynew text end
approved, the license holder shall provide written notification within five working days to:

(1) the lead agencies responsible for authorizing the licensed services for the residents
of the affected adult foster care settings; and

(2) current and prospective residents, any legal representatives, and family members
involved.

(b) This notification must occur at least deleted text begin45deleted text endnew text begin 90new text end days prior to the implementation of the
closure proposal.

Sec. 29.

Minnesota Statutes 2020, section 256B.493, is amended by adding a subdivision
to read:


new text begin Subd. 5a. new text end

new text begin Notification of conditionally approved proposal to Centers for Independent
Living.
new text end

new text begin (a) Once conditional approval has been sent to the license holder, the commissioner
shall provide written notice within five working days to the regional Center for Independent
Living.
new text end

new text begin (b) The commissioner must provide in the written notice the number of persons affected
by closure, location of group homes, provider information, and contact information of
persons or current guardians to coordinate transition support of residents.
new text end

Sec. 30.

Minnesota Statutes 2020, section 256B.493, is amended by adding a subdivision
to read:


new text begin Subd. 5b. new text end

new text begin Approval for planned closure. new text end

new text begin The commissioner may finalize approval of
conditional applications for planned closure after the license holder takes the following
actions and submits proof of documentation to the commissioner:
new text end

new text begin (1) all parties were provided notice within five business days of receiving conditional
approval and residents, support team, and family members were provided 90 days' notice
prior to the implementation of the closure proposal;
new text end

new text begin (2) information regarding rights to appeal service termination and seek a temporary
order to stay the termination of services according to the procedures in section 256.045,
subdivision 4a or 6, paragraph (c), were provided to the resident, family, and support team
at time of closure notice;
new text end

new text begin (3) residents were provided options to live in the geographic community of their own
choice; and
new text end

new text begin (4) residents were provided options to live in a community residential or own-home
setting with the services and supports of their choice.
new text end

Sec. 31.

Minnesota Statutes 2020, section 256B.493, subdivision 6, is amended to read:


Subd. 6.

Adjustment to rates.

(a) For purposes of this section, the commissioner shall
establish enhanced medical assistance payment rates under sections 256B.092 and 256B.49
to facilitate an orderly transition for persons with disabilities from adult foster carenew text begin or
community residential settings
new text end to other community-based settings.

(b) The enhanced payment rate shall be effective the day after the first resident has
moved until the day the last resident has moved, not to exceed six months.

Sec. 32.

Minnesota Statutes 2020, section 256B.493, is amended by adding a subdivision
to read:


new text begin Subd. 7. new text end

new text begin Termination of license or satellite license upon approved closure
date.
new text end

new text begin Following approval of a planned closure, the commissioner shall confirm termination
of licensure for the residence location, whether satellite or home and community-based
license for single residence as referenced in section 245D.23. The commissioner must
provide written notice confirming termination of licensure to the provider.
new text end

Sec. 33.

Minnesota Statutes 2020, section 256B.5012, is amended by adding a subdivision
to read:


new text begin Subd. 19. new text end

new text begin ICF/DD rate increase effective July 1, 2022. new text end

new text begin (a) Effective July 1, 2022, the
daily operating payment rate for a class A intermediate care facility for persons with
developmental disabilities is increased by $50.
new text end

new text begin (b) Effective July 1, 2022, the daily operating payment rate for a class B intermediate
care facility for persons with developmental disabilities is increased by $50.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 34.

Minnesota Statutes 2020, section 256B.5012, is amended by adding a subdivision
to read:


new text begin Subd. 20. new text end

new text begin ICF/DD minimum daily operating payment rates. new text end

new text begin (a) The minimum daily
operating payment rate for a class A intermediate care facility for persons with developmental
disabilities is $300.
new text end

new text begin (b) The minimum daily operating payment rate for a class B intermediate care facility
for persons with developmental disabilities is $400.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 35.

Minnesota Statutes 2020, section 256B.5012, is amended by adding a subdivision
to read:


new text begin Subd. 21. new text end

new text begin Spending requirements. new text end

new text begin (a) At least 80 percent of the marginal increase in
revenue resulting from implementation of the rate increases under subdivisions 19 and 20
for services rendered on or after the day of implementation of the increases must be used
to increase compensation-related costs for employees directly employed by the facility.
new text end

new text begin (b) For the purposes of this subdivision, compensation-related costs include:
new text end

new text begin (1) wages and salaries;
new text end

new text begin (2) the employer's share of FICA taxes, Medicare taxes, state and federal unemployment
taxes, workers' compensation, and mileage reimbursement;
new text end

new text begin (3) the employer's paid share of health and dental insurance, life insurance, disability
insurance, long-term care insurance, uniform allowance, pensions, and contributions to
employee retirement accounts; and
new text end

new text begin (4) benefits that address direct support professional workforce needs above and beyond
what employees were offered prior to implementation of the rate increases.
new text end

new text begin (c) Compensation-related costs for persons employed in the central office of a corporation
or entity that has an ownership interest in the provider or exercises control over the provider,
or for persons paid by the provider under a management contract, do not count toward the
80 percent requirement under this subdivision.
new text end

new text begin (d) A provider agency or individual provider that receives additional revenue subject to
the requirements of this subdivision shall prepare, and upon request submit to the
commissioner, a distribution plan that specifies the amount of money the provider expects
to receive that is subject to the requirements of this subdivision, including how that money
was or will be distributed to increase compensation-related costs for employees. Within 60
days of final implementation of the new rate methodology or any rate adjustment subject
to the requirements of this subdivision, the provider must post the distribution plan and
leave it posted for a period of at least six months in an area of the provider's operation to
which all direct support professionals have access. The posted distribution plan must include
instructions regarding how to contact the commissioner, or the commissioner's representative,
if an employee has not received the compensation-related increase described in the plan.
new text end

Sec. 36.

Minnesota Statutes 2021 Supplement, section 256B.85, subdivision 7, is amended
to read:


Subd. 7.

Community first services and supports; covered services.

Services and
supports covered under CFSS include:

(1) assistance to accomplish activities of daily living (ADLs), instrumental activities of
daily living (IADLs), and health-related procedures and tasks through hands-on assistance
to accomplish the task or constant supervision and cueing to accomplish the task;

(2) assistance to acquire, maintain, or enhance the skills necessary for the participant to
accomplish activities of daily living, instrumental activities of daily living, or health-related
tasks;

(3) expenditures for items, services, supports, environmental modifications, or goods,
including assistive technology. These expenditures must:

(i) relate to a need identified in a participant's CFSS service delivery plan; and

(ii) increase independence or substitute for human assistance, to the extent that
expenditures would otherwise be made for human assistance for the participant's assessed
needs;

(4) observation and redirection for behavior or symptoms where there is a need for
assistance;

(5) back-up systems or mechanisms, such as the use of pagers or other electronic devices,
to ensure continuity of the participant's services and supports;

(6) services provided by a consultation services provider as defined under subdivision
17, that is under contract with the department and enrolled as a Minnesota health care
program provider;

(7) services provided by an FMS provider as defined under subdivision 13a, that is an
enrolled provider with the department;

(8) CFSS services provided by a support worker who is a parent, stepparent, or legal
guardian of a participant under age 18, or who is the participant's spouse. deleted text beginThese support
workers shall not:
deleted text endnew text begin Covered services under this clause are subject to the limitations described
in subdivision 7b; and
new text end

deleted text begin (i) provide any medical assistance home and community-based services in excess of 40
hours per seven-day period regardless of the number of parents providing services,
combination of parents and spouses providing services, or number of children who receive
medical assistance services; and
deleted text end

deleted text begin (ii) have a wage that exceeds the current rate for a CFSS support worker including the
wage, benefits, and payroll taxes; and
deleted text end

(9) worker training and development services as described in subdivision 18a.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 37.

Minnesota Statutes 2021 Supplement, section 256B.85, subdivision 7a, is amended
to read:


Subd. 7a.

Enhanced rate.

An enhanced rate of deleted text begin107.5deleted text endnew text begin 143new text end percent of the rate paid for
CFSS must be paid for services provided to persons who qualify for ten or more hours of
CFSS per day when provided by a support worker who meets the requirements of subdivision
16, paragraph (e). Any change in the eligibility criteria for the enhanced rate for CFSS as
described in this subdivision and referenced in subdivision 16, paragraph (e), does not
constitute a change in a term or condition for individual providers as defined in section
256B.0711, and is not subject to the state's obligation to meet and negotiate under chapter
179A.

Sec. 38.

Minnesota Statutes 2020, section 256B.85, is amended by adding a subdivision
to read:


new text begin Subd. 7b. new text end

new text begin Services provided by parents and spouses. new text end

new text begin (a) This subdivision applies to
services and supports described in subdivision 7, clause (8).
new text end

new text begin (b) If multiple parents are support workers providing CFSS services to their minor child
or children, each parent may provide up to 40 hours of medical assistance home and
community-based services in any seven-day period regardless of the number of children
served. The total number of hours of medical assistance home and community-based services
provided by all of the parents must not exceed 80 hours in a seven-day period regardless of
the number of children served.
new text end

new text begin (c) If only one parent is a support worker providing CFSS services to the parent's minor
child or children, the parent may provide up to 60 hours of medical assistance home and
community-based services in a seven-day period regardless of the number of children served.
new text end

new text begin (d) If a spouse is a support worker providing CFSS services, the spouse may provide up
to 60 hours of medical assistance home and community-based services in a seven-day period.
new text end

new text begin (e) Paragraphs (b) to (d) must not be construed to permit an increase in either the total
authorized service budget for an individual or the total number of authorized service units.
new text end

new text begin (f) A parent or spouse must not receive a wage that exceeds the current rate for a CFSS
support worker, including the wage, benefits, and payroll taxes.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 39.

Minnesota Statutes 2021 Supplement, section 256B.851, subdivision 5, is amended
to read:


Subd. 5.

Payment rates; component values.

(a) The commissioner must use the
following component values:

(1) employee vacation, sick, and training factor, 8.71 percent;

(2) employer taxes and workers' compensation factor, 11.56 percent;

(3) employee benefits factor, 12.04 percent;

(4) client programming and supports factor, 2.30 percent;

(5) program plan support factor, 7.00 percent;

(6) general business and administrative expenses factor, 13.25 percent;

(7) program administration expenses factor, 2.90 percent; and

(8) absence and utilization factor, 3.90 percent.

(b) For purposes of implementation, the commissioner shall use the following
implementation components:

(1) personal care assistance services and CFSS: deleted text begin75.45deleted text endnew text begin 83.5new text end percent;

(2) enhanced rate personal care assistance services and enhanced rate CFSS: deleted text begin75.45deleted text endnew text begin 83.5new text end
percent; and

(3) qualified professional services and CFSS worker training and development: deleted text begin75.45deleted text endnew text begin
83.5
new text end percent.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, or 60 days following
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. 40.

Minnesota Statutes 2020, section 256I.04, subdivision 3, is amended to read:


Subd. 3.

Moratorium on development of housing support beds.

(a) Agencies shall
not enter into agreements for new housing support beds with total rates in excess of the
MSA equivalent rate except:

(1) for establishments licensed under chapter 245D provided the facility is needed to
meet the census reduction targets for persons with developmental disabilities at regional
treatment centers;

(2) up to 80 beds in a single, specialized facility located in Hennepin County that will
provide housing for chronic inebriates who are repetitive users of detoxification centers and
are refused placement in emergency shelters because of their state of intoxication, and
planning for the specialized facility must have been initiated before July 1, 1991, in
anticipation of receiving a grant from the Housing Finance Agency under section 462A.05,
subdivision 20a
, paragraph (b);

(3) notwithstanding the provisions of subdivision 2a, for up to 226 supportive housing
units in Anoka, new text beginCarver, new text endDakota, Hennepin, deleted text beginordeleted text end Ramseynew text begin, Scott, or Washingtonnew text end County for
homeless adults with a new text begindisability, including but not limited to new text endmental illness, a history of
substance abuse, or human immunodeficiency virus or acquired immunodeficiency syndrome.
For purposes of this deleted text beginsectiondeleted text endnew text begin clausenew text end, "homeless adult" means a person who is new text begin(i) new text endliving on
the street or in a shelter or new text begin(ii) new text enddischarged from a regional treatment center, community
hospital, or residential treatment program and has no appropriate housing available and
lacks the resources and support necessary to access appropriate housing. deleted text beginAt least 70 percent
of the supportive housing units must serve homeless adults with mental illness, substance
abuse problems, or human immunodeficiency virus or acquired immunodeficiency syndrome
who are about to be or, within the previous six months, have been discharged from a regional
treatment center, or a state-contracted psychiatric bed in a community hospital, or a residential
mental health or chemical dependency treatment program.
deleted text end If a person meets the requirements
of subdivision 1, paragraph (a)new text begin or (b)new text end, and receives a federal or state housing subsidy, the
housing support rate for that person is limited to the supplementary rate under section
256I.05, subdivision 1adeleted text begin, and is determined by subtracting the amount of the person's
countable income that exceeds the MSA equivalent rate from the housing support
supplementary service rate
deleted text end. A resident in a demonstration project site who no longer
participates in the demonstration program shall retain eligibility for a housing support
payment in an amount determined under section 256I.06, subdivision 8, using the MSA
equivalent rate. deleted text beginService funding under section 256I.05, subdivision 1a, will end June 30,
1997, if federal matching funds are available and the services can be provided through a
managed care entity. If federal matching funds are not available, then service funding will
continue under section 256I.05, subdivision 1a
deleted text end;

(4) for an additional two beds, resulting in a total of 32 beds, for a facility located in
Hennepin County providing services for recovering and chemically dependent men that has
had a housing support contract with the county and has been licensed as a board and lodge
facility with special services since 1980;

(5) for a housing support provider located in the city of St. Cloud, or a county contiguous
to the city of St. Cloud, that operates a 40-bed facility, that received financing through the
Minnesota Housing Finance Agency Ending Long-Term Homelessness Initiative and serves
chemically dependent clientele, providing 24-hour-a-day supervision;

(6) for a new 65-bed facility in Crow Wing County that will serve chemically dependent
persons, operated by a housing support provider that currently operates a 304-bed facility
in Minneapolis, and a 44-bed facility in Duluth;

(7) for a housing support provider that operates two ten-bed facilities, one located in
Hennepin County and one located in Ramsey County, that provide community support and
24-hour-a-day supervision to serve the mental health needs of individuals who have
chronically lived unsheltered; and

(8) for a facility authorized for recipients of housing support in Hennepin County with
a capacity of up to 48 beds that has been licensed since 1978 as a board and lodging facility
and that until August 1, 2007, operated as a licensed chemical dependency treatment program.

(b) An agency may enter into a housing support agreement for beds with rates in excess
of the MSA equivalent rate in addition to those currently covered under a housing support
agreement if the additional beds are only a replacement of beds with rates in excess of the
MSA equivalent rate which have been made available due to closure of a setting, a change
of licensure or certification which removes the beds from housing support payment, or as
a result of the downsizing of a setting authorized for recipients of housing support. The
transfer of available beds from one agency to another can only occur by the agreement of
both agencies.

Sec. 41.

Minnesota Statutes 2020, section 256I.05, is amended by adding a subdivision
to read:


new text begin Subd. 1s. new text end

new text begin Supplemental rate; Douglas County. new text end

new text begin Notwithstanding the provisions in this
section, a county agency shall negotiate a supplemental rate for up to 20 beds in addition
to the rate specified in subdivision 1, not to exceed the maximum rate allowed under
subdivision 1a, including any legislatively authorized inflationary adjustments, for a housing
support provider located in Douglas County that operates two facilities and provides room
and board and supplementary services to adult males recovering from substance use disorder,
mental illness, or housing instability.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 42.

Laws 2014, chapter 312, article 27, section 75, is amended to read:


Sec. 75. PROVIDER RATE AND GRANT INCREASES EFFECTIVE JULY 1, 2014.

(a) The commissioner of human services shall increase reimbursement rates, grants,
allocations, individual limits, and rate limits, as applicable, by five percent for the rate period
beginning July 1, 2014, for services rendered on or after July 1, 2014. County or tribal
contracts for services, grants, and programs under paragraph (b) must be amended to pass
through these rate increases by September 1, 2014.

(b) The rate changes described in this section must be provided to:

(1) home and community-based waivered services for persons with developmental
disabilities, including consumer-directed community supports, under Minnesota Statutes,
section 256B.092;

(2) waivered services under community alternatives for disabled individuals, including
consumer-directed community supports, under Minnesota Statutes, section 256B.49;

(3) community alternative care waivered services, including consumer-directed
community supports, under Minnesota Statutes, section 256B.49;

(4) brain injury waivered services, including consumer-directed community supports,
under Minnesota Statutes, section 256B.49;

(5) home and community-based waivered services for the elderly under Minnesota
Statutes, section 256B.0915;

(6) nursing services and home health services under Minnesota Statutes, section
256B.0625, subdivision 6a;

(7) personal care services and qualified professional supervision of personal care services
under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;

(8) private duty nursing services under Minnesota Statutes, section 256B.0625,
subdivision 7
;

(9) community first services and supports under Minnesota Statutes, section 256B.85;

(10) essential community supports under Minnesota Statutes, section 256B.0922;

(11) day training and habilitation services for adults with developmental disabilities
under Minnesota Statutes, sections 252.41 to 252.46deleted text begin, including the additional cost to counties
deleted text enddeleted text begin of the rate adjustments on day training and habilitation services, provided as a social servicedeleted text end;

(12) alternative care services under Minnesota Statutes, section 256B.0913;

(13) living skills training programs for persons with intractable epilepsy who need
assistance in the transition to independent living under Laws 1988, chapter 689;

(14) semi-independent living services (SILS) under Minnesota Statutes, section 252.275;

(15) consumer support grants under Minnesota Statutes, section 256.476;

(16) family support grants under Minnesota Statutes, section 252.32;

(17) housing access grants under Minnesota Statutes, section 256B.0658;

(18) self-advocacy grants under Laws 2009, chapter 101;

(19) technology grants under Laws 2009, chapter 79;

(20) aging grants under Minnesota Statutes, sections 256.975 to 256.977 and 256B.0917;

(21) deaf and hard-of-hearing grants, including community support services for deaf
and hard-of-hearing adults with mental illness who use or wish to use sign language as their
primary means of communication under Minnesota Statutes, section 256.01, subdivision 2;

(22) deaf and hard-of-hearing grants under Minnesota Statutes, sections 256C.233,
256C.25, and 256C.261;

(23) Disability Linkage Line grants under Minnesota Statutes, section 256.01, subdivision
24
;

(24) transition initiative grants under Minnesota Statutes, section 256.478;

(25) employment support grants under Minnesota Statutes, section 256B.021, subdivision
6
; and

(26) grants provided to people who are eligible for the Housing Opportunities for Persons
with AIDS program under Minnesota Statutes, section 256B.492.

(c) A managed care plan or county-based purchasing plan receiving state payments for
the services grants and programs in paragraph (b) must include these increases in their
payments to providers. To implement the rate increase in paragraph (a), capitation rates
paid by the commissioner to managed care plans and county-based purchasing plans under
Minnesota Statutes, section 256B.69, shall reflect a five percent increase for the services
and programs specified in paragraph (b) for the period beginning July 1, 2014.

(d) Counties shall increase the budget for each recipient of consumer-directed community
supports by the amount in paragraph (a) on July 1, 2014.

(e) To receive the rate increase described in this section, providers under paragraphs (a)
and (b) must submit to the commissioner documentation that identifies a quality improvement
project that the provider will implement by June 30, 2015. Documentation must be provided
in a format specified by the commissioner. Projects must:

(1) improve the quality of life of home and community-based services recipients in a
meaningful way;

(2) improve the quality of services in a measurable way; or

(3) deliver good quality service more efficiently while using the savings to enhance
services for the participants served.

Providers listed in paragraph (b), clauses (7), (9), (10), and (13) to (26), are not subject to
this requirement.

(f) For a provider that fails to submit documentation described in paragraph (e) by a date
or in a format specified by the commissioner, the commissioner shall reduce the provider's
rate by one percent effective January 1, 2015.

(g) Providers that receive a rate increase under paragraph (a) shall use 80 percent of the
additional revenue to increase compensation-related costs for employees directly employed
by the program on or after July 1, 2014, except:

(1) persons employed in the central office of a corporation or entity that has an ownership
interest in the provider or exercises control over the provider; and

(2) persons paid by the provider under a management contract.

This requirement is subject to audit by the commissioner.

(h) Compensation-related costs include:

(1) wages and salaries;

(2) the employer's share of FICA taxes, Medicare taxes, state and federal unemployment
taxes, workers' compensation, and mileage reimbursement;

(3) the employer's share of health and dental insurance, life insurance, disability insurance,
long-term care insurance, uniform allowance, pensions, and contributions to employee
retirement accounts; and

(4) other benefits provided and workforce needs, including the recruiting and training
of employees as specified in the distribution plan required under paragraph (m).

(i) For public employees under a collective bargaining agreement, the increase for wages
and benefits is available and pay rates must be increased only to the extent that the increases
comply with laws governing public employees' collective bargaining. Money received by
a provider for pay increases for public employees under paragraph (g) must be used only
for pay increases implemented between July 1, 2014, and August 1, 2014.

(j) For a provider that has employees that are represented by an exclusive bargaining
representative, the provider shall obtain a letter of acceptance of the distribution plan required
under paragraph (m), in regard to the members of the bargaining unit, signed by the exclusive
bargaining agent. Upon receipt of the letter of acceptance, the provider shall be deemed to
have met all the requirements of this section in regard to the members of the bargaining
unit. Upon request, the provider shall produce the letter of acceptance for the commissioner.

(k) The commissioner shall amend state grant contracts that include direct
personnel-related grant expenditures to include the allocation for the portion of the contract
related to employee compensation. Grant contracts for compensation-related services must
be amended to pass through these adjustments by September 1, 2014, and must be retroactive
to July 1, 2014.

(l) The Board on Aging and its area agencies on aging shall amend their grants that
include direct personnel-related grant expenditures to include the rate adjustment for the
portion of the grant related to employee compensation. Grants for compensation-related
services must be amended to pass through these adjustments by September 1, 2014, and
must be retroactive to July 1, 2014.

(m) A provider that receives a rate adjustment under paragraph (a) that is subject to
paragraph (g) shall prepare, and upon request submit to the commissioner, a distribution
plan that specifies the amount of money the provider expects to receive that is subject to
the requirements of paragraph (g), including how that money will be distributed to increase
compensation for employees. The commissioner may recover funds from a provider that
fails to comply with this requirement.

(n) By January 1, 2015, the provider shall post the distribution plan required under
paragraph (m) for a period of at least six weeks in an area of the provider's operation to
which all eligible employees have access and shall provide instructions for employees who
do not believe they have received the wage and other compensation-related increases
specified in the distribution plan. The instructions must include a mailing address, e-mail
address, and telephone number that the employee may use to contact the commissioner or
the commissioner's representative.

(o) For providers with rates established under Minnesota Statutes, section 256B.4914,
and with a historical rate established under Minnesota Statutes, section 256B.4913,
subdivision 4a
, paragraph (b), that is greater than the rate established under Minnesota
Statutes, section 256B.4914, the requirements in paragraph (g) must only apply to the portion
of the rate increase that exceeds the difference between the rate established under Minnesota
Statutes, section 256B.4914, and the banding value established under Minnesota Statutes,
section 256B.4913, subdivision 4a, paragraph (b).

Sec. 43.

Laws 2021, First Special Session chapter 7, article 17, section 14, is amended to
read:


Sec. 14. TASK FORCE ON deleted text beginELIMINATINGdeleted text end SUBMINIMUM WAGES.

Subdivision 1.

Establishment; purpose.

The Task Force on deleted text beginEliminatingdeleted text end Subminimum
Wages is established to develop a plan and make recommendations to deleted text beginphase out payment
of subminimum wages to people with disabilities on or before August 1, 2025
deleted text endnew text begin promote
independence and increase opportunities for people with disabilities to earn competitive
wages
new text end.

Subd. 2.

Definitions.

For the purposes of this section, "subminimum wage" means wages
authorized under section 14(c) of the federal Fair Labor Standards Act, Minnesota Statutes,
section 177.28, subdivision 5, or Minnesota Rules, parts 5200.0030 and 5200.0040.

Subd. 3.

Membership.

(a) The task force consists of deleted text begin16deleted text endnew text begin 20new text end members, appointed as
follows:

(1) the commissioner of human services or a designee;

(2) the commissioner of labor and industry or a designee;

(3) the commissioner of education or a designee;

(4) the commissioner of employment and economic development or a designee;

(5) a representative of the Department of Employment and Economic Development's
Vocational Rehabilitation Services Division appointed by the commissioner of employment
and economic development;

(6) one member appointed by the Minnesota Disability Law Center;

(7) one member appointed by The Arc of Minnesota;

(8) deleted text beginthreedeleted text endnew text begin fournew text end members who are persons with disabilities appointed by the commissioner
of human services, at least one of whom deleted text beginmust bedeleted text endnew text begin isnew text end neurodiverse, deleted text beginanddeleted text end at least one of whom
deleted text begin must havedeleted text endnew text begin hasnew text end a significant physical disabilitynew text begin, and at least one of whom at the time of the
appointment is being paid a subminimum wage
new text end;

(9) two representatives of employers authorized to pay subminimum wage and one
representative of an employer who successfully transitioned away from payment of
subminimum wages to people with disabilities, appointed by the commissioner of human
services;

(10) one member appointed by the Minnesota Organization for Habilitation and
Rehabilitation;

(11) one member appointed by ARRM;deleted text begin and
deleted text end

(12) one member appointed by the State Rehabilitation Councilnew text begin; and
new text end

new text begin (13) three members who are parents or guardians of persons with disabilities appointed
by the commissioner of human services, at least one of whom is a parent or guardian of a
person who is neurodiverse, at least one of whom is a parent or guardian of a person with
a significant physical disability, and at least one of whom is a parent or guardian of a person
being paid a subminimum wage as of the date of the appointment
new text end.

(b) To the extent possible, membership on the task force under paragraph (a) shall reflect
geographic parity throughout the state and representation from Black, Indigenous, and
communities of color.

Subd. 4.

Appointment deadline; first meeting; chair.

Appointing authorities must
complete member selections by January 1, 2022. The commissioner of human services shall
convene the first meeting of the task force by February 15, 2022. The task force shall select
a chair from among its members at its first meeting.

Subd. 5.

Compensation.

Members shall be compensated and may be reimbursed for
expenses as provided in Minnesota Statutes, section 15.059, subdivision 3.

Subd. 6.

Duties; plan and recommendations.

The task force shall:

(1) develop a plan to deleted text beginphase out the payment of subminimum wages to people with
disabilities by August 1, 2025
deleted text endnew text begin promote independence and increase opportunities for people
with disabilities to earn competitive wages
new text end;

(2) consult with and advise the commissioner of human services on statewide plans for
deleted text begin limitingdeleted text endnew text begin reducing reliance onnew text end subminimum wages in medical assistance home and
community-based services waivers under Minnesota Statutes, sections 256B.092 and
256B.49;

(3) engage with employees with disabilities paid subminimum wages and conduct
community education on the payment of subminimum wages to people with disabilities in
Minnesota;

(4) identify and collaborate with employees, employers, businesses, organizations,
agencies, and stakeholders deleted text beginimpacted by the phase out of subminimum wagedeleted text end on how to
implement the plan and create sustainable work opportunities for employees with disabilities;

(5) propose a plan to establish and evaluate benchmarks for measuring annual progress
toward deleted text begineliminatingdeleted text endnew text begin reducing reliance onnew text end subminimum wages;

(6) propose a plan to monitor and track outcomes of employees with disabilitiesnew text begin, including
those who transition to competitive employment
new text end;

(7) identify initiatives, investment, training, and services designed to improve wages,
reduce unemployment rates, and provide support and sustainable work opportunities for
persons with disabilities;

(8) identify benefits to the state deleted text beginin eliminatingdeleted text endnew text begin in reducing reliance onnew text end subminimum deleted text beginwage
by August 1, 2025
deleted text endnew text begin wagesnew text end;

(9) identify barriers to eliminating subminimum deleted text beginwage by August 1, 2025deleted text endnew text begin wagesnew text end, including
the cost of implementing and providing ongoing employment services, training, and support
for employees with disabilities deleted text beginanddeleted text endnew text begin,new text end the cost of paying minimum deleted text beginwagedeleted text endnew text begin wagesnew text end to employees
with disabilitiesnew text begin, and the potential impact on persons with disabilities who would be unable
to find sustainable employment in the absence of a subminimum wage or who would not
choose competitive employment
new text end;

(10) make recommendations to eliminate the barriers identified in clause (9); and

(11) identify and make recommendations for sustainable financial support, funding, and
resources for deleted text begineliminatingdeleted text endnew text begin reducing reliance onnew text end subminimum deleted text beginwage by August 1, 2025deleted text endnew text begin wagesnew text end.

Subd. 7.

Duties; provider reinvention grants.

(a) The commissioner of human services
shall establish a provider reinvention grant program to promote independence and increase
opportunities for people with disabilities to earn competitive wages. The commissioner
shall make the grants available to at least the following:

(1) providers of disability services under Minnesota Statutes, sections 256B.092 and
256B.49, for developing and implementing a business plan to shift the providers' business
models away from paying waiver participants subminimum wages;

(2) organizations to develop peer-to-peer mentoring for people with disabilities who
have successfully transitioned to earning competitive wages;

(3) organizations to facilitate provider-to-provider mentoring to promote shifting away
from paying employees with disabilities a subminimum wage; and

(4) organizations to conduct family outreach and education on working with people with
disabilities who are transitioning from subminimum wage employment to competitive
employment.

(b) The provider reinvention grant program must be competitive. The commissioner of
human services must develop criteria for evaluating responses to requests for proposals.
Criteria for evaluating grant applications must be finalized no later than November 1, 2021.
The commissioner of human services shall administer grants in compliance with Minnesota
Statutes, sections 16B.97 and 16B.98, and related policies set forth by the Department of
Administration's Office of Grants Management.

(c) Grantees must work with the commissioner to develop their business model and, as
a condition of receiving grant funds, grantees must fully phase out the use of subminimum
wage by April 1, 2024, unless the grantee receives a waiver from the commissioner of
human services for a demonstrated need.

(d) Of the total amount available for provider reinvention grants, the commissioner may
award up to 25 percent of the grant funds to providers who have already successfully shifted
their business model away from paying employees with disabilities subminimum wages to
provide provider-to-provider mentoring to providers receiving a provider reinvention grant.

Subd. 8.

Report.

By February 15, 2023, the task force shall submit to the chairs and
ranking minority members of the committees and divisions in the senate and house of
representatives with jurisdiction over employment and wages and over health and human
services a report with recommendations to deleted text begineliminate by August 1, 2025, the payment of
subminimum wage
deleted text endnew text begin increase opportunities for people with disabilities to earn competitive
wages
new text end, and any changes to statutes, laws, or rules required to implement the recommendations
of the task force. The task force must include in the report a recommendation concerning
continuing the task force beyond its scheduled expiration.

Subd. 9.

Administrative support.

The commissioner of human services shall provide
meeting space and administrative services to the task force.

Subd. 10.

Expiration.

The task force shall conclude their duties and expire on March
31, 2024.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment. The
commissioner of human services must make the additional appointments required under
this section within 30 days following final enactment.
new text end

Sec. 44.

Laws 2022, chapter 33, section 1, subdivision 5a, is amended to read:


Subd. 5a.

Base wage index; calculations.

The base wage index must be calculated as
follows:

(1) for supervisory staff, 100 percent of the median wage for community and social
services specialist (SOC code 21-1099), with the exception of the supervisor of positive
supports professional, positive supports analyst, and positive supports specialist, which is
100 percent of the median wage for clinical counseling and school psychologist (SOC code
19-3031);

(2) for registered nurse staff, 100 percent of the median wage for registered nurses (SOC
code 29-1141);

(3) for licensed practical nurse staff, 100 percent of the median wage for licensed practical
nurses (SOC code 29-2061);

(4) for residential asleep-overnight staff, the minimum wage in Minnesota for large
employers, with the exception of asleep-overnight staff for family residential services, which
is 36 percent of the minimum wage in Minnesota for large employers;

(5) for residential direct care staff, the sum of:

(i) 15 percent of the subtotal of 50 percent of the median wage for home health and
personal care aide (SOC code 31-1120); 30 percent of the median wage for nursing assistant
(SOC code 31-1131); and 20 percent of the median wage for social and human services
aide (SOC code 21-1093); and

(ii) 85 percent of the subtotal of 40 percent of the median wage for home health and
personal care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant
(SOC code 31-1014); 20 percent of the median wage for psychiatric technician (SOC code
29-2053); and 20 percent of the median wage for social and human services aide (SOC code
21-1093);

(6) for adult day services staff, 70 percent of the median wage for nursing assistant (SOC
code 31-1131); and 30 percent of the median wage for home health and personal care aide
(SOC code 31-1120);

(7) for day support services staff and prevocational services staff, 20 percent of the
median wage for nursing assistant (SOC code 31-1131); 20 percent of the median wage for
psychiatric technician (SOC code 29-2053); and 60 percent of the median wage for social
and human services aide (SOC code 21-1093);

(8) for positive supports analyst staff, 100 percent of the median wage for substance
abuse, behavioral disorder, and mental health counselor (SOC code 21-1018);

(9) for positive supports professional staff, 100 percent of the median wage for clinical
counseling and school psychologist (SOC code 19-3031);

(10) for positive supports specialist staff, 100 percent of the median wage for psychiatric
technicians (SOC code 29-2053);

(11) for individualized home supports with family training staff, 20 percent of the median
wage for nursing aide (SOC code 31-1131); 30 percent of the median wage for community
social service specialist (SOC code 21-1099); 40 percent of the median wage for social and
human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric
technician (SOC code 29-2053);

(12) for individualized home supports with training services staff, 40 percent of the
median wage for community social service specialist (SOC code 21-1099); 50 percent of
the median wage for social and human services aide (SOC code 21-1093); and ten percent
of the median wage for psychiatric technician (SOC code 29-2053);

(13) for employment support services staff, 50 percent of the median wage for
rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for
community and social services specialist (SOC code 21-1099);

(14) for employment exploration services staff, 50 percent of the median wage for
deleted text begin rehabilitation counselor (SOC code 21-1015)deleted text endnew text begin education, guidance, school, and vocational
counselors (SOC code 21-1012)
new text end; and 50 percent of the median wage for community and
social services specialist (SOC code 21-1099);

(15) for employment development services staff, 50 percent of the median wage for
education, guidance, school, and vocational counselors (SOC code 21-1012); and 50 percent
of the median wage for community and social services specialist (SOC code 21-1099);

(16) for individualized home support without training staff, 50 percent of the median
wage for home health and personal care aide (SOC code 31-1120); and 50 percent of the
median wage for nursing assistant (SOC code 31-1131);new text begin and
new text end

(17) for night supervision staff, 40 percent of the median wage for home health and
personal care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant
(SOC code 31-1131); 20 percent of the median wage for psychiatric technician (SOC code
29-2053); and 20 percent of the median wage for social and human services aide (SOC code
21-1093)deleted text begin; and
deleted text end

deleted text begin (18) for respite staff, 50 percent of the median wage for home health and personal care
aide (SOC code 31-1131); and 50 percent of the median wage for nursing assistant (SOC
code 31-1014)
deleted text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 45.

Laws 2022, chapter 33, section 1, subdivision 5b, is amended to read:


Subd. 5b.

Standard component value adjustments.

The commissioner shall update
the client and programming support, transportation, and program facility cost component
values as required in subdivisions 6 to deleted text begin9adeleted text endnew text begin 9new text end for changes in the Consumer Price Index. The
commissioner shall adjust these values higher or lower, publish these updated values, and
load them into the rate management system as follows:

(1) on January 1, 2022, by the percentage change in the CPI-U from the date of the
previous update to the data available on December 31, 2019;

(2) new text beginon January 1, 2023, by the percentage change in the CPI-U from the date of previous
update to the data available on December 31, 2021;
new text end

new text begin (3) new text endon deleted text beginNovember 1, 2024deleted text endnew text begin January 1, 2025new text end, by the percentage change in the CPI-U from
the date of the previous update to the data available as of December 31, deleted text begin2021deleted text endnew text begin 2023new text end; and

deleted text begin (3)deleted text endnew text begin (4)new text end on deleted text beginJuly 1, 2026deleted text endnew text begin January 1, 2027new text end, and every two years thereafter, by the percentage
change in the CPI-U from the date of the previous update to the data available deleted text begin30deleted text endnew text begin 12new text end months
and one day prior to the scheduled update.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 46.

Laws 2022, chapter 33, section 1, subdivision 5c, is amended to read:


Subd. 5c.

Removal of after-framework adjustments.

Any rate adjustments applied to
the service rates calculated under this section outside of the cost components and rate
methodology specified in this section shall be removed from rate calculations upon
implementation of the updates under subdivisions 5 deleted text beginanddeleted text endnew text begin,new text end 5bnew text begin, and 5fnew text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 47.

Laws 2022, chapter 33, section 1, subdivision 5d, is amended to read:


Subd. 5d.

Unavailable data for updates and adjustments.

If Bureau of Labor Statistics
occupational codes or Consumer Price Index items specified in subdivisions 5 deleted text beginordeleted text endnew text begin,new text end 5bnew text begin, or 5fnew text end
are unavailable in the future, the commissioner shall recommend to the legislature codes or
items to update and replace.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 48.

Laws 2022, chapter 33, section 1, subdivision 5e, is amended to read:


Subd. 5e.

Inflationary update spending requirement.

(a) At least 80 percent of the
marginal increase in revenue from the rate adjustment applied to the service rates calculated
under subdivisions 5 and 5b beginning on January 1, 2022, for services rendered between
January 1, 2022, and March 31, 2024, must be used to increase compensation-related costs
for employees directly employed by the program on or after January 1, 2022.

(b) For the purposes of this subdivision, compensation-related costs include:

(1) wages and salaries;

(2) the employer's share of FICA taxes, Medicare taxes, state and federal unemployment
taxes, workers' compensation, and mileage reimbursement;

(3) the employer's paid share of health and dental insurance, life insurance, disability
insurance, long-term care insurance, uniform allowance, pensions, and contributions to
employee retirement accounts; and

(4) benefits that address direct support professional workforce needs above and beyond
what employees were offered prior to deleted text beginJanuary 1, 2022deleted text endnew text begin implementation of the applicable
rate adjustment
new text end, including retention and recruitment bonuses and tuition reimbursement.

(c) Compensation-related costs for persons employed in the central office of a corporation
or entity that has an ownership interest in the provider or exercises control over the provider,
or for persons paid by the provider under a management contract, do not count toward the
80 percent requirement under this subdivision.

(d) A provider agency or individual provider that receives a rate subject to the
requirements of this subdivision shall prepare, and upon request submit to the commissioner,
a distribution plan that specifies the amount of money the provider expects to receive that
is subject to the requirements of this subdivision, including how that money was or will be
distributed to increase compensation-related costs for employees. Within 60 days of final
implementation of a rate adjustment subject to the requirements of this subdivision, the
provider must post the distribution plan and leave it posted for a period of at least six months
in an area of the provider's operation to which all direct support professionals have access.new text begin
The posted distribution plan must include instructions regarding how to contact the
commissioner or commissioner's representative if an employee believes the employee has
not received the compensation-related increase described in the plan.
new text end

(e) deleted text beginThis subdivision expires June 30, 2024deleted text endnew text begin At least 80 percent of the marginal increase
in revenue from the rate adjustments applied to service rates calculated under subdivisions
5, 5b, and 5f beginning on January 1, 2023, and on January 1, 2025, for services rendered
on or after those dates must be used to increase compensation-related costs for employees
directly employed by the program
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 49.

Laws 2022, chapter 33, section 1, is amended by adding a subdivision to read:


new text begin Subd. 5f. new text end

new text begin Competitive workforce factor adjustments. new text end

new text begin (a) On January 1, 2023, and
every two years thereafter, the commissioner shall update the competitive workforce factor
to equal the differential between:
new text end

new text begin (1) the most recently available wage data by SOC code for the weighted average wage
for direct care staff for residential services and direct care staff for day services; and
new text end

new text begin (2) the most recently available wage data by SOC code of the weighted average wage
of comparable occupations.
new text end

new text begin (b) For each update of the competitive workforce factor, the update shall not decrease
the competitive workforce factor by more than 2.0. If the competitive workforce factor is
less than or equal to zero, then the competitive workforce factor is zero.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 50.

Laws 2022, chapter 33, section 1, subdivision 10c, is amended to read:


Subd. 10c.

Reporting and analysis of competitive workforce factor.

(a) Beginning
February 1, deleted text begin2021deleted text endnew text begin 2024new text end, and every two years thereafter, the commissioner shall report to the
chairs and ranking minority members of the legislative committees and divisions with
jurisdiction over health and human services policy and finance an analysis of the competitive
workforce factor.

(b) The report must include deleted text beginrecommendations to update the competitive workforce factor
using
deleted text end:

(1) the most recently available wage data by SOC code for the weighted average wage
for direct care staff for residential services and direct care staff for day services;

(2) the most recently available wage data by SOC code of the weighted average wage
of comparable occupations; and

(3) workforce data as required under subdivision 10b.

(c) deleted text beginThe commissioner shall not recommend an increase or decrease of the competitive
deleted text enddeleted text begin workforce factor from the current value by more than two percentage points. If, after a
deleted text enddeleted text begin biennial analysis for the next report, the competitive workforce factor is less than or equal
deleted text enddeleted text begin to zero, the commissioner shall recommend a competitive workforce factor of zerodeleted text end new text beginThis
subdivision expires upon submission of the calendar year 2030 report
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 51.

Laws 2022, chapter 40, section 6, is amended to read:


Sec. 6. COMMISSIONER OF HUMAN SERVICES; TEMPORARY STAFFING
POOLdeleted text begin; APPROPRIATIONdeleted text end.

(a) The commissioner of human services shall establish a temporary emergency staffing
pool for congregate settingsnew text begin and for providers or recipients of home- and community-based
services
new text end experiencing staffing crises. Vendor contracts may include retention bonuses,
sign-on bonuses, and payment for hours on call. The commissioner may pay for necessary
training, travel, and lodging expenses of the temporary staff. Contracts for temporary staffing
executed under this section: (1) should minimize the recruitment away from providers'
current workforces; and (2) may not be executed with an individual until at least 30 days
since the individual was last employed in Minnesota by one of the types of facilitiesnew text begin,
providers, or individuals
new text end listed in paragraph (g).

(b) Temporary staff, at the request of the commissioner, may be deployed tonew text begin providers
of home- and community-based services, individual recipients of home- and
community-based services, and
new text end long-term care facilities and other congregate care residential
facilities and programs experiencing an emergency staffing crisis on or after the effective
date of this section. Temporary staff must be provided at no cost to thenew text begin provider, individual
recipient,
new text end facilitynew text begin,new text end or program receiving the temporary staff.

(c) Members of the temporary staffing pool under this section are not state employees.

(d) The commissioner must coordinate the activities under this section with any other
impacted state agencies, to appropriately prioritize locations to deploy contracted temporary
staff.

(e) The commissioner must give priority for deploying staff tonew text begin providers, individual
recipients,
new text end facilitiesnew text begin,new text end and programs with the most significant staffing crises and where, but
for this assistance, residentsnew text begin or service recipientsnew text end would be at significant risk of injury due
to the need to transfer to deleted text beginanotherdeleted text endnew text begin anew text end facility or a hospital for adequately staffed care.

(f) Anew text begin provider, individual recipient,new text end facilitynew text begin,new text end or program may seek onetime assistance
per settingnew text begin or individual service recipientnew text end from the temporary staffing pool only after thenew text begin
provider, individual recipient,
new text end facilitynew text begin,new text end or program has used all resources available to obtain
temporary staff but is unable to meet thenew text begin provider's, individual's,new text end facility'snew text begin,new text end or program's
temporary staffing needs. Anew text begin provider, individual,new text end facilitynew text begin,new text end or program may apply for
temporary staff for up to 21 days. Applicants must submit a proposed plan for ensuring
resident safety at the end of that time period.

(g)new text begin Providers, individuals,new text end facilitiesnew text begin,new text end and programs eligible to obtain temporary staff
from the temporary staffing pool include:

(1) nursing facilities;

(2) assisted living facilities;

(3) intermediate care facilities for persons with developmental disabilities;

(4) adult foster care deleted text beginordeleted text endnew text begin ,new text end community residential settingsnew text begin, or integrated community supports
settings
new text end;

(5) licensed substance use disorder treatment facilities;

(6) unlicensed county-based substance use disorder treatment facilities;

(7) licensed facilities for adults with mental illness;

(8) licensed detoxification programs;

(9) licensed withdrawal management programs;

(10) licensed children's residential facilities;

(11) licensed child foster residence settings;

(12) unlicensed, Tribal-certified facilities that perform functions similar to the licensed
facilities listed in this paragraph;

(13) boarding care homes;

(14) board and lodging establishments serving people with disabilities or disabling
conditions;

(15) board and lodging establishments with special services;

(16) supervised living facilities;

(17) supportive housing;

(18) sober homes;

(19) community-based halfway houses for people exiting the correctional system;

(20) shelters serving people experiencing homelessness;

(21) drop-in centers for people experiencing homelessness;

(22) homeless outreach services for unsheltered individuals;

(23) shelters for people experiencing domestic violence; deleted text beginand
deleted text end

(24) temporary isolation spaces for people who test positive for COVID-19new text begin;
new text end

new text begin (25) individuals who use consumer-directed community supports;
new text end

new text begin (26) individuals who use the personal care assistance choice program;
new text end

new text begin (27) personal care assistance provider agencies;
new text end

new text begin (28) individuals who use the community first services and supports budget model;
new text end

new text begin (29) agency-providers of community first services and supports; and
new text end

new text begin (30) providers of individualized home supportsnew text end.

(h) Notwithstanding Minnesota Statutes, chapter 16C, the commissioner may maintain,
extend, or renew contracts for temporary staffing entered into on or after September 1, 2020.
The commissioner may also enter into new contracts with eligible entities for temporary
staff deployed in the temporary staffing pool. The commissioner may use up to 6.5 percent
of this funding for the commissioner's costs related to administration of this program.

(i) The commissioner shall seek all allowable FEMA reimbursement for the costs of this
activity.

Sec. 52. new text beginPERSONAL CARE ASSISTANCE ENHANCED RATE FOR PERSONS
WHO USE CONSUMER-DIRECTED COMMUNITY SUPPORTS.
new text end

new text begin The commissioner of human services shall increase the annual budgets for participants
who use consumer-directed community supports under Minnesota Statutes, sections
256B.0913, subdivision 5, clause (17); 256B.092, subdivision 1b, paragraph (a), clause (4);
256B.49, subdivision 16, paragraph (c); and chapter 256S, by 43 percent for participants
who are determined by assessment to be eligible for ten or more hours of personal care
assistance services or community first services and supports per day when the participant
uses direct support services provided by a worker employed by the participant who has
completed training identified in Minnesota Statutes, section 256B.0659, subdivision 11,
paragraph (d), or 256B.85, subdivision 16, paragraph (e).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, or upon federal approval,
whichever occurs later. The commissioner of human services shall notify the revisor of
statutes when federal approval is obtained.
new text end

Sec. 53. new text beginRATE INCREASE FOR CERTAIN HOME CARE SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Rate increases. new text end

new text begin (a) Effective January 1, 2023, or upon federal approval,
whichever is later, the commissioner of human services shall increase payment rates for
home health aide visits by 14 percent from the rates in effect on December 31, 2022. The
commissioner must apply the annual rate increases under Minnesota Statutes, section
256B.0653, subdivision 8, to the rates resulting from the application of the rate increases
under this paragraph.
new text end

new text begin (b) Effective January 1, 2023, or upon federal approval, whichever is later, the
commissioner shall increase payment rates for respiratory therapy under Minnesota Rules,
part 9505.0295, subpart 2, item E, and for home health services and home care nursing
services under Minnesota Statutes, section 256B.0651, subdivision 2, clauses (1) to (3),
except home health aide visits, by 38.8 percent from the rates in effect on December 31,
2022. The commissioner must apply the annual rate increases under Minnesota Statutes,
sections 256B.0653, subdivision 8, and 256B.0654, subdivision 5, to the rates resulting
from the application of the rate increase under this paragraph.
new text end

new text begin Subd. 2. new text end

new text begin Spending requirements. new text end

new text begin (a) At least 80 percent of the marginal increase in
revenue for home care services resulting from implementation of the rate increases under
this section for services rendered on or after the day of implementation of the increase must
be used to increase compensation-related costs for employees directly employed by the
provider to provide the services.
new text end

new text begin (b) For the purposes of this subdivision, compensation-related costs include:
new text end

new text begin (1) wages and salaries;
new text end

new text begin (2) the employer's share of FICA taxes, Medicare taxes, state and federal unemployment
taxes, workers' compensation, and mileage reimbursement;
new text end

new text begin (3) the employer's paid share of health and dental insurance, life insurance, disability
insurance, long-term care insurance, uniform allowance, pensions, and contributions to
employee retirement accounts; and
new text end

new text begin (4) benefits that address direct support professional workforce needs above and beyond
what employees were offered prior to implementation of the rate increases.
new text end

new text begin (c) Compensation-related costs for persons employed in the central office of a corporation
or entity that has an ownership interest in the provider or exercises control over the provider,
or for persons paid by the provider under a management contract, do not count toward the
80 percent requirement under this subdivision.
new text end

new text begin (d) A provider agency or individual provider that receives additional revenue subject to
the requirements of this subdivision shall prepare, and upon request submit to the
commissioner, a distribution plan that specifies the amount of money the provider expects
to receive that is subject to the requirements of this subdivision, including how that money
was or will be distributed to increase compensation-related costs for employees. Within 60
days of final implementation of the new rate methodology or any rate adjustment subject
to the requirements of this subdivision, the provider must post the distribution plan and
leave it posted for a period of at least six months in an area of the provider's operation to
which all direct support professionals have access. The posted distribution plan must include
instructions regarding how to contact the commissioner, or the commissioner's representative,
if an employee has not received the compensation-related increase described in the plan.
new text end

Sec. 54. new text beginDIRECTION TO COMMISSIONER OF HUMAN SERVICES;
ADDITIONAL DWRS RATE INCREASES.
new text end

new text begin Subdivision 1. new text end

new text begin Additional rate increases. new text end

new text begin (a) In addition to the rate increases described
in the amendments contained in this act to Minnesota Statutes, section 256B.4914, the
commissioner shall further adjust the rates as described in paragraphs (b) to (f) until the net
increase in the rates established under Minnesota Statutes, section 256B.4914, as amended
in this act, and under this section are equivalent to a three-year appropriation of $253,001,000
for fiscal years 2023, 2024, and 2025. The commissioner shall apply the rate changes in
this section after applying other changes contained in this act. The commissioner shall apply
the rate changes in this section in the order presented in the following paragraphs. If the
three-year appropriation target is reached after applying the provisions of a paragraph, the
commissioner shall not apply the provisions in the remaining paragraphs.
new text end

new text begin (b) Notwithstanding Minnesota Statutes, section 256B.4914, subdivision 5, paragraph
(b), clause (2), as added by amendment in this act, on January 1, 2023, the commissioner
shall adjust the data used to update the base wage index by using up to the most recently
available wage data by SOC code from the Bureau of Labor Statistics. If the estimated cost
of fully implementing the rate adjustment in this paragraph exceeds the three-year
appropriation target, the commissioner shall proportionately reduce the estimated change
to the wage index to reach the target.
new text end

new text begin (c) Notwithstanding Minnesota Statutes, section 256B.4914, subdivision 5b, clause (2),
as added by amendment in this act, on January 1, 2023, the commissioner shall adjust the
data used to update the client and programming support, transportation, and program facility
cost component values by using up to the most recently available data. If the estimated cost
of fully implementing the rate adjustment in this paragraph exceeds the three-year
appropriation target, the commissioner shall proportionately reduce the estimated change
to component values to reach the target.
new text end

new text begin (d) Notwithstanding the provision in Minnesota Statutes, section 256B.4914, subdivision
5f, paragraph (a), as added by amendment in this act, requiring a biennial update of the
competitive workforce factor, on January 1, 2024, the commissioner shall update the
competitive workforce factor. If the estimated cost of fully implementing the rate adjustment
in this paragraph exceeds the three-year appropriation target, the commissioner shall cap
the increase in the competitive workforce factor to reach the target.
new text end

new text begin (e) Notwithstanding the provision in Minnesota Statutes, section 256B.4914, subdivision
5, paragraph (b), as amended in this act, on January 1, 2024, the commissioner shall update
the base wage index in Minnesota Statutes, section 256B.4914, subdivision 5a, based on
the most recently available wage data by SOC from the Bureau of Labor Statistics. If the
estimated cost of fully implementing the rate adjustment in this paragraph exceeds the
three-year appropriation target, the commissioner shall proportionately reduce the estimated
change to component values to reach the target.
new text end

new text begin (f) Notwithstanding the provision in Minnesota Statutes, section 256B.4914, subdivision
5b, as amended in this act, on January 1, 2024, the commissioner shall update the client and
programming support, transportation, and program facility cost component values based
on the most recently available wage data by SOC from the Bureau of Labor Statistics. If
the estimated cost of fully implementing the rate adjustment in this paragraph exceeds the
three-year appropriation target, the commissioner shall proportionately reduce the estimated
change to component values to reach the target.
new text end

new text begin Subd. 2. new text end

new text begin Spending requirements. new text end

new text begin A program or provider that receives a rate increase
under this section is subject to the requirements of Minnesota Statutes, section 256B.4914,
subdivision 5e.
new text end

Sec. 55. new text beginDIRECTION TO COMMISSIONER OF HUMAN SERVICES;
APPLICATION OF ICF/DD RATE INCREASES.
new text end

new text begin The commissioner of human services shall apply the rate increases under Minnesota
Statutes, section 256B.5012, subdivisions 19 and 20, as follows:
new text end

new text begin (1) apply Minnesota Statutes, section 256B.5012, subdivision 19; and
new text end

new text begin (2) apply any required rate increase as required under Minnesota Statutes, section
256B.5012, subdivision 20, to the results of clause (1).
new text end

Sec. 56. new text beginDIRECTION TO COMMISSIONER OF HUMAN SERVICES; BUDGET
EXCEPTIONS FOR COMMUNITY RESIDENTIAL SETTINGS.
new text end

new text begin The commissioner of human services must take steps to inform individuals, families,
and lead agencies of the amendments to Minnesota Statutes, section 256B.4911, subdivision
4, and widely disseminate easily understood instructions for quickly applying for a budget
exception under that section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 57. new text beginDIRECTION TO COMMISSIONER; DISABILITY WAIVER SHARED
SERVICES RATES.
new text end

new text begin The commissioner of human services shall establish a rate system for shared homemaker
services and shared chore services provided under Minnesota Statutes, sections 256B.092
and 256B.49. For two persons sharing services, the rate paid to a provider must not exceed
1-1/2 times the rate paid for serving a single individual, and for three persons sharing
services, the rate paid to a provider must not exceed two times the rate paid for serving a
single individual. These rates apply only when all of the criteria for the shared service have
been met.
new text end

Sec. 58. new text beginDIRECTION TO COMMISSIONER OF HUMAN SERVICES; SHARED
SERVICES.
new text end

new text begin (a) By December 1, 2022, the commissioner of human services shall seek any necessary
changes to home and community-based services waiver plans regarding sharing services in
order to:
new text end

new text begin (1) permit shared services for more services, including chore, homemaker, and night
supervision;
new text end

new text begin (2) permit shared services for some services for higher ratios, including individualized
home supports without training, individualized home supports with training, and
individualized home supports with family training for a ratio of one staff person to three
recipients;
new text end

new text begin (3) ensure that individuals who are seeking to share services permitted under the waiver
plans in an own-home setting are not required to live in a licensed setting in order to share
services so long as all other requirements are met; and
new text end

new text begin (4) issue guidance for shared services, including:
new text end

new text begin (i) informed choice for all individuals sharing the services;
new text end

new text begin (ii) guidance for when multiple shared services by different providers occur in one home
and how lead agencies and individuals shall determine that shared service is appropriate to
meet the needs, health, and safety of each individual for whom the lead agency provides
case management or care coordination; and
new text end

new text begin (iii) guidance clarifying that an individual's decision to share services does not reduce
any determination of the individual's overall or assessed needs for services.
new text end

new text begin (b) The commissioner shall develop or provide guidance outlining:
new text end

new text begin (1) instructions for shared services support planning;
new text end

new text begin (2) person-centered approaches and informed choice in shared services support planning;
and
new text end

new text begin (3) required contents of shared services agreements.
new text end

new text begin (c) The commissioner shall seek and utilize stakeholder input for any proposed changes
to waiver plans and any shared services guidance.
new text end

Sec. 59. new text beginDIRECTION TO COMMISSIONER OF HUMAN SERVICES;
LIFE-SHARING SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Recommendations required. new text end

new text begin The commissioner of human services shall
develop recommendations for establishing life sharing as a covered medical assistance
waiver service.
new text end

new text begin Subd. 2. new text end

new text begin Definition. new text end

new text begin For the purposes of this section, "life sharing" means a
relationship-based living arrangement between an adult with a disability and an individual
or family in which they share their lives and experiences while the adult with a disability
receives support from the individual or family using person-centered practices.
new text end

new text begin Subd. 3. new text end

new text begin Stakeholder engagement and consultation. new text end

new text begin (a) The commissioner must
proactively solicit participation in the development of the life-sharing medical assistance
service through a robust stakeholder engagement process that results in the inclusion of a
racially, culturally, and geographically diverse group of interested stakeholders from each
of the following groups:
new text end

new text begin (1) providers currently providing or interested in providing life-sharing services;
new text end

new text begin (2) people with disabilities accessing or interested in accessing life-sharing services;
new text end

new text begin (3) disability advocacy organizations; and
new text end

new text begin (4) lead agencies.
new text end

new text begin (b) The commissioner must proactively seek input into and assistance with the
development of recommendations for establishing the life-sharing service from interested
stakeholders.
new text end

new text begin (c) The commissioner must provide a method for the commissioner and interested
stakeholders to cofacilitate public meetings. The first meeting must occur before January
31, 2023. The commissioner must host the cofacilitated meetings at least monthly through
December 31, 2023. All meetings must be accessible to all interested stakeholders, recorded,
and posted online within one week of the meeting date.
new text end

new text begin Subd. 4. new text end

new text begin Required topics to be discussed during development of the
recommendations.
new text end

new text begin The commissioner and the interested stakeholders must discuss the
following topics:
new text end

new text begin (1) the distinction between life sharing and adult family foster care;
new text end

new text begin (2) successful life-sharing models used in other states;
new text end

new text begin (3) services and supports that could be included in a life-sharing service;
new text end

new text begin (4) potential barriers to providing or accessing life-sharing services;
new text end

new text begin (5) solutions to remove identified barriers to providing or accessing life-sharing services;
new text end

new text begin (6) potential medical assistance payment methodologies for life-sharing services;
new text end

new text begin (7) expanding awareness of the life-sharing model; and
new text end

new text begin (8) draft language for legislation necessary to define and implement life-sharing services.
new text end

new text begin Subd. 5. new text end

new text begin Report to the legislature. new text end

new text begin By December 31, 2023, the commissioner must
provide to the chairs and ranking minority members of the house of representatives and
senate committees and divisions with jurisdiction over direct care services a report
summarizing the discussions between the commissioner and the interested stakeholders and
the commissioner's recommendations. The report must also include any draft legislation
necessary to define and implement life-sharing services.
new text end

Sec. 60. new text beginDIRECTION TO COMMISSIONER OF HUMAN SERVICES; FINANCIAL
MANAGEMENT SERVICES PROVIDERS.
new text end

new text begin The commissioner of human services shall accept on a rolling basis proposals submitted
in response to "Request for Proposals for Qualified Grantees to Provide Vendor
Fiscal/Employer Agent Financial Management Services," published on May 2, 2016.
Responders must comply with all proposal instructions and requirements as set forth in the
request for proposals except the submission deadlines. The commissioner shall evaluate all
responsive proposals submitted under this section regardless of the date on which the proposal
is submitted. The commissioner shall conduct phase I and phase II evaluations using the
same procedures and evaluation standards set forth in the request for proposals. The
commissioner shall contact responders who submit substantially complete proposals to
provide further or missing information or to clarify the responder's proposal. The
commissioner shall select all responders that successfully move on to phase III evaluation.
For all proposals that move on to phase III evaluation, the commissioner shall not exercise
the commissioner's right to reject any or all proposals. The commissioner shall not compare
proposals that successfully move on to phase III evaluation. The commissioner shall not
reject a proposal that successfully moved on to phase III evaluation after determining that
another proposal is more advantageous to the state. This section expires upon publication
of a new request for proposals related to financial management services providers.
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. 61. new text beginREPEALER.
new text end

new text begin Laws 2022, chapter 33, section 1, subdivision 9a, 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 January 1, 2023, 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

ARTICLE 2

CONTINUING CARE FOR OLDER ADULTS

Section 1.

Minnesota Statutes 2020, section 256R.02, subdivision 16, is amended to read:


Subd. 16.

Dietary costs.

"Dietary costs" means the costs for deleted text beginthe salaries and wages of
the dietary supervisor, dietitians, chefs, cooks, dishwashers, and other employees assigned
to the kitchen and dining room, and associated fringe benefits and payroll taxes. Dietary
costs also includes
deleted text end the salaries or fees of dietary consultants, dietary supplies, and food
preparation and serving.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for the rate year beginning January 1,
2024, or upon federal approval, whichever occurs later. The commissioner of human services
shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 2.

Minnesota Statutes 2020, section 256R.02, is amended by adding a subdivision to
read:


new text begin Subd. 16a. new text end

new text begin Dietary labor costs. new text end

new text begin "Dietary labor costs" means the costs for the salaries
and wages of the dietary supervisor, dietitians, chefs, cooks, dishwashers, and other
employees assigned to the kitchen and dining room, and associated fringe benefits and
payroll taxes.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for the rate year beginning January 1,
2024, or upon federal approval, whichever occurs later. The commissioner of human services
shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 3.

Minnesota Statutes 2020, section 256R.02, subdivision 24, is amended to read:


Subd. 24.

Housekeeping costs.

"Housekeeping costs" means deleted text beginthe costs for the salaries
and wages of the housekeeping supervisor, housekeepers, and other cleaning employees
and associated fringe benefits and payroll taxes. It also includes
deleted text end the cost of housekeeping
supplies, including, but not limited to, cleaning and lavatory supplies and contract services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for the rate year beginning January 1,
2024, or upon federal approval, whichever occurs later. The commissioner of human services
shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 4.

Minnesota Statutes 2020, section 256R.02, is amended by adding a subdivision to
read:


new text begin Subd. 24a. new text end

new text begin Housekeeping labor costs. new text end

new text begin "Housekeeping labor costs" means the costs for
the salaries and wages of the housekeeping supervisor, housekeepers, and other cleaning
employees, and associated fringe benefits and payroll taxes.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for the rate year beginning January 1,
2024, or upon federal approval, whichever occurs later. The commissioner of human services
shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 5.

Minnesota Statutes 2020, section 256R.02, is amended by adding a subdivision to
read:


new text begin Subd. 25b. new text end

new text begin Known cost change factor. new text end

new text begin "Known cost change factor" means 1.00 plus
the forecasted percentage change in the CPI-U index from July 1 of the reporting period to
July 1 of the rate year as determined by the national economic consultant used by the
commissioner of management and budget.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for the rate year beginning January 1,
2024, or upon federal approval, whichever occurs later. The commissioner of human services
shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 6.

Minnesota Statutes 2020, section 256R.02, subdivision 26, is amended to read:


Subd. 26.

Laundry costs.

"Laundry costs" means the costs deleted text beginfor the salaries and wages
of the laundry supervisor and other laundry employees, associated fringe benefits, and
payroll taxes. It also includes the costs
deleted text end of linen and bedding, the laundering of resident
clothing, laundry supplies, and contract services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for the rate year beginning January 1,
2024, or upon federal approval, whichever occurs later. The commissioner of human services
shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 7.

Minnesota Statutes 2020, section 256R.02, is amended by adding a subdivision to
read:


new text begin Subd. 26a. new text end

new text begin Laundry labor costs. new text end

new text begin "Laundry labor costs" means the costs for the salaries
and wages of the laundry supervisor and other laundry employees, and associated fringe
benefits and payroll taxes.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for the rate year beginning January 1,
2024, or upon federal approval, whichever occurs later. The commissioner of human services
shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 8.

Minnesota Statutes 2020, section 256R.02, subdivision 29, is amended to read:


Subd. 29.

Maintenance and plant operations costs.

"Maintenance and plant operations
costs" means deleted text beginthe costs for the salaries and wages of the maintenance supervisor, engineers,
heating-plant employees, and other maintenance employees and associated fringe benefits
and payroll taxes. It also includes
deleted text end identifiable costs for maintenance and operation of the
building and grounds, including, but not limited to, fuel, electricity, medical waste and
garbage removal, water, sewer, supplies, tools, and repairs.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for the rate year beginning January 1,
2024, or upon federal approval, whichever occurs later. The commissioner of human services
shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 9.

Minnesota Statutes 2020, section 256R.02, is amended by adding a subdivision to
read:


new text begin Subd. 29a. new text end

new text begin Maintenance and plant operations labor costs. new text end

new text begin "Maintenance and plant
operations labor costs" means the costs for the salaries and wages of the maintenance
supervisor, engineers, heating-plant employees, and other maintenance employees, and
associated fringe benefits and payroll taxes.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for the rate year beginning January 1,
2024, or upon federal approval, whichever occurs later. The commissioner of human services
shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 10.

Minnesota Statutes 2020, section 256R.02, subdivision 34, is amended to read:


Subd. 34.

Other care-related costs.

"Other care-related costs" means the sum of activities
costs, other direct care costs, raw food costs,new text begin dietary labor costs, housekeeping labor costs,
laundry labor costs, maintenance and plant operations labor costs,
new text end therapy costs, and social
services costs.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for the rate year beginning January 1,
2024, or upon federal approval, whichever occurs later. The commissioner of human services
shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 11.

Minnesota Statutes 2020, section 256R.23, subdivision 2, is amended to read:


Subd. 2.

Calculation of direct care cost per standardized day.

Each facility's direct
care cost per standardized day isnew text begin the product ofnew text end the facility's direct care costsnew text begin and the known
cost change factor,
new text end divided by the sum of the facility's standardized days. A facility's direct
care cost per standardized day is the facility's cost per day for direct care services associated
with a case mix index of 1.00.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for the rate year beginning January 1,
2024, or upon federal approval, whichever occurs later. The commissioner of human services
shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 12.

Minnesota Statutes 2020, section 256R.23, subdivision 3, is amended to read:


Subd. 3.

Calculation of other care-related cost per resident day.

Each facility's other
care-related cost per resident day isnew text begin the product ofnew text end its other care-related costsnew text begin and the known
cost change factor
new text end, divided by the sum of the facility's resident days.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for the rate year beginning January 1,
2024, or upon federal approval, whichever occurs later. The commissioner of human services
shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 13.

Minnesota Statutes 2020, section 256R.24, subdivision 1, is amended to read:


Subdivision 1.

Determination of other operating cost per day.

Each facility's other
operating cost per day isnew text begin the product ofnew text end its other operating costsnew text begin and the known cost change
factor,
new text end divided by the sum of the facility's resident days.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for the rate year beginning January 1,
2024, or upon federal approval, whichever occurs later. The commissioner of human services
shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 14.

Minnesota Statutes 2020, section 256R.25, is amended to read:


256R.25 EXTERNAL FIXED COSTS PAYMENT RATE.

(a) The payment rate for external fixed costs is the sum of the amounts in paragraphs
(b) to (o).

(b) For a facility licensed as a nursing home, the portion related to the provider surcharge
under section 256.9657 is equal to $8.86 per resident day. For a facility licensed as both a
nursing home and a boarding care home, the portion related to the provider surcharge under
section 256.9657 is equal to $8.86 per resident day multiplied by the result of its number
of nursing home beds divided by its total number of licensed beds.

(c) The portion related to the licensure fee under section 144.122, paragraph (d), is the
amount of the fee divided by the sum of the facility's resident days.

(d) The portion related to development and education of resident and family advisory
councils under section 144A.33 is $5 per resident day divided by 365.

(e) The portion related to scholarships is determined under section 256R.37.

(f) The portion related to planned closure rate adjustments is as determined under section
256R.40, subdivision 5, and Minnesota Statutes 2010, section 256B.436.

(g) The portion related to consolidation rate adjustments shall be as determined under
section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d.

(h) The portion related to single-bed room incentives is as determined under section
256R.41.

(i) The portions related to real estate taxes, special assessments, and payments made in
lieu of real estate taxes directly identified or allocated to the nursing facility are the allowable
amounts divided by the sum of the facility's resident days. Allowable costs under this
paragraph for payments made by a nonprofit nursing facility that are in lieu of real estate
taxes shall not exceed the amount which the nursing facility would have paid to a city or
township and county for fire, police, sanitation services, and road maintenance costs had
real estate taxes been levied on that property for those purposes.

(j) The portion related to employer health insurance costs isnew text begin the product ofnew text end the allowable
costsnew text begin and the known cost change factor,new text end divided by the sum of the facility's resident days.

(k) The portion related to the Public Employees Retirement Association is the allowable
costs divided by the sum of the facility's resident days.

(l) The portion related to quality improvement incentive payment rate adjustments is
the amount determined under section 256R.39.

(m) The portion related to performance-based incentive payments is the amount
determined under section 256R.38.

(n) The portion related to special dietary needs is the amount determined under section
256R.51.

(o) The portion related to the rate adjustments for border city facilities is the amount
determined under section 256R.481.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for the rate year beginning January 1,
2024, or upon federal approval, whichever occurs later. The commissioner of human services
shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 15.

Minnesota Statutes 2020, section 256S.16, is amended to read:


256S.16 AUTHORIZATION OF ELDERLY WAIVER SERVICES AND SERVICE
RATES.

new text begin Subdivision 1. new text end

new text begin Service rates; generally. new text end

A lead agency must use the service rates and
service rate limits published by the commissioner to authorize services.

new text begin Subd. 2. new text end

new text begin Shared services; rates. new text end

new text begin The commissioner shall establish a rate system for
shared homemaker services and shared chore services, based on homemaker rates for a
single individual under section 256S.215, subdivisions 9 to 11, and the chore rate for a
single individual under section 256S.215, subdivision 7. For two persons sharing services,
the rate paid to a provider must not exceed 1-1/2 times the rate paid for serving a single
individual, and for three persons sharing services, the rate paid to a provider must not exceed
two times the rate paid for serving a single individual. These rates apply only when all of
the criteria for the shared service have been met.
new text end

Sec. 16.

Minnesota Statutes 2021 Supplement, section 256S.205, is amended to read:


256S.205 CUSTOMIZED LIVING SERVICES; DISPROPORTIONATE SHARE
RATE ADJUSTMENTS.

Subdivision 1.

Definitions.

(a) For the purposes of this section, the terms in this
subdivision have the meanings given.

(b) "Application year" means a year in which a facility submits an application for
designation as a disproportionate share facility.

(c) deleted text begin"Assisted living facility" or "facility" means an assisted living facility licensed under
chapter 144G
deleted text endnew text begin "Customized living resident" means a resident of a facility who is receiving
either 24-hour customized living services or customized living services authorized under
the elderly waiver, the brain injury waiver, or the community access for disability inclusion
waiver
new text end.

(d) "Disproportionate share facility" means deleted text beginan assisted livingdeleted text endnew text begin anew text end facility designated by
the commissioner under subdivision 4.

new text begin (e) "Facility" means either an assisted living facility licensed under chapter 144G or a
setting that is exempt from assisted living licensure under section 144G.08, subdivision 7,
clauses (10) to (13).
new text end

new text begin (f) "Rate year" means January 1 to December 31 of the year following an application
year.
new text end

Subd. 2.

Rate adjustment application.

deleted text beginAn assisted livingdeleted text endnew text begin Anew text end facility may apply to the
commissioner for designation as a disproportionate share facility. Applications must be
submitted annually between deleted text beginOctoberdeleted text endnew text begin Septembernew text end 1 and deleted text beginOctober 31deleted text endnew text begin September 30new text end. The
applying facility must apply in a manner determined by the commissioner. The applying
facility must document deleted text beginas a percentage the census of elderly waiver participantsdeleted text endnew text begin each of the
following on the application:
new text end

new text begin (1) the number of customized living residents in the facility on September 1 of the
application year, broken out by specific waiver program; and
new text end

new text begin (2) the total number of peoplenew text end residing in the facility on deleted text beginOctoberdeleted text endnew text begin Septembernew text end 1 of the
application year.

Subd. 3.

Rate adjustment eligibility criteria.

Only facilities deleted text beginwith a census of at least
80 percent elderly waiver participants
deleted text endnew text begin satisfying all of the following conditionsnew text end on deleted text beginOctoberdeleted text endnew text begin
September
new text end 1 of the application year are eligible for designation as a disproportionate share
facilitynew text begin:
new text end

new text begin (1) at least 80 percent of the residents of the facility are customized living residents; and
new text end

new text begin (2) at least 50 percent of the customized living residents are elderly waiver participantsnew text end.

Subd. 4.

Designation as a disproportionate share facility.

new text begin(a) new text endBy deleted text beginNovemberdeleted text endnew text begin Octobernew text end
15 of each application year, the commissioner must designate as a disproportionate share
facility a facility that complies with the application requirements of subdivision 2 and meets
the eligibility criteria of subdivision 3.

new text begin (b) An annual designation is effective for one rate year.
new text end

Subd. 5.

Rate adjustment; rate floor.

(a) Notwithstanding the 24-hour customized
living monthly service rate limits under section 256S.202, subdivision 2, and the component
service rates established under section 256S.201, subdivision 4, the commissioner must
establish a rate floor equal to deleted text begin$119deleted text endnew text begin $139new text end per resident per day for 24-hour customized living
services providednew text begin to an elderly waiver participantnew text end in a designated disproportionate share
facility deleted text beginfor the purpose of ensuring the minimal level of staffing required to meet the health
and safety needs of elderly waiver participants
deleted text end.

new text begin (b) The commissioner must apply the rate floor to the services described in paragraph
(a) provided during the rate year.
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end The commissioner must adjust the rate floor deleted text beginat least annually in the manner
described under section deleted text begin256S.18, subdivisions 5deleted text end and 6
deleted text endnew text begin by the same amount and at the same
time as any adjustment to the 24-hour customized living monthly service rate limits under
section 256S.202, subdivision 2
new text end.

deleted text begin (c)deleted text endnew text begin (d)new text end The commissioner shall not implement the rate floor under this section if the
customized living rates established under sections 256S.21 to 256S.215 will be implemented
at 100 percent on January 1 of the year following an application year.

Subd. 6.

Budget cap disregard.

The value of the rate adjustment under this section
must not be included in an elderly waiver client's monthly case mix budget cap.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later, and applies to services provided on or after October 1, 2022, or on or
after the date upon which federal approval is obtained, whichever is later. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 17.

Minnesota Statutes 2021 Supplement, section 256S.2101, is amended to read:


256S.2101 RATE SETTING; PHASE-IN.

Subdivision 1.

Phase-in for disability waiver customized living rates.

All rates and
rate components for community access for disability inclusion customized living and brain
injury customized living under section 256B.4914 shall be the sum of deleted text begintendeleted text endnew text begin 27.2new text end percent of
the rates calculated under sections 256S.211 to 256S.215 and deleted text begin90deleted text endnew text begin 72.8new text end percent of the rates
calculated using the rate methodology in effect as of June 30, 2017.

Subd. 2.

Phase-in for elderly waiver rates.

Except for home-delivered meals as
described in section 256S.215, subdivision 15, all rates and rate components for elderly
waiver, elderly waiver customized living, and elderly waiver foster care under this chapter;
alternative care under section 256B.0913; and essential community supports under section
256B.0922 shall be the sum of deleted text begin18.8deleted text endnew text begin 27.2new text end percent of the rates calculated under sections
256S.211 to 256S.215, and deleted text begin81.2deleted text endnew text begin 72.8new text end percent of the rates calculated using the rate
methodology in effect as of June 30, 2017. The rate for home-delivered meals shall be the
sum of the service rate in effect as of January 1, 2019, and the increases described in section
256S.215, subdivision 15.

new text begin Subd. 3. new text end

new text begin Spending requirements. new text end

new text begin (a) At least 80 percent of the marginal increase in
revenue from the implementation of adjusted phase-in proportions under this section,
including any concurrent or subsequent adjustments to the base wage indices, for services
rendered on or after the day of implementation of the modified phase-in proportion or
applicable adjustment to the base wage indices must be used to increase compensation-related
costs for employees directly employed by the provider.
new text end

new text begin (b) For the purposes of this subdivision, compensation-related costs include:
new text end

new text begin (1) wages and salaries;
new text end

new text begin (2) the employer's share of FICA taxes, Medicare taxes, state and federal unemployment
taxes, workers' compensation, and mileage reimbursement;
new text end

new text begin (3) the employer's paid share of health and dental insurance, life insurance, disability
insurance, long-term care insurance, uniform allowance, pensions, and contributions to
employee retirement accounts; and
new text end

new text begin (4) benefits that address direct support professional workforce needs above and beyond
what employees were offered prior to the implementation of adjusted phase-in proportions
under this section, including any concurrent or subsequent adjustments to the base wage
indices.
new text end

new text begin (c) Compensation-related costs for persons employed in the central office of a corporation
or entity that has an ownership interest in the provider or exercises control over the provider,
or for persons paid by the provider under a management contract, do not count toward the
80 percent requirement under this subdivision.
new text end

new text begin (d) A provider or individual provider that receives additional revenue subject to the
requirements of this subdivision shall prepare, and upon request submit to the commissioner,
a distribution plan that specifies the amount of money the provider expects to receive that
is subject to the requirements of this subdivision, including how that money was or will be
distributed to increase compensation-related costs for employees. Within 60 days of final
implementation of the new phase-in proportion or adjustment to the base wage indices
subject to the requirements of this subdivision, the provider must post the distribution plan
and leave it posted for a period of at least six months in an area of the provider's operation
to which all direct support professionals have access. The posted distribution plan must
include instructions regarding how to contact the commissioner, or the commissioner's
representative, if an employee has not received the compensation-related increase described
in the plan.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 18. new text beginNURSING FACILITY FUNDING.
new text end

new text begin (a) Effective July 1, 2022, through December 31, 2024, the total payment rate for all
facilities reimbursed under this section must be increased by $28.65 per resident day.
new text end

new text begin (b) To be eligible to receive a payment under this section, a nursing facility must attest
to the commissioner of human services that the additional revenue will be used exclusively
to increase compensation-related costs for employees directly employed by the facility on
or after July 1, 2022, excluding:
new text end

new text begin (1) owners of the building and operation;
new text end

new text begin (2) persons employed in the central office of an entity that has any ownership interest
in the nursing facility or exercises control over the nursing facility;
new text end

new text begin (3) persons paid by the nursing facility under a management contract; and
new text end

new text begin (4) persons providing separately billable services.
new text end

new text begin (c) Contracted housekeeping, dietary, and laundry employees providing services on site
at the nursing facility are eligible for compensation-related cost increases under this section,
provided the agency that employs them submits to the nursing facility proof of the costs of
the increases provided to those employees.
new text end

new text begin (d) For purposes of this section, compensation-related costs include:
new text end

new text begin (1) permanent new increases to wages and salaries implemented on or after July 1, 2022,
and before September 1, 2022, for nursing facility employees;
new text end

new text begin (2) permanent new increases to wages and salaries implemented on or after July 1, 2022,
and before September 1, 2022, for employees in the organization's shared services
departments of hospital-attached nursing facilities for the nursing facility allocated share
of wages; and
new text end

new text begin (3) the employer's share of FICA taxes, Medicare taxes, state and federal unemployment
taxes, PERA, workers' compensation, and pension and employee retirement accounts directly
associated with the wage and salary increases in clauses (1) and (2) incurred no later than
December 31, 2024, and paid for no later than June 30, 2025.
new text end

new text begin (e) A facility that receives a rate increase under this section must complete a distribution
plan in the form and manner determined by the commissioner. This plan must specify the
total amount of money the facility is estimated to receive from this rate increase and how
that money will be distributed to increase the allowable compensation-related costs described
in paragraph (d) for employees described in paragraphs (b) and (c). This estimate must be
computed by multiplying $28.65 by the sum of the medical assistance and private pay
resident days as defined in Minnesota Statutes, section 256R.02, subdivision 45, for the
period beginning October 1, 2020, through September 30, 2021, dividing this sum by 365
and multiplying the result by 915. A facility must submit its distribution plan to the
commissioner by October 1, 2022. The commissioner may review the distribution plan to
ensure that the payment rate adjustment per resident day is used in accordance with this
section. The commissioner may allow for a distribution plan amendment under exceptional
circumstances to be determined at the sole discretion of the commissioner.
new text end

new text begin (f) By September 1, 2022, a facility must post the distribution plan summary and leave
it posted for a period of at least six months in an area of the facility to which all employees
have access. The posted distribution plan summary must be in the form and manner
determined by the commissioner. The distribution plan summary must include instructions
regarding how to contact the commissioner or the commissioner's representative if an
employee believes the employee is covered by paragraph (b) or (c) and has not received the
compensation-related increases described in paragraph (d). The instruction to such employees
must include the e-mail address and telephone number that may be used by the employee
to contact the commissioner's representative. The posted distribution plan summary must
demonstrate how the increase in paragraph (a) received by the nursing facility from July 1,
2022, through December 1, 2024, will be used in full to pay the compensation-related costs
in paragraph (d) for employees described in paragraphs (b) and (c).
new text end

new text begin (g) If the nursing facility expends less on new compensation-related costs than the amount
that was made available by the rate increase in this section for that purpose, the amount of
this rate adjustment must be reduced to equal the amount utilized by the facility for purposes
authorized under this section. If the facility fails to post the distribution plan summary in
its facility as required, fails to submit its distribution plan to the commissioner by the due
date, or uses these funds for unauthorized purposes, these rate increases must be treated as
an overpayment and subsequently recovered.
new text end

new text begin (h) The commissioner shall not treat payments received under this section as an applicable
credit for purposes of setting total payment rates under Minnesota Statutes, chapter 256R.
new text end

Sec. 19. new text beginDIRECTION TO COMMISSIONER OF HUMAN SERVICES;
IMPLEMENTATION OF DISPROPORTIONATE SHARE RATE ADJUSTMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin For the purposes of this section, the definitions in Minnesota
Statutes, section 256S.205, apply.
new text end

new text begin Subd. 2. new text end

new text begin Modified implementation of rate years 2022 and 2023. new text end

new text begin (a) Notwithstanding
the provisions of Minnesota Statutes, section 256S.205, subdivisions 2 to 5, regarding
application dates, eligibility dates, designation dates, and payment adjustment dates, a
facility may apply between July 1, 2022, and July 31, 2022, to be designated a
disproportionate share facility on the basis of the conditions outlined in Minnesota Statutes,
section 256S.205, subdivision 3, as of July 1, 2022. The commissioner shall designate
disproportionate share facilities by August 15, 2022. Between October 1, 2022, and December
31, 2023, the commissioner shall apply the rate floor under Minnesota Statutes, section
256S.205, as amended in this act, to eligible customized living services provided in
disproportionate share facilities between those dates. On January 1, 2023, the commissioner
shall adjust the rate floor amount as directed in Minnesota Statutes, section 256S.205,
subdivision 5, paragraph (c).
new text end

new text begin Subd. 3. new text end

new text begin Rate year 2023. new text end

new text begin The commissioner shall not administer an application between
September 1, 2022, and September 30, 2022, as described in Minnesota Statutes, section
256S.205, subdivisions 2 to 4, for the purposes of rate year 2023.
new text end

new text begin Subd. 4. new text end

new text begin Treatment of prior rate adjustments. new text end

new text begin (a) The commissioner shall apply rate
adjustments required under Minnesota Statutes 2021 Supplement, section 256S.205, until
September 30, 2022. Beginning October 1, 2022, the commissioner shall remove all rate
adjustments required under Minnesota Statutes 2021 Supplement, section 256S.205.
new text end

new text begin (b) A disproportionate share facility receiving a rate adjustment under Minnesota Statutes
2021 Supplement, section 256S.205, as of July 1, 2022, may apply for an adjustment under
this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin (a) Subdivisions 1 to 3 are effective July 1, 2022, or upon federal
approval, whichever is later, and apply to services provided on or after October 1, 2022, or
on or after the date upon which federal approval is obtained, whichever is later. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

new text begin (b) Subdivision 4 is effective July 1, 2022.
new text end

Sec. 20. new text beginDIRECTION TO COMMISSIONER OF HUMAN SERVICES; ELDERLY
WAIVER BASE WAGE INDEX ADJUSTMENTS.
new text end

new text begin On January 1, 2023, the commissioner shall update the base wage indices in Minnesota
Statutes, section 256S.212, based on the most recently available Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage data from the Bureau of Labor Statistics.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, or upon federal approval,
whichever occurs later. The commissioner of human services shall inform the revisor of
statutes when federal approval is obtained.
new text end

ARTICLE 3

HEALTH CARE

Section 1.

Minnesota Statutes 2020, section 137.68, is amended to read:


137.68 new text beginMINNESOTA RARE DISEASE new text endADVISORY COUNCIL deleted text beginON RARE
DISEASES
deleted text end.

Subdivision 1.

Establishment.

deleted text beginThe University of Minnesota is requested to establishdeleted text endnew text begin
There is established
new text end an advisory council on rare diseases to provide advice onnew text begin policies,
access, equity,
new text end research, diagnosis, treatment, and education related to rare diseases.new text begin The
advisory council is established in honor of Chloe Barnes and her experiences in the health
care system.
new text end For purposes of this section, "rare disease" has the meaning given in United
States Code, title 21, section 360bb. The council shall be called the deleted text beginChloe Barnes Advisory
Council on Rare Diseases
deleted text endnew text begin Minnesota Rare Disease Advisory Councilnew text end.new text begin The Council on
Disability shall provide meeting and office space and administrative support to the advisory
council but does not have authority over the work of the advisory council.
new text end

Subd. 2.

Membership.

(a) The advisory council deleted text beginmaydeleted text endnew text begin shallnew text end consist of new text beginat least 17 new text endpublic
members new text beginwho reflect statewide representation. Except for initial members, members are
new text end appointed by deleted text beginthe Board of Regents or a designeedeleted text endnew text begin the governornew text end according to paragraph (b)
deleted text begin anddeleted text endnew text begin.new text end Four members of the legislature new text beginare new text endappointed according to paragraph (c).

(b) deleted text beginThe Board of Regents or a designee is requested todeleted text endnew text begin The governor shallnew text end appoint new text beginat
least
new text endthe following public membersnew text begin according to section 15.0597new text end:

(1) three physicians licensed and practicing in the state with experience researching,
diagnosing, or treating rare diseases, including one specializing in pediatrics;

(2) one registered nurse or advanced practice registered nurse licensed and practicing
in the state with experience treating rare diseases;

(3) at least two hospital administrators, or their designees, from hospitals in the state
that provide care to persons diagnosed with a rare disease. One administrator or designee
appointed under this clause must represent a hospital in which the scope of service focuses
on rare diseases of pediatric patients;

(4) three persons age 18 or older who either have a rare disease or are a caregiver of a
person with a rare diseasenew text begin. One person appointed under this clause must reside in rural
Minnesota
new text end;

(5) a representative of a rare disease patient organization that operates in the state;

(6) a social worker with experience providing services to persons diagnosed with a rare
disease;

(7) a pharmacist with experience with drugs used to treat rare diseases;

(8) a dentist licensed and practicing in the state with experience treating rare diseases;

(9) a representative of the biotechnology industry;

(10) a representative of health plan companies;

(11) a medical researcher with experience conducting research on rare diseases; deleted text beginand
deleted text end

(12) a genetic counselor with experience providing services to persons diagnosed with
a rare disease or caregivers of those personsdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (13) representatives with other areas of expertise as identified by the advisory council.
new text end

(c) The advisory council shall include two members of the senate, one appointed by the
majority leader and one appointed by the minority leader; and two members of the house
of representatives, one appointed by the speaker of the house and one appointed by the
minority leader. new text beginMembers appointed under this paragraph serve until their successors are
appointed.
new text end

(d) The commissioner of health or a designee, a representative of Mayo Medical School,
and a representative of the University of Minnesota Medical School shall serve as ex officio,
nonvoting members of the advisory council.

(e) deleted text beginInitial appointments to the advisory council shall be made no later than September
1, 2019.
deleted text end Members appointed according to paragraph (b) shall serve for a term of three years,
except deleted text beginthatdeleted text end the initial members appointed according to paragraph (b) deleted text beginshall have an initial
term of two, three, or four years determined by lot by the chairperson
deleted text end. Members appointed
according to paragraph (b) shall serve until their successors have been appointed.

new text begin (f) Members may be reappointed for up to two full additional terms according to the
advisory council's operating procedures.
new text end

new text begin (g) Members may be removed as provided in section 15.059, subdivision 4.
new text end

new text begin (h) Public members serve without compensation, but may have expenses reimbursed as
provided in section 15.059, subdivision 3. Legislative members may receive per diem
according to the rules of their respective bodies.
new text end

Subd. 3.

Meetings.

deleted text beginThe Board of Regents or a designee is requested to convene the first
meeting of the advisory council no later than October 1, 2019.
deleted text end The advisory council shall
meet at the call of the chairperson or at the request of a majority of advisory council members.new text begin
Meetings of the advisory council are subject to section 13D.01, and notice of its meetings
is governed by section 13D.04.
new text end

new text begin Subd. 3a. new text end

new text begin Chairperson; executive director; staff; executive committee. new text end

new text begin (a) The
advisory council shall elect a chairperson and other officers as it deems necessary and in
accordance with the advisory council's operating procedures.
new text end

new text begin (b) The advisory council shall be governed by an executive committee elected by the
members of the advisory council. One member of the executive committee must be the
advisory council chairperson.
new text end

new text begin (c) The advisory council shall appoint an executive director. The executive director
serves as an ex officio nonvoting member of the executive committee. The advisory council
may delegate to the executive director any powers and duties under this section that do not
require advisory council approval. The executive director serves in the unclassified service
and may be removed at any time by a majority vote of the advisory council. The executive
director may employ and direct staff necessary to carry out advisory council mandates,
policies, activities, and objectives.
new text end

new text begin (d) The executive committee may appoint additional subcommittees and work groups
as necessary to fulfill the duties of the advisory council.
new text end

Subd. 4.

Duties.

(a) The advisory council's duties may include, but are not limited to:

(1) in conjunction with the state's medical schools, the state's schools of public health,
and hospitals in the state that provide care to persons diagnosed with a rare disease,
developing resources or recommendations relating to quality of and access to treatment and
services in the state for persons with a rare disease, including but not limited to:

(i) a list of existing, publicly accessible resources on research, diagnosis, treatment, and
education relating to rare diseases;

(ii) identifying best practices for rare disease care implemented in other states, at the
national level, and at the international level that will improve rare disease care in the state
and seeking opportunities to partner with similar organizations in other states and countries;

(iii) identifyingnew text begin and addressingnew text end problems faced by patients with a rare disease when
changing health plans, including recommendations on how to remove obstacles faced by
these patients to finding a new health plan and how to improve the ease and speed of finding
a new health plan that meets the needs of patients with a rare disease; deleted text beginand
deleted text end

new text begin (iv) identifying and addressing barriers faced by patients with a rare disease to obtaining
care, caused by prior authorization requirements in private and public health plans; and
new text end

deleted text begin (iv)deleted text endnew text begin (v)new text end identifyingnew text begin, recommending, and implementingnew text end best practices to ensure health
care providers are adequately informed of the most effective strategies for recognizing and
treating rare diseases; deleted text beginand
deleted text end

(2) advising, consulting, and cooperating with the Department of Health,new text begin includingnew text end the
Advisory Committee on Heritable and Congenital Disordersdeleted text begin,deleted text endnew text begin; the Department of Human
Services, including the Drug Utilization Review Board and the Drug Formulary Committee;
new text end
and other agencies of state government in developing new text beginrecommendations, new text endinformationnew text begin,new text end and
programs for the public and the health care community relating to diagnosis, treatment, and
awareness of rare diseasesdeleted text begin.deleted text endnew text begin;
new text end

new text begin (3) advising on policy issues and advancing policy initiatives at the state and federal
levels; and
new text end

new text begin (4) receiving funds and issuing grants.
new text end

(b) The advisory council shall collect additional topic areas for study and evaluation
from the general public. In order for the advisory council to study and evaluate a topic, the
topic must be approved for study and evaluation by the advisory council.

new text begin (c) Legislative members may not deliberate about or vote on decisions related to the
issuance of grants of state money.
new text end

Subd. 5.

Conflict of interest.

Advisory council members are subject to the deleted text beginBoard of
Regents policy on conflicts
deleted text endnew text begin advisory council's conflictnew text end of interestnew text begin policy as outlined in the
advisory council's operating procedures
new text end.

Subd. 6.

Annual report.

By January 1 of each year, beginning January 1, 2020, the
advisory council shall report to the chairs and ranking minority members of the legislative
committees with jurisdiction over higher education and health care policy on the advisory
council's activities under subdivision 4 and other issues on which the advisory council may
choose to report.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 2.

Minnesota Statutes 2021 Supplement, section 256B.0371, subdivision 4, is amended
to read:


Subd. 4.

Dental utilization report.

(a) The commissioner shall submit an annual report
beginning March 15, 2022, and ending March 15, 2026, to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance that includes the percentage for adults and children one through 20 years
of age for the most recent complete calendar year receiving at least one dental visit for both
fee-for-service and the prepaid medical assistance program. The report must include:

(1) statewide utilization for both fee-for-service and for the prepaid medical assistance
program;

(2) utilization by county;

(3) utilization by children receiving dental services through fee-for-service and through
a managed care plan or county-based purchasing plan;

(4) utilization by adults receiving dental services through fee-for-service and through a
managed care plan or county-based purchasing plan.

(b) The report must also include a description of any corrective action plans required to
be submitted under subdivision 2.

(c) The initial report due on March 15, 2022, must include the utilization metrics described
in paragraph (a) for each of the following calendar years: 2017, 2018, 2019, and 2020.

new text begin (d) In the annual report due on March 15, 2023, and in each report due thereafter, the
commissioner shall include the following:
new text end

new text begin (1) the number of dentists enrolled with the commissioner as a medical assistance dental
provider and the congressional district or districts in which the dentist provides services;
new text end

new text begin (2) the number of enrolled dentists who provided fee-for-service dental services to
medical assistance or MinnesotaCare patients within the previous calendar year in the
following increments: one to nine patients, ten to 100 patients, and over 100 patients;
new text end

new text begin (3) the number of enrolled dentists who provided dental services to medical assistance
or MinnesotaCare patients through a managed care plan or county-based purchasing plan
within the previous calendar year in the following increments: one to nine patients, ten to
100 patients, and over 100 patients; and
new text end

new text begin (4) the number of dentists who provided dental services to a new patient who was enrolled
in medical assistance or MinnesotaCare within the previous calendar year.
new text end

new text begin (e) The report due on March 15, 2023, must include the metrics described in paragraph
(d) for each of the following years: 2017, 2018, 2019, 2020, and 2021.
new text end

Sec. 3.

Minnesota Statutes 2020, section 256B.057, subdivision 9, is amended to read:


Subd. 9.

Employed persons with disabilities.

(a) Medical assistance may be paid for
a person who is employed and who:

(1) but for excess earnings or assets, meets the definition of disabled under the
Supplemental Security Income program;

(2) meets the asset limits in paragraph (d); and

(3) pays a premium and other obligations under paragraph (e).

(b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible
for medical assistance under this subdivision, a person must have more than $65 of earned
income. Earned income must have Medicare, Social Security, and applicable state and
federal taxes withheld. The person must document earned income tax withholding. Any
spousal income or assets shall be disregarded for purposes of eligibility and premium
determinations.

(c) After the month of enrollment, a person enrolled in medical assistance under this
subdivision who:

(1) is temporarily unable to work and without receipt of earned income due to a medical
condition, as verified by a physician, advanced practice registered nurse, or physician
assistant; or

(2) loses employment for reasons not attributable to the enrollee, and is without receipt
of earned income may retain eligibility for up to four consecutive months after the month
of job loss. To receive a four-month extension, enrollees must verify the medical condition
or provide notification of job loss. All other eligibility requirements must be met and the
enrollee must pay all calculated premium costs for continued eligibility.

(d) For purposes of determining eligibility under this subdivision, a person's assets must
not exceed $20,000, excluding:

(1) all assets excluded under section 256B.056;

(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, Keogh
plans, and pension plans;

(3) medical expense accounts set up through the person's employer; and

(4) spousal assets, including spouse's share of jointly held assets.

(e) All enrollees must pay a premium to be eligible for medical assistance under this
subdivision, except as provided under new text beginclause (1), item (i), andnew text end clause (5).

(1) An enrollee must pay deleted text beginthe greater of a $35 premium ordeleted text end the premium calculated deleted text beginbased
on
deleted text endnew text begin by applying the following sliding premium fee scale tonew text end the person's gross earned and
unearned income and the applicable family size deleted text beginusing a sliding fee scale established by the
commissioner, which begins at one percent of income at 100 percent of the federal poverty
guidelines and increases to 7.5 percent of income for those with incomes at or above 300
percent of the federal poverty guidelines.
deleted text endnew text begin:
new text end

new text begin (i) for enrollees with income less than 200 percent of federal poverty guidelines, the
premium shall be zero percent of income;
new text end

new text begin (ii) for enrollees with income from 200 to 250 percent of federal poverty guidelines, the
sliding premium fee scale shall begin at zero percent of income and increase to 2.5 percent;
new text end

new text begin (iii) for enrollees with income from 250 to 300 percent of federal poverty guidelines,
the sliding premium fee scale shall begin at 2.5 percent of income and increase to 4.5 percent;
new text end

new text begin (iv) for enrollees with income from 300 to 400 percent of federal poverty guidelines,
the sliding premium fee scale shall begin at 4.5 percent of income and increase to six percent;
new text end

new text begin (v) for enrollees with income from 400 to 500 percent of federal poverty guidelines, the
sliding premium fee scale shall begin at six percent of income and increase to 7.5 percent;
and
new text end

new text begin (vi) for enrollees with income greater than 500 percent of federal poverty guidelines,
the premium shall be 7.5 percent of income.
new text end

(2) Annual adjustments in the premium schedule based upon changes in the federal
poverty guidelines shall be effective for premiums due in July of each year.

(3) All enrollees who receive unearned income must pay one-half of one percent of
unearned income in addition to the premium amount, except as provided under clause (5).

(4) Increases in benefits under title II of the Social Security Act shall not be counted as
income for purposes of this subdivision until July 1 of each year.

(5) Effective July 1, 2009, American Indians are exempt from paying premiums as
required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public
Law 111-5. For purposes of this clause, an American Indian is any person who meets the
definition of Indian according to Code of Federal Regulations, title 42, section 447.50.

(f) A person's eligibility and premium shall be determined by the local county agency.
Premiums must be paid to the commissioner. All premiums are dedicated to the
commissioner.

(g) Any required premium shall be determined at application and redetermined at the
enrollee's six-month income review or when a change in income or household size is reported.
Enrollees must report any change in income or household size within ten days of when the
change occurs. A decreased premium resulting from a reported change in income or
household size shall be effective the first day of the next available billing month after the
change is reported. Except for changes occurring from annual cost-of-living increases, a
change resulting in an increased premium shall not affect the premium amount until the
next six-month review.

(h) Premium payment is due upon notification from the commissioner of the premium
amount required. Premiums may be paid in installments at the discretion of the commissioner.

(i) Nonpayment of the premium shall result in denial or termination of medical assistance
unless the person demonstrates good cause for nonpayment. "Good cause" means an excuse
for the enrollee's failure to pay the required premium when due because the circumstances
were beyond the enrollee's control or not reasonably foreseeable. The commissioner shall
determine whether good cause exists based on the weight of the supporting evidence
submitted by the enrollee to demonstrate good cause. Except when an installment agreement
is accepted by the commissioner, all persons disenrolled for nonpayment of a premium must
pay any past due premiums as well as current premiums due prior to being reenrolled.
Nonpayment shall include payment with a returned, refused, or dishonored instrument. The
commissioner may require a guaranteed form of payment as the only means to replace a
returned, refused, or dishonored instrument.

(j) For enrollees whose income does not exceed 200 percent of the federal poverty
guidelines and who are also enrolled in Medicare, the commissioner shall reimburse the
enrollee for Medicare Part B premiums under section 256B.0625, subdivision 15, paragraph
(a).

Sec. 4.

Minnesota Statutes 2021 Supplement, section 256B.0625, subdivision 10, is
amended to read:


Subd. 10.

Laboratory, x-ray, and opioid testing services.

(a) Medical assistance covers
laboratory and x-ray services.

(b) Medical assistance covers screening and urinalysis tests for opioids without lifetime
or annual limits.

new text begin (c) Medical assistance covers laboratory tests ordered and performed by a licensed
pharmacist, according to the requirements of section 151.01, subdivision 27, clause (3), at
no less than the rate for which the same services are covered when provided by any other
licensed practitioner.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 5.

Minnesota Statutes 2021 Supplement, section 256B.0625, subdivision 17, is
amended to read:


Subd. 17.

Transportation costs.

(a) "Nonemergency medical transportation service"
means motor vehicle transportation provided by a public or private person that serves
Minnesota health care program beneficiaries who do not require emergency ambulance
service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.

(b) Medical assistance covers medical transportation costs incurred solely for obtaining
emergency medical care or transportation costs incurred by eligible persons in obtaining
emergency or nonemergency medical care when paid directly to an ambulance company,
nonemergency medical transportation company, or other recognized providers of
transportation services. Medical transportation must be provided by:

(1) nonemergency medical transportation providers who meet the requirements of this
subdivision;

(2) ambulances, as defined in section 144E.001, subdivision 2;

(3) taxicabs that meet the requirements of this subdivision;

(4) public transit, as defined in section 174.22, subdivision 7; or

(5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472,
subdivision 1, paragraph (h).

(c) Medical assistance covers nonemergency medical transportation provided by
nonemergency medical transportation providers enrolled in the Minnesota health care
programs. All nonemergency medical transportation providers must comply with the
operating standards for special transportation service as defined in sections 174.29 to 174.30
and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the
commissioner and reported on the claim as the individual who provided the service. All
nonemergency medical transportation providers shall bill for nonemergency medical
transportation services in accordance with Minnesota health care programs criteria. Publicly
operated transit systems, volunteers, and not-for-hire vehicles are exempt from the
requirements outlined in this paragraph.

(d) An organization may be terminated, denied, or suspended from enrollment if:

(1) the provider has not initiated background studies on the individuals specified in
section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or

(2) the provider has initiated background studies on the individuals specified in section
174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:

(i) the commissioner has sent the provider a notice that the individual has been
disqualified under section 245C.14; and

(ii) the individual has not received a disqualification set-aside specific to the special
transportation services provider under sections 245C.22 and 245C.23.

(e) The administrative agency of nonemergency medical transportation must:

(1) adhere to the policies defined by the commissioner in consultation with the
Nonemergency Medical Transportation Advisory Committee;

(2) pay nonemergency medical transportation providers for services provided to
Minnesota health care programs beneficiaries to obtain covered medical services;

(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
trips, and number of trips by mode; and

(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single
administrative structure assessment tool that meets the technical requirements established
by the commissioner, reconciles trip information with claims being submitted by providers,
and ensures prompt payment for nonemergency medical transportation services.

(f) Until the commissioner implements the single administrative structure and delivery
system under subdivision 18e, clients shall obtain their level-of-service certificate from the
commissioner or an entity approved by the commissioner that does not dispatch rides for
clients using modes of transportation under paragraph (i), clauses (4), (5), (6), and (7).

(g) The commissioner may use an order by the recipient's attending physician, advanced
practice registered nurse, or a medical or mental health professional to certify that the
recipient requires nonemergency medical transportation services. Nonemergency medical
transportation providers shall perform driver-assisted services for eligible individuals, when
appropriate. Driver-assisted service includes passenger pickup at and return to the individual's
residence or place of business, assistance with admittance of the individual to the medical
facility, and assistance in passenger securement or in securing of wheelchairs, child seats,
or stretchers in the vehicle.

Nonemergency medical transportation providers must take clients to the health care
provider using the most direct route, and must not exceed 30 miles for a trip to a primary
care provider or 60 miles for a trip to a specialty care provider, unless the client receives
authorization from the local agency.

Nonemergency medical transportation providers may not bill for separate base rates for
the continuation of a trip beyond the original destination. Nonemergency medical
transportation providers must maintain trip logs, which include pickup and drop-off times,
signed by the medical provider or client, whichever is deemed most appropriate, attesting
to mileage traveled to obtain covered medical services. Clients requesting client mileage
reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
services.

(h) The administrative agency shall use the level of service process established by the
commissioner in consultation with the Nonemergency Medical Transportation Advisory
Committee to determine the client's most appropriate mode of transportation. If public transit
or a certified transportation provider is not available to provide the appropriate service mode
for the client, the client may receive a onetime service upgrade.

(i) The covered modes of transportation are:

(1) client reimbursement, which includes client mileage reimbursement provided to
clients who have their own transportation, or to family or an acquaintance who provides
transportation to the client;

(2) volunteer transport, which includes transportation by volunteers using their own
vehicle;

(3) unassisted transport, which includes transportation provided to a client by a taxicab
or public transit. If a taxicab or public transit is not available, the client can receive
transportation from another nonemergency medical transportation provider;

(4) assisted transport, which includes transport provided to clients who require assistance
by a nonemergency medical transportation provider;

(5) lift-equipped/ramp transport, which includes transport provided to a client who is
dependent on a device and requires a nonemergency medical transportation provider with
a vehicle containing a lift or ramp;

(6) protected transport, which includes transport provided to a client who has received
a prescreening that has deemed other forms of transportation inappropriate and who requires
a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
locks, a video recorder, and a transparent thermoplastic partition between the passenger and
the vehicle driver; and (ii) who is certified as a protected transport provider; and

(7) stretcher transport, which includes transport for a client in a prone or supine position
and requires a nonemergency medical transportation provider with a vehicle that can transport
a client in a prone or supine position.

(j) The local agency shall be the single administrative agency and shall administer and
reimburse for modes defined in paragraph (i) according to paragraphs (m) and (n) when the
commissioner has developed, made available, and funded the web-based single administrative
structure, assessment tool, and level of need assessment under subdivision 18e. The local
agency's financial obligation is limited to funds provided by the state or federal government.

(k) The commissioner shall:

(1) in consultation with the Nonemergency Medical Transportation Advisory Committee,
verify that the mode and use of nonemergency medical transportation is appropriate;

(2) verify that the client is going to an approved medical appointment; and

(3) investigate all complaints and appeals.

(l) The administrative agency shall pay for the services provided in this subdivision and
seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
local agencies are subject to the provisions in section 256B.041, the sanctions and monetary
recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.

(m) Payments for nonemergency medical transportation must be paid based on the client's
assessed mode under paragraph (h), not the type of vehicle used to provide the service. The
medical assistance reimbursement rates for nonemergency medical transportation services
that are payable by or on behalf of the commissioner for nonemergency medical
transportation services are:

(1) $0.22 per mile for client reimbursement;

(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
transport;

(3) equivalent to the standard fare for unassisted transport when provided by public
transit, and deleted text begin$11deleted text endnew text begin $12.93new text end for the base rate and deleted text begin$1.30deleted text endnew text begin $1.53new text end per mile when provided by a
nonemergency medical transportation provider;

(4) deleted text begin$13deleted text endnew text begin $15.28new text end for the base rate and deleted text begin$1.30deleted text endnew text begin $1.53new text end per mile for assisted transport;

(5) deleted text begin$18deleted text endnew text begin $21.15new text end for the base rate and deleted text begin$1.55deleted text endnew text begin $1.82new text end per mile for lift-equipped/ramp transport;

(6) $75 for the base rate and $2.40 per mile for protected transport; and

(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
an additional attendant if deemed medically necessary.

(n) The base rate for nonemergency medical transportation services in areas defined
under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
paragraph (m), clauses (1) to (7). The mileage rate for nonemergency medical transportation
services in areas defined under RUCA to be rural or super rural areas is:

(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
rate in paragraph (m), clauses (1) to (7); and

(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
rate in paragraph (m), clauses (1) to (7).

(o) For purposes of reimbursement rates for nonemergency medical transportation
services under paragraphs (m) and (n), the zip code of the recipient's place of residence
shall determine whether the urban, rural, or super rural reimbursement rate applies.

(p) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
a census-tract based classification system under which a geographical area is determined
to be urban, rural, or super rural.

(q) The commissioner, when determining reimbursement rates for nonemergency medical
transportation under paragraphs (m) and (n), shall exempt all modes of transportation listed
under paragraph (i) from Minnesota Rules, part 9505.0445, item R, subitem (2).

new text begin (r) Effective for the first day of each calendar quarter in which the price of gasoline as
posted publicly by the United States Energy Information Administration exceeds $3.00 per
gallon, the commissioner shall adjust the rate paid per mile in paragraph (m) by one percent
up or down for every increase or decrease of ten cents for the price of gasoline. The increase
or decrease must be calculated using a base gasoline price of $3.00. The percentage increase
or decrease must be calculated using the average of the most recently available price of all
grades of gasoline for Minnesota as posted publicly by the United States Energy Information
Administration.
new text end

Sec. 6.

Minnesota Statutes 2020, section 256B.0625, subdivision 17a, is amended to read:


Subd. 17a.

Payment for ambulance services.

(a) Medical assistance covers ambulance
services. Providers shall bill ambulance services according to Medicare criteria.
Nonemergency ambulance services shall not be paid as emergencies. Effective for services
rendered on or after July 1, 2001, medical assistance payments for ambulance services shall
be paid at the Medicare reimbursement rate or at the medical assistance payment rate in
effect on July 1, 2000, whichever is greater.

(b) Effective for services provided on or after July 1, 2016, medical assistance payment
rates for ambulance services identified in this paragraph are increased by five percent.
Capitation payments made to managed care plans and county-based purchasing plans for
ambulance services provided on or after January 1, 2017, shall be increased to reflect this
rate increase. The increased rate described in this paragraph applies to ambulance service
providers whose base of operations as defined in section 144E.10 is located:

(1) outside the metropolitan counties listed in section 473.121, subdivision 4, and outside
the cities of Duluth, Mankato, Moorhead, St. Cloud, and Rochester; or

(2) within a municipality with a population of less than 1,000.

new text begin (c) Effective for the first day of each calendar quarter in which the price of gasoline as
posted publicly by the United Sates Energy Information Administration exceeds $3.00 per
gallon, the commissioner shall adjust the rate paid per mile in paragraphs (a) and (b) by one
percent up or down for every increase or decrease of ten cents for the price of gasoline. The
increase or decrease must be calculated using a base gasoline price of $3.00. The percentage
increase or decrease must be calculated using the average of the most recently available
price of all grades of gasoline for Minnesota as posted publicly by the United States Energy
Information Administration.
new text end

Sec. 7.

Minnesota Statutes 2020, section 256B.0625, subdivision 39, is amended to read:


Subd. 39.

deleted text beginChildhooddeleted text end Immunizations.

new text begin(a) new text endProviders who administer pediatric vaccines
within the scope of their licensure, and who are enrolled as a medical assistance provider,
must enroll in the pediatric vaccine administration program established by section 13631
of the Omnibus Budget Reconciliation Act of 1993. Medical assistance shall pay for
administration of the vaccine to children eligible for medical assistance. Medical assistance
does not pay for vaccines that are available at no cost from the pediatric vaccine
administration program.

new text begin (b) Medical assistance covers vaccines initiated, ordered, or administered by a licensed
pharmacist, according to the requirements of section 151.01, subdivision 27, clause (6), at
no less than the rate for which the same services are covered when provided by any other
licensed practitioner.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 8.

Minnesota Statutes 2021 Supplement, section 256B.69, subdivision 9f, is amended
to read:


Subd. 9f.

Annual report on provider reimbursement rates.

(a) The commissioner,
by December 15 of each year, deleted text beginbeginning December 15, 2021,deleted text end shall submit to the chairs and
ranking minority members of the legislative committees with jurisdiction over health care
policy and finance a report on managed care and county-based purchasing plan provider
reimbursement rates.

(b) The report must include, for each managed care and county-based purchasing plan,
the mean and median provider reimbursement rates by county for the calendar year preceding
the reporting year, for the five most common billing codes statewide across all plans, in
each of the following provider service categories if within the county there are more than
three medical assistance enrolled providers providing the specific service within the specific
category:

(1) physician prenatal services;

(2) physician preventive services;

(3) physician services other than prenatal or preventive;

(4) dental services;

(5) inpatient hospital services;

(6) outpatient hospital services; deleted text beginand
deleted text end

(7) mental health servicesnew text begin; and
new text end

new text begin (8) substance use disorder servicesnew text end.

(c) The commissioner shall also include in the report:

(1) the mean and median reimbursement rates across all plans by county for the calendar
year preceding the reporting year for the billing codes and provider service categories
described in paragraph (b); and

(2) the mean and median fee-for-service reimbursement rates by county for the calendar
year preceding the reporting year for the billing codes and provider service categories
described in paragraph (b).

Sec. 9. new text beginDIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
ENTERAL NUTRITION AND SUPPLIES.
new text end

new text begin Notwithstanding Minnesota Statutes, section 256B.766, paragraph (i), but subject to
Minnesota Statutes, section 256B.766, paragraph (l), effective for dates of service on or
after the effective date of this section through June 30, 2023, the commissioner of human
services shall not adjust rates paid for enteral nutrition and supplies.
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. 10. new text beginTEMPORARY TELEPHONE-ONLY TELEHEALTH AUTHORIZATION.
new text end

new text begin Beginning July 1, 2021, and until the COVID-19 federal public health emergency ends
or July 1, 2023, whichever is earlier, telehealth visits, as described in Minnesota Statutes,
section 256B.0625, subdivision 3b, provided through telephone may satisfy the face-to-face
requirements for reimbursement under the payment methods that apply to a federally qualified
health center, rural health clinic, Indian health service, 638 Tribal clinic, and certified
community behavioral health clinic, if the service would have otherwise qualified for
payment if performed in person.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from July 1, 2021, and
expires when the COVID-19 federal public health emergency ends or July 1, 2023, whichever
is earlier. The commissioner of human services shall notify the revisor of statutes when this
section expires.
new text end

Sec. 11. new text beginNONEMERGENCY MEDICAL TRANSPORTATION SPENDING
REQUIREMENTS.
new text end

new text begin (a) At least 80 percent of the marginal increase in revenue from the implementation of
rate increases in this act under Minnesota Statutes, section 256B.0625, subdivision 17,
paragraph (m), clauses (3) to (5), for services rendered on or after the day of implementation
of the rate increases must be used to increase compensation-related costs for drivers.
new text end

new text begin (b) For the purposes of this subdivision, compensation-related costs include:
new text end

new text begin (1) wages and salaries;
new text end

new text begin (2) the employer's share of FICA taxes, Medicare taxes, state and federal unemployment
taxes, workers' compensation, and mileage reimbursement;
new text end

new text begin (3) the employer's paid share of health and dental insurance, life insurance, disability
insurance, long-term care insurance, uniform allowance, pensions, and contributions to
employee retirement accounts; and
new text end

new text begin (4) benefits that address direct support professional workforce needs above and beyond
what employees were offered prior to the implementation of the rate increases.
new text end

new text begin (c) Compensation-related costs for persons employed in the central office of a corporation
or entity that has an ownership interest in the provider or exercises control over the provider,
or for persons paid by the provider under a management contract, do not count toward the
80 percent requirement under this subdivision.
new text end

new text begin (d) A provider or individual provider that receives additional revenue subject to the
requirements of this subdivision shall prepare, and upon request submit to the commissioner,
a distribution plan that specifies the amount of money the provider expects to receive that
is subject to the requirements of this section, including how that money was or will be
distributed to increase compensation-related costs for drivers. Within 60 days of final
implementation of the new phase-in proportion or adjustment to the base wage indices
subject to the requirements of this subdivision, the provider must post the distribution plan
and leave it posted for a period of at least six months in an area of the provider's operation
to which all drivers have access. The posted distribution plan must include instructions
regarding how to contact the commissioner, or the commissioner's representative, if a driver
has not received the compensation-related increase described in the plan.
new text end

Sec. 12. new text beginPRESCRIPTION DIGITAL THERAPEUTICS PILOT PROGRAM.
new text end

new text begin (a) The commissioner of human services shall allocate $8,091,000 in round three of the
federal opioid response grant program to be used to establish a pilot program to explore the
effectiveness of using FDA authorized prescription digital therapeutics for the treatment of
substance use disorders within the medical assistance program. The pilot program shall
include at least one clinic or practice site located within the seven county metropolitan area
and at least one clinic or practice site located outside the seven county metropolitan area.
The clinic or practice site must be capable of incorporating in the pilot program a minimum
of 1,000 patients enrolled in medical assistance who represent different demographics and
who are receiving or are eligible to receive substance use disorder services, including
treatment with medication or behavioral health services, or both. Participation in the pilot
program by a patient is voluntary. The clinic or practice site must obtain informed consent
from each patient before enrolling the patient in the pilot program.
new text end

new text begin (b) By July 1, 2024, the commissioner of human services shall submit a report to the
chairs and ranking minority members of the legislative committee with jurisdiction over
health and human services policy and finances on the prescription digital therapeutics pilot
program. The report must include the following:
new text end

new text begin (1) a description of each clinic or practice site and the demographics of the patient
population included in the pilot program;
new text end

new text begin (2) the successes and challenges of the pilot program, including but not limited to patient
access to treatment; patient satisfaction; and successful completion of patient treatment
goals;
new text end

new text begin (3) the impact of the pilot program on health equity issues;
new text end

new text begin (4) a comparison of hospitalization rates for the pilot program patient population as
compared to the medical assistance population at large and as compared to patients who
did not chose to participate in the pilot program; and
new text end

new text begin (5) any recommendations on providing medical assistance coverage for prescription
digital therapeutics for the treatment of substance use disorders.
new text end

new text begin (c) Of the allocation in paragraph (a), up to $810,000 may be used by the commissioner
for the administration of the pilot program. Any funds allocated under this section are
available until expended or until March 1, 2024, whichever occurs first.
new text end

Sec. 13. new text beginINITIAL MEMBERS AND FIRST MEETING; MINNESOTA RARE
DISEASE ADVISORY COUNCIL.
new text end

new text begin Public members serving on the University of Minnesota's Advisory Council on Rare
Diseases on June 30, 2022, are the initial public members of the Minnesota Rare Disease
Advisory Council. The terms of the members begin on July 1, 2022. The governor must
designate six members to serve a two-year term; six members to serve a three-year term;
and five members to serve a four-year term. The governor may appoint additional members
under Minnesota Statutes, section 137.68, subdivision 2, paragraph (b), clause (13), and
must set their terms so that roughly one-third of the members' terms expire after two years,
one-third after three years, and one-third after four years. Legislative members of the
University of Minnesota's Advisory Council on Rare Disease serve on the Minnesota Rare
Disease Advisory Council until appointing authorities appoint successors. The person serving
as chair of the executive subcommittee of the University of Minnesota's Advisory Council
on Rare Diseases shall convene the first meeting of the Minnesota Rare Disease Advisory
Council by September 1, 2022.
new text end

Sec. 14. new text beginAPPROPRIATIONS.
new text end

new text begin In accordance with Minnesota Statutes, section 15.039, subdivision 6, the unexpended
balance of money appropriated from the general fund to the Board of Regents of the
University of Minnesota for purposes of the advisory council on rare diseases under
Minnesota Statutes, section 137.68, shall be under the control of the Minnesota Rare Disease
Advisory Council and the Council on Disability.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 15. new text beginREVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall renumber as Minnesota Statutes, section 256.4835, the
Minnesota Rare Disease Advisory Council that is currently coded as Minnesota Statutes,
section 137.68. The revisor shall also make necessary cross-reference changes consistent
with the renumbering.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

ARTICLE 4

BEHAVIORAL HEALTH

Section 1.

Minnesota Statutes 2020, section 13.46, subdivision 7, is amended to read:


Subd. 7.

Mental health data.

(a) Mental health data are private data on individuals and
shall not be disclosed, except:

(1) pursuant to section 13.05, as determined by the responsible authority for the
community mental health center, mental health division, or provider;

(2) pursuant to court order;

(3) pursuant to a statute specifically authorizing access to or disclosure of mental health
data or as otherwise provided by this subdivision;

(4) to personnel of the welfare system working in the same program or providing services
to the same individual or family to the extent necessary to coordinate services, provided
that a health record may be disclosed only as provided under section 144.293;

(5) to a health care provider governed by sections 144.291 to 144.298, to the extent
necessary to coordinate services; or

(6) with the consent of the client or patient.

(b) An agency of the welfare system may not require an individual to consent to the
release of mental health data as a condition for receiving services or for reimbursing a
community mental health center, mental health division of a county, or provider under
contract to deliver mental health services.

(c) Notwithstanding section 245.69, subdivision 2, paragraph (f), or any other law to the
contrary, deleted text beginthe responsible authority fordeleted text end a community mental health center, mental health
division of a county, or a mental health provider must disclose mental health data to a law
enforcement agency if the law enforcement agency provides the name of a client or patient
and communicates that the:

(1) client or patient is currently involved in deleted text beginan emergency interaction withdeleted text endnew text begin a mental
health crisis as defined in section 256B.0624, subdivision 2, paragraph (j), to which
new text end the law
enforcement agencynew text begin has respondednew text end; and

(2) data is necessary to protect the health or safety of the client or patient or of another
person.

The scope of disclosure under this paragraph is limited to the minimum necessary for
law enforcement to new text beginsafely new text endrespond to the deleted text beginemergencydeleted text endnew text begin mental health crisisnew text end. Disclosure under
this paragraph may includedeleted text begin, but is not limited to,deleted text end the name and telephone number of the
psychiatrist, psychologist, therapist, mental health professional, practitioner, or case manager
of the client or patientnew text begin, if known; and strategies to address the mental health crisisnew text end. A law
enforcement agency that obtains mental health data under this paragraph shall maintain a
record of the requestor, the provider of the deleted text begininformationdeleted text endnew text begin datanew text end, and the client or patient name.
Mental health data obtained by a law enforcement agency under this paragraph are private
data on individuals and must not be used by the law enforcement agency for any other
purpose. A law enforcement agency that obtains mental health data under this paragraph
shall inform the subject of the data that mental health data was obtained.

(d) In the event of a request under paragraph (a), clause (6), a community mental health
center, county mental health division, or provider must release mental health data to Criminal
Mental Health Court personnel in advance of receiving a copy of a consent if the Criminal
Mental Health Court personnel communicate that the:

(1) client or patient is a defendant in a criminal case pending in the district court;

(2) data being requested is limited to information that is necessary to assess whether the
defendant is eligible for participation in the Criminal Mental Health Court; and

(3) client or patient has consented to the release of the mental health data and a copy of
the consent will be provided to the community mental health center, county mental health
division, or provider within 72 hours of the release of the data.

For purposes of this paragraph, "Criminal Mental Health Court" refers to a specialty
criminal calendar of the Hennepin County District Court for defendants with mental illness
and brain injury where a primary goal of the calendar is to assess the treatment needs of the
defendants and to incorporate those treatment needs into voluntary case disposition plans.
The data released pursuant to this paragraph may be used for the sole purpose of determining
whether the person is eligible for participation in mental health court. This paragraph does
not in any way limit or otherwise extend the rights of the court to obtain the release of mental
health data pursuant to court order or any other means allowed by law.

Sec. 2.

Minnesota Statutes 2020, section 62N.25, subdivision 5, is amended to read:


Subd. 5.

Benefits.

Community integrated service networks must offer the health
maintenance organization benefit set, as defined in chapter 62D, and other laws applicable
to entities regulated under chapter 62D. Community networks and chemical dependency
facilities under contract with a community network shall use the assessment criteria in
deleted text begin Minnesota Rules, parts 9530.6600 to 9530.6655,deleted text endnew text begin section 245G.05new text end when assessing enrollees
for chemical dependency treatment.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 3.

Minnesota Statutes 2020, section 62Q.1055, is amended to read:


62Q.1055 CHEMICAL DEPENDENCY.

All health plan companies shall use the assessment criteria in deleted text beginMinnesota Rules, parts
9530.6600 to 9530.6655,
deleted text endnew text begin section 245G.05new text end when assessing and deleted text beginplacingdeleted text endnew text begin treatingnew text end enrollees
for chemical dependency treatment.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 4.

Minnesota Statutes 2020, section 62Q.47, is amended to read:


62Q.47 ALCOHOLISM, MENTAL HEALTH, AND CHEMICAL DEPENDENCY
SERVICES.

(a) All health plans, as defined in section 62Q.01, that provide coverage for alcoholism,
mental health, or chemical dependency services, must comply with the requirements of this
section.

(b) Cost-sharing requirements and benefit or service limitations for outpatient mental
health and outpatient chemical dependency and alcoholism services, except for persons
deleted text begin placed indeleted text endnew text begin seekingnew text end chemical dependency services under deleted text beginMinnesota Rules, parts 9530.6600
to 9530.6655
deleted text endnew text begin section 245G.05new text end, must not place a greater financial burden on the insured or
enrollee, or be more restrictive than those requirements and limitations for outpatient medical
services.

(c) Cost-sharing requirements and benefit or service limitations for inpatient hospital
mental health and inpatient hospital and residential chemical dependency and alcoholism
services, except for persons deleted text beginplaced indeleted text endnew text begin seekingnew text end chemical dependency services under deleted text beginMinnesota
Rules, parts 9530.6600 to 9530.6655
deleted text endnew text begin section 245G.05new text end, must not place a greater financial
burden on the insured or enrollee, or be more restrictive than those requirements and
limitations for inpatient hospital medical services.

(d) A health plan company must not impose an NQTL with respect to mental health and
substance use disorders in any classification of benefits unless, under the terms of the health
plan as written and in operation, any processes, strategies, evidentiary standards, or other
factors used in applying the NQTL to mental health and substance use disorders in the
classification are comparable to, and are applied no more stringently than, the processes,
strategies, evidentiary standards, or other factors used in applying the NQTL with respect
to medical and surgical benefits in the same classification.

(e) All health plans must meet the requirements of the federal Mental Health Parity Act
of 1996, Public Law 104-204; Paul Wellstone and Pete Domenici Mental Health Parity and
Addiction Equity Act of 2008; the Affordable Care Act; and any amendments to, and federal
guidance or regulations issued under, those acts.

(f) The commissioner may require information from health plan companies to confirm
that mental health parity is being implemented by the health plan company. Information
required may include comparisons between mental health and substance use disorder
treatment and other medical conditions, including a comparison of prior authorization
requirements, drug formulary design, claim denials, rehabilitation services, and other
information the commissioner deems appropriate.

(g) Regardless of the health care provider's professional license, if the service provided
is consistent with the provider's scope of practice and the health plan company's credentialing
and contracting provisions, mental health therapy visits and medication maintenance visits
shall be considered primary care visits for the purpose of applying any enrollee cost-sharing
requirements imposed under the enrollee's health plan.

(h) By June 1 of each year, beginning June 1, 2021, the commissioner of commerce, in
consultation with the commissioner of health, shall submit a report on compliance and
oversight to the chairs and ranking minority members of the legislative committees with
jurisdiction over health and commerce. The report must:

(1) describe the commissioner's process for reviewing health plan company compliance
with United States Code, title 42, section 18031(j), any federal regulations or guidance
relating to compliance and oversight, and compliance with this section and section 62Q.53;

(2) identify any enforcement actions taken by either commissioner during the preceding
12-month period regarding compliance with parity for mental health and substance use
disorders benefits under state and federal law, summarizing the results of any market conduct
examinations. The summary must include: (i) the number of formal enforcement actions
taken; (ii) the benefit classifications examined in each enforcement action; and (iii) the
subject matter of each enforcement action, including quantitative and nonquantitative
treatment limitations;

(3) detail any corrective action taken by either commissioner to ensure health plan
company compliance with this section, section 62Q.53, and United States Code, title 42,
section 18031(j); and

(4) describe the information provided by either commissioner to the public about
alcoholism, mental health, or chemical dependency parity protections under state and federal
law.

The report must be written in nontechnical, readily understandable language and must be
made available to the public by, among other means as the commissioners find appropriate,
posting the report on department websites. Individually identifiable information must be
excluded from the report, consistent with state and federal privacy protections.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 5.

Minnesota Statutes 2020, section 144.294, subdivision 2, is amended to read:


Subd. 2.

Disclosure to law enforcement agency.

Notwithstanding section 144.293,
subdivisions 2 and 4, a provider must disclose health records relating to a patient's mental
health to a law enforcement agency if the law enforcement agency provides the name of
the patient and communicates that the:

(1) patient is currently involved in deleted text beginan emergency interaction withdeleted text endnew text begin a mental health crisis
as defined in section 256B.0624, subdivision 2, paragraph (j), to which
new text end the law enforcement
agencynew text begin has respondednew text end; and

(2) disclosure of the records is necessary to protect the health or safety of the patient or
of another person.

The scope of disclosure under this subdivision is limited to the minimum necessary for
law enforcement to new text beginsafely new text endrespond to the deleted text beginemergencydeleted text endnew text begin mental health crisisnew text end. new text beginThe disclosure
may include the name and telephone number of the psychiatrist, psychologist, therapist,
mental health professional, practitioner, or case manager of the patient, if known; and
strategies to address the mental health crisis.
new text endA law enforcement agency that obtains health
records under this subdivision shall maintain a record of the requestor, the provider of the
information, and the patient's name. Health records obtained by a law enforcement agency
under this subdivision are private data on individuals as defined in section 13.02, subdivision
12, and must not be used by law enforcement for any other purpose.new text begin A law enforcement
agency that obtains health records under this subdivision shall inform the patient that health
records were obtained.
new text end

Sec. 6.

Minnesota Statutes 2020, section 169A.70, subdivision 3, is amended to read:


Subd. 3.

Assessment report.

(a) The assessment report must be on a form prescribed
by the commissioner and shall contain an evaluation of the convicted defendant concerning
the defendant's prior traffic and criminal record, characteristics and history of alcohol and
chemical use problems, and amenability to rehabilitation through the alcohol safety program.
The report is classified as private data on individuals as defined in section 13.02, subdivision
12
.

(b) The assessment report must include:

(1) a diagnosis of the nature of the offender's chemical and alcohol involvement;

(2) an assessment of the severity level of the involvement;

(3) a recommended level of care for the offender in accordance with the criteria contained
in deleted text beginrules adopted by the commissioner of human services under section 254A.03, subdivision
3
(chemical dependency treatment rules)
deleted text endnew text begin section 245G.05new text end;

(4) an assessment of the offender's placement needs;

(5) recommendations for other appropriate remedial action or care, including aftercare
services in section 254B.01, subdivision 3, that may consist of educational programs,
one-on-one counseling, a program or type of treatment that addresses mental health concerns,
or a combination of them; and

(6) a specific explanation why no level of care or action was recommended, if applicable.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 7.

Minnesota Statutes 2020, section 169A.70, subdivision 4, is amended to read:


Subd. 4.

Assessor standards; rules; assessment time limits.

A chemical use assessment
required by this section must be conducted by an assessor appointed by the court. The
assessor must meet the training and qualification requirements of deleted text beginrules adopted by the
commissioner of human services under section 254A.03, subdivision 3 (chemical dependency
treatment rules)
deleted text endnew text begin section 245G.11, subdivisions 1 and 5new text end. Notwithstanding section 13.82 (law
enforcement data), the assessor shall have access to any police reports, laboratory test results,
and other law enforcement data relating to the current offense or previous offenses that are
necessary to complete the evaluation. deleted text beginAn assessor providing an assessment under this section
may not have any direct or shared financial interest or referral relationship resulting in
shared financial gain with a treatment provider, except as authorized under section 254A.19,
subdivision 3. If an independent assessor is not available, the court may use the services of
an assessor authorized to perform assessments for the county social services agency under
a variance granted under rules adopted by the commissioner of human services under section
254A.03, subdivision 3.
deleted text end An appointment for the defendant to undergo the assessment must
be made by the court, a court services probation officer, or the court administrator as soon
as possible but in no case more than one week after the defendant's court appearance. The
assessment must be completed no later than three weeks after the defendant's court
appearance. If the assessment is not performed within this time limit, the county where the
defendant is to be sentenced shall perform the assessment. The county of financial
responsibility must be determined under chapter 256G.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 8.

Minnesota Statutes 2021 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 emotional disturbances or severe emotional
disturbances who are at risk of out-of-home placementnew text begin or already in out-of-home placement
in family foster settings as defined in chapter 245A and at risk of change in out-of-home
placement or placement in a residential facility or other higher level of care. Allowable
activities and expenses for respite care services are defined under subdivision 4
new text end. A child is
not required to have case management services to receive respite care services;

(4) children's mental health crisis services;

(5) mental health services for people from cultural and ethnic minorities, including
supervision of clinical trainees who are Black, indigenous, or people of color;

(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 July 1, 2022.
new text end

Sec. 9.

Minnesota Statutes 2020, section 245.4889, is amended by adding a subdivision
to read:


new text begin Subd. 4. new text end

new text begin Respite care services. new text end

new text begin Respite care services under subdivision 1, paragraph
(b), clause (3), include hourly or overnight stays at a licensed foster home or with a qualified
and approved family member or friend and may occur at a child's or provider's home. Respite
care services may also include the following activities and expenses:
new text end

new text begin (1) recreational, sport, and nonsport extracurricular activities and programs for the child
including camps, clubs, lessons, group outings, sports, or other activities and programs;
new text end

new text begin (2) family activities, camps, and retreats that the family does together and provide a
break from the family's circumstance;
new text end

new text begin (3) cultural programs and activities for the child and family designed to address the
unique needs of individuals who share a common language, racial, ethnic, or social
background; and
new text end

new text begin (4) costs of transportation, food, supplies, and equipment directly associated with
approved respite care services and expenses necessary for the child and family to access
and participate in respite care services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 10.

Minnesota Statutes 2020, section 245F.03, is amended to read:


245F.03 APPLICATION.

(a) This chapter establishes minimum standards for withdrawal management programs
licensed by the commissioner that serve one or more unrelated persons.

(b) This chapter does not apply to a withdrawal management program licensed as a
hospital under sections 144.50 to 144.581. A withdrawal management program located in
a hospital licensed under sections 144.50 to 144.581 that chooses to be licensed under this
chapter is deemed to be in compliance with section 245F.13.

deleted text begin (c) Minnesota Rules, parts 9530.6600 to 9530.6655, do not apply to withdrawal
management programs licensed under this chapter.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 11.

Minnesota Statutes 2020, section 245G.05, subdivision 2, is amended to read:


Subd. 2.

Assessment summary.

(a) An alcohol and drug counselor must complete an
assessment summary within three calendar days from the day of service initiation for a
residential program and within three calendar days on which a treatment session has been
provided from the day of service initiation for a client in a nonresidential program. The
comprehensive assessment summary is complete upon a qualified staff member's dated
signature. If the comprehensive assessment is used to authorize the treatment service, the
alcohol and drug counselor must prepare an assessment summary on the same date the
comprehensive assessment is completed. If the comprehensive assessment and assessment
summary are to authorize treatment services, the assessor must determine appropriatenew text begin level
of care and
new text end services for the client using the deleted text begindimensions in Minnesota Rules, part 9530.6622deleted text endnew text begin
criteria established in section 254B.04, subdivision 4
new text end, and document the recommendations.

(b) An assessment summary must include:

(1) a risk description according to section 245G.05 for each dimension listed in paragraph
(c);

(2) a narrative summary supporting the risk descriptions; and

(3) a determination of whether the client has a substance use disorder.

(c) An assessment summary must contain information relevant to treatment service
planning and recorded in the dimensions in clauses (1) to (6). The license holder must
consider:

(1) Dimension 1, acute intoxication/withdrawal potential; the client's ability to cope with
withdrawal symptoms and current state of intoxication;

(2) Dimension 2, biomedical conditions and complications; the degree to which any
physical disorder of the client would interfere with treatment for substance use, and the
client's ability to tolerate any related discomfort. The license holder must determine the
impact of continued substance use on the unborn child, if the client is pregnant;

(3) Dimension 3, emotional, behavioral, and cognitive conditions and complications;
the degree to which any condition or complication is likely to interfere with treatment for
substance use or with functioning in significant life areas and the likelihood of harm to self
or others;

(4) Dimension 4, readiness for change; the support necessary to keep the client involved
in treatment service;

(5) Dimension 5, relapse, continued use, and continued problem potential; the degree
to which the client recognizes relapse issues and has the skills to prevent relapse of either
substance use or mental health problems; and

(6) Dimension 6, recovery environment; whether the areas of the client's life are
supportive of or antagonistic to treatment participation and recovery.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 12.

Minnesota Statutes 2020, section 245G.07, subdivision 1, is amended to read:


Subdivision 1.

Treatment service.

(a) A licensed residential treatment program must
offer the treatment services in clauses (1) to (5) to each client, unless clinically inappropriate
and the justifying clinical rationale is documented. A nonresidential treatment program must
offer all treatment services in clauses (1) to (5) and document in the individual treatment
plan the specific services for which a client has an assessed need and the plan to provide
the services:

(1) individual and group counseling to help the client identify and address needs related
to substance use and develop strategies to avoid harmful substance use after discharge and
to help the client obtain the services necessary to establish a lifestyle free of the harmful
effects of substance use disorder;

(2) client education strategies to avoid inappropriate substance use and health problems
related to substance use and the necessary lifestyle changes to regain and maintain health.
Client education must include information on tuberculosis education on a form approved
by the commissioner, the human immunodeficiency virus according to section 245A.19,
other sexually transmitted diseases, drug and alcohol use during pregnancy, and hepatitisnew text begin.
Client education must also include education on naloxone by a formalized training program
or onsite registered nurse, and must include the process for the administration of naloxone,
overdose awareness, and locations where naloxone can be obtained
new text end;

(3) a service to help the client integrate gains made during treatment into daily living
and to reduce the client's reliance on a staff member for support;

(4) a service to address issues related to co-occurring disorders, including client education
on symptoms of mental illness, the possibility of comorbidity, and the need for continued
medication compliance while recovering from substance use disorder. A group must address
co-occurring disorders, as needed. When treatment for mental health problems is indicated,
the treatment must be integrated into the client's individual treatment plan; and

(5) treatment coordination provided one-to-one by an individual who meets the staff
qualifications in section 245G.11, subdivision 7. Treatment coordination services include:

(i) assistance in coordination with significant others to help in the treatment planning
process whenever possible;

(ii) assistance in coordination with and follow up for medical services as identified in
the treatment plan;

(iii) facilitation of referrals to substance use disorder services as indicated by a client's
medical provider, comprehensive assessment, or treatment plan;

(iv) facilitation of referrals to mental health services as identified by a client's
comprehensive assessment or treatment plan;

(v) assistance with referrals to economic assistance, social services, housing resources,
and prenatal care according to the client's needs;

(vi) life skills advocacy and support accessing treatment follow-up, disease management,
and education services, including referral and linkages to long-term services and supports
as needed; and

(vii) documentation of the provision of treatment coordination services in the client's
file.

(b) A treatment service provided to a client must be provided according to the individual
treatment plan and must consider cultural differences and special needs of a client.

new text begin EFFECTIVE DATE. new text end

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

Sec. 13.

Minnesota Statutes 2020, section 245G.08, subdivision 3, is amended to read:


Subd. 3.

Standing order protocol.

A license holder deleted text beginthat maintainsdeleted text endnew text begin must maintainnew text end a
new text begin proper new text endsupply of naloxone available for emergency treatment of opioid overdose new text beginon site in
a conspicuous location and
new text endmust have a written standing order protocol by a physician who
is licensed under chapter 147 or advanced practice registered nurse who is licensed under
chapter 148, that permits the license holder to maintain a supply of naloxone on site. A
license holder must require staff to undergo training in the specific mode of administration
used at the program, which may include intranasal administration, intramuscular injection,
or both.

Sec. 14.

Minnesota Statutes 2020, section 245G.21, is amended by adding a subdivision
to read:


new text begin Subd. 9. new text end

new text begin Denial of medication. new text end

new text begin A license holder cannot deny medications and
pharmacotherapies to a client if such medications and pharmacotherapies are prescribed by
a licensed physician.
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. 15.

Minnesota Statutes 2020, section 245G.22, subdivision 2, is amended to read:


Subd. 2.

Definitions.

(a) For purposes of this section, the terms defined in this subdivision
have the meanings given them.

(b) "Diversion" means the use of a medication for the treatment of opioid addiction being
diverted from intended use of the medication.

(c) "Guest dose" means administration of a medication used for the treatment of opioid
addiction to a person who is not a client of the program that is administering or dispensing
the medication.

(d) "Medical director" means a practitioner licensed to practice medicine in the
jurisdiction that the opioid treatment program is located who assumes responsibility for
administering all medical services performed by the program, either by performing the
services directly or by delegating specific responsibility to a practitioner of the opioid
treatment program.

(e) "Medication used for the treatment of opioid use disorder" means a medication
approved by the Food and Drug Administration for the treatment of opioid use disorder.

(f) "Minnesota health care programs" has the meaning given in section 256B.0636.

(g) "Opioid treatment program" has the meaning given in Code of Federal Regulations,
title 42, section 8.12, and includes programs licensed under this chapter.

deleted text begin (h) "Placing authority" has the meaning given in Minnesota Rules, part 9530.6605,
subpart 21a.
deleted text end

deleted text begin (i)deleted text endnew text begin (h)new text end "Practitioner" means a staff member holding a current, unrestricted license to
practice medicine issued by the Board of Medical Practice or nursing issued by the Board
of Nursing and is currently registered with the Drug Enforcement Administration to order
or dispense controlled substances in Schedules II to V under the Controlled Substances Act,
United States Code, title 21, part B, section 821. Practitioner includes an advanced practice
registered nurse and physician assistant if the staff member receives a variance by the state
opioid treatment authority under section 254A.03 and the federal Substance Abuse and
Mental Health Services Administration.

deleted text begin (j)deleted text endnew text begin (i)new text end "Unsupervised use" means the use of a medication for the treatment of opioid use
disorder dispensed for use by a client outside of the program setting.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 16.

Minnesota Statutes 2021 Supplement, section 254A.03, subdivision 3, is amended
to read:


Subd. 3.

Rules for substance use disorder care.

(a) deleted text beginThe 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,
deleted text end An eligible vendor of
comprehensive assessments under section 254B.05 may determine deleted text beginand approvedeleted text end the
appropriate level of substance use disorder treatment for a recipient of public assistance.
deleted text begin The process for determining an individual's financial eligibility for the behavioral health
deleted text enddeleted text begin fund or determining an individual's enrollment in or eligibility for a publicly subsidized
deleted text enddeleted text begin health plan is not affected by the individual's choice to access a comprehensive assessment
deleted text enddeleted text begin for placement.
deleted text end

(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. deleted text beginMinnesota Rules,
parts 9530.6600 to 9530.6655, and
deleted text end A comprehensive assessment pursuant to section 245G.05
deleted text begin are not applicabledeleted text endnew text begin is not requirednew text end tonew text begin receivenew text end 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.

(d) deleted text beginNotwithstanding Minnesota Rules, parts 9530.6600 to 9530.6655,deleted text end 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
deleted text begin, paragraph (d)deleted text end. If the individual is enrolled in a prepaid health plan, the individual must
comply with any provider network requirements or limitations. deleted text beginThis paragraph expires July
1, 2022.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 17.

new text begin [254A.087] SOBER HOUSES.
new text end

new text begin Subdivision 1. new text end

new text begin Definition. new text end

new text begin "Sober house" means a cooperative living residence, a room
and board residence, an apartment, or any other living accommodation that:
new text end

new text begin (1) provides temporary housing to persons with alcohol or other drug dependency or
abuse problems in exchange for compensation;
new text end

new text begin (2) stipulates that residents must abstain from using alcohol or drugs not prescribed by
a licensed physician, and meet other requirements as a condition of living in the residence;
new text end

new text begin (3) does not provide direct counseling or treatment services to the residents;
new text end

new text begin (4) does not deny medications or pharmacotherapies as prescribed by a licensed physician;
new text end

new text begin (5) provides lockboxes, controlled medication count, and urinalysis testing; and
new text end

new text begin (6) properly maintains a supply of naloxone on site in a conspicuous location.
new text end

new text begin Subd. 2. new text end

new text begin Provision of counseling services. new text end

new text begin Persons with alcohol or drug dependency
or abuse problems residing in sober houses shall be:
new text end

new text begin (1) provided with naloxone training and education by a formalized training program or
trained house manager. The training must include the process for administration of naloxone
and a supply of naloxone must be kept on site in a conspicuous location; and
new text end

new text begin (2) provided with counseling and related services by alcohol and drug counselors licensed
under chapter 148C, or referred by the sober house to counseling and related services
provided by alcohol and drug counselors licensed under chapter 148C.
new text end

new text begin Subd. 3. new text end

new text begin Notice; alternative living arrangements; referral for counseling. new text end

new text begin Persons
with alcohol or drug dependency or abuse problems receiving residential services shall be:
new text end

new text begin (1) provided with 48 hours written notice prior to discharge or termination of services,
stating the reason for discharge and proposed alternative living arrangements as recommended
by an assessment under Minnesota Rules, parts 9530.6600 to 9530.6655. Weekends and
legal holidays are excluded when calculating the 48 hours' notice;
new text end

new text begin (2) provided alternative living arrangements to meet their needs as recommended by an
assessment under Minnesota Rules, parts 9530.6600 to 9530.6655, if discharge from the
program must occur prior to the expiration of 48 hours is deemed necessary by the facility;
new text end

new text begin (3) provided with information in writing who to contact to appeal the proposed discharge;
new text end

new text begin (4) informed of their right to request that designated individuals receive immediate notice
of the proposed discharge by telephone, fax, or other means of communication. Weekends
and legal holidays are excluded when calculating the 48 hours' notice; and
new text end

new text begin (5) referred to emergency services, detoxification services, or crisis facilities if relapse
is the reason for discharge. The referral must be provided in a written form or by telephone,
fax, or other means of communication.
new text end

new text begin Subd. 4. new text end

new text begin Services by licensed providers. new text end

new text begin (a) Residential or outpatient facilities licensed
under chapter 245A shall only refer persons with alcohol or drug dependency or abuse
problems, or their family members or others affected by the person's dependency or abuse,
to persons licensed under chapter 148C or to facilities licensed under chapter 245A.
new text end

new text begin (b) If a referring facility has an economic interest in the referral, this interest shall be
disclosed in writing and two alternative referrals shall be provided. A release of information
for both parties must be presented to the person with alcohol or drug dependency or abuse
or their family members or others affected by the person's dependency or abuse.
new text end

new text begin (c) Organizations and groups that do not receive compensation for their services, such
as 12-step programs, are excluded from the requirements of this subdivision.
new text end

new text begin Subd. 5. new text end

new text begin Resident property upon service termination. new text end

new text begin Upon the service termination
of a resident, a sober house must:
new text end

new text begin (1) return all property that belonged to a resident upon that resident's service termination
regardless of that resident's service termination status;
new text end

new text begin (2) retain the resident's property for a minimum of seven days after the resident's service
termination, if the resident did not claim the resident's property upon service termination;
and
new text end

new text begin (3) retain the resident's property for a minimum of 30 days after the resident's service
termination, if the resident did not claim the resident's property upon service termination
and received room and board, emergency services, crisis services, detoxification services,
or facility transfer.
new text end

new text begin Subd. 6. new text end

new text begin Sober house management. new text end

new text begin A sober house must:
new text end

new text begin (1) have written procedures for scheduled drug monitoring;
new text end

new text begin (2) have written procedures for counting and documenting a resident's controlled
medications, including a standardized data collection tool for collecting, documenting, and
filing daily controlled medications counts that includes the date, time, and the signature of
the staff member taking the daily count of scheduled medications;
new text end

new text begin (3) have a statement that no medication supply for one resident shall be provided to
another resident; and
new text end

new text begin (4) file and store controlled medications counts for a minimum of two years.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective May 1, 2023.
new text end

Sec. 18.

Minnesota Statutes 2020, section 254A.19, subdivision 1, is amended to read:


Subdivision 1.

Persons arrested outside of deleted text beginhomedeleted text end county new text beginof residencenew text end.

When a chemical
use assessment is required deleted text beginunder Minnesota Rules, parts 9530.6600 to 9530.6655,deleted text end for a
person who is arrested and taken into custody by a peace officer outside of the person's
county of residence, the deleted text beginassessment must be completed by the person's county of residence
no later than three weeks after the assessment is initially requested. If the assessment is not
performed within this time limit, the county where the person is to be sentenced shall perform
the assessment
deleted text endnew text begin county where the person is detained must facilitate access to an assessor
qualified under subdivision 3
new text end. The county of financial responsibility is determined under
chapter 256G.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 19.

Minnesota Statutes 2020, section 254A.19, subdivision 3, is amended to read:


Subd. 3.

deleted text beginFinancial conflicts of interestdeleted text endnew text begin Comprehensive assessmentsnew text end.

deleted text begin (a) Except as
provided in paragraph (b), (c), or (d), an assessor conducting a chemical use assessment
under Minnesota Rules, parts 9530.6600 to 9530.6655, may not have any direct or shared
financial interest or referral relationship resulting in shared financial gain with a treatment
provider.
deleted text end

deleted text begin (b) A county may contract with an assessor having a conflict described in paragraph (a)
if the county documents that:
deleted text end

deleted text begin (1) the assessor is employed by a culturally specific service provider or a service provider
with a program designed to treat individuals of a specific age, sex, or sexual preference;
deleted text end

deleted text begin (2) the county does not employ a sufficient number of qualified assessors and the only
qualified assessors available in the county have a direct or shared financial interest or a
referral relationship resulting in shared financial gain with a treatment provider; or
deleted text end

deleted text begin (3) the county social service agency has an existing relationship with an assessor or
service provider and elects to enter into a contract with that assessor to provide both
assessment and treatment under circumstances specified in the county's contract, provided
the county retains responsibility for making placement decisions.
deleted text end

deleted text begin (c) The county may contract with a hospital to conduct chemical assessments if the
requirements in subdivision 1a are met.
deleted text end

deleted text begin An assessor under this paragraph may not place clients in treatment. The assessor shall
gather required information and provide it to the county along with any required
documentation. The county shall make all placement decisions for clients assessed by
assessors under this paragraph.
deleted text end

deleted text begin (d)deleted text end An eligible vendor under section 254B.05 conducting a comprehensive assessment
for an individual seeking treatment shall approve the nature, intensity level, and duration
of treatment service if a need for services is indicated, but the individual assessed can access
any enrolled provider that is licensed to provide the level of service authorized, including
the provider or program that completed the assessment. If an individual is enrolled in a
prepaid health plan, the individual must comply with any provider network requirements
or limitations. new text beginAn eligible vendor of a comprehensive assessment must provide information,
in a format provided by the commissioner, on medical assistance and the behavioral health
fund to individuals seeking an assessment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 20.

Minnesota Statutes 2021 Supplement, section 254A.19, subdivision 4, is amended
to read:


Subd. 4.

Civil commitments.

deleted text beginA Rule 25 assessment, under Minnesota Rules, part
9530.6615,
deleted text endnew text begin For the purposes of determining level of care, a comprehensive assessmentnew text end does
not need to be completed for an individual being committed as a chemically dependent
person, as defined in section 253B.02, and for the duration of a civil commitment under
section deleted text begin253B.065,deleted text end 253B.09deleted text begin,deleted text end or 253B.095 in order for a county to access the behavioral
health fund under section 254B.04. The county must determine if the individual meets the
financial eligibility requirements for the behavioral health fund under section 254B.04.
deleted text begin Nothing in this subdivision prohibits placement in a treatment facility or treatment program
governed under this chapter or Minnesota Rules, parts 9530.6600 to 9530.6655.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 21.

Minnesota Statutes 2020, section 254A.19, is amended by adding a subdivision
to read:


new text begin Subd. 6. new text end

new text begin Assessments for detoxification programs. new text end

new text begin For detoxification programs licensed
under chapter 245A according to Minnesota Rules, parts 9530.6510 to 9530.6590, a
"chemical use assessment" means a comprehensive assessment and assessment summary
completed according to section 245G.05 and a "chemical dependency assessor" or "assessor"
means an individual who meets the qualifications of section 245G.11, subdivisions 1 and
5.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 22.

Minnesota Statutes 2020, section 254A.19, is amended by adding a subdivision
to read:


new text begin Subd. 7. new text end

new text begin Assessments for children's residential facilities. new text end

new text begin For children's residential
facilities licensed under chapter 245A according to Minnesota Rules, parts 2960.0010 to
2960.0220 and 2960.0430 to 2960.0500, a "chemical use assessment" means a comprehensive
assessment and assessment summary completed according to section 245G.05 by an
individual who meets the qualifications of section 245G.11, subdivisions 1 and 5.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 23.

Minnesota Statutes 2020, section 254B.01, is amended by adding a subdivision
to read:


new text begin Subd. 2a. new text end

new text begin Behavioral health fund. new text end

new text begin "Behavioral health fund" means money allocated
for payment of treatment services under this chapter.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 24.

Minnesota Statutes 2020, section 254B.01, is amended by adding a subdivision
to read:


new text begin Subd. 2b. new text end

new text begin Client. new text end

new text begin "Client" means an individual who has requested substance use disorder
services, or for whom substance use disorder services have been requested.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 25.

Minnesota Statutes 2020, section 254B.01, is amended by adding a subdivision
to read:


new text begin Subd. 2c. new text end

new text begin Co-payment. new text end

new text begin "Co-payment" means the amount an insured person is obligated
to pay before the person's third-party payment source is obligated to make a payment, or
the amount an insured person is obligated to pay in addition to the amount the person's
third-party payment source is obligated to pay.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 26.

Minnesota Statutes 2020, section 254B.01, is amended by adding a subdivision
to read:


new text begin Subd. 4c. new text end

new text begin Department. new text end

new text begin "Department" means the Department of Human Services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 27.

Minnesota Statutes 2020, section 254B.01, is amended by adding a subdivision
to read:


new text begin Subd. 4d. new text end

new text begin Drug and alcohol abuse normative evaluation system or DAANES. new text end

new text begin "Drug
and alcohol abuse normative evaluation system" or "DAANES" means the reporting system
used to collect substance use disorder treatment data across all levels of care and providers.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 28.

Minnesota Statutes 2020, section 254B.01, subdivision 5, is amended to read:


Subd. 5.

Local agency.

"Local agency" means the agency designated by a board of
county commissioners, a local social services agency, or a human services board deleted text beginto make
placements and submit state invoices according to Laws 1986, chapter 394, sections 8 to
20
deleted text endnew text begin authorized under section 254B.03, subdivision 1, to determine financial eligibility for
the behavioral health fund
new text end.

Sec. 29.

Minnesota Statutes 2020, section 254B.01, is amended by adding a subdivision
to read:


new text begin Subd. 6a. new text end

new text begin Minor child. new text end

new text begin "Minor child" means an individual under the age of 18 years.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 30.

Minnesota Statutes 2020, section 254B.01, is amended by adding a subdivision
to read:


new text begin Subd. 6b. new text end

new text begin Policy holder. new text end

new text begin "Policy holder" means a person who has a third-party payment
policy under which a third-party payment source has an obligation to pay all or part of a
client's treatment costs.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 31.

Minnesota Statutes 2020, section 254B.01, is amended by adding a subdivision
to read:


new text begin Subd. 9. new text end

new text begin Responsible relative. new text end

new text begin "Responsible relative" means a person who is a member
of the client's household and is a client's spouse or the parent of a minor child who is a
client.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 32.

Minnesota Statutes 2020, section 254B.01, is amended by adding a subdivision
to read:


new text begin Subd. 10. new text end

new text begin Third-party payment source. new text end

new text begin "Third-party payment source" means a person,
entity, or public or private agency other than medical assistance or general assistance medical
care that has a probable obligation to pay all or part of the costs of a client's substance use
disorder treatment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 33.

Minnesota Statutes 2020, section 254B.01, is amended by adding a subdivision
to read:


new text begin Subd. 11. new text end

new text begin Vendor. new text end

new text begin "Vendor" means a provider of substance use disorder treatment
services that meets the criteria established in section 254B.05 and that has applied to
participate as a provider in the medical assistance program according to Minnesota Rules,
part 9505.0195.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 34.

Minnesota Statutes 2020, section 254B.01, is amended by adding a subdivision
to read:


new text begin Subd. 12. new text end

new text begin American Society of Addiction Medicine criteria or ASAM
criteria.
new text end

new text begin "American Society of Addiction Medicine criteria" or "ASAM criteria" means the
clinical guidelines for purposes of the assessment, treatment, placement, and transfer or
discharge of individuals with substance use disorders. The ASAM criteria are contained in
the current edition of the ASAM Criteria: Treatment Criteria for Addictive,
Substance-Related, and Co-Occurring Conditions.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 35.

Minnesota Statutes 2020, section 254B.01, is amended by adding a subdivision
to read:


new text begin Subd. 13. new text end

new text begin Skilled treatment services. new text end

new text begin "Skilled treatment services" means the "treatment
services" described by section 245G.07, subdivisions 1, paragraph (a), clauses (1) to (4);
and 2, clauses (1) to (6). Skilled treatment services must be provided by qualified
professionals as identified in section 245G.07, subdivision 3.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 36.

Minnesota Statutes 2020, section 254B.03, subdivision 1, is amended to read:


Subdivision 1.

Local agency duties.

(a) Every local agency deleted text beginshalldeleted text endnew text begin must determine financial
eligibility for substance use disorder services and
new text end provide deleted text beginchemical dependencydeleted text endnew text begin substance
use disorder
new text end services to persons residing within its jurisdiction who meet criteria established
by the commissioner deleted text beginfor placement in a chemical dependency residential or nonresidential
treatment service
deleted text end. Chemical dependency money must be administered by the local agencies
according to law and rules adopted by the commissioner under sections 14.001 to 14.69.

(b) In order to contain costs, the commissioner of human services shall select eligible
vendors of chemical dependency services who can provide economical and appropriate
treatment. Unless the local agency is a social services department directly administered by
a county or human services board, the local agency shall not be an eligible vendor under
section 254B.05. The commissioner may approve proposals from county boards to provide
services in an economical manner or to control utilization, with safeguards to ensure that
necessary services are provided. If a county implements a demonstration or experimental
medical services funding plan, the commissioner shall transfer the money as appropriate.

deleted text begin (c) A culturally specific vendor that provides assessments under a variance under
Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to persons
not covered by the variance.
deleted text end

deleted text begin (d) Notwithstanding Minnesota Rules, parts 9530.6600 to 9530.6655,deleted text end new text begin(c) new text endAn 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
deleted text begin, paragraph (d)deleted text end. If the individual is enrolled in a prepaid health plan, the individual must
comply with any provider network requirements or limitations.

deleted text begin (e)deleted text endnew text begin (d)new text end Beginning July 1, 2022, local agencies shall not make placement location
determinations.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 37.

Minnesota Statutes 2021 Supplement, section 254B.03, subdivision 2, is amended
to read:


Subd. 2.

Behavioral health fund payment.

(a) Payment from the behavioral health
fund is limited to payments for services identified in section 254B.05, other than
detoxification licensed under Minnesota Rules, parts 9530.6510 to 9530.6590, and
detoxification provided in another state that would be required to be licensed as a chemical
dependency program if the program were in the state. Out of state vendors must also provide
the commissioner with assurances that the program complies substantially with state licensing
requirements and possesses all licenses and certifications required by the host state to provide
chemical dependency treatment. Vendors receiving payments from the behavioral health
fund must not require co-payment from a recipient of benefits for services provided under
this subdivision. The vendor is prohibited from using the client's public benefits to offset
the cost of services paid under this section. The vendor shall not require the client to use
public benefits for room or board costs. This includes but is not limited to cash assistance
benefits under chapters 119B, 256D, and 256J, or SNAP benefits. Retention of SNAP
benefits is a right of a client receiving services through the behavioral health fund or through
state contracted managed care entities. Payment from the behavioral health fund shall be
made for necessary room and board costs provided by vendors meeting the criteria under
section 254B.05, subdivision 1a, or in a community hospital licensed by the commissioner
of health according to sections 144.50 to 144.56 to a client who is:

(1) determined to meet the criteria for placement in a residential chemical dependency
treatment program according to rules adopted under section 254A.03, subdivision 3; and

(2) concurrently receiving a chemical dependency treatment service in a program licensed
by the commissioner and reimbursed by the behavioral health fund.

deleted text begin (b) A county may, from its own resources, provide chemical dependency services for
which state payments are not made. A county may elect to use the same invoice procedures
and obtain the same state payment services as are used for chemical dependency services
for which state payments are made under this section if county payments are made to the
state in advance of state payments to vendors. When a county uses the state system for
payment, the commissioner shall make monthly billings to the county using the most recent
available information to determine the anticipated services for which payments will be made
in the coming month. Adjustment of any overestimate or underestimate based on actual
expenditures shall be made by the state agency by adjusting the estimate for any succeeding
month.
deleted text end

deleted text begin (c)deleted text endnew text begin (b)new text end The commissioner shall coordinate chemical dependency services and determine
whether there is a need for any proposed expansion of chemical dependency treatment
services. The commissioner shall deny vendor certification to any provider that has not
received prior approval from the commissioner for the creation of new programs or the
expansion of existing program capacity. The commissioner shall consider the provider's
capacity to obtain clients from outside the state based on plans, agreements, and previous
utilization history, when determining the need for new treatment services.

deleted text begin (d)deleted text endnew text begin (c)new text end At least 60 days prior to submitting an application for new licensure under chapter
245G, the applicant must notify the county human services director in writing of the
applicant's intent to open a new treatment program. The written notification must include,
at a minimum:

(1) a description of the proposed treatment program; and

(2) a description of the target population to be served by the treatment program.

deleted text begin (e)deleted text endnew text begin (d)new text end The county human services director may submit a written statement to the
commissioner, within 60 days of receiving notice from the applicant, regarding the county's
support of or opposition to the opening of the new treatment program. The written statement
must include documentation of the rationale for the county's determination. The commissioner
shall consider the county's written statement when determining whether there is a need for
the treatment program as required by paragraph deleted text begin(c)deleted text endnew text begin (b)new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 38.

Minnesota Statutes 2020, section 254B.03, subdivision 5, is amended to read:


Subd. 5.

Rules; appeal.

The commissioner shall adopt rules as necessary to implement
this chapter. deleted text beginThe commissioner shall establish an appeals process for use by recipients when
services certified by the county are disputed. The commissioner shall adopt rules and
standards for the appeal process to assure adequate redress for persons referred to
inappropriate services.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 39.

Minnesota Statutes 2021 Supplement, section 254B.04, subdivision 1, is amended
to read:


Subdivision 1.

new text beginClient new text endeligibility.

(a) Persons eligible for benefits under Code of Federal
Regulations, title 25, part 20, who meet the income standards of section 256B.056,
subdivision 4
, and are not enrolled in medical assistance, are entitled to behavioral health
fund services. State money appropriated for this paragraph must be placed in a separate
account established for this purpose.

(b) Persons with dependent children who are determined to be in need of chemical
dependency treatment pursuant to an assessment under section 260E.20, subdivision 1, or
a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the
local agency to access needed treatment services. Treatment services must be appropriate
for the individual or family, which may include long-term care treatment or treatment in a
facility that allows the dependent children to stay in the treatment facility. The county shall
pay for out-of-home placement costs, if applicable.

(c) Notwithstanding paragraph (a), persons enrolled in medical assistance are eligible
for room and board services under section 254B.05, subdivision 5, paragraph (b), clause
deleted text begin (12)deleted text endnew text begin (11)new text end.

new text begin (d) A client is eligible to have substance use disorder treatment paid for with funds from
the behavioral health fund if:
new text end

new text begin (1) the client is eligible for MFIP as determined under chapter 256J;
new text end

new text begin (2) the client is eligible for medical assistance as determined under Minnesota Rules,
parts 9505.0010 to 9505.0150;
new text end

new text begin (3) the client is eligible for general assistance or work readiness as determined under
Minnesota Rules, parts 9500.1200 to 9500.1272; or
new text end

new text begin (4) the client's income is within current household size and income guidelines for entitled
persons, as defined in this subdivision and subdivision 7.
new text end

new text begin (e) Clients who meet the financial eligibility requirement in paragraph (a) and who have
a third-party payment source are eligible for the behavioral health fund if the third-party
payment source pays less than 100 percent of the cost of treatment services for eligible
clients.
new text end

new text begin (f) A client is ineligible to have substance use disorder treatment services paid for by
the behavioral health fund if the client:
new text end

new text begin (1) has an income that exceeds current household size and income guidelines for entitled
persons, as defined in this subdivision and subdivision 7; or
new text end

new text begin (2) has an available third-party payment source that will pay the total cost of the client's
treatment.
new text end

new text begin (g) A client who is disenrolled from a state prepaid health plan during a treatment episode
is eligible for continued treatment service paid for by the behavioral health fund until the
treatment episode is completed or the client is re-enrolled in a state prepaid health plan if
the client:
new text end

new text begin (1) continues to be enrolled in MinnesotaCare, medical assistance, or general assistance
medical care; or
new text end

new text begin (2) is eligible according to paragraphs (a) and (b) and is determined eligible by a local
agency under this section.
new text end

new text begin (h) If a county commits a client under chapter 253B to a regional treatment center for
substance use disorder services and the client is ineligible for the behavioral health fund,
the county is responsible for payment to the regional treatment center according to section
254B.05, subdivision 4.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 40.

Minnesota Statutes 2020, section 254B.04, subdivision 2a, is amended to read:


Subd. 2a.

Eligibility for deleted text begintreatment in residential settingsdeleted text endnew text begin room and board services
for persons in outpatient substance use disorder treatment
new text end.

deleted text beginNotwithstanding provisions
of Minnesota Rules, part 9530.6622, subparts 5 and 6, related to an assessor's discretion in
making placements to residential treatment settings,
deleted text end A person eligible fornew text begin room and boardnew text end
services under deleted text beginthisdeleted text end sectionnew text begin 254B.05, subdivision 5, paragraph (b), clause (12),new text end must score
at level 4 on assessment dimensions related tonew text begin readiness to change,new text end relapse, continued use,
or recovery environment deleted text beginin orderdeleted text end to be assigned to services with a room and board component
reimbursed under this section. Whether a treatment facility has been designated an institution
for mental diseases under United States Code, title 42, section 1396d, shall not be a factor
in making placements.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 41.

Minnesota Statutes 2020, section 254B.04, is amended by adding a subdivision
to read:


new text begin Subd. 4. new text end

new text begin Assessment criteria and risk descriptions. new text end

new text begin (a) The level of care determination
must follow criteria approved by the commissioner.
new text end

new text begin (b) Dimension 1: the vendor must use the criteria in Dimension 1 to determine a client's
acute intoxication and withdrawal potential.
new text end

new text begin (1) "0" The client displays full functioning with good ability to tolerate and cope with
withdrawal discomfort. The client displays no signs or symptoms of intoxication or
withdrawal or diminishing signs or symptoms.
new text end

new text begin (2) "1" The client can tolerate and cope with withdrawal discomfort. The client displays
mild to moderate intoxication or signs and symptoms interfering with daily functioning but
does not immediately endanger self or others. The client poses minimal risk of severe
withdrawal.
new text end

new text begin (3) "2" The client has some difficulty tolerating and coping with withdrawal discomfort.
The client's intoxication may be severe, but the client responds to support and treatment
such that the client does not immediately endanger self or others. The client displays moderate
signs and symptoms with moderate risk of severe withdrawal.
new text end

new text begin (4) "3" The client tolerates and copes with withdrawal discomfort poorly. The client has
severe intoxication, such that the client endangers self or others, or has intoxication that has
not abated with less intensive services. The client displays severe signs and symptoms, risk
of severe but manageable withdrawal, or worsening withdrawal despite detoxification at a
less intensive level.
new text end

new text begin (5) "4" The client is incapacitated with severe signs and symptoms. The client displays
severe withdrawal and is a danger to self or others.
new text end

new text begin (c) Dimension 2: the vendor must use the criteria in Dimension 2 to determine a client's
biomedical conditions and complications.
new text end

new text begin (1) "0" The client displays full functioning with good ability to cope with physical
discomfort.
new text end

new text begin (2) "1" The client tolerates and copes with physical discomfort and is able to get the
services that the client needs.
new text end

new text begin (3) "2" The client has difficulty tolerating and coping with physical problems or has
other biomedical problems that interfere with recovery and treatment. The client neglects
or does not seek care for serious biomedical problems.
new text end

new text begin (4) "3" The client tolerates and copes poorly with physical problems or has poor general
health. The client neglects the client's medical problems without active assistance.
new text end

new text begin (5) "4" The client is unable to participate in substance use disorder treatment and has
severe medical problems, has a condition that requires immediate intervention, or is
incapacitated.
new text end

new text begin (d) Dimension 3: the vendor must use the criteria in Dimension 3 to determine a client's
emotional, behavioral, and cognitive conditions and complications.
new text end

new text begin (1) "0" The client has good impulse control and coping skills and presents no risk of
harm to self or others. The client functions in all life areas and displays no emotional,
behavioral, or cognitive problems or the problems are stable.
new text end

new text begin (2) "1" The client has impulse control and coping skills. The client presents a mild to
moderate risk of harm to self or others or displays symptoms of emotional, behavioral, or
cognitive problems. The client has a mental health diagnosis and is stable. The client
functions adequately in significant life areas.
new text end

new text begin (3) "2" The client has difficulty with impulse control and lacks coping skills. The client
has thoughts of suicide or harm to others without means; however, the thoughts may interfere
with participation in some activities. The client has difficulty functioning in significant life
areas. The client has moderate symptoms of emotional, behavioral, or cognitive problems.
The client is able to participate in most treatment activities.
new text end

new text begin (4) "3" The client has a severe lack of impulse control and coping skills. The client also
has frequent thoughts of suicide or harm to others, including a plan and the means to carry
out the plan. In addition, the client is severely impaired in significant life areas and has
severe symptoms of emotional, behavioral, or cognitive problems that interfere with the
client's participation in treatment activities.
new text end

new text begin (5) "4" The client has severe emotional or behavioral symptoms that place the client or
others at acute risk of harm. The client also has intrusive thoughts of harming self or others.
The client is unable to participate in treatment activities.
new text end

new text begin (e) Dimension 4: the vendor must use the criteria in Dimension 4 to determine a client's
readiness for change.
new text end

new text begin (1) "0" The client admits to problems and is cooperative, motivated, ready to change,
committed to change, and engaged in treatment as a responsible participant.
new text end

new text begin (2) "1" The client is motivated with active reinforcement to explore treatment and
strategies for change but ambivalent about the client's illness or need for change.
new text end

new text begin (3) "2" The client displays verbal compliance but lacks consistent behaviors, has low
motivation for change, and is passively involved in treatment.
new text end

new text begin (4) "3" The client displays inconsistent compliance, has minimal awareness of either
the client's addiction or mental disorder, and is minimally cooperative.
new text end

new text begin (5) "4" The client is:
new text end

new text begin (i) noncompliant with treatment and has no awareness of addiction or mental disorder
and does not want or is unwilling to explore change or is in total denial of the client's illness
and its implications; or
new text end

new text begin (ii) dangerously oppositional to the extent that the client is a threat of imminent harm
to self and others.
new text end

new text begin (f) Dimension 5: the vendor must use the criteria in Dimension 5 to determine a client's
relapse, continued substance use, and continued problem potential.
new text end

new text begin (1) "0" The client recognizes risk well and is able to manage potential problems.
new text end

new text begin (2) "1" The client recognizes relapse issues and prevention strategies, but displays some
vulnerability for further substance use or mental health problems.
new text end

new text begin (3) "2" The client has minimal recognition and understanding of relapse and recidivism
issues and displays moderate vulnerability for further substance use or mental health
problems. The client has some coping skills inconsistently applied.
new text end

new text begin (4) "3" The client has poor recognition and understanding of relapse and recidivism
issues and displays moderately high vulnerability for further substance use or mental health
problems. The client has few coping skills and rarely applies coping skills.
new text end

new text begin (5) "4" The client has no coping skills to arrest mental health or addiction illnesses or
to prevent relapse. The client has no recognition or understanding of relapse and recidivism
issues and displays high vulnerability for further substance use or mental health problems.
new text end

new text begin (g) Dimension 6: the vendor must use the criteria in Dimension 6 to determine a client's
recovery environment.
new text end

new text begin (1) "0" The client is engaged in structured, meaningful activity and has a supportive
significant other, family, and living environment.
new text end

new text begin (2) "1" The client has passive social network support or the client's family and significant
other are not interested in the client's recovery. The client is engaged in structured, meaningful
activity.
new text end

new text begin (3) "2" The client is engaged in structured, meaningful activity, but the client's peers,
family, significant other, and living environment are unsupportive, or there is criminal
justice system involvement by the client or among the client's peers or significant other or
in the client's living environment.
new text end

new text begin (4) "3" The client is not engaged in structured, meaningful activity and the client's peers,
family, significant other, and living environment are unsupportive, or there is significant
criminal justice system involvement.
new text end

new text begin (5) "4" The client has:
new text end

new text begin (i) a chronically antagonistic significant other, living environment, family, or peer group
or long-term criminal justice system involvement that is harmful to the client's recovery or
treatment progress; or
new text end

new text begin (ii) an actively antagonistic significant other, family, work, or living environment, with
an immediate threat to the client's safety and well-being.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 42.

Minnesota Statutes 2020, section 254B.04, is amended by adding a subdivision
to read:


new text begin Subd. 5. new text end

new text begin Scope and applicability. new text end

new text begin This section governs administration of the behavioral
health fund, establishes the criteria to be applied by local agencies to determine a client's
financial eligibility under the behavioral health fund, and determines a client's obligation
to pay for substance use disorder treatment services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 43.

Minnesota Statutes 2020, section 254B.04, is amended by adding a subdivision
to read:


new text begin Subd. 6. new text end

new text begin Local agency responsibility to provide services. new text end

new text begin The local agency may employ
individuals to conduct administrative activities and facilitate access to substance use disorder
treatment services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 44.

Minnesota Statutes 2020, section 254B.04, is amended by adding a subdivision
to read:


new text begin Subd. 7. new text end

new text begin Local agency to determine client financial eligibility. new text end

new text begin (a) The local agency
shall determine a client's financial eligibility for the behavioral health fund according to
subdivision 1 with the income calculated prospectively for one year from the date of
comprehensive assessment. The local agency shall pay for eligible clients according to
chapter 256G. The local agency shall enter the financial eligibility span within ten calendar
days of request. Client eligibility must be determined using forms prescribed by the
commissioner. The local agency must determine a client's eligibility as follows:
new text end

new text begin (1) The local agency must determine the client's income. A client who is a minor child
must not be deemed to have income available to pay for substance use disorder treatment,
unless the minor child is responsible for payment under section 144.347 for substance use
disorder treatment services sought under section 144.343, subdivision 1.
new text end

new text begin (2) The local agency must determine the client's household size according to the
following:
new text end

new text begin (i) If the client is a minor child, the household size includes the following persons living
in the same dwelling unit:
new text end

new text begin (A) the client;
new text end

new text begin (B) the client's birth or adoptive parents; and
new text end

new text begin (C) the client's siblings who are minors.
new text end

new text begin (ii) If the client is an adult, the household size includes the following persons living in
the same dwelling unit:
new text end

new text begin (A) the client;
new text end

new text begin (B) the client's spouse;
new text end

new text begin (C) the client's minor children; and
new text end

new text begin (D) the client's spouse's minor children.
new text end

new text begin (iii) Household size includes a person listed in items (i) and (ii) who is in out-of-home
placement if a person listed in item (i) or (ii) is contributing to the cost of care of the person
in out-of-home placement.
new text end

new text begin (3) The local agency must determine the client's current prepaid health plan enrollment
and the availability of a third-party payment source, including the availability of total or
partial payment and the amount of co-payment.
new text end

new text begin (4) The local agency must provide the required eligibility information to the commissioner
in the manner specified by the commissioner.
new text end

new text begin (5) The local agency must require the client and policyholder to conditionally assign to
the department the client's and policyholder's rights and the rights of minor children to
benefits or services provided to the client if the commissioner is required to collect from a
third-party payment source.
new text end

new text begin (b) The local agency must redetermine a client's eligibility for the behavioral health fund
every 12 months.
new text end

new text begin (c) A client, responsible relative, and policyholder must provide income or wage
verification and household size verification under paragraph (a), clause (3), and must make
an assignment of third-party payment rights under paragraph (a), clause (5). If a client,
responsible relative, or policyholder does not comply with this subdivision, the client is
ineligible for behavioral health fund payment for substance use disorder treatment, and the
client and responsible relative are obligated to pay the full cost of substance use disorder
treatment services provided to the client.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 45.

Minnesota Statutes 2020, section 254B.04, is amended by adding a subdivision
to read:


new text begin Subd. 8. new text end

new text begin Client fees. new text end

new text begin A client whose household income is within current household size
and income guidelines for entitled persons as defined in subdivision 1 must pay no fee.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 46.

Minnesota Statutes 2020, section 254B.04, is amended by adding a subdivision
to read:


new text begin Subd. 9. new text end

new text begin Vendor must participate in DAANES. new text end

new text begin To be eligible for payment under the
behavioral health fund, a vendor must participate in DAANES or submit to the commissioner
the information required in DAANES in the format specified by the commissioner.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 47.

Minnesota Statutes 2021 Supplement, section 254B.05, subdivision 4, is amended
to read:


Subd. 4.

Regional treatment centers.

Regional treatment center chemical dependency
treatment units are eligible vendors. The commissioner may expand the capacity of chemical
dependency treatment units beyond the capacity funded by direct legislative appropriation
to serve individuals who are referred for treatment by counties and whose treatment will be
paid for by funding under this chapter or other funding sources. Notwithstanding the
provisions of sections 254B.03 to deleted text begin254B.041deleted text endnew text begin 254B.04new text end, payment for any person committed
at county request to a regional treatment center under chapter 253B for chemical dependency
treatment and determined to be ineligible under the behavioral health fund, shall become
the responsibility of the county.

Sec. 48.

Minnesota Statutes 2021 Supplement, section 254B.05, subdivision 5, is amended
to read:


Subd. 5.

Rate requirements.

(a) The commissioner shall establish rates for substance
use disorder services and service enhancements funded under this chapter.

(b) Eligible substance use disorder treatment services include:

deleted text begin (1) outpatient treatment services that are licensed according to sections 245G.01 to
245G.17, or applicable tribal license;
deleted text end

new text begin (1) outpatient treatment services licensed under sections 245G.01 to 245G.17, or
applicable Tribal license, including:
new text end

new text begin (i) ASAM 1.0 outpatient: zero to eight hours per week of skilled treatment services for
adults and zero to five hours per week for adolescents. Peer recovery and treatment
coordination may be provided beyond the skilled treatment service hours allowable per
week; and
new text end

new text begin (ii) ASAM 2.1 intensive outpatient: nine or more hours per week of skilled treatment
services for adults and six or more hours per week for adolescents in accordance with the
limitations in paragraph (h). Peer recovery and treatment coordination may be provided
beyond the skilled treatment service hours allowable per week;
new text end

(2) comprehensive assessments provided according to sections 245.4863, paragraph (a),
and 245G.05;

(3) deleted text begincaredeleted text endnew text begintreatmentnew text end coordination services provided according to section 245G.07,
subdivision 1
, paragraph (a), clause (5);

(4) peer recovery support services provided according to section 245G.07, subdivision
2, clause (8);

(5) on July 1, 2019, or upon federal approval, whichever is later, withdrawal management
services provided according to chapter 245F;

(6) medication-assisted therapy services that are licensed according to sections 245G.01
to 245G.17 and 245G.22, or applicable tribal license;

deleted text begin (7) medication-assisted therapy plus enhanced treatment services that meet the
deleted text end deleted text begin requirements of clause (6) and provide nine hours of clinical services each week;
deleted text end

deleted text begin (8)deleted text endnew text begin (7)new text end high, medium, and low intensity residential treatment services that are licensed
according to sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license deleted text beginwhichdeleted text endnew text beginthatnew text end
provide, respectively, 30, 15, and five hours of clinical services each new text begintreatment new text endweeknew text begin. For
purposes of this section, residential treatment services provided by a program that meets
the American Society of Addiction Medicine (ASAM) level 3.3 standards for care, must
be considered high intensity, including when the program makes and appropriately documents
clinically supported modifications to, or reductions in, the hours of services provided to
better meet the needs of individuals with cognitive deficits
new text end;

deleted text begin (9)deleted text endnew text begin (8)new text end hospital-based treatment services that are licensed according to sections 245G.01
to 245G.17 or applicable tribal license and licensed as a hospital under sections 144.50 to
144.56;

deleted text begin (10)deleted text endnew text begin (9)new text end adolescent treatment programs that are licensed as outpatient treatment programs
according to sections 245G.01 to 245G.18 or as residential treatment programs according
to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or
applicable tribal license;

deleted text begin (11)deleted text endnew text begin (10)new text end high-intensity residential treatment services that are licensed according to
sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license, deleted text beginwhichdeleted text endnew text beginthatnew text end provide
30 hours of clinical services each week provided by a state-operated vendor or to clients
who have been civilly committed to the commissioner, present the most complex and difficult
care needs, and are a potential threat to the community; and

deleted text begin (12)deleted text endnew text begin (11)new text end room and board facilities that meet the requirements of subdivision 1a.

(c) The commissioner shall establish higher rates for programs that meet the requirements
of paragraph (b) and one of the following additional requirements:

(1) programs that serve parents with their children if the program:

(i) provides on-site child care during the hours of treatment activity that:

(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter
9503; or

(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph
(a), clause (6), and meets the requirements under section 245G.19, subdivision 4; or

(ii) arranges for off-site child care during hours of treatment activity at a facility that is
licensed under chapter 245A as:

(A) a child care center under Minnesota Rules, chapter 9503; or

(B) a family child care home under Minnesota Rules, chapter 9502;

(2) culturally specific or culturally responsive programs as defined in section 254B.01,
subdivision 4a
;

(3) disability responsive programs as defined in section 254B.01, subdivision 4b;

(4) programs that offer medical services delivered by appropriately credentialed health
care staff in an amount equal to two hours per client per week if the medical needs of the
client and the nature and provision of any medical services provided are documented in the
client file; or

(5) programs that offer services to individuals with co-occurring mental health and
chemical dependency problems if:

(i) the program meets the co-occurring requirements in section 245G.20;

(ii)deleted text begin 25 percent ofdeleted text end the new text beginprogram employs sufficient new text endcounseling staffnew text begin, including at least one
full-time equivalent staff member, who
new text end are licensed mental health professionalsdeleted text begin, as defined
in section 245.462, subdivision 18, clauses (1) to (6)
deleted text endnew text begin under section 245I.04, subdivision 2new text end,
or are students or licensing candidates under the supervision of a licensed alcohol and drug
counselor supervisor and deleted text beginlicenseddeleted text end mental health professionalnew text begin under section 245I.04,
subdivision 2
new text end,deleted text begin except that no more than 50 percent of the mental health staff may be students
deleted text enddeleted text begin or licensing candidates with time documented to be directly related to provisions of
co-occurring
deleted text endnew text beginto meet the need for client new text endservices;

(iii) clients scoring positive on a standardized mental health screen receive a mental
health diagnostic assessment within ten days of admission;

(iv) the program has standards for multidisciplinary case review that include a monthly
review for each client that, at a minimum, includes a licensed mental health professional
and licensed alcohol and drug counselor, and their involvement in the review is documented;

(v) family education is offered that addresses mental health and substance abuse disorders
and the interaction between the two; and

(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder
training annually.

(d) deleted text beginIn order todeleted text endnew text beginTonew text end be eligible for a higher rate under paragraph (c), clause (1), a program
that provides arrangements for off-site child care must maintain current documentation at
the chemical dependency facility of the child care provider's current licensure to provide
child care services. Programs that provide child care according to paragraph (c), clause (1),
must be deemed in compliance with the licensing requirements in section 245G.19.

(e) Adolescent residential programs that meet the requirements of Minnesota Rules,
parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements
in paragraph (c), clause (4), items (i) to (iv).

(f) Subject to federal approval, substance use disorder services that are otherwise covered
as direct face-to-face services may be provided via telehealth as defined in section 256B.0625,
subdivision 3b. The use of telehealth to deliver services must be medically appropriate to
the condition and needs of the person being served. Reimbursement shall be at the same
rates and under the same conditions that would otherwise apply to direct face-to-face services.

(g) For the purpose of reimbursement under this section, substance use disorder treatment
services provided in a group setting without a group participant maximum or maximum
client to staff ratio under chapter 245G shall not exceed a client to staff ratio of 48 to one.
At least one of the attending staff must meet the qualifications as established under this
chapter for the type of treatment service provided. A recovery peer may not be included as
part of the staff ratio.

(h) Payment for outpatient substance use disorder services that are licensed according
to sections 245G.01 to 245G.17 is limited to six hours per day or 30 hours per week unless
prior authorization of a greater number of hours is obtained from the commissioner.

new text begin (i) Programs using a qualified guest speaker must maintain documentation of the person's
qualifications to present to clients on a topic the program has determined to be of value to
its clients. The guest speaker must present less than half of any treatment group. A qualified
counselor must be present during the delivery of content and must be responsible for
documentation of the group.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 49.

Minnesota Statutes 2020, section 256B.0757, subdivision 5, is amended to read:


Subd. 5.

Payments.

The commissioner shall make payments to each designated provider
for the provision ofnew text begin behavioralnew text end health home services described in subdivision 3 to each
eligible individual under subdivision 2 that selects thenew text begin behavioralnew text end health home as a provider.

Sec. 50.

Minnesota Statutes 2021 Supplement, section 256B.0946, subdivision 1, is
amended to read:


Subdivision 1.

Required covered service components.

(a) Subject to federal approval,
medical assistance covers medically necessary intensive treatment services when the services
are provided by a provider entity certified under and meeting the standards in this section.
The provider entity must make reasonable and good faith efforts to report individual client
outcomes to the commissioner, using instruments and protocols approved by the
commissioner.

(b) Intensive treatment services to children with mental illness residing in foster family
settings that comprise specific required service components provided in clauses (1) to (6)
are reimbursed by medical assistance when they meet the following standards:

(1) psychotherapy provided by a mental health professional or a clinical trainee;

(2) crisis planning;

(3) individual, family, and group psychoeducation services provided by a mental health
professional or a clinical trainee;

(4) clinical care consultation provided by a mental health professional or a clinical
trainee;

(5) individual treatment plan development as defined in deleted text beginMinnesota Rules, part 9505.0371,
subpart 7
deleted text endnew text begin section 245I.10, subdivisions 7 and 8new text end; and

(6) service delivery payment requirements as provided under subdivision 4.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 51.

Minnesota Statutes 2020, section 256D.09, subdivision 2a, is amended to read:


Subd. 2a.

Vendor payments for drug dependent persons.

If, at the time of application
or at any other time, there is a reasonable basis for questioning whether a person applying
for or receiving financial assistance is drug dependent, as defined in section 254A.02,
subdivision 5
, the person shall be referred for a chemical health assessment, and only
emergency assistance payments or general assistance vendor payments may be provided
until the assessment is complete and the results of the assessment made available to the
county agency. A reasonable basis for referring an individual for an assessment exists when:

(1) the person has required detoxification two or more times in the past 12 months;

(2) the person appears intoxicated at the county agency as indicated by two or more of
the following:

(i) the odor of alcohol;

(ii) slurred speech;

(iii) disconjugate gaze;

(iv) impaired balance;

(v) difficulty remaining awake;

(vi) consumption of alcohol;

(vii) responding to sights or sounds that are not actually present;

(viii) extreme restlessness, fast speech, or unusual belligerence;

(3) the person has been involuntarily committed for drug dependency at least once in
the past 12 months; or

(4) the person has received treatment, including domiciliary care, for drug abuse or
dependency at least twice in the past 12 months.

The assessment and determination of drug dependency, if any, must be made by an
assessor qualified under deleted text beginMinnesota Rules, part 9530.6615, subpart 2deleted text endnew text begin section 245G.11,
subdivisions 1 and 5
new text end, to perform an assessment of chemical use. The county shall only
provide emergency general assistance or vendor payments to an otherwise eligible applicant
or recipient who is determined to be drug dependent, except up to 15 percent of the grant
amount the person would otherwise receive may be paid in cash. Notwithstanding subdivision
1, the commissioner of human services shall also require county agencies to provide
assistance only in the form of vendor payments to all eligible recipients who assert chemical
dependency as a basis for eligibility under section 256D.05, subdivision 1, paragraph (a),
clauses (1) and (5).

The determination of drug dependency shall be reviewed at least every 12 months. If
the county determines a recipient is no longer drug dependent, the county may cease vendor
payments and provide the recipient payments in cash.

Sec. 52.

Minnesota Statutes 2021 Supplement, section 256L.03, subdivision 2, is amended
to read:


Subd. 2.

Alcohol and drug dependency.

Beginning July 1, 1993, covered health services
shall include individual outpatient treatment of alcohol or drug dependency by a qualified
health professional or outpatient program.

Persons who may need chemical dependency services under the provisions of this chapter
deleted text begin shall be assessed by a local agencydeleted text endnew text begin must be offered access by a local agency to a
comprehensive assessment
new text end as defined under section deleted text begin254B.01deleted text endnew text begin 245G.05new text end, and under the
assessment provisions of section 254A.03, subdivision 3. A local agency or managed care
plan under contract with the Department of Human Services must deleted text beginplacedeleted text endnew text begin offer services tonew text end a
person in need of chemical dependency services deleted text beginas provided in Minnesota Rules, parts
9530.6600 to 9530.6655
deleted text endnew text begin based on the recommendations of section 245G.05new text end. Persons who
are recipients of medical benefits under the provisions of this chapter and who are financially
eligible for behavioral health fund services provided under the provisions of chapter 254B
shall receive chemical dependency treatment services under the provisions of chapter 254B
only if:

(1) they have exhausted the chemical dependency benefits offered under this chapter;
or

(2) an assessment indicates that they need a level of care not provided under the provisions
of this chapter.

Recipients of covered health services under the children's health plan, as provided in
Minnesota Statutes 1990, section 256.936, and as amended by Laws 1991, chapter 292,
article 4, section 17, and recipients of covered health services enrolled in the children's
health plan or the MinnesotaCare program after October 1, 1992, pursuant to Laws 1992,
chapter 549, article 4, sections 5 and 17, are eligible to receive alcohol and drug dependency
benefits under this subdivision.

Sec. 53.

Minnesota Statutes 2020, section 256L.12, subdivision 8, is amended to read:


Subd. 8.

Chemical dependency assessments.

The managed care plan shall be responsible
for assessing the need and deleted text beginplacement fordeleted text endnew text begin provision ofnew text end chemical dependency services
according to criteria set forth in deleted text beginMinnesota Rules, parts 9530.6600 to 9530.6655deleted text endnew text begin section
245G.05
new text end.

Sec. 54.

Minnesota Statutes 2020, section 260B.157, subdivision 1, is amended to read:


Subdivision 1.

Investigation.

Upon request of the court the local social services agency
or probation officer shall investigate the personal and family history and environment of
any minor coming within the jurisdiction of the court under section 260B.101 and shall
report its findings to the court. The court may order any minor coming within its jurisdiction
to be examined by a duly qualified physician, psychiatrist, or psychologist appointed by the
court.

The court shall order a chemical use assessment conducted when a child is (1) found to
be delinquent for violating a provision of chapter 152, or for committing a felony-level
violation of a provision of chapter 609 if the probation officer determines that alcohol or
drug use was a contributing factor in the commission of the offense, or (2) alleged to be
delinquent for violating a provision of chapter 152, if the child is being held in custody
under a detention order. The assessor's qualifications new text beginmust comply with section 245G.11,
subdivisions 1 and 5,
new text endand the assessment criteria deleted text beginshalldeleted text endnew text begin mustnew text end comply with deleted text beginMinnesota Rules,
parts 9530.6600 to 9530.6655
deleted text endnew text begin section 245G.05new text end. If funds under chapter 254B are to be used
to pay for the recommended treatment, the assessment deleted text beginand placementdeleted text end must comply with all
provisions of deleted text beginMinnesota Rules, parts 9530.6600 to 9530.6655 and 9530.7000 to 9530.7030deleted text endnew text begin
sections 245G.05 and 254B.04
new text end. The commissioner of human services shall reimburse the
court for the cost of the chemical use assessment, up to a maximum of $100.

The court shall order a children's mental health screening conducted when a child is
found to be delinquent. The screening shall be conducted with a screening instrument
approved by the commissioner of human services and shall be conducted by a mental health
practitioner as defined in section 245.4871, subdivision 26, or a probation officer who is
trained in the use of the screening instrument. If the screening indicates a need for assessment,
the local social services agency, in consultation with the child's family, shall have a diagnostic
assessment conducted, including a functional assessment, as defined in section 245.4871.

With the consent of the commissioner of corrections and agreement of the county to pay
the costs thereof, the court may, by order, place a minor coming within its jurisdiction in
an institution maintained by the commissioner for the detention, diagnosis, custody and
treatment of persons adjudicated to be delinquent, in order that the condition of the minor
be given due consideration in the disposition of the case. Any funds received under the
provisions of this subdivision shall not cancel until the end of the fiscal year immediately
following the fiscal year in which the funds were received. The funds are available for use
by the commissioner of corrections during that period and are hereby appropriated annually
to the commissioner of corrections as reimbursement of the costs of providing these services
to the juvenile courts.

Sec. 55.

Minnesota Statutes 2020, section 260B.157, subdivision 3, is amended to read:


Subd. 3.

Juvenile treatment screening team.

(a) The local social services agency shall
establish a juvenile treatment screening team to conduct screenings and prepare case plans
under this subdivision. The team, which may be the team constituted under section 245.4885
or 256B.092 or deleted text beginMinnesota Rules, parts 9530.6600 to 9530.6655deleted text endnew text begin chapter 254Bnew text end, shall consist
of social workers, juvenile justice professionals, and persons with expertise in the treatment
of juveniles who are emotionally disabled, chemically dependent, or have a developmental
disability. The team shall involve parents or guardians in the screening process as appropriate.
The team may be the same team as defined in section 260C.157, subdivision 3.

(b) If the court, prior to, or as part of, a final disposition, proposes to place a child:

(1) for the primary purpose of treatment for an emotional disturbance, and residential
placement is consistent with section 260.012, a developmental disability, or chemical
dependency in a residential treatment facility out of state or in one which is within the state
and licensed by the commissioner of human services under chapter 245A; or

(2) in any out-of-home setting potentially exceeding 30 days in duration, including a
post-dispositional placement in a facility licensed by the commissioner of corrections or
human services, the court shall notify the county welfare agency. The county's juvenile
treatment screening team must either:

(i) screen and evaluate the child and file its recommendations with the court within 14
days of receipt of the notice; or

(ii) elect not to screen a given case, and notify the court of that decision within three
working days.

(c) If the screening team has elected to screen and evaluate the child, the child may not
be placed for the primary purpose of treatment for an emotional disturbance, a developmental
disability, or chemical dependency, in a residential treatment facility out of state nor in a
residential treatment facility within the state that is licensed under chapter 245A, unless one
of the following conditions applies:

(1) a treatment professional certifies that an emergency requires the placement of the
child in a facility within the state;

(2) the screening team has evaluated the child and recommended that a residential
placement is necessary to meet the child's treatment needs and the safety needs of the
community, that it is a cost-effective means of meeting the treatment needs, and that it will
be of therapeutic value to the child; or

(3) the court, having reviewed a screening team recommendation against placement,
determines to the contrary that a residential placement is necessary. The court shall state
the reasons for its determination in writing, on the record, and shall respond specifically to
the findings and recommendation of the screening team in explaining why the
recommendation was rejected. The attorney representing the child and the prosecuting
attorney shall be afforded an opportunity to be heard on the matter.

Sec. 56.

Minnesota Statutes 2021 Supplement, section 260C.157, subdivision 3, is amended
to read:


Subd. 3.

Juvenile treatment screening team.

(a) The responsible social services agency
shall establish a juvenile treatment screening team to conduct screenings under this chapter
and chapter 260D, for a child to receive treatment for an emotional disturbance, a
developmental disability, or related condition in a residential treatment facility licensed by
the commissioner of human services under chapter 245A, or licensed or approved by a
Tribe. A screening team is not required for a child to be in: (1) a residential facility
specializing in prenatal, postpartum, or parenting support; (2) a facility specializing in
high-quality residential care and supportive services to children and youth who have been
or are at risk of becoming victims of sex trafficking or commercial sexual exploitation; (3)
supervised settings for youth who are 18 years of age or older and living independently; or
(4) a licensed residential family-based treatment facility for substance abuse consistent with
section 260C.190. Screenings are also not required when a child must be placed in a facility
due to an emotional crisis or other mental health emergency.

(b) The responsible social services agency shall conduct screenings within 15 days of a
request for a screening, unless the screening is for the purpose of residential treatment and
the child is enrolled in a prepaid health program under section 256B.69, in which case the
agency shall conduct the screening within ten working days of a request. The responsible
social services agency shall convene the juvenile treatment screening team, which may be
constituted under section 245.4885 deleted text beginordeleted text endnew text begin, 254B.05, ornew text end 256B.092 deleted text beginor Minnesota Rules, parts
9530.6600 to 9530.6655
deleted text end. The team shall consist of social workers; persons with expertise
in the treatment of juveniles who are emotionally disturbed, chemically dependent, or have
a developmental disability; and the child's parent, guardian, or permanent legal custodian.
The team may include the child's relatives as defined in section 260C.007, subdivisions 26b
and 27, the child's foster care provider, and professionals who are a resource to the child's
family such as teachers, medical or mental health providers, and clergy, as appropriate,
consistent with the family and permanency team as defined in section 260C.007, subdivision
16a
. Prior to forming the team, the responsible social services agency must consult with the
child's parents, the child if the child is age 14 or older, and, if applicable, the child's Tribe
to obtain recommendations regarding which individuals to include on the team and to ensure
that the team is family-centered and will act in the child's best interests. If the child, child's
parents, or legal guardians raise concerns about specific relatives or professionals, the team
should not include those individuals. This provision does not apply to paragraph (c).

(c) If the agency provides notice to Tribes under section 260.761, and the child screened
is an Indian child, the responsible social services agency must make a rigorous and concerted
effort to include a designated representative of the Indian child's Tribe on the juvenile
treatment screening team, unless the child's Tribal authority declines to appoint a
representative. The Indian child's Tribe may delegate its authority to represent the child to
any other federally recognized Indian Tribe, as defined in section 260.755, subdivision 12.
The provisions of the Indian Child Welfare Act of 1978, United States Code, title 25, sections
1901 to 1963, and the Minnesota Indian Family Preservation Act, sections 260.751 to
260.835, apply to this section.

(d) If the court, prior to, or as part of, a final disposition or other court order, proposes
to place a child with an emotional disturbance or developmental disability or related condition
in residential treatment, the responsible social services agency must conduct a screening.
If the team recommends treating the child in a qualified residential treatment program, the
agency must follow the requirements of sections 260C.70 to 260C.714.

The court shall ascertain whether the child is an Indian child and shall notify the
responsible social services agency and, if the child is an Indian child, shall notify the Indian
child's Tribe as paragraph (c) requires.

(e) When the responsible social services agency is responsible for placing and caring
for the child and the screening team recommends placing a child in a qualified residential
treatment program as defined in section 260C.007, subdivision 26d, the agency must: (1)
begin the assessment and processes required in section 260C.704 without delay; and (2)
conduct a relative search according to section 260C.221 to assemble the child's family and
permanency team under section 260C.706. Prior to notifying relatives regarding the family
and permanency team, the responsible social services agency must consult with the child's
parent or legal guardian, the child if the child is age 14 or older, and, if applicable, the child's
Tribe to ensure that the agency is providing notice to individuals who will act in the child's
best interests. The child and the child's parents may identify a culturally competent qualified
individual to complete the child's assessment. The agency shall make efforts to refer the
assessment to the identified qualified individual. The assessment may not be delayed for
the purpose of having the assessment completed by a specific qualified individual.

(f) When a screening team determines that a child does not need treatment in a qualified
residential treatment program, the screening team must:

(1) document the services and supports that will prevent the child's foster care placement
and will support the child remaining at home;

(2) document the services and supports that the agency will arrange to place the child
in a family foster home; or

(3) document the services and supports that the agency has provided in any other setting.

(g) When the Indian child's Tribe or Tribal health care services provider or Indian Health
Services provider proposes to place a child for the primary purpose of treatment for an
emotional disturbance, a developmental disability, or co-occurring emotional disturbance
and chemical dependency, the Indian child's Tribe or the Tribe delegated by the child's Tribe
shall submit necessary documentation to the county juvenile treatment screening team,
which must invite the Indian child's Tribe to designate a representative to the screening
team.

(h) The responsible social services agency must conduct and document the screening in
a format approved by the commissioner of human services.

Sec. 57.

Minnesota Statutes 2020, section 260E.20, subdivision 1, is amended to read:


Subdivision 1.

General duties.

(a) The local welfare agency shall offer services to
prevent future maltreatment, safeguarding and enhancing the welfare of the maltreated child,
and supporting and preserving family life whenever possible.

(b) If the report alleges a violation of a criminal statute involving maltreatment or child
endangerment under section 609.378, the local law enforcement agency and local welfare
agency shall coordinate the planning and execution of their respective investigation and
assessment efforts to avoid a duplication of fact-finding efforts and multiple interviews.
Each agency shall prepare a separate report of the results of the agency's investigation or
assessment.

(c) In cases of alleged child maltreatment resulting in death, the local agency may rely
on the fact-finding efforts of a law enforcement investigation to make a determination of
whether or not maltreatment occurred.

(d) When necessary, the local welfare agency shall seek authority to remove the child
from the custody of a parent, guardian, or adult with whom the child is living.

(e) In performing any of these duties, the local welfare agency shall maintain an
appropriate record.

(f) In conducting a family assessment or investigation, the local welfare agency shall
gather information on the existence of substance abuse and domestic violence.

(g) If the family assessment or investigation indicates there is a potential for abuse of
alcohol or other drugs by the parent, guardian, or person responsible for the child's care,
the local welfare agency deleted text beginshall conduct a chemical usedeleted text endnew text begin must coordinate a comprehensive new text end
assessment pursuant to deleted text beginMinnesota Rules, part 9530.6615deleted text endnew text begin section 245G.05new text end.

(h) The agency may use either a family assessment or investigation to determine whether
the child is safe when responding to a report resulting from birth match data under section
260E.03, subdivision 23, paragraph (c). If the child subject of birth match data is determined
to be safe, the agency shall consult with the county attorney to determine the appropriateness
of filing a petition alleging the child is in need of protection or services under section
260C.007, subdivision 6, clause (16), in order to deliver needed services. If the child is
determined not to be safe, the agency and the county attorney shall take appropriate action
as required under section 260C.503, subdivision 2.

Sec. 58.

Minnesota Statutes 2021 Supplement, section 297E.02, subdivision 3, is amended
to read:


Subd. 3.

Collection; disposition.

(a) Taxes imposed by this section are due and payable
to the commissioner when the gambling tax return is required to be filed. Distributors must
file their monthly sales figures with the commissioner on a form prescribed by the
commissioner. Returns covering the taxes imposed under this section must be filed with
the commissioner on or before the 20th day of the month following the close of the previous
calendar month. The commissioner shall prescribe the content, format, and manner of returns
or other documents pursuant to section 270C.30. The proceeds, along with the revenue
received from all license fees and other fees under sections 349.11 to 349.191, 349.211,
and 349.213, must be paid to the commissioner of management and budget for deposit in
the general fund.

(b) The sales tax imposed by chapter 297A on the sale of pull-tabs and tipboards by the
distributor is imposed on the retail sales price. The retail sale of pull-tabs or tipboards by
the organization is exempt from taxes imposed by chapter 297A and is exempt from all
local taxes and license fees except a fee authorized under section 349.16, subdivision 8.

(c) One-half of one percent of the revenue deposited in the general fund under paragraph
(a), is appropriated to the commissioner of human services for the compulsive gambling
treatment program established under section 245.98. new text beginMoney appropriated under this paragraph
must not replace existing state funding for these programs.
new text end

new text begin (d) new text endOne-half of one percent of the revenue deposited in the general fund under paragraph
(a), is appropriated to the commissioner of human servicesdeleted text begin for a grantdeleted text endnew text begin. By June 30 of each
fiscal year, the commissioner of human services must transfer the amount deposited in the
general fund under this paragraph to the special revenue fund. By October 15 of each fiscal
year, the commissioner of human services must award a grant in an amount equal to the
entire amount transferred to the special revenue fund under this paragraph for the prior fiscal
year
new text end to the state affiliate recognized by the National Council on Problem Gambling 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 relating to problem gambling. Money appropriated by this paragraph must
supplement and must not replace existing state funding for these programs.

deleted text begin (d)deleted text endnew text begin (e)new text end The commissioner of human services must provide to the state affiliate recognized
by the National Council on Problem Gambling a monthly statement of the amounts deposited
under deleted text beginparagraphdeleted text endnew text begin paragraphsnew text end (c)new text begin and (d)new text end. Beginning January 1, 2022, the commissioner of
human services must provide to the chairs and ranking minority members of the legislative
committees with jurisdiction over treatment for problem gambling and to the state affiliate
recognized by the National Council on Problem Gambling an annual reconciliation of the
amounts deposited under paragraph (c). The annual reconciliation under this paragraph must
include the amount allocated to the commissioner of human services for the compulsive
gambling treatment program established under section 245.98, and the amount allocated to
the state affiliate recognized by the National Council on Problem Gambling.

Sec. 59.

Minnesota Statutes 2020, section 297E.021, subdivision 3, is amended to read:


Subd. 3.

Available revenues.

For purposes of this section, "available revenues" equals
the amount determined under subdivision 2, plus up to $20,000,000 each fiscal year from
the taxes imposed under section 290.06, subdivision 1:

(1) reduced by the following amounts paid for the fiscal year under:

(i) the appropriation to principal and interest on appropriation bonds under section
16A.965, subdivision 8;

(ii) the appropriation from the general fund to make operating expense payments under
section 473J.13, subdivision 2, paragraph (b);

(iii) the appropriation for contributions to the capital reserve fund under section 473J.13,
subdivision 4
, paragraph (c);

(iv) the appropriations under Laws 2012, chapter 299, article 4, for administration and
any successor appropriation;

(v) the reduction in revenues resulting from the sales tax exemptions under section
297A.71, subdivision 43;

(vi) reimbursements authorized by section 473J.15, subdivision 2, paragraph (d);

(vii) the compulsive gambling appropriations under section 297E.02, subdivision 3,
deleted text begin paragraphdeleted text endnew text begin paragraphsnew text end (c)new text begin and (d)new text end, and any successor appropriation; and

(viii) the appropriation for the city of St. Paul under section 16A.726, paragraph (c); and

(2) increased by the revenue deposited in the general fund under section 297A.994,
subdivision 4, clauses (1) to (3), for the fiscal year.

Sec. 60.

Minnesota Statutes 2020, section 299A.299, subdivision 1, is amended to read:


Subdivision 1.

Establishment of team.

A county, a multicounty organization of counties
formed by an agreement under section 471.59, or a city with a population of no more than
50,000, may establish a multidisciplinary chemical abuse prevention team. The chemical
abuse prevention team may include, but not be limited to, representatives of health, mental
health, public health, law enforcement, educational, social service, court service, community
education, religious, and other appropriate agencies, and parent and youth groups. For
purposes of this section, "chemical abuse" has the meaning given in deleted text beginMinnesota Rules, part
9530.6605, subpart 6
deleted text endnew text begin section 254A.02, subdivision 6anew text end. When possible the team must
coordinate its activities with existing local groups, organizations, and teams dealing with
the same issues the team is addressing.

Sec. 61.

Minnesota Statutes 2020, section 626.5571, subdivision 1, is amended to read:


Subdivision 1.

Establishment of team.

A county may establish a multidisciplinary adult
protection team comprised of the director of the local welfare agency or designees, the
county attorney or designees, the county sheriff or designees, and representatives of health
care. In addition, representatives of mental health or other appropriate human service
agencies, new text begincommunity corrections agencies, new text endrepresentatives from local tribal governments,
new text begin local law enforcement agencies or designees thereof, new text endand adult advocate groups may be
added to the adult protection team.

Sec. 62.

new text begin [626.8477] MENTAL HEALTH AND HEALTH RECORDS; WRITTEN
POLICY REQUIRED.
new text end

new text begin The chief officer of every state and local law enforcement agency that seeks or uses
mental health data under section 13.46, subdivision 7, paragraph (c), or health records under
section 144.294, subdivision 2, must establish and enforce a written policy governing its
use. At a minimum, the written policy must incorporate the requirements of sections 13.46,
subdivision 7, paragraph (c), and 144.294, subdivision 2, and access procedures, retention
policies, and data security safeguards that, at a minimum, meet the requirements of chapter
13 and any other applicable law.
new text end

Sec. 63. new text beginOLMSTED COUNTY RECOVERY COMMUNITY ORGANIZATION.
new text end

new text begin The commissioner of human services shall establish a grant to a recovery community
organization in Olmsted County, located in the city of Rochester, Minnesota, that provides
services in an 11-county region, to provide services to individuals in substance use recovery.
new text end

Sec. 64. new text beginRATE INCREASE FOR ADULT DAY TREATMENT SERVICES.
new text end

new text begin Effective January 1, 2023, or 60 days following federal approval, whichever is later, the
commissioner of human services shall increase the reimbursement rate under Minnesota
Rules, part 9505.0372, subpart 8, for adult day treatment services covered under Minnesota
Statutes, section 256B.0671, subdivision 3, by 50 percent from the rates in effect on
December 31, 2022.
new text end

Sec. 65. new text beginROCHESTER NONPROFIT RECOVERY COMMUNITY
ORGANIZATION.
new text end

new text begin The commissioner shall establish a grant to a nonprofit recovery community organization
located in the city of Rochester, Minnesota, that provides pretreatment housing,
post-treatment recovery housing, treatment coordination, and peer recovery support to
individuals pursuing a life of recovery from substance use disorders, and that also offers a
recovery coaching academy to individuals interested in becoming peer recovery specialists.
new text end

Sec. 66. new text beginWELLNESS IN THE WOODS.
new text end

new text begin The commissioner shall establish a grant to Wellness in the Woods to provide daily peer
support and special sessions for individuals who are in substance use recovery, are
transitioning out of incarceration, or have experienced trauma.
new text end

Sec. 67. new text beginDIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
BEHAVIORAL HEALTH FUND ALLOCATION.
new text end

new text begin The commissioner of human services, in consultation with counties and Tribal Nations,
must make recommendations on an updated allocation to local agencies from funds allocated
under Minnesota Statutes, section 254B.02, subdivision 5. The commissioner must submit
the recommendations to the chairs and ranking minority members of the legislative
committees with jurisdiction over health and human services finance and policy by January
1, 2024.
new text end

Sec. 68. new text beginREPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2020, sections 169A.70, subdivision 6; 245G.22, subdivision 19;
254A.02, subdivision 8a; 254A.16, subdivision 6; 254A.19, subdivisions 1a and 2; 254B.04,
subdivisions 2b and 2c; and 254B.041, subdivision 2,
new text end new text begin are repealed.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2021 Supplement, section 254A.19, subdivision 5, new text end new text begin is repealed.
new text end

new text begin (c) new text end new text begin Minnesota Rules, parts 9530.7000, subparts 1, 2, 5, 6, 7, 8, 9, 10, 11, 13, 14, 15, 17a,
19, 20, and 21; 9530.7005; 9530.7010; 9530.7012; 9530.7015, subparts 1, 2a, 4, 5, and 6;
9530.7020, subparts 1, 1a, and 2; 9530.7021; 9530.7022, subpart 1; 9530.7025; and
9530.7030, subpart 1,
new text end new text begin are repealed.
new text end

ARTICLE 5

CHILDREN AND FAMILY SERVICES

Section 1.

Minnesota Statutes 2020, section 256D.0515, is amended to read:


256D.0515 ASSET LIMITATIONS FOR SUPPLEMENTAL NUTRITION
ASSISTANCE PROGRAM HOUSEHOLDS.

new text begin (a) new text endAll Supplemental Nutrition Assistance Program (SNAP) households must be
determined eligible for the benefit discussed under section 256.029. SNAP households must
demonstrate that their gross income is equal to or less than deleted text begin165deleted text endnew text begin 200new text end percent of the federal
poverty guidelines for the same family size.

new text begin (b) The governor or the commissioner of human services cannot waive federal work
requirements for SNAP households, except as provided under section 256D.0512, and
counties must verify that SNAP households are meeting their work requirements.
new text end

Sec. 2.

Minnesota Statutes 2020, section 256P.03, subdivision 2, is amended to read:


Subd. 2.

Earned income disregard.

The agency shall disregard the first $65 of earned
income plus deleted text beginone-halfdeleted text endnew text begin 60 percentnew text end of the remaining earned income per month.

Sec. 3.

Laws 2021, First Special Session chapter 7, article 14, section 21, subdivision 4,
is amended to read:


Subd. 4.

Grant awards.

(a) The commissioner shall award transition grants to all eligible
programs on a noncompetitive basis through August 31, 2021.

(b) The commissioner shall award base grant amounts to all eligible programs on a
noncompetitive basis beginning September 1, 2021, through June 30, 2023. The base grant
amounts shall be:

(1) based on the full-time equivalent number of staff who regularly care for children in
the program, including any employees, sole proprietors, or independent contractorsnew text begin. Effective
July 1, 2022, one full-time equivalent is defined as an individual caring for children 32
hours per week. An individual may count as more or less than one full-time equivalent, but
no more than two
new text end;

(2) reduced between July 1, 2022, and June 30, 2023, with amounts for the final month
being no more than 50 percent of the amounts awarded in September 2021; and

(3) enhanced in amounts determined by the commissioner for any providers receiving
payments through the child care assistance program under sections 119B.03 and 119B.05
or early learning scholarships under section 124D.165.

(c) The commissioner may provide grant amounts in addition to any base grants received
to eligible programs in extreme financial hardship until all money set aside for that purpose
is awarded.

(d) The commissioner may pay any grants awarded to eligible programs under this
section in the form and manner established by the commissioner, except that such payments
must occur on a monthly basis.

Sec. 4. new text beginQUALITY PARENTING INITIATIVE.
new text end

new text begin The commissioner shall establish a grant to Quality Parenting Initiative Minnesota to
implement Quality Parenting Initiative principles and practices and support children and
families experiencing foster care placements. Quality Parenting Initiative Minnesota shall
use grant funds to provide training and technical assistance to county and Tribal agencies,
community-based agencies, and other stakeholders on the following activities:
new text end

new text begin (1) conducting initial foster care phone calls under Minnesota Statutes, section 260C.219,
subdivision 6;
new text end

new text begin (2) supporting practices that create birth family to foster family partnerships; and
new text end

new text begin (3) informing child welfare practices by supporting youth leadership and the participation
of individuals with experience in the foster care system.
new text end

ARTICLE 6

OPERATIONS AND LICENSING

Section 1.

Minnesota Statutes 2020, section 245A.11, subdivision 7, is amended to read:


Subd. 7.

Adult foster care; variance for alternate overnight supervision.

(a) The
commissioner may grant a variance under section 245A.04, subdivision 9, to rule parts
requiring a caregiver to be present in an adult foster care home during normal sleeping hours
to allow for alternative methods of overnight supervision. The commissioner may grant the
variance if the local county licensing agency recommends the variance and the county
recommendation includes documentation verifying that:

(1) the county has approved the license holder's plan for alternative methods of providing
overnight supervision and determined the plan protects the residents' health, safety, and
rights;

(2) the license holder has obtained written and signed informed consent from each
resident or each resident's legal representative documenting the resident's or legal
representative's agreement with the alternative method of overnight supervision; and

(3) the alternative method of providing overnight supervision, which may include the
use of technology, 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.

(b) To be eligible for a variance under paragraph (a), the adult foster care license holder
must not have had a conditional license issued under section 245A.06, or any other licensing
sanction issued under section 245A.07 during the prior 24 months based on failure to provide
adequate supervision, health care services, or resident safety in the adult foster care home.

(c) A license holder requesting a variance under this subdivision to utilize technology
as a component of a plan for alternative overnight supervision may request the commissioner's
review in the absence of a county recommendation. Upon receipt of such a request from a
license holder, the commissioner shall review the variance request with the county.

(d) deleted text beginA variance granted by the commissioner according to this subdivision before January
1, 2014, to a license holder for an adult foster care home must transfer with the license when
the license converts to a community residential setting license under chapter 245D. The
terms and conditions of the variance remain in effect as approved at the time the variance
was granted.
deleted text endnew text begin The variance requirements under this subdivision for alternate overnight
supervision do not apply to community residential settings licensed under chapter 245D.
new text end

Sec. 2.

Minnesota Statutes 2020, section 245A.11, subdivision 7a, is amended to read:


Subd. 7a.

Alternate overnight supervision technology; adult foster care deleted text beginand
community residential setting
deleted text end licenses.

(a) The commissioner may grant an applicant or
license holder an adult foster care deleted text beginor community residential settingdeleted text end license for a residence
that does not have a caregiver in the residence during normal sleeping hours as required
under Minnesota Rules, part 9555.5105, subpart 37, item B, or section 245D.02, subdivision
33b
, but uses monitoring technology to alert the license holder when an incident occurs that
may jeopardize the health, safety, or rights of a foster care recipient. The applicant or license
holder must comply with all other requirements under Minnesota Rules, parts 9555.5105
to 9555.6265, deleted text beginor applicable requirements under chapter deleted text enddeleted text begin245Ddeleted text enddeleted text begin,deleted text end and the requirements under
this subdivision. The license printed by the commissioner must state in bold and large font:

(1) that the facility is under electronic monitoring; and

(2) the telephone number of the county's common entry point for making reports of
suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.

(b) Applications for a license under this section must be submitted directly to the
Department of Human Services licensing division. The licensing division must immediately
notify the county licensing agency. The licensing division must collaborate with the county
licensing agency in the review of the application and the licensing of the program.

(c) Before a license is issued by the commissioner, and for the duration of the license,
the applicant or license holder must establish, maintain, and document the implementation
of written policies and procedures addressing the requirements in paragraphs (d) through
(f).

(d) The applicant or license holder must have policies and procedures that:

(1) establish characteristics of target populations that will be admitted into the home,
and characteristics of populations that will not be accepted into the home;

(2) explain the discharge process when a resident served by the program requires
overnight supervision or other services that cannot be provided by the license holder due
to the limited hours that the license holder is on site;

(3) describe the types of events to which the program will respond with a physical
presence when those events occur in the home during time when staff are not on site, and
how the license holder's response plan meets the requirements in paragraph (e), clause (1)
or (2);

(4) establish a process for documenting a review of the implementation and effectiveness
of the response protocol for the response required under paragraph (e), clause (1) or (2).
The documentation must include:

(i) a description of the triggering incident;

(ii) the date and time of the triggering incident;

(iii) the time of the response or responses under paragraph (e), clause (1) or (2);

(iv) whether the response met the resident's needs;

(v) whether the existing policies and response protocols were followed; and

(vi) whether the existing policies and protocols are adequate or need modification.

When no physical presence response is completed for a three-month period, the license
holder's written policies and procedures must require a physical presence response drill to
be conducted for which the effectiveness of the response protocol under paragraph (e),
clause (1) or (2), will be reviewed and documented as required under this clause; and

(5) establish that emergency and nonemergency phone numbers are posted in a prominent
location in a common area of the home where they can be easily observed by a person
responding to an incident who is not otherwise affiliated with the home.

(e) The license holder must document and include in the license application which
response alternative under clause (1) or (2) is in place for responding to situations that
present a serious risk to the health, safety, or rights of residents served by the program:

(1) response alternative (1) requires only the technology to provide an electronic
notification or alert to the license holder that an event is underway that requires a response.
Under this alternative, no more than ten minutes will pass before the license holder will be
physically present on site to respond to the situation; or

(2) response alternative (2) requires the electronic notification and alert system under
alternative (1), but more than ten minutes may pass before the license holder is present on
site to respond to the situation. Under alternative (2), all of the following conditions are
met:

(i) the license holder has a written description of the interactive technological applications
that will assist the license holder in communicating with and assessing the needs related to
the care, health, and safety of the foster care recipients. This interactive technology must
permit the license holder to remotely assess the well being of the resident served by the
program without requiring the initiation of the foster care recipient. Requiring the foster
care recipient to initiate a telephone call does not meet this requirement;

(ii) the license holder documents how the remote license holder is qualified and capable
of meeting the needs of the foster care recipients and assessing foster care recipients' needs
under item (i) during the absence of the license holder on site;

(iii) the license holder maintains written procedures to dispatch emergency response
personnel to the site in the event of an identified emergency; and

(iv) each resident's individualized plan of care, coordinated service and support plan
under sections 256B.0913, subdivision 8; 256B.092, subdivision 1b; 256B.49, subdivision
15; and 256S.10, if required, or individual resident placement agreement under Minnesota
Rules, part 9555.5105, subpart 19, if required, identifies the maximum response time, which
may be greater than ten minutes, for the license holder to be on site for that resident.

(f) Each resident's placement agreement, individual service agreement, and plan must
clearly state that the adult foster care deleted text beginor community residential settingdeleted text end license category is
a program without the presence of a caregiver in the residence during normal sleeping hours;
the protocols in place for responding to situations that present a serious risk to the health,
safety, or rights of residents served by the program under paragraph (e), clause (1) or (2);
and a signed informed consent from each resident served by the program or the person's
legal representative documenting the person's or legal representative's agreement with
placement in the program. If electronic monitoring technology is used in the home, the
informed consent form must also explain the following:

(1) how any electronic monitoring is incorporated into the alternative supervision system;

(2) the backup system for any electronic monitoring in times of electrical outages or
other equipment malfunctions;

(3) how the caregivers or direct support staff are trained on the use of the technology;

(4) the event types and license holder response times established under paragraph (e);

(5) how the license holder protects each resident's privacy related to electronic monitoring
and related to any electronically recorded data generated by the monitoring system. A
resident served by the program may not be removed from a program under this subdivision
for failure to consent to electronic monitoring. The consent form must explain where and
how the electronically recorded data is stored, with whom it will be shared, and how long
it is retained; and

(6) the risks and benefits of the alternative overnight supervision system.

The written explanations under clauses (1) to (6) may be accomplished through
cross-references to other policies and procedures as long as they are explained to the person
giving consent, and the person giving consent is offered a copy.

(g) Nothing in this section requires the applicant or license holder to develop or maintain
separate or duplicative policies, procedures, documentation, consent forms, or individual
plans that may be required for other licensing standards, if the requirements of this section
are incorporated into those documents.

(h) The commissioner may grant variances to the requirements of this section according
to section 245A.04, subdivision 9.

(i) For the purposes of paragraphs (d) through (h), "license holder" has the meaning
under section 245A.02, subdivision 9, and additionally includes all staff, volunteers, and
contractors affiliated with the license holder.

(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to remotely
determine what action the license holder needs to take to protect the well-being of the foster
care recipient.

(k) The commissioner shall evaluate license applications using the requirements in
paragraphs (d) to (f). The commissioner shall provide detailed application forms, including
a checklist of criteria needed for approval.

(l) To be eligible for a license under paragraph (a), the adult foster care deleted text beginor community
residential setting
deleted text end license holder must not have had a conditional license issued under section
245A.06 or any licensing sanction under section 245A.07 during the prior 24 months based
on failure to provide adequate supervision, health care services, or resident safety in the
adult foster care home deleted text beginor community residential settingdeleted text end.

(m) The commissioner shall review an application for an alternative overnight supervision
license within 60 days of receipt of the application. When the commissioner receives an
application that is incomplete because the applicant failed to submit required documents or
that is substantially deficient because the documents submitted do not meet licensing
requirements, the commissioner shall provide the applicant written notice that the application
is incomplete or substantially deficient. In the written notice to the applicant, the
commissioner shall identify documents that are missing or deficient and give the applicant
45 days to resubmit a second application that is substantially complete. An applicant's failure
to submit a substantially complete application after receiving notice from the commissioner
is a basis for license denial under section 245A.05. The commissioner shall complete
subsequent review within 30 days.

(n) Once the application is considered complete under paragraph (m), the commissioner
will approve or deny an application for an alternative overnight supervision license within
60 days.

(o) For the purposes of this subdivision, "supervision" means:

(1) oversight by a caregiver or direct support staff as specified in the individual resident's
place agreement or coordinated service and support plan and awareness of the resident's
needs and activities; and

(2) the presence of a caregiver or direct support staff in a residence during normal sleeping
hours, unless a determination has been made and documented in the individual's coordinated
service and support plan that the individual does not require the presence of a caregiver or
direct support staff during normal sleeping hours.

Sec. 3.

Minnesota Statutes 2020, section 245C.02, is amended by adding a subdivision to
read:


new text begin Subd. 11f. new text end

new text begin Health care worker platform. new text end

new text begin "Health care worker platform" means any
person, firm, corporation, partnership, or association that maintains a system or technology
that provides a media or Internet platform for a health care worker to be listed and identified
as available for hire as an independent contractor by health care facilities seeking health
care workers.
new text end

Sec. 4.

Minnesota Statutes 2020, section 245C.02, subdivision 17a, is amended to read:


Subd. 17a.

Roster.

(a) "Roster" means the electronic method used to identify the entity
or entities required to conduct background studies under this chapter with which a background
subject is affiliated. There are three types of rosters: active roster, inactive roster, and master
roster.

(b) "Active roster" means the list of individuals specific to an entity who have been
determined eligible under this chapter to provide services for the entity and who the entity
has identified as affiliated. An individual shall remain on the entity's active roster and is
considered affiliated until the commissioner determines the individual is ineligible or the
entity removes the individual from the entity's active roster.

(c) "Inactive roster" means the list maintained by the commissioner of individuals who
are eligible under this chapter to provide services and are not on an active roster. Individuals
shall remain on the inactive roster for no more than 180 consecutive days, unlessnew text begin:
new text end

new text begin (1)new text end the individual submits a written request to the commissioner requesting to remain
on the inactive roster for a longer period of timenew text begin;
new text end

new text begin (2) the individual self-initiated a background study, in which case the individual shall
remain on the inactive roster for one year; or
new text end deleted text begin .
deleted text end

new text begin (3) a health care worker platform initiated a background study on behalf of an individual,
in which case the individual shall remain on the inactive roster for one year.
new text end

Upon the commissioner's receipt of information that may cause an individual on the inactive
roster to be disqualified under this chapter, the commissioner shall remove the individual
from the inactive roster, and if the individual again seeks a position requiring a background
study, the individual shall be required to complete a new background study.

(d) "Master roster" means the list maintained by the commissioner of all individuals
who, as a result of a background study under this chapter, and regardless of affiliation with
an entity, are determined by the commissioner to be eligible to provide services for one or
more entities. The master roster includes all background study subjects on rosters under
paragraphs (b) and (c).

Sec. 5.

Minnesota Statutes 2021 Supplement, section 245C.03, is amended by adding a
subdivision to read:


new text begin Subd. 16. new text end

new text begin Self-initiated background studies. new text end

new text begin The commissioner shall conduct
background studies according to this chapter when initiated by an individual who is not on
the master roster. A subject under this subdivision who is not disqualified must be placed
on the inactive roster.
new text end

Sec. 6.

Minnesota Statutes 2021 Supplement, section 245C.03, is amended by adding a
subdivision to read:


new text begin Subd. 17. new text end

new text begin Health care worker platform. new text end

new text begin The commissioner shall conduct background
studies according to this chapter when initiated by a health care worker platform on behalf
of an individual who is not on the master roster. A subject under this subdivision who is
not disqualified must be placed on the inactive roster.
new text end

Sec. 7.

Minnesota Statutes 2020, section 245C.04, subdivision 1, is amended to read:


Subdivision 1.

Licensed programs; other child care programs.

(a) The commissioner
shall conduct a background study of an individual required to be studied under section
245C.03, subdivision 1, at least upon application for initial license for all license types.

(b) The commissioner shall conduct a background study of an individual required to be
studied under section 245C.03, subdivision 1, including a child care background study
subject as defined in section 245C.02, subdivision 6a, in a family child care program, licensed
child care center, certified license-exempt child care center, or legal nonlicensed child care
provider, on a schedule determined by the commissioner. Except as provided in section
245C.05, subdivision 5a, a child care background study must include submission of
fingerprints for a national criminal history record check and a review of the information
under section 245C.08. A background study for a child care program must be repeated
within five years from the most recent study conducted under this paragraph.

(c) At reapplication for a family child care license:

(1) for a background study affiliated with a licensed family child care center or legal
nonlicensed child care provider, the individual shall provide information required under
section 245C.05, subdivision 1, paragraphs (a), (b), and (d), to the county agency, and be
fingerprinted and photographed under section 245C.05, subdivision 5;

(2) the county agency shall verify the information received under clause (1) and forward
the information to the commissioner to complete the background study; and

(3) the background study conducted by the commissioner under this paragraph must
include a review of the information required under section 245C.08.

(d) The commissioner is not required to conduct a study of an individual at the time of
reapplication for a license if the individual's background study was completed by the
commissioner of human services and the following conditions are met:

(1) a study of the individual was conducted either at the time of initial licensure or when
the individual became affiliated with the license holder;

(2) the individual has been continuously affiliated with the license holder since the last
study was conducted; and

(3) the last study of the individual was conducted on or after October 1, 1995.

(e) The commissioner of human services shall conduct a background study of an
individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6),
who is newly affiliated with a child foster family setting license holder:

(1) the county or private agency shall collect and forward to the commissioner the
information required under section 245C.05, subdivisions 1 and 5, when the child foster
family setting applicant or license holder resides in the home where child foster care services
are provided; and

(2) the background study conducted by the commissioner of human services under this
paragraph must include a review of the information required under section 245C.08,
subdivisions 1
, 3, and 4.

(f) The commissioner shall conduct a background study of an individual specified under
section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly affiliated
with an adult foster care or family adult day services and with a family child care license
holder or a legal nonlicensed child care provider authorized under chapter 119B and:

(1) except as provided in section 245C.05, subdivision 5a, the county shall collect and
forward to the commissioner the information required under section 245C.05, subdivision
1
, paragraphs (a) and (b), and subdivision 5, paragraphs (a), (b), and (d), for background
studies conducted by the commissioner for all family adult day services, for adult foster
care when the adult foster care license holder resides in the adult foster care residence, and
for family child care and legal nonlicensed child care authorized under chapter 119B;

(2) the license holder shall collect and forward to the commissioner the information
required under section 245C.05, subdivisions 1, paragraphs (a) and (b); and 5, paragraphs
(a) and (b), for background studies conducted by the commissioner for adult foster care
when the license holder does not reside in the adult foster care residence; and

(3) the background study conducted by the commissioner under this paragraph must
include a review of the information required under section 245C.08, subdivision 1, paragraph
(a), and subdivisions 3 and 4.

(g) Applicants for licensure, license holders, and other entities as provided in this chapter
must submit completed background study requests to the commissioner using the electronic
system known as NETStudy before individuals specified in section 245C.03, subdivision
1
, begin positions allowing direct contact in any licensed program.

(h) For an individual who is not on the entity's active roster, the entity must initiate a
new background study through NETStudy when:

(1) an individual returns to a position requiring a background study following an absence
of 120 or more consecutive days; or

(2) a program that discontinued providing licensed direct contact services for 120 or
more consecutive days begins to provide direct contact licensed services again.

The license holder shall maintain a copy of the notification provided to the commissioner
under this paragraph in the program's files. If the individual's disqualification was previously
set aside for the license holder's program and the new background study results in no new
information that indicates the individual may pose a risk of harm to persons receiving
services from the license holder, the previous set-aside shall remain in effect.

(i) For purposes of this section, a physician licensed under chapter 147 or advanced
practice registered nurse licensed under chapter 148 is considered to be continuously affiliated
upon the license holder's receipt from the commissioner of health or human services of the
physician's or advanced practice registered nurse's background study results.

(j) For purposes of family child care, a substitute caregiver must receive repeat
background studies at the time of each license renewal.

(k) A repeat background study at the time of license renewal is not required if the family
child care substitute caregiver's background study was completed by the commissioner on
or after October 1, 2017, and the substitute caregiver is on the license holder's active roster
in NETStudy 2.0.

(l) Before and after school programs authorized under chapter 119B, are exempt from
the background study requirements under section 123B.03, for an employee for whom a
background study under this chapter has been completed.

new text begin (m) Upon request of the license holder, the commissioner of human services shall conduct
a background study of an individual specified under section 245C.03, subdivision 1,
paragraph (a), clauses (2) to (6), who is newly affiliated with a home and community-based
service provider licensed certified to provide children's out-of-home respite under section
245D.34. The license holder shall collect and forward to the commissioner all the information
described under section 245C.05, subdivisions 1 and 5. The background study conducted
by the commissioner of human services under this paragraph must include a review of all
the information described under section 245C.08, subdivisions 1, 3, and 4.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 8.

Minnesota Statutes 2020, section 245C.04, subdivision 4a, is amended to read:


Subd. 4a.

Agency background studies; electronic criminal case information updates;
rosters; and criteria for eliminating repeat background studies.

(a) The commissioner
shall develop and implement an electronic process as a part of NETStudy 2.0 for the regular
transfer of new criminal case information that is added to the Minnesota court information
system. The commissioner's system must include for review only information that relates
to individuals who are on the master roster.

(b) The commissioner shall develop and implement an online system as a part of
NETStudy 2.0 for agencies that initiate background studies under this chapter to access and
maintain records of background studies initiated by that agency. The system must show all
active background study subjects affiliated with that agency and the status of each individual's
background study. Each agency that initiates background studies must use this system to
notify the commissioner of discontinued affiliation for purposes of the processes required
under paragraph (a).

(c) After an entity initiating a background study has paid the applicable fee for the study
and has provided the individual with the privacy notice required under section 245C.05,
subdivision 2c
, NETStudy 2.0 shall immediately inform the entity whether the individual
requires a background study or whether the individual is immediately eligible to provide
services based on a previous background study. If the individual is immediately eligible,
the entity initiating the background study shall be able to view the information previously
supplied by the individual who is the subject of a background study as required under section
245C.05, subdivision 1, including the individual's photograph taken at the time the
individual's fingerprints were recorded. The commissioner shall not provide any entity
initiating a subsequent background study with information regarding the other entities that
initiated background studies on the subject.

(d) Verification that an individual is eligible to provide services based on a previous
background study is dependent on the individual voluntarily providing the individual's
Social Security number to the commissioner at the time each background study is initiated.
When an individual does not provide the individual's Social Security number for the
background study, that study is not transferable and a repeat background study on that
individual is required if the individual seeks a position requiring a background study under
this chapter with another entity.

new text begin (e) Notwithstanding paragraphs (b) and (c), the commissioner must not provide a health
care worker platform that initiates a background study on an individual's behalf under section
245C.03, subdivision 17, with access to any information regarding the subject other than
whether the individual is immediately eligible to provide services.
new text end

Sec. 9.

Minnesota Statutes 2020, section 245C.04, is amended by adding a subdivision to
read:


new text begin Subd. 12. new text end

new text begin Individuals. new text end

new text begin An individual who initiates a background study under section
245C.03, subdivision 16, must initiate the studies annually through NETStudy 2.0.
new text end

Sec. 10.

Minnesota Statutes 2020, section 245C.04, is amended by adding a subdivision
to read:


new text begin Subd. 13. new text end

new text begin Health care worker platform. new text end

new text begin A health care worker platform that initiates
a background study on an individual's behalf under section 245C.03, subdivision 17, must
initiate the studies annually through NETStudy 2.0.
new text end

Sec. 11.

Minnesota Statutes 2021 Supplement, section 245C.05, subdivision 5, is amended
to read:


Subd. 5.

Fingerprints and photograph.

(a) Notwithstanding paragraph (b), for
background studies conducted by the commissioner fornew text begin certified children's out-of-home
respite,
new text end child foster care, children's residential facilities, adoptions, or a transfer of permanent
legal and physical custody of a child, the subject of the background study, who is 18 years
of age or older, shall provide the commissioner with a set of classifiable fingerprints obtained
from an authorized agency for a national criminal history record check.

(b) For background studies initiated on or after the implementation of NETStudy 2.0,
except as provided under subdivision 5a, every subject of a background study must provide
the commissioner with a set of the background study subject's classifiable fingerprints and
photograph. The photograph and fingerprints must be recorded at the same time by the
authorized fingerprint collection vendor or vendors and sent to the commissioner through
the commissioner's secure data system described in section 245C.32, subdivision 1a,
paragraph (b).

(c) The fingerprints shall be submitted by the commissioner to the Bureau of Criminal
Apprehension and, when specifically required by law, submitted to the Federal Bureau of
Investigation for a national criminal history record check.

(d) The fingerprints must not be retained by the Department of Public Safety, Bureau
of Criminal Apprehension, or the commissioner. The Federal Bureau of Investigation will
not retain background study subjects' fingerprints.

(e) The authorized fingerprint collection vendor or vendors shall, for purposes of verifying
the identity of the background study subject, be able to view the identifying information
entered into NETStudy 2.0 by the entity that initiated the background study, but shall not
retain the subject's fingerprints, photograph, or information from NETStudy 2.0. The
authorized fingerprint collection vendor or vendors shall retain no more than the name and
date and time the subject's fingerprints were recorded and sent, only as necessary for auditing
and billing activities.

(f) For any background study conducted under this chapter, the subject shall provide the
commissioner with a set of classifiable fingerprints when the commissioner has reasonable
cause to require a national criminal history record check as defined in section 245C.02,
subdivision 15a.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 12.

Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:


new text begin Subd. 22. new text end

new text begin Individuals. new text end

new text begin The commissioner shall recover the cost of the background
studies initiated by individuals under section 245C.03, subdivision 16, through a fee of no
more than $42 per study charged to the individual. The fees collected under this subdivision
are appropriated to the commissioner for the purpose of conducting background studies.
new text end

Sec. 13.

Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:


new text begin Subd. 23. new text end

new text begin Health care worker platform. new text end

new text begin The commissioner shall recover the cost of
the background studies initiated by health care worker platforms under section 245C.03,
subdivision 17, through a fee of no more than $42 per study charged to the platform. The
fees collected under this subdivision are appropriated to the commissioner for the purpose
of conducting background studies.
new text end

Sec. 14.

new text begin [245D.34] CHILDREN'S OUT-OF-HOME RESPITE CERTIFICATION
STANDARDS.
new text end

new text begin Subdivision 1. new text end

new text begin Certification. new text end

new text begin (a) The commissioner of human services shall issue a
children's out-of-home respite certification for services licensed under this chapter when a
license holder is determined to have met the requirements under this section. This certification
is voluntary for license holders. The certification shall be printed on the license and identified
on the commissioner's public website.
new text end

new text begin (b) A license holder seeking certification under this section must request this certification
on forms and in the manner prescribed by the commissioner.
new text end

new text begin (c) If a commissioner finds that a license holder has failed to comply with the certification
requirements under this section, the commissioner may issue a correction order and an order
of conditional license in accordance with section 245A.06 or may issue a sanction in
accordance with section 245A.07, including and up to removal of the certification.
new text end

new text begin (d) A denial of the certification or the removal of the certification based on a
determination that the requirements of this section have not been met is not subject to appeal.
A license holder that has been denied a certification or that has had a certification removed
may again request certification when the license holder is in compliance with the
requirements of this section.
new text end

new text begin Subd. 2. new text end

new text begin Certification requirements. new text end

new text begin The requirements for certification under this
section are:
new text end

new text begin (1) the license holder maintains a current roster of staff who meet the background study
requirements under section 245C.04, subdivision 1, paragraph (n);
new text end

new text begin (2) the license holder assigns only individuals on the roster described in clause (1) to
provide out-of-home respite to a minor in an unlicensed service site;
new text end

new text begin (3) the case manager has verified, on the forms and in the manner prescribed by the
commissioner, and documented in the person's coordinated service and support plan that
any proposed unlicensed service site is appropriate to meet the person's unique assessed
needs; and
new text end

new text begin (4) when providing out-of-home respite to a minor at an unlicensed service site, the
service site the license holder uses is identified and approved by the case manager in the
person's coordinated service and support plan.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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

ARTICLE 7

DEPARTMENT OF BEHAVIORAL HEALTH

Section 1.

Minnesota Statutes 2021 Supplement, section 15.01, is amended to read:


15.01 DEPARTMENTS OF THE STATE.

The following agencies are designated as the departments of the state government: the
Department of Administration; the Department of Agriculture;new text begin the Department of Behavioral
Health;
new text end the Department of Commerce; the Department of Corrections; the Department of
Education; the Department of Employment and Economic Development; the Department
of Health; the Department of Human Rights; the Department of Information Technology
Services; the Department of Iron Range Resources and Rehabilitation; the Department of
Labor and Industry; the Department of Management and Budget; the Department of Military
Affairs; the Department of Natural Resources; the Department of Public Safety; the
Department of Human Services; the Department of Revenue; the Department of
Transportation; the Department of Veterans Affairs; and their successor departments.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 2.

Minnesota Statutes 2021 Supplement, section 15.06, subdivision 1, is amended to
read:


Subdivision 1.

Applicability.

This section applies to the following departments or
agencies: the Departments of Administration, Agriculture,new text begin Behavioral Health,new text end Commerce,
Corrections, Education, Employment and Economic Development, Health, Human Rights,
Labor and Industry, Management and Budget, Natural Resources, Public Safety, Human
Services, Revenue, Transportation, and Veterans Affairs; the Housing Finance and Pollution
Control Agencies; the Office of Commissioner of Iron Range Resources and Rehabilitation;
the Department of Information Technology Services; the Bureau of Mediation Services;
and their successor departments and agencies. The heads of the foregoing departments or
agencies are "commissioners."

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 3.

Minnesota Statutes 2020, section 15A.0815, subdivision 2, is amended to read:


Subd. 2.

Group I salary limits.

The salary for a position listed in this subdivision shall
not exceed 133 percent of the salary of the governor. This limit must be adjusted annually
on January 1. The new limit must equal the limit for the prior year increased by the percentage
increase, if any, in the Consumer Price Index for all urban consumers from October of the
second prior year to October of the immediately prior year. The commissioner of management
and budget must publish the limit on the department's website. This subdivision applies to
the following positions:

Commissioner of administration;

Commissioner of agriculture;

new text begin Commissioner of behavioral health;
new text end

Commissioner of education;

Commissioner of commerce;

Commissioner of corrections;

Commissioner of health;

Commissioner, Minnesota Office of Higher Education;

Commissioner, Housing Finance Agency;

Commissioner of human rights;

Commissioner of human services;

Commissioner of labor and industry;

Commissioner of management and budget;

Commissioner of natural resources;

Commissioner, Pollution Control Agency;

Commissioner of public safety;

Commissioner of revenue;

Commissioner of employment and economic development;

Commissioner of transportation; and

Commissioner of veterans affairs.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 4.

Minnesota Statutes 2021 Supplement, section 43A.08, subdivision 1a, is amended
to read:


Subd. 1a.

Additional unclassified positions.

Appointing authorities for the following
agencies may designate additional unclassified positions according to this subdivision: the
Departments of Administration; Agriculture;new text begin Behavioral Health;new text end Commerce; Corrections;
Education; Employment and Economic Development; Explore Minnesota Tourism;
Management and Budget; Health; Human Rights; Labor and Industry; Natural Resources;
Public Safety; Human Services; Revenue; Transportation; and Veterans Affairs; the Housing
Finance and Pollution Control Agencies; the State Lottery; the State Board of Investment;
the Office of Administrative Hearings; the Department of Information Technology Services;
the Offices of the Attorney General, Secretary of State, and State Auditor; the Minnesota
State Colleges and Universities; the Minnesota Office of Higher Education; the Perpich
Center for Arts Education; and the Minnesota Zoological Board.

A position designated by an appointing authority according to this subdivision must
meet the following standards and criteria:

(1) the designation of the position would not be contrary to other law relating specifically
to that agency;

(2) the person occupying the position would report directly to the agency head or deputy
agency head and would be designated as part of the agency head's management team;

(3) the duties of the position would involve significant discretion and substantial
involvement in the development, interpretation, and implementation of agency policy;

(4) the duties of the position would not require primarily personnel, accounting, or other
technical expertise where continuity in the position would be important;

(5) there would be a need for the person occupying the position to be accountable to,
loyal to, and compatible with, the governor and the agency head, the employing statutory
board or commission, or the employing constitutional officer;

(6) the position would be at the level of division or bureau director or assistant to the
agency head; and

(7) the commissioner has approved the designation as being consistent with the standards
and criteria in this subdivision.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 5.

new text begin [256T.01] DEPARTMENT OF BEHAVIORAL HEALTH.
new text end

new text begin The Department of Behavioral Health is created. The governor shall appoint the
commissioner of behavioral health under section 15.06. The commissioner shall administer:
new text end

new text begin (1) the behavioral health services under the medical assistance program under chapters
256 and 256B;
new text end

new text begin (2) the behavioral health services under the MinnesotaCare program under chapter 256L;
new text end

new text begin (3) mental health and chemical dependency services under chapters 245, 245G, 253C,
254A, and 254B; and
new text end

new text begin (4) behavioral health quality, behavioral health analysis, behavioral health economics,
and related data collection initiatives under chapters 62J, 62U, and 144.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 6.

new text begin [256T.02] TRANSFER.
new text end

new text begin (a) Section 15.039 applies to the transfer under this chapter.
new text end

new text begin (b) The commissioner of administration, with the approval of the governor, may issue
reorganization orders under section 16B.37 as necessary to carry out the transfer required
by this chapter. The provision of section 16B.37, subdivision 1, stating that transfers under
section 16B.37 may be made only to an agency that has been in existence for at least one
year does not apply to transfers to an agency created by this chapter.
new text end

new text begin (c) The initial salary for the commissioner of behavioral health is the same as the salary
for the commissioner of health. The salary may be changed in the manner specified in section
15A.0815.
new text end

new text begin (d) For an employee affected by the transfer of duties required by this chapter, the
seniority accrued by the employee at the employee's former agency transfers to the employee's
new agency.
new text end

new text begin (e) The commissioner of management and budget must ensure that the aggregate cost
for the commissioner of behavioral health is not more than the aggregate cost during the
transition of creating the Department of Behavioral Health as it currently exists under the
Department of Human Services and the Department of Health immediately before the
effective date of this chapter, excluding any appropriation made during the 2022 legislative
session.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 7. new text beginREVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes, in consultation with staff from the House Research Department;
House Fiscal Analysis; the Office of Senate Counsel, Research, and Fiscal Analysis; and
the respective departments shall prepare legislation for introduction in the 2023 legislative
session proposing the statutory changes needed to implement the transfers of duties required
for the creation of the Department of Behavioral Health.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

ARTICLE 8

COMMUNITY SUPPORTS AND BEHAVIORAL HEALTH POLICY

Section 1.

Minnesota Statutes 2021 Supplement, section 62A.673, subdivision 2, is
amended to read:


Subd. 2.

Definitions.

(a) For purposes of this section, the terms defined in this subdivision
have the meanings given.

(b) "Distant site" means a site at which a health care provider is located while providing
health care services or consultations by means of telehealth.

(c) "Health care provider" means a health care professional who is licensed or registered
by the state to perform health care services within the provider's scope of practice and in
accordance with state law. A health care provider includes a mental health professional deleted text beginas
defined
deleted text end under section deleted text begin245.462, subdivision 18, or 245.4871, subdivision 27deleted text endnew text begin 245I.04,
subdivision 2
new text end; a mental health practitioner deleted text beginas defineddeleted text end under section deleted text begin245.462, subdivision
17
, or 245.4871, subdivision 26
deleted text endnew text begin 245I.04, subdivision 4; a clinical trainee under section
245I.04, subdivision 6
new text end; a treatment coordinator under section 245G.11, subdivision 7; an
alcohol and drug counselor under section 245G.11, subdivision 5; and a recovery peer under
section 245G.11, subdivision 8.

(d) "Health carrier" has the meaning given in section 62A.011, subdivision 2.

(e) "Health plan" has the meaning given in section 62A.011, subdivision 3. Health plan
includes dental plans as defined in section 62Q.76, subdivision 3, but does not include dental
plans that provide indemnity-based benefits, regardless of expenses incurred, and are designed
to pay benefits directly to the policy holder.

(f) "Originating site" means a site at which a patient is located at the time health care
services are provided to the patient by means of telehealth. For purposes of store-and-forward
technology, the originating site also means the location at which a health care provider
transfers or transmits information to the distant site.

(g) "Store-and-forward technology" means the asynchronous electronic transfer or
transmission of a patient's medical information or data from an originating site to a distant
site for the purposes of diagnostic and therapeutic assistance in the care of a patient.

(h) "Telehealth" means the delivery of health care services or consultations through the
use of real time two-way interactive audio and visual communications to provide or support
health care delivery and facilitate the assessment, diagnosis, consultation, treatment,
education, and care management of a patient's health care. Telehealth includes the application
of secure video conferencing, store-and-forward technology, and synchronous interactions
between a patient located at an originating site and a health care provider located at a distant
site. Until July 1, 2023, telehealth also includes audio-only communication between a health
care provider and a patient in accordance with subdivision 6, paragraph (b). Telehealth does
not include communication between health care providers that consists solely of a telephone
conversation, e-mail, or facsimile transmission. Telehealth does not include communication
between a health care provider and a patient that consists solely of an e-mail or facsimile
transmission. Telehealth does not include telemonitoring services as defined in paragraph
(i).

(i) "Telemonitoring services" means the remote monitoring of clinical data related to
the enrollee's vital signs or biometric data by a monitoring device or equipment that transmits
the data electronically to a health care provider for analysis. Telemonitoring is intended to
collect an enrollee's health-related data for the purpose of assisting a health care provider
in assessing and monitoring the enrollee's medical condition or status.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 2.

Minnesota Statutes 2021 Supplement, section 148F.11, subdivision 1, is amended
to read:


Subdivision 1.

Other professionals.

(a) Nothing in this chapter prevents members of
other professions or occupations from performing functions for which they are qualified or
licensed. This exception includes, but is not limited to: licensed physicians; registered nurses;
licensed practical nurses; licensed psychologists and licensed psychological practitioners;
members of the clergy provided such services are provided within the scope of regular
ministries; American Indian medicine men and women; licensed attorneys; probation officers;
licensed marriage and family therapists; licensed social workers; social workers employed
by city, county, or state agencies; licensed professional counselors; licensed professional
clinical counselors; licensed school counselors; registered occupational therapists or
occupational therapy assistants; Upper Midwest Indian Council on Addictive Disorders
(UMICAD) certified counselors when providing services to Native American people; city,
county, or state employees when providing assessments or case management under Minnesota
Rules, chapter 9530; and deleted text beginindividuals defined in section 256B.0623, subdivision 5, clauses
(1) to (6),
deleted text endnew text begin staff personsnew text end providing co-occurring substance use disorder treatment in adult
mental health rehabilitative programs certified or licensed by the Department of Human
Services under section 245I.23, 256B.0622, or 256B.0623.

(b) Nothing in this chapter prohibits technicians and resident managers in programs
licensed by the Department of Human Services from discharging their duties as provided
in Minnesota Rules, chapter 9530.

(c) Any person who is exempt from licensure under this section must not use a title
incorporating the words "alcohol and drug counselor" or "licensed alcohol and drug
counselor" or otherwise hold himself or herself out to the public by any title or description
stating or implying that he or she is engaged in the practice of alcohol and drug counseling,
or that he or she is licensed to engage in the practice of alcohol and drug counseling, unless
that person is also licensed as an alcohol and drug counselor. Persons engaged in the practice
of alcohol and drug counseling are not exempt from the board's jurisdiction solely by the
use of one of the titles in paragraph (a).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 3.

Minnesota Statutes 2021 Supplement, section 245.467, subdivision 2, is amended
to read:


Subd. 2.

Diagnostic assessment.

deleted text beginProvidersdeleted text endnew text begin A providernew text end of services governed by this
section must complete a diagnostic assessment new text beginof a client new text endaccording to the standards of
section 245I.10deleted text begin, subdivisions 4 to 6deleted text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 4.

Minnesota Statutes 2021 Supplement, section 245.467, subdivision 3, is amended
to read:


Subd. 3.

Individual treatment plans.

deleted text beginProvidersdeleted text endnew text begin A providernew text end of services governed by
this section must complete an individual treatment plan new text beginfor a client new text endaccording to the standards
of section 245I.10, subdivisions 7 and 8.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 5.

Minnesota Statutes 2021 Supplement, section 245.4871, subdivision 21, is amended
to read:


Subd. 21.

Individual treatment plan.

new text begin(a) new text end"Individual treatment plan" means the
formulation of planned services that are responsive to the needs and goals of a client. An
individual treatment plan must be completed according to section 245I.10, subdivisions 7
and 8.

new text begin (b) A children's residential facility licensed under Minnesota Rules, chapter 2960, is
exempt from the requirements of section 245I.10, subdivisions 7 and 8. Instead, the individual
treatment plan must:
new text end

new text begin (1) include a written plan of intervention, treatment, and services for a child with an
emotional disturbance that the service provider develops under the clinical supervision of
a mental health professional on the basis of a diagnostic assessment;
new text end

new text begin (2) be developed in conjunction with the family unless clinically inappropriate; and
new text end

new text begin (3) identify goals and objectives of treatment, treatment strategy, a schedule for
accomplishing treatment goals and objectives, and the individuals responsible for providing
treatment to the child with an emotional disturbance.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 6.

Minnesota Statutes 2021 Supplement, section 245.4876, subdivision 2, is amended
to read:


Subd. 2.

Diagnostic assessment.

deleted text beginProvidersdeleted text endnew text begin A providernew text end of services governed by this
section deleted text beginshalldeleted text endnew text begin mustnew text end complete a diagnostic assessment new text beginof a client new text endaccording to the standards
of section 245I.10deleted text begin, subdivisions 4 to 6deleted text end.new text begin Notwithstanding the required timelines for completing
a diagnostic assessment in section 245I.10, a children's residential facility licensed under
Minnesota Rules, chapter 2960, that provides mental health services to children must, within
ten days of the client's admission: (1) complete the client's diagnostic assessment; or (2)
review and update the client's diagnostic assessment with a summary of the child's current
mental health status and service needs if a diagnostic assessment is available that was
completed within 180 days preceding admission and the client's mental health status has
not changed markedly since the diagnostic assessment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 7.

Minnesota Statutes 2021 Supplement, section 245.4876, subdivision 3, is amended
to read:


Subd. 3.

Individual treatment plans.

deleted text beginProvidersdeleted text endnew text begin A providernew text end of services governed by
this section deleted text beginshalldeleted text endnew text begin mustnew text end complete an individual treatment plan new text beginfor a client new text endaccording to the
standards of section 245I.10, subdivisions 7 and 8.new text begin A children's residential facility licensed
according to Minnesota Rules, chapter 2960, is exempt from the requirements in section
245I.10, subdivisions 7 and 8. Instead, the facility must involve the child and the child's
family in all phases of developing and implementing the individual treatment plan to the
extent appropriate and must review the individual treatment plan every 90 days after intake.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 8.

Minnesota Statutes 2021 Supplement, section 245.735, subdivision 3, is amended
to read:


Subd. 3.

Certified community behavioral health clinics.

(a) The commissioner shall
establish a state certification process for certified community behavioral health clinics
(CCBHCs) that satisfy all federal requirements necessary for CCBHCs certified under this
section to be eligible for reimbursement under medical assistance, without service area
limits based on geographic area or region. The commissioner shall consult with CCBHC
stakeholders before establishing and implementing changes in the certification process and
requirements. Entities that choose to be CCBHCs must:

(1) comply with state licensing requirements and other requirements issued by the
commissioner;

(2) employ or contract for clinic staff who have backgrounds in diverse disciplines,
including licensed mental health professionals and licensed alcohol and drug counselors,
and staff who are culturally and linguistically trained to meet the needs of the population
the clinic serves;

(3) ensure that clinic services are available and accessible to individuals and families of
all ages and genders and that crisis management services are available 24 hours per day;

(4) establish fees for clinic services for individuals who are not enrolled in medical
assistance using a sliding fee scale that ensures that services to patients are not denied or
limited due to an individual's inability to pay for services;

(5) comply with quality assurance reporting requirements and other reporting
requirements, including any required reporting of encounter data, clinical outcomes data,
and quality data;

(6) provide crisis mental health and substance use services, withdrawal management
services, emergency crisis intervention services, and stabilization services through existing
mobile crisis services; screening, assessment, and diagnosis services, including risk
assessments and level of care determinations; person- and family-centered treatment planning;
outpatient mental health and substance use services; targeted case management; psychiatric
rehabilitation services; peer support and counselor services and family support services;
and intensive community-based mental health services, including mental health services
for members of the armed forces and veterans. CCBHCs must directly provide the majority
of these services to enrollees, but may coordinate some services with another entity through
a collaboration or agreement, pursuant to paragraph (b);

(7) provide coordination of care across settings and providers to ensure seamless
transitions for individuals being served across the full spectrum of health services, including
acute, chronic, and behavioral needs. Care coordination may be accomplished through
partnerships or formal contracts with:

(i) counties, health plans, pharmacists, pharmacies, rural health clinics, federally qualified
health centers, inpatient psychiatric facilities, substance use and detoxification facilities, or
community-based mental health providers; and

(ii) other community services, supports, and providers, including schools, child welfare
agencies, juvenile and criminal justice agencies, Indian health services clinics, tribally
licensed health care and mental health facilities, urban Indian health clinics, Department of
Veterans Affairs medical centers, outpatient clinics, drop-in centers, acute care hospitals,
and hospital outpatient clinics;

(8) be certified as new text begina new text endmental health deleted text beginclinicsdeleted text endnew text begin clinicnew text end under section deleted text begin245.69, subdivision 2deleted text endnew text begin
245I.20
new text end;

(9) comply with standards established by the commissioner relating to CCBHC
screenings, assessments, and evaluations;

(10) be licensed to provide substance use disorder treatment under chapter 245G;

(11) be certified to provide children's therapeutic services and supports under section
256B.0943;

(12) be certified to provide adult rehabilitative mental health services under section
256B.0623;

(13) be enrolled to provide mental health crisis response services under deleted text beginsectionsdeleted text endnew text begin sectionnew text end
256B.0624 deleted text beginand 256B.0944deleted text end;

(14) be enrolled to provide mental health targeted case management under section
256B.0625, subdivision 20;

(15) comply with standards relating to mental health case management in Minnesota
Rules, parts 9520.0900 to 9520.0926;

(16) provide services that comply with the evidence-based practices described in
paragraph (e); and

(17) comply with standards relating to peer services under sections 256B.0615,
256B.0616, and 245G.07, subdivision 1, paragraph (a), clause (5), as applicable when peer
services are provided.

(b) If a certified CCBHC is unable to provide one or more of the services listed in
paragraph (a), clauses (6) to (17), the CCBHC may contract with another entity that has the
required authority to provide that service and that meets the following criteria as a designated
collaborating organization:

(1) the entity has a formal agreement with the CCBHC to furnish one or more of the
services under paragraph (a), clause (6);

(2) the entity provides assurances that it will provide services according to CCBHC
service standards and provider requirements;

(3) the entity agrees that the CCBHC is responsible for coordinating care and has clinical
and financial responsibility for the services that the entity provides under the agreement;
and

(4) the entity meets any additional requirements issued by the commissioner.

(c) Notwithstanding any other law that requires a county contract or other form of county
approval for certain services listed in paragraph (a), clause (6), a clinic that otherwise meets
CCBHC requirements may receive the prospective payment under section 256B.0625,
subdivision 5m
, for those services without a county contract or county approval. As part of
the certification process in paragraph (a), the commissioner shall require a letter of support
from the CCBHC's host county confirming that the CCBHC and the county or counties it
serves have an ongoing relationship to facilitate access and continuity of care, especially
for individuals who are uninsured or who may go on and off medical assistance.

(d) When the standards listed in paragraph (a) or other applicable standards conflict or
address similar issues in duplicative or incompatible ways, the commissioner may grant
variances to state requirements if the variances do not conflict with federal requirements
for services reimbursed under medical assistance. If standards overlap, the commissioner
may substitute all or a part of a licensure or certification that is substantially the same as
another licensure or certification. The commissioner shall consult with stakeholders, as
described in subdivision 4, before granting variances under this provision. For the CCBHC
that is certified but not approved for prospective payment under section 256B.0625,
subdivision 5m
, the commissioner may grant a variance under this paragraph if the variance
does not increase the state share of costs.

(e) The commissioner shall issue a list of required evidence-based practices to be
delivered by CCBHCs, and may also provide a list of recommended evidence-based practices.
The commissioner may update the list to reflect advances in outcomes research and medical
services for persons living with mental illnesses or substance use disorders. The commissioner
shall take into consideration the adequacy of evidence to support the efficacy of the practice,
the quality of workforce available, and the current availability of the practice in the state.
At least 30 days before issuing the initial list and any revisions, the commissioner shall
provide stakeholders with an opportunity to comment.

(f) The commissioner shall recertify CCBHCs at least every three years. The
commissioner shall establish a process for decertification and shall require corrective action,
medical assistance repayment, or decertification of a CCBHC that no longer meets the
requirements in this section or that fails to meet the standards provided by the commissioner
in the application and certification process.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 9.

Minnesota Statutes 2021 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 family child foster care home or family adult foster care home
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 where at least 80 percent of the residents are 55 years of age or
older;

(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

deleted text begin (5) new foster care licenses or community residential setting licenses for people receiving
services under chapter
deleted text end deleted text begin 245D deleted text end deleted text begin 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
deleted text end deleted text begin 14 deleted text end deleted text begin . The exception is available
until June 30, 2018. This exception is available 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, including in the person's home, to help
the person make an informed choice; and
deleted text end

deleted text begin (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; or
deleted text end

deleted text begin (6)deleted text endnew text begin (5)new text end new foster care licenses or community residential setting licenses for people
receiving customized living or 24-hour customized living services under the brain injury
or community access for disability inclusion waiver plans under section 256B.49 and residing
in the customized living setting before July 1, 2022, for which a license is required. A
customized living service provider 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, 2023. This exception is available
when:

(i) the person's customized living services are provided in a customized living service
setting serving four or fewer people under the brain injury or community access for disability
inclusion waiver plans under section 256B.49 in a single-family home operational on or
before June 30, 2021. Operational is defined in section 256B.49, subdivision 28;

(ii) 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

(iii) 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 customized
living 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. 10.

Minnesota Statutes 2020, section 245A.11, subdivision 2, is amended to read:


Subd. 2.

Permitted single-family residential use.

new text begin(a) new text endResidential programs with a
licensed capacity of six or fewer persons shall be considered a permitted single-family
residential use of property for the purposes of zoning and other land use regulations, except
that a residential program whose primary purpose is to treat juveniles who have violated
criminal statutes relating to sex offenses or have been adjudicated delinquent on the basis
of conduct in violation of criminal statutes relating to sex offenses shall not be considered
a permitted use. This exception shall not apply to residential programs licensed before July
1, 1995. Programs otherwise allowed under this subdivision shall not be prohibited by
operation of restrictive covenants or similar restrictions, regardless of when entered into,
which cannot be met because of the nature of the licensed program, including provisions
which require the home's occupants be related, and that the home must be occupied by the
owner, or similar provisions.

new text begin (b) Unless otherwise provided in any town, municipal, or county zoning regulation, a
licensed residential program in an intermediate care facility for persons with developmental
disabilities with a licensed capacity of seven to eight persons shall be considered a permitted
single-family residential use of property for the purposes of zoning and other land use
regulations. A town, municipal, or county zoning authority may require a conditional use
or special use permit to assure proper maintenance and operation of the residential program.
Conditions imposed on the residential program must not be more restrictive than those
imposed on other conditional uses or special uses of residential property in the same zones,
unless the additional conditions are necessary to protect the health and safety of the persons
being served by the program.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 11.

Minnesota Statutes 2020, 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 deleted text beginof fivedeleted text endnew text begin up to sixnew text end beds,
including roomers and boarders, according to paragraphs (b) to deleted text begin(g)deleted text endnew text begin (f)new text end.

(b) The license holder may have a maximum license capacity of deleted text beginfivedeleted text endnew text begin sixnew text end 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 deleted text beginfivedeleted text endnew text begin sixnew text end 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 deleted text beginfivedeleted text endnew text begin sixnew text end, 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 deleted text beginmay issuedeleted text endnew text begin shall increase the licensed capacity ofnew text end an adult foster
care or community residential setting license deleted text beginwithdeleted text endnew text begin up tonew text end a capacity of deleted text beginfivedeleted text endnew text begin sixnew text end adults if the
fifthnew text begin or sixthnew text end 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 rulenew text begin or the community residential settings requirements in chapter 245Dnew text end;

(2) the five-bednew text begin or six-bednew text end 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;new text begin and
new text end

(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 terminationdeleted text begin; and
deleted text end

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

deleted text begin (g) The commissioner shall not issue a new adult foster care license under paragraph (f)
after December 31, 2020
deleted text end. The commissioner shall allow a facility deleted text beginwith an adult foster care
license issued under paragraph (f) before December 31, 2020,
deleted text end to continue with deleted text beginadeleted text endnew text begin an increasednew text end
capacity deleted text beginof five adultsdeleted text end if the license holder continues to comply with the requirements innew text begin
this
new text end paragraph deleted text begin(f)deleted text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 12.

Minnesota Statutes 2020, section 245A.11, is amended by adding a subdivision
to read:


new text begin Subd. 2c. new text end

new text begin Residential programs in intermediate care facilities; license
capacity.
new text end

new text begin Notwithstanding subdivision 4 and section 252.28, subdivision 3, for a licensed
residential program in an intermediate care facility for persons with developmental disabilities
located in a single-family home and in a town, municipal, or county zoning authority that
will permit a licensed capacity of seven or eight persons in a single-family home, the
commissioner may increase the licensed capacity of the program to seven or eight if the
seventh or eighth bed does not increase the overall statewide capacity in intermediate care
facilities for persons with developmental disabilities. If the licensed capacity of a residential
program in an intermediate care facility for persons with developmental disabilities is
increased under this subdivision, the capacity of the license may remain at the increased
number of persons.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 13.

Minnesota Statutes 2020, section 245A.19, is amended to read:


245A.19 HIV TRAINING IN deleted text beginCHEMICAL DEPENDENCYdeleted text endnew text begin SUBSTANCE USE
DISORDER
new text end TREATMENT PROGRAM.

(a) Applicants and license holders for deleted text beginchemical dependencydeleted text endnew text begin substance use disordernew text end
residential and nonresidential programs must demonstrate compliance with HIV minimum
standards deleted text beginprior todeleted text endnew text begin beforenew text end their application deleted text beginbeingdeleted text endnew text begin isnew text end complete. The HIV minimum standards
contained in the HIV-1 Guidelines for deleted text beginchemical dependencydeleted text endnew text begin substance use disordernew text end treatment
and care programs in Minnesota are not subject to rulemaking.

(b) deleted text beginNinety days after April 29, 1992,deleted text end The applicant or license holder shall orient all
deleted text begin chemical dependencydeleted text endnew text begin substance use disordernew text end treatment staff and clients to the HIV minimum
standards.deleted text begin Thereafter,deleted text end Orientation shall be provided to all staff and clientsdeleted text begin,deleted text end within 72 hours
of employment or admission to the program. In-service training shall be provided to all staff
on at least an annual basis and the license holder shall maintain records of training and
attendance.

(c) The license holder shall maintain a list of referral sources for the purpose of making
necessary referrals of clients to HIV-related services. The list of referral services shall be
updated at least annually.

(d) Written policies and procedures, consistent with HIV minimum standards, shall be
developed and followed by the license holder. All policies and procedures concerning HIV
minimum standards shall be approved by the commissioner. The commissioner deleted text beginshall provide
training on HIV minimum standards to applicants
deleted text endnew text begin must outline the content required for the
annual staff training under paragraph (b)
new text end.

(e) The commissioner may permit variances from the requirements in this section. License
holders seeking variances must follow the procedures in section 245A.04, subdivision 9.

Sec. 14.

Minnesota Statutes 2020, 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 programnew text begin or to continue
receiving services
new text end and must not terminate services unless:

(1) the termination is necessary for the person's welfare and the deleted text beginfacilitydeleted text endnew text begin providernew text end cannot
meet the person's needs;

(2) the safety of the person or others deleted text beginin the programdeleted text end 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 deleted text beginin the programdeleted text end would otherwise be endangered;

(4) the deleted text beginprogramdeleted text endnew text begin providernew text end has not been paid for services;

(5) the deleted text beginprogramdeleted text endnew text begin providernew text end ceases to operate;

(6) the person has been terminated by the lead agency from waiver eligibility; or

(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).

(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 new text beginthe person andnew text end the person's support team or expanded support team
to identify and resolve issues leading to issuance of the termination notice;

(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), clauses (4) and (7); deleted text beginand
deleted text end

(3) for state-operated community-based services terminating services under paragraph
(b), clause (7), the state-operated community-based services must engage in consultation
with new text beginthe person andnew text end the person's support team or expanded support team to:

(i) 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);

(ii) provide notice of intent to issue a termination of services to the lead agency when a
finding has been made that a 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);

(iii) assist the lead agency and case manager in developing a person-centered transition
plan to a private community-based provider to ensure continuity of care; and

(iv) coordinate with the lead agency to ensure the private community-based service
provider is able to meet the person's needs and criteria established in a person's
person-centered transition plandeleted text begin.deleted text endnew text begin; and
new text end

new text begin (4) providing the person, the person's legal representative, and the person's extended
support team with:
new text end

new text begin (i) a statement that the person or the person's legal representative may contact the Office
of Ombudsman for Mental Health and Developmental Disabilities or the Office of
Ombudsman for Long-Term Care to request an advocate to assist regarding the termination;
and
new text end

new text begin (ii) the telephone number, e-mail address, website address, mailing address, and street
address for the state and applicable regional Office of Ombudsman for Long-Term Care
and the Office of Ombudsman for Mental Health and Developmental Disabilities.
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 deleted text beginthe commissionerdeleted text end in writingnew text begin the
commissioner, the Office of Ombudsman for Long-Term Care and the Office of Ombudsman
for Mental Health and Developmental Disabilities
new text end; and

(2) the notice must include:

(i) the reason for the action;

(ii) deleted text beginexcept for a service termination under paragraph (b), clause (5),deleted text end 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 90 days prior to termination of
services under paragraph (b), clause (7), new text beginand new text end60 days prior to termination when a license
holder is providing intensive supports and services identified in section 245D.03, subdivision
1
, paragraph (c)deleted text begin, anddeleted text endnew text begin. Notice of the proposed termination of service, including those situations
that began with temporary service suspension, must be given at least
new text end 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.

(g) For notices issued under paragraph (b), clause (7), the lead agency shall provide
notice to the commissioner and state-operated services at least 30 days before the conclusion
of the 90-day termination period, if an appropriate alternative provider cannot be secured.
Upon receipt of this notice, the commissioner and state-operated services shall reassess
whether a private community-based service can meet the person's needs. If the commissioner
determines that a private provider can meet the person's needs, state-operated services shall,
if necessary, extend notice of service termination until placement can be made. If the
commissioner determines that a private provider cannot meet the person's needs,
state-operated services shall rescind the notice of service termination and re-engage with
the lead agency in service planning for the person.

new text begin (h) For notices issued under paragraph (b), if the lead agency has not finalized an
alternative program or service that will meet the assessed needs of the individual receiving
services 30 days before the effective date of the termination period for services under
paragraph (b), clause (7), or section 245D.03, subdivision 1, paragraph (c), the lead agency
shall provide written notice to the commissioner. Upon receipt of this notice, the
commissioner shall provide technical assistance as necessary to the lead agency until the
lead agency finalizes an alternative placement or service that will meet the assessed needs
of the individual. After assessing the circumstance, the commissioner is authorized to require
the license holder to continue services until the lead agency finalizes an alternative program
or service.
new text end

deleted text begin (h)deleted text endnew text begin (i)new text end For state-operated community-based services, the license holder shall prioritize
the capacity created within the existing service site by the termination of services under
paragraph (b), clause (7), to serve persons described in section 252.50, subdivision 5,
paragraph (a), clause (1).

Sec. 15.

Minnesota Statutes 2020, section 245D.12, is amended to read:


245D.12 INTEGRATED COMMUNITY SUPPORTS; SETTING CAPACITY
REPORT.

(a) The license holder providing integrated community support, as defined in section
245D.03, subdivision 1, paragraph (c), clause (8), must submit a setting capacity report to
the commissioner to ensure the identified location of service delivery meets the criteria of
the home and community-based service requirements as specified in section 256B.492.

(b) The license holder shall provide the setting capacity report on the forms and in the
manner prescribed by the commissioner. The report must include:

(1) the address of the multifamily housing building where the license holder delivers
integrated community supports and owns, leases, or has a direct or indirect financial
relationship with the property owner;

(2) the total number of living units in the multifamily housing building described in
clause (1) where integrated community supports are delivered;

(3) the total number of living units in the multifamily housing building described in
clause (1), including the living units identified in clause (2); deleted text beginand
deleted text end

new text begin (4) the total number of people who could reside in the living units in the multifamily
housing building described in clause (2) and receive integrated community supports; and
new text end

deleted text begin (4)deleted text endnew text begin (5)new text end the percentage of living units that are controlled by the license holder in the
multifamily housing building by dividing clause (2) by clause (3).

(c) Only one license holder may deliver integrated community supports at the address
of the multifamily housing building.

new text begin EFFECTIVE DATE. new text end

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

Sec. 16.

Minnesota Statutes 2020, section 245F.04, subdivision 1, is amended to read:


Subdivision 1.

General application and license requirements.

An applicant for licensure
as a clinically managed withdrawal management program or medically monitored withdrawal
management program must meet the following requirements, except where otherwise noted.
All programs must comply with federal requirements and the general requirements in sections
626.557 and 626.5572 and chapters 245A, 245C, and 260E. A withdrawal management
program must be located in a hospital licensed under sections 144.50 to 144.581, or must
be a supervised living facility with a class new text beginA or new text endB license from the Department of Health
under Minnesota Rules, parts 4665.0100 to 4665.9900.

Sec. 17.

Minnesota Statutes 2020, section 245G.01, is amended by adding a subdivision
to read:


new text begin Subd. 13b. new text end

new text begin Guest speaker. new text end

new text begin "Guest speaker" means an individual who works under the
direct observation of the license holder to present to clients on topics in which the guest
speaker has expertise and that the license holder has determined to be beneficial to a client's
recovery. Tribally licensed programs have autonomy to identify the qualifications of their
guest speakers.
new text end

Sec. 18.

Minnesota Statutes 2020, section 245G.12, is amended to read:


245G.12 PROVIDER POLICIES AND PROCEDURES.

A license holder must develop a written policies and procedures manual, indexed
according to section 245A.04, subdivision 14, paragraph (c), that provides staff members
immediate access to all policies and procedures and provides a client and other authorized
parties access to all policies and procedures. The manual must contain the following
materials:

(1) assessment and treatment planning policies, including screening for mental health
concerns and treatment objectives related to the client's identified mental health concerns
in the client's treatment plan;

(2) policies and procedures regarding HIV according to section 245A.19;

(3) the license holder's methods and resources to provide information on tuberculosis
and tuberculosis screening to each client and to report a known tuberculosis infection
according to section 144.4804;

(4) personnel policies according to section 245G.13;

(5) policies and procedures that protect a client's rights according to section 245G.15;

(6) a medical services plan according to section 245G.08;

(7) emergency procedures according to section 245G.16;

(8) policies and procedures for maintaining client records according to section 245G.09;

(9) procedures for reporting the maltreatment of minors according to chapter 260E, and
vulnerable adults according to sections 245A.65, 626.557, and 626.5572;

(10) a description of treatment services that: (i) includes the amount and type of services
provided; (ii) identifies which services meet the definition of group counseling under section
245G.01, subdivision 13a; deleted text beginanddeleted text end (iii) new text beginidentifies which groups and topics on which a guest
speaker could provide services under the direct observation of a licensed alcohol and drug
counselor; and (iv)
new text enddefines the program's treatment week;

(11) the methods used to achieve desired client outcomes;

(12) the hours of operation; and

(13) the target population served.

Sec. 19.

Minnesota Statutes 2021 Supplement, section 245I.02, subdivision 19, is amended
to read:


Subd. 19.

Level of care assessment.

"Level of care assessment" means the level of care
decision support tool appropriate to the client's age. For a client five years of age or younger,
a level of care assessment is the Early Childhood Service Intensity Instrument (ESCII). For
a client six to 17 years of age, a level of care assessment is the Child and Adolescent Service
Intensity Instrument (CASII). For a client 18 years of age or older, a level of care assessment
is the Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS)new text begin
or another tool authorized by the commissioner
new text end.

Sec. 20.

Minnesota Statutes 2021 Supplement, section 245I.02, subdivision 36, is amended
to read:


Subd. 36.

Staff person.

"Staff person" means an individual who works under a license
holder's direction or under a contract with a license holder. Staff person includes an intern,
consultant, contractor, individual who works part-time, and an individual who does not
provide direct contact services to clientsnew text begin but does have physical access to clientsnew text end. Staff
person includes a volunteer who provides treatment services to a client or a volunteer whom
the license holder regards as a staff person for the purpose of meeting staffing or service
delivery requirements. A staff person must be 18 years of age or older.

Sec. 21.

Minnesota Statutes 2021 Supplement, section 245I.03, subdivision 9, is amended
to read:


Subd. 9.

Volunteers.

deleted text beginAdeleted text endnew text begin If a license holder uses volunteers, thenew text end license holder must have
policies and procedures for using volunteers, including when deleted text beginadeleted text endnew text begin thenew text end license holder must
submit a background study for a volunteer, and the specific tasks that a volunteer may
perform.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 22.

Minnesota Statutes 2021 Supplement, section 245I.04, subdivision 4, is amended
to read:


Subd. 4.

Mental health practitioner qualifications.

(a) An individual who is qualified
in at least one of the ways described in paragraph (b) to (d) may serve as a mental health
practitioner.

(b) An individual is qualified as a mental health practitioner through relevant coursework
if the individual completes at least 30 semester hours or 45 quarter hours in behavioral
sciences or related fields and:

(1) has at least 2,000 hours of experience providing services to individuals with:

(i) a mental illness or a substance use disorder; or

(ii) a traumatic brain injury or a developmental disability, and completes the additional
training described in section 245I.05, subdivision 3, paragraph (c), before providing direct
contact services to a client;

(2) is fluent in the non-English language of the ethnic group to which at least 50 percent
of the individual's clients belong, and completes the additional training described in section
245I.05, subdivision 3, paragraph (c), before providing direct contact services to a client;

(3) is working in a day treatment program under section 256B.0671, subdivision 3, or
256B.0943; deleted text beginor
deleted text end

(4) has completed a practicum or internship that (i) required direct interaction with adult
clients or child clients, and (ii) was focused on behavioral sciences or related fieldsdeleted text begin.deleted text endnew text begin; or
new text end

new text begin (5) is in the process of completing a practicum or internship as part of a formal
undergraduate or graduate training program in social work, psychology, or counseling.
new text end

(c) An individual is qualified as a mental health practitioner through work experience
if the individual:

(1) has at least 4,000 hours of experience in the delivery of services to individuals with:

(i) a mental illness or a substance use disorder; or

(ii) a traumatic brain injury or a developmental disability, and completes the additional
training described in section 245I.05, subdivision 3, paragraph (c), before providing direct
contact services to clients; or

(2) receives treatment supervision at least once per week until meeting the requirement
in clause (1) of 4,000 hours of experience and has at least 2,000 hours of experience providing
services to individuals with:

(i) a mental illness or a substance use disorder; or

(ii) a traumatic brain injury or a developmental disability, and completes the additional
training described in section 245I.05, subdivision 3, paragraph (c), before providing direct
contact services to clients.

(d) An individual is qualified as a mental health practitioner if the individual has a
master's or other graduate degree in behavioral sciences or related fields.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 23.

Minnesota Statutes 2021 Supplement, section 245I.05, subdivision 3, is amended
to read:


Subd. 3.

Initial training.

(a) A staff person must receive training about:

(1) vulnerable adult maltreatment under section 245A.65, subdivision 3; and

(2) the maltreatment of minor reporting requirements and definitions in chapter 260E
within 72 hours of first providing direct contact services to a client.

(b) Before providing direct contact services to a client, a staff person must receive training
about:

(1) client rights and protections under section 245I.12;

(2) the Minnesota Health Records Act, including client confidentiality, family engagement
under section 144.294, and client privacy;

(3) emergency procedures that the staff person must follow when responding to a fire,
inclement weather, a report of a missing person, and a behavioral or medical emergency;

(4) specific activities and job functions for which the staff person is responsible, including
the license holder's program policies and procedures applicable to the staff person's position;

(5) professional boundaries that the staff person must maintain; and

(6) specific needs of each client to whom the staff person will be providing direct contact
services, including each client's developmental status, cognitive functioning, and physical
and mental abilities.

(c) Before providing direct contact services to a client, a mental health rehabilitation
worker, mental health behavioral aide, or mental health practitioner deleted text beginqualified underdeleted text end new text beginrequired
to receive the training according to
new text end section 245I.04, subdivision 4, must receive 30 hours
of training about:

(1) mental illnesses;

(2) client recovery and resiliency;

(3) mental health de-escalation techniques;

(4) co-occurring mental illness and substance use disorders; and

(5) psychotropic medications and medication side effects.

(d) Within 90 days of first providing direct contact services to an adult client, a clinical
trainee, mental health practitioner, mental health certified peer specialist, or mental health
rehabilitation worker must receive training about:

(1) trauma-informed care and secondary trauma;

(2) person-centered individual treatment plans, including seeking partnerships with
family and other natural supports;

(3) co-occurring substance use disorders; and

(4) culturally responsive treatment practices.

(e) Within 90 days of first providing direct contact services to a child client, a clinical
trainee, mental health practitioner, mental health certified family peer specialist, mental
health certified peer specialist, or mental health behavioral aide must receive training about
the topics in clauses (1) to (5). This training must address the developmental characteristics
of each child served by the license holder and address the needs of each child in the context
of the child's family, support system, and culture. Training topics must include:

(1) trauma-informed care and secondary trauma, including adverse childhood experiences
(ACEs);

(2) family-centered treatment plan development, including seeking partnership with a
child client's family and other natural supports;

(3) mental illness and co-occurring substance use disorders in family systems;

(4) culturally responsive treatment practices; and

(5) child development, including cognitive functioning, and physical and mental abilities.

(f) For a mental health behavioral aide, the training under paragraph (e) must include
parent team training using a curriculum approved by the commissioner.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 24.

Minnesota Statutes 2021 Supplement, section 245I.08, subdivision 4, is amended
to read:


Subd. 4.

Progress notes.

A license holder must use a progress note to document each
occurrence of a mental health service that a staff person provides to a client. A progress
note must include the following:

(1) the type of service;

(2) the date of service;

(3) the start and stop time of the service unless the license holder is licensed as a
residential program;

(4) the location of the service;

(5) the scope of the service, including: (i) the targeted goal and objective; (ii) the
intervention that the staff person provided to the client and the methods that the staff person
used; (iii) the client's response to the intervention; (iv) the staff person's plan to take future
actions, including changes in treatment that the staff person will implement if the intervention
was ineffective; and (v) the service modality;

(6) the signaturedeleted text begin, printed name,deleted text end and credentials of the staff person who provided the
service to the client;

(7) the mental health provider travel documentation required by section 256B.0625, if
applicable; and

(8) significant observations by the staff person, if applicable, including: (i) the client's
current risk factors; (ii) emergency interventions by staff persons; (iii) consultations with
or referrals to other professionals, family, or significant others; and (iv) changes in the
client's mental or physical symptoms.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 25.

Minnesota Statutes 2021 Supplement, section 245I.09, subdivision 2, is amended
to read:


Subd. 2.

Record retention.

A license holder must retain client records of a discharged
client for a minimum of five years from the date of the client's discharge. A license holder
who deleted text beginceases to provide treatment services to a clientdeleted text endnew text begin closes a programnew text end must retain deleted text beginthedeleted text endnew text begin anew text end
client's records for a minimum of five years from the date that the license holder stopped
providing services to the client and must notify the commissioner of the location of the
client records and the name of the individual responsible for storing and maintaining the
client records.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 26.

Minnesota Statutes 2021 Supplement, section 245I.10, subdivision 2, is amended
to read:


Subd. 2.

Generally.

(a) A license holder must use a client's diagnostic assessment or
crisis assessment to determine a client's eligibility for mental health services, except as
provided in this section.

(b) Prior to completing a client's initial diagnostic assessment, a license holder may
provide a client with the following services:

(1) an explanation of findings;

(2) neuropsychological testing, neuropsychological assessment, and psychological
testing;

(3) any combination of psychotherapy sessions, family psychotherapy sessions, and
family psychoeducation sessions not to exceed three sessions;

(4) crisis assessment services according to section 256B.0624; and

(5) ten days of intensive residential treatment services according to the assessment and
treatment planning standards in section deleted text begin245.23deleted text endnew text begin 245I.23new text end, subdivision 7.

(c) Based on the client's needs that a crisis assessment identifies under section 256B.0624,
a license holder may provide a client with the following services:

(1) crisis intervention and stabilization services under section 245I.23 or 256B.0624;
and

(2) any combination of psychotherapy sessions, group psychotherapy sessions, family
psychotherapy sessions, and family psychoeducation sessions not to exceed ten sessions
within a 12-month period without prior authorization.

(d) Based on the client's needs in the client's brief diagnostic assessment, a license holder
may provide a client with any combination of psychotherapy sessions, group psychotherapy
sessions, family psychotherapy sessions, and family psychoeducation sessions not to exceed
ten sessions within a 12-month period without prior authorization for any new client or for
an existing client who the license holder projects will need fewer than ten sessions during
the next 12 months.

(e) Based on the client's needs that a hospital's medical history and presentation
examination identifies, a license holder may provide a client with:

(1) any combination of psychotherapy sessions, group psychotherapy sessions, family
psychotherapy sessions, and family psychoeducation sessions not to exceed ten sessions
within a 12-month period without prior authorization for any new client or for an existing
client who the license holder projects will need fewer than ten sessions during the next 12
months; and

(2) up to five days of day treatment services or partial hospitalization.

(f) A license holder must complete a new standard diagnostic assessment of a client:

(1) when the client requires services of a greater number or intensity than the services
that paragraphs (b) to (e) describe;

(2) at least annually following the client's initial diagnostic assessment if the client needs
additional mental health services and the client does not meet the criteria for a brief
assessment;

(3) when the client's mental health condition has changed markedly since the client's
most recent diagnostic assessment; or

(4) when the client's current mental health condition does not meet the criteria of the
client's current diagnosis.

(g) For an existing client, the license holder must ensure that a new standard diagnostic
assessment includes a written update containing all significant new or changed information
about the client, and an update regarding what information has not significantly changed,
including a discussion with the client about changes in the client's life situation, functioning,
presenting problems, and progress with achieving treatment goals since the client's last
diagnostic assessment was completed.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 27.

Minnesota Statutes 2021 Supplement, section 245I.10, subdivision 6, is amended
to read:


Subd. 6.

Standard diagnostic assessment; required elements.

(a) Only a mental health
professional or a clinical trainee may complete a standard diagnostic assessment of a client.
A standard diagnostic assessment of a client must include a face-to-face interview with a
client and a written evaluation of the client. The assessor must complete a client's standard
diagnostic assessment within the client's cultural context.

(b) When completing a standard diagnostic assessment of a client, the assessor must
gather and document information about the client's current life situation, including the
following information:

(1) the client's age;

(2) the client's current living situation, including the client's housing status and household
members;

(3) the status of the client's basic needs;

(4) the client's education level and employment status;

(5) the client's current medications;

(6) any immediate risks to the client's health and safety;

(7) the client's perceptions of the client's condition;

(8) the client's description of the client's symptoms, including the reason for the client's
referral;

(9) the client's history of mental health treatment; and

(10) cultural influences on the client.

(c) If the assessor cannot obtain the information that this deleted text beginsubdivisiondeleted text endnew text begin paragraphnew text end requires
without retraumatizing the client or harming the client's willingness to engage in treatment,
the assessor must identify which topics will require further assessment during the course
of the client's treatment. The assessor must gather and document information related to the
following topics:

(1) the client's relationship with the client's family and other significant personal
relationships, including the client's evaluation of the quality of each relationship;

(2) the client's strengths and resources, including the extent and quality of the client's
social networks;

(3) important developmental incidents in the client's life;

(4) maltreatment, trauma, potential brain injuries, and abuse that the client has suffered;

(5) the client's history of or exposure to alcohol and drug usage and treatment; and

(6) the client's health history and the client's family health history, including the client's
physical, chemical, and mental health history.

(d) When completing a standard diagnostic assessment of a client, an assessor must use
a recognized diagnostic framework.

(1) When completing a standard diagnostic assessment of a client who is five years of
age or younger, the assessor must use the current edition of the DC: 0-5 Diagnostic
Classification of Mental Health and Development Disorders of Infancy and Early Childhood
published by Zero to Three.

(2) When completing a standard diagnostic assessment of a client who is six years of
age or older, the assessor must use the current edition of the Diagnostic and Statistical
Manual of Mental Disorders published by the American Psychiatric Association.

(3) When completing a standard diagnostic assessment of a client who is five years of
age or younger, an assessor must administer the Early Childhood Service Intensity Instrument
(ECSII) to the client and include the results in the client's assessment.

(4) When completing a standard diagnostic assessment of a client who is six to 17 years
of age, an assessor must administer the Child and Adolescent Service Intensity Instrument
(CASII) to the client and include the results in the client's assessment.

(5) When completing a standard diagnostic assessment of a client who is 18 years of
age or older, an assessor must use either (i) the CAGE-AID Questionnaire or (ii) the criteria
in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders
published by the American Psychiatric Association to screen and assess the client for a
substance use disorder.

(e) When completing a standard diagnostic assessment of a client, the assessor must
include and document the following components of the assessment:

(1) the client's mental status examination;

(2) the client's baseline measurements; symptoms; behavior; skills; abilities; resources;
vulnerabilities; safety needs, including client information that supports the assessor's findings
after applying a recognized diagnostic framework from paragraph (d); and any differential
diagnosis of the client;

(3) an explanation of: (i) how the assessor diagnosed the client using the information
from the client's interview, assessment, psychological testing, and collateral information
about the client; (ii) the client's needs; (iii) the client's risk factors; (iv) the client's strengths;
and (v) the client's responsivity factors.

(f) When completing a standard diagnostic assessment of a client, the assessor must
consult the client and the client's family about which services that the client and the family
prefer to treat the client. The assessor must make referrals for the client as to services required
by law.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 28.

Minnesota Statutes 2021 Supplement, section 245I.20, subdivision 5, is amended
to read:


Subd. 5.

Treatment supervision specified.

(a) A mental health professional must remain
responsible for each client's case. The certification holder must document the name of the
mental health professional responsible for each case and the dates that the mental health
professional is responsible for the client's case from beginning date to end date. The
certification holder must assign each client's case for assessment, diagnosis, and treatment
services to a treatment team member who is competent in the assigned clinical service, the
recommended treatment strategy, and in treating the client's characteristics.

(b) Treatment supervision of mental health practitioners and clinical trainees required
by section 245I.06 must include case reviews as described in this paragraph. Every two
months, a mental health professional must completenew text begin and documentnew text end a case review of each
client assigned to the mental health professional when the client is receiving clinical services
from a mental health practitioner or clinical trainee. The case review must include a
consultation process that thoroughly examines the client's condition and treatment, including:
(1) a review of the client's reason for seeking treatment, diagnoses and assessments, and
the individual treatment plan; (2) a review of the appropriateness, duration, and outcome
of treatment provided to the client; and (3) treatment recommendations.

Sec. 29.

Minnesota Statutes 2021 Supplement, section 245I.23, subdivision 22, is amended
to read:


Subd. 22.

Additional policy and procedure requirements.

(a) In addition to the policies
and procedures in section 245I.03, the license holder must establish, enforce, and maintain
the policies and procedures in this subdivision.

(b) The license holder must have policies and procedures for receiving referrals and
making admissions determinations about referred persons under subdivisions deleted text begin14 to 16deleted text endnew text begin 15
to 17
new text end.

(c) The license holder must have policies and procedures for discharging clients under
subdivision deleted text begin17deleted text endnew text begin 18new text end. In the policies and procedures, the license holder must identify the staff
persons who are authorized to discharge clients from the program.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 30.

Minnesota Statutes 2020, section 254B.01, is amended by adding a subdivision
to read:


new text begin Subd. 6a. new text end

new text begin Minnesota Certification Board. new text end

new text begin "Minnesota Certification Board" means the
nonprofit agency member board of the International Certification and Reciprocity Consortium
that sets the policies and procedures for alcohol and other drug professional certifications
in Minnesota, including peer recovery specialists.
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. 31.

Minnesota Statutes 2020, 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 as defined in section 245G.01, subdivision
17
, 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 (5), and (b); and subdivision 2, clauses
(1) to (6).

(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 deleted text begincertification requirements identified
by the commissioner
deleted text endnew text begin the definition in section 254B.01, subdivision 8, and one of the
following certification requirements,
new text end is an eligible vendor of peer new text beginrecovery new text endsupport servicesnew text begin
under section 254B.05, subdivision 5, paragraph (b), clause (4):
new text end

new text begin (1) the recovery community organization is certified by the Minnesota Certification
Board as defined in section 254B.01, subdivision 6a;
new text end

new text begin (2) the recovery community organization was certified as of July 1, 2022, by an
organization previously authorized by the commissioner to certify recovery community
organizations; or
new text end

new text begin (3) the recovery community organization is certified by an organization authorized by
the commissioner, provided that organization does not require additional certification
requirements beyond the recovery community organization meeting the definition under
section 254B.01, subdivision 8
new text end.

(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.

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.

Minnesota Statutes 2020, section 256.01, is amended by adding a subdivision to
read:


new text begin Subd. 12b. new text end

new text begin Department of Human Services systemic critical incident review team. new text end

new text begin (a)
The commissioner may establish a Department of Human Services systemic critical incident
review team to review critical incidents reported as required under section 626.557 for
which the Department of Human Services is responsible under section 626.5572, subdivision
13; chapter 245D; or Minnesota Rules, chapter 9544. When reviewing a critical incident,
the systemic critical incident review team shall identify systemic influences to the incident
rather than determining the culpability of any actors involved in the incident. The systemic
critical incident review may assess the entire critical incident process from the point of an
entity reporting the critical incident through the ongoing case management process.
Department staff shall lead and conduct the reviews and may utilize county staff as reviewers.
The systemic critical incident review process may include but is not limited to:
new text end

new text begin (1) data collection about the incident and actors involved. Data may include the critical
incident report under review; previous incident reports pertaining to the person receiving
services; the service provider's policies and procedures applicable to the incident; the
coordinated service and support plan as defined in section 245D.02, subdivision 4b, for the
person receiving services; or an interview of an actor involved in the critical incident or the
review of the critical incident. Actors may include:
new text end

new text begin (i) staff of the provider agency;
new text end

new text begin (ii) lead agency staff administering home and community-based services delivered by
the provider;
new text end

new text begin (iii) Department of Human Services staff with oversight of home and community-based
services;
new text end

new text begin (iv) Department of Health staff with oversight of home and community-based services;
new text end

new text begin (v) members of the community including advocates, legal representatives, health care
providers, pharmacy staff, or others with knowledge of the incident or the actors in the
incident; and
new text end

new text begin (vi) staff from the office of the ombudsman for mental health and developmental
disabilities;
new text end

new text begin (2) systemic mapping of the critical incident. The team conducting the systemic mapping
of the incident may include any actors identified in clause (1), designated representatives
of other provider agencies, regional teams, and representatives of the local regional quality
council identified in section 256B.097; and
new text end

new text begin (3) analysis of the case for systemic influences.
new text end

new text begin Data collected by the critical incident review team shall be aggregated and provided to
regional teams, participating regional quality councils, and the commissioner. The regional
teams and quality councils shall analyze the data and make recommendations to the
commissioner regarding systemic changes that would decrease the number and severity of
critical incidents in the future or improve the quality of the home and community-based
service system.
new text end

new text begin (b) Cases selected for the systemic critical incident review process shall be selected by
a selection committee among the following critical incident categories:
new text end

new text begin (1) cases of caregiver neglect identified in section 626.5572, subdivision 17;
new text end

new text begin (2) cases involving financial exploitation identified in section 626.5572, subdivision 9;
new text end

new text begin (3) incidents identified in section 245D.02, subdivision 11;
new text end

new text begin (4) incidents identified in Minnesota Rules, part 9544.0110; and
new text end

new text begin (5) service terminations reported to the department in accordance with section 245D.10,
subdivision 3a.
new text end

new text begin (c) The systemic critical incident review under this section shall not replace the process
for screening or investigating cases of alleged maltreatment of an adult under section 626.557.
The department may select cases for systemic critical incident review, under the jurisdiction
of the commissioner, reported for suspected maltreatment and closed following initial or
final disposition.
new text end

new text begin (d) The proceedings and records of the review team are confidential data on individuals
or protected nonpublic data as defined in section 13.02, subdivisions 3 and 13. Data that
document a person's opinions formed as a result of the review are not subject to discovery
or introduction into evidence in a civil or criminal action against a professional, the state,
or a county agency arising out of the matters that the team is reviewing. Information,
documents, and records otherwise available from other sources are not immune from
discovery or use in a civil or criminal action solely because the information, documents,
and records were assessed or presented during proceedings of the review team. A person
who presented information before the systemic critical incident review team or who is a
member of the team shall not be prevented from testifying about matters within the person's
knowledge. In a civil or criminal proceeding, a person shall not be questioned about opinions
formed by the person as a result of the review.
new text end

new text begin (e) By October 1 of each year, the commissioner shall prepare an annual public report
containing the following information:
new text end

new text begin (1) the number of cases reviewed under each critical incident category identified in
paragraph (b) and a geographical description of where cases under each category originated;
new text end

new text begin (2) an aggregate summary of the systemic themes from the critical incidents examined
by the critical incident review team during the previous year;
new text end

new text begin (3) a synopsis of the conclusions, incident analyses, or exploratory activities taken in
regard to the critical incidents examined by the critical incident review team; and
new text end

new text begin (4) recommendations made to the commissioner regarding systemic changes that could
decrease the number and severity of critical incidents in the future or improve the quality
of the home and community-based service system.
new text end

Sec. 33.

Minnesota Statutes 2020, section 256.045, subdivision 3, is amended to read:


Subd. 3.

State agency hearings.

(a) State agency hearings are available for the following:

(1) any person applying for, receiving or having received public assistance, medical
care, or a program of social services granted by the state agency or a county agency or the
federal Food and Nutrition Act whose application for assistance is denied, not acted upon
with reasonable promptness, or whose assistance is suspended, reduced, terminated, or
claimed to have been incorrectly paid;

(2) any patient or relative aggrieved by an order of the commissioner under section
252.27;

(3) a party aggrieved by a ruling of a prepaid health plan;

(4) except as provided under chapter 245C, any individual or facility determined by a
lead investigative agency to have maltreated a vulnerable adult under section 626.557 after
they have exercised their right to administrative reconsideration under section 626.557;

(5) any person whose claim for foster care payment according to a placement of the
child resulting from a child protection assessment under chapter 260E is denied or not acted
upon with reasonable promptness, regardless of funding source;

(6) any person to whom a right of appeal according to this section is given by other
provision of law;

(7) an applicant aggrieved by an adverse decision to an application for a hardship waiver
under section 256B.15;

(8) an applicant aggrieved by an adverse decision to an application or redetermination
for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;

(9) except as provided under chapter 245A, an individual or facility determined to have
maltreated a minor under chapter 260E, after the individual or facility has exercised the
right to administrative reconsideration under chapter 260E;

(10) except as provided under chapter 245C, an individual disqualified under sections
245C.14 and 245C.15, following a reconsideration decision issued under section 245C.23,
on the basis of serious or recurring maltreatment; a preponderance of the evidence that the
individual has committed an act or acts that meet the definition of any of the crimes listed
in section 245C.15, subdivisions 1 to 4; or for failing to make reports required under section
260E.06, subdivision 1, or 626.557, subdivision 3. Hearings regarding a maltreatment
determination under clause (4) or (9) and a disqualification under this clause in which the
basis for a disqualification is serious or recurring maltreatment, shall be consolidated into
a single fair hearing. In such cases, the scope of review by the human services judge shall
include both the maltreatment determination and the disqualification. The failure to exercise
the right to an administrative reconsideration shall not be a bar to a hearing under this section
if federal law provides an individual the right to a hearing to dispute a finding of
maltreatment;

(11) any person with an outstanding debt resulting from receipt of public assistance,
medical care, or the federal Food and Nutrition Act who is contesting a setoff claim by the
Department of Human Services or a county agency. The scope of the appeal is the validity
of the claimant agency's intention to request a setoff of a refund under chapter 270A against
the debt;

(12) a person issued a notice of service termination under section 245D.10, subdivision
3a, deleted text beginfromdeleted text endnew text begin by a licensed provider of anynew text end residential supports deleted text beginanddeleted text endnew text begin ornew text end services deleted text beginas defineddeleted text endnew text begin listednew text end
in section 245D.03, subdivision 1, deleted text beginparagraphdeleted text endnew text begin paragraphs (b) andnew text end (c), deleted text beginclause (3),deleted text end that is not
otherwise subject to appeal under subdivision 4a;

(13) an individual disability waiver recipient based on a denial of a request for a rate
exception under section 256B.4914; or

(14) a person issued a notice of service termination under section 245A.11, subdivision
11, that is not otherwise subject to appeal under subdivision 4a.

(b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or (10),
is the only administrative appeal to the final agency determination specifically, including
a challenge to the accuracy and completeness of data under section 13.04. Hearings requested
under paragraph (a), clause (4), apply only to incidents of maltreatment that occur on or
after October 1, 1995. Hearings requested by nursing assistants in nursing homes alleged
to have maltreated a resident prior to October 1, 1995, shall be held as a contested case
proceeding under the provisions of chapter 14. Hearings requested under paragraph (a),
clause (9), apply only to incidents of maltreatment that occur on or after July 1, 1997. A
hearing for an individual or facility under paragraph (a), clauses (4), (9), and (10), is only
available when there is no district court action pending. If such action is filed in district
court while an administrative review is pending that arises out of some or all of the events
or circumstances on which the appeal is based, the administrative review must be suspended
until the judicial actions are completed. If the district court proceedings are completed,
dismissed, or overturned, the matter may be considered in an administrative hearing.

(c) For purposes of this section, bargaining unit grievance procedures are not an
administrative appeal.

(d) The scope of hearings involving claims to foster care payments under paragraph (a),
clause (5), shall be limited to the issue of whether the county is legally responsible for a
child's placement under court order or voluntary placement agreement and, if so, the correct
amount of foster care payment to be made on the child's behalf and shall not include review
of the propriety of the county's child protection determination or child placement decision.

(e) The scope of hearings under paragraph (a), clauses (12) and (14), shall be limited to
whether the proposed termination of services is authorized under section 245D.10,
subdivision 3a
, paragraph (b), or 245A.11, subdivision 11, and whether the requirements
of section 245D.10, subdivision 3a, paragraphs (c) to (e), or 245A.11, subdivision 2a,
paragraphs (d) to (f), were met. If the appeal includes a request for a temporary stay of
termination of services, the scope of the hearing shall also include whether the case
management provider has finalized arrangements for a residential facility, a program, or
services that will meet the assessed needs of the recipient by the effective date of the service
termination.

(f) A vendor of medical care as defined in section 256B.02, subdivision 7, or a vendor
under contract with a county agency to provide social services is not a party and may not
request a hearing under this section, except if assisting a recipient as provided in subdivision
4.

(g) An applicant or recipient is not entitled to receive social services beyond the services
prescribed under chapter 256M or other social services the person is eligible for under state
law.

(h) The commissioner may summarily affirm the county or state agency's proposed
action without a hearing when the sole issue is an automatic change due to a change in state
or federal law.

(i) Unless federal or Minnesota law specifies a different time frame in which to file an
appeal, an individual or organization specified in this section may contest the specified
action, decision, or final disposition before the state agency by submitting a written request
for a hearing to the state agency within 30 days after receiving written notice of the action,
decision, or final disposition, or within 90 days of such written notice if the applicant,
recipient, patient, or relative shows good cause, as defined in section 256.0451, subdivision
13, why the request was not submitted within the 30-day time limit. The individual filing
the appeal has the burden of proving good cause by a preponderance of the evidence.

Sec. 34.

Minnesota Statutes 2021 Supplement, section 256B.0622, subdivision 2, is
amended to read:


Subd. 2.

Definitions.

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

(b) "ACT team" means the group of interdisciplinary mental health staff who work as
a team to provide assertive community treatment.

(c) "Assertive community treatment" means intensive nonresidential treatment and
rehabilitative mental health services provided according to the assertive community treatment
model. Assertive community treatment provides a single, fixed point of responsibility for
treatment, rehabilitation, and support needs for clients. Services are offered 24 hours per
day, seven days per week, in a community-based setting.

(d) "Individual treatment plan" means a plan described by section 245I.10, subdivisions
7
and 8.

(e) "Crisis assessment and intervention" means deleted text beginmental healthdeleted text endnew text begin mobilenew text end crisis response
services deleted text beginas defined indeleted text endnew text begin undernew text end section 256B.0624deleted text begin, subdivision 2deleted text end.

(f) "Individual treatment team" means a minimum of three members of the ACT team
who are responsible for consistently carrying out most of a client's assertive community
treatment services.

(g) "Primary team member" means the person who leads and coordinates the activities
of the individual treatment team and is the individual treatment team member who has
primary responsibility for establishing and maintaining a therapeutic relationship with the
client on a continuing basis.

(h) "Certified rehabilitation specialist" means a staff person who is qualified according
to section 245I.04, subdivision 8.

(i) "Clinical trainee" means a staff person who is qualified according to section 245I.04,
subdivision 6.

(j) "Mental health certified peer specialist" means a staff person who is qualified
according to section 245I.04, subdivision 10.

(k) "Mental health practitioner" means a staff person who is qualified according to section
245I.04, subdivision 4.

(l) "Mental health professional" means a staff person who is qualified according to
section 245I.04, subdivision 2.

(m) "Mental health rehabilitation worker" means a staff person who is qualified according
to section 245I.04, subdivision 14.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 35.

Minnesota Statutes 2021 Supplement, section 256B.0625, subdivision 3b, is
amended to read:


Subd. 3b.

Telehealth services.

(a) Medical assistance covers medically necessary services
and consultations delivered by a health care provider through telehealth in the same manner
as if the service or consultation was delivered through in-person contact. Services or
consultations delivered through telehealth shall be paid at the full allowable rate.

(b) The commissioner may establish criteria that a health care provider must attest to in
order to demonstrate the safety or efficacy of delivering a particular service through
telehealth. The attestation may include that the health care provider:

(1) has identified the categories or types of services the health care provider will provide
through telehealth;

(2) has written policies and procedures specific to services delivered through telehealth
that are regularly reviewed and updated;

(3) has policies and procedures that adequately address patient safety before, during,
and after the service is delivered through telehealth;

(4) has established protocols addressing how and when to discontinue telehealth services;
and

(5) has an established quality assurance process related to delivering services through
telehealth.

(c) As a condition of payment, a licensed health care provider must document each
occurrence of a health service delivered through telehealth to a medical assistance enrollee.
Health care service records for services delivered through telehealth must meet the
requirements set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and must
document:

(1) the type of service delivered through telehealth;

(2) the time the service began and the time the service ended, including an a.m. and p.m.
designation;

(3) the health care provider's basis for determining that telehealth is an appropriate and
effective means for delivering the service to the enrollee;

(4) the mode of transmission used to deliver the service through telehealth and records
evidencing that a particular mode of transmission was utilized;

(5) the location of the originating site and the distant site;

(6) if the claim for payment is based on a physician's consultation with another physician
through telehealth, the written opinion from the consulting physician providing the telehealth
consultation; and

(7) compliance with the criteria attested to by the health care provider in accordance
with paragraph (b).

(d) Telehealth visits, as described in this subdivision provided through audio and visual
communicationdeleted text begin,deleted text endnew text begin or accessible video-based platformsnew text end may deleted text beginbe used todeleted text end satisfy the face-to-face
requirement for reimbursement under the payment methods that apply to a federally qualified
health center, rural health clinic, Indian health service, 638 tribal clinic, and certified
community behavioral health clinic, if the service would have otherwise qualified for
payment if performed in person.

deleted text begin (e) For mental health services or assessments delivered through telehealth that are based
on an individual treatment plan, the provider may document the client's verbal approval or
electronic written approval of the treatment plan or change in the treatment plan in lieu of
the client's signature in accordance with Minnesota Rules, part 9505.0371.
deleted text end

deleted text begin (f)deleted text endnew text begin (e)new text end For purposes of this subdivision, unless otherwise covered under this chapter:

(1) "telehealth" means the delivery of health care services or consultations through the
use of real-time two-way interactive audio and visual communication to provide or support
health care delivery and facilitate the assessment, diagnosis, consultation, treatment,
education, and care management of a patient's health care. Telehealth includes the application
of secure video conferencing, store-and-forward technology, and synchronous interactions
between a patient located at an originating site and a health care provider located at a distant
site. Telehealth does not include communication between health care providers, or between
a health care provider and a patient that consists solely of an audio-only communication,
e-mail, or facsimile transmission or as specified by law;

(2) "health care provider" means a health care provider as defined under section 62A.673,
a community paramedic as defined under section 144E.001, subdivision 5f, a community
health worker who meets the criteria under subdivision 49, paragraph (a), a mental health
certified peer specialist under section deleted text begin256B.0615, subdivision 5deleted text endnew text begin 245I.04, subdivision 10new text end, a
mental health certified family peer specialist under section deleted text begin256B.0616, subdivision 5deleted text endnew text begin 245I.04,
subdivision 12
new text end, a mental health rehabilitation worker under section deleted text begin256B.0623, subdivision
5, paragraph (a), clause (4), and paragraph (b)
deleted text endnew text begin 245I.04, subdivision 14new text end, a mental health
behavioral aide under section deleted text begin256B.0943, subdivision 7, paragraph (b), clause (3)deleted text endnew text begin 245I.04,
subdivision 16
new text end, a treatment coordinator under section 245G.11, subdivision 7, an alcohol
and drug counselor under section 245G.11, subdivision 5, a recovery peer under section
245G.11, subdivision 8; and

(3) "originating site," "distant site," and "store-and-forward technology" have the
meanings given in section 62A.673, subdivision 2.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 36.

Minnesota Statutes 2020, section 256B.0659, subdivision 19, is amended to read:


Subd. 19.

Personal care assistance choice option; qualifications; duties.

(a) Under
personal care assistance choice, the recipient or responsible party shall:

(1) recruit, hire, schedule, and terminate personal care assistants according to the terms
of the written agreement required under subdivision 20, paragraph (a);

(2) develop a personal care assistance care plan based on the assessed needs and
addressing the health and safety of the recipient with the assistance of a qualified professional
as needed;

(3) orient and train the personal care assistant with assistance as needed from the qualified
professional;

(4) deleted text begineffective January 1, 2010,deleted text end supervise and evaluate the personal care assistant with the
qualified professional, who is required to visit the recipient at least every 180 days;

(5) monitor and verify in writing and report to the personal care assistance choice agency
the number of hours worked by the personal care assistant and the qualified professional;

(6) engage in an annual deleted text beginface-to-facedeleted text end reassessmentnew text begin as required in subdivision 3anew text end to
determine continuing eligibility and service authorization; and

(7) use the same personal care assistance choice provider agency if shared personal
assistance care is being used.

(b) The personal care assistance choice provider agency shall:

(1) meet all personal care assistance provider agency standards;

(2) enter into a written agreement with the recipient, responsible party, and personal
care assistants;

(3) not be related as a parent, child, sibling, or spouse to the recipient or the personal
care assistant; and

(4) ensure arm's-length transactions without undue influence or coercion with the recipient
and personal care assistant.

(c) The duties of the personal care assistance choice provider agency are to:

(1) be the employer of the personal care assistant and the qualified professional for
employment law and related regulations includingdeleted text begin,deleted text end but not limited todeleted text begin,deleted text end purchasing and
maintaining workers' compensation, unemployment insurance, surety and fidelity bonds,
and liability insurance, and submit any or all necessary documentation includingdeleted text begin,deleted text end but not
limited todeleted text begin,deleted text end workers' compensation, unemployment insurance, and labor market data required
under section 256B.4912, subdivision 1a;

(2) bill the medical assistance program for personal care assistance services and qualified
professional services;

(3) request and complete background studies that comply with the requirements for
personal care assistants and qualified professionals;

(4) pay the personal care assistant and qualified professional based on actual hours of
services provided;

(5) withhold and pay all applicable federal and state taxes;

(6) verify and keep records of hours worked by the personal care assistant and qualified
professional;

(7) make the arrangements and pay taxes and other benefits, if any, and comply with
any legal requirements for a Minnesota employer;

(8) enroll in the medical assistance program as a personal care assistance choice agency;
and

(9) enter into a written agreement as specified in subdivision 20 before services are
provided.

Sec. 37.

Minnesota Statutes 2021 Supplement, section 256B.0671, subdivision 6, is
amended to read:


Subd. 6.

Dialectical behavior therapy.

(a) Subject to federal approval, medical assistance
covers intensive mental health outpatient treatment for dialectical behavior therapy for
adults. A dialectical behavior therapy provider must make reasonable and good faith efforts
to report individual client outcomes to the commissioner using instruments and protocols
that are approved by the commissioner.

(b) "Dialectical behavior therapy" means an evidence-based treatment approach that a
mental health professional or clinical trainee provides to a client or a group of clients in an
intensive outpatient treatment program using a combination of individualized rehabilitative
and psychotherapeutic interventions. A dialectical behavior therapy program involves:
individual dialectical behavior therapy, group skills training, telephone coaching, and team
consultation meetings.

(c) To be eligible for dialectical behavior therapy, a client must:

deleted text begin (1) be 18 years of age or older;
deleted text end

deleted text begin (2)deleted text endnew text begin (1)new text end have mental health needs that available community-based services cannot meet
or that the client must receive concurrently with other community-based services;

deleted text begin (3)deleted text endnew text begin (2)new text end have either:

(i) a diagnosis of borderline personality disorder; or

(ii) multiple mental health diagnoses, exhibit behaviors characterized by impulsivity or
intentional self-harm, and be at significant risk of death, morbidity, disability, or severe
dysfunction in multiple areas of the client's life;

deleted text begin (4)deleted text endnew text begin (3)new text end be cognitively capable of participating in dialectical behavior therapy as an
intensive therapy program and be able and willing to follow program policies and rules to
ensure the safety of the client and others; and

deleted text begin (5)deleted text endnew text begin (4)new text end be at significant risk of one or more of the following if the client does not receive
dialectical behavior therapy:

(i) having a mental health crisis;

(ii) requiring a more restrictive setting such as hospitalization;

(iii) decompensating; or

(iv) engaging in intentional self-harm behavior.

(d) Individual dialectical behavior therapy combines individualized rehabilitative and
psychotherapeutic interventions to treat a client's suicidal and other dysfunctional behaviors
and to reinforce a client's use of adaptive skillful behaviors. A mental health professional
or clinical trainee must provide individual dialectical behavior therapy to a client. A mental
health professional or clinical trainee providing dialectical behavior therapy to a client must:

(1) identify, prioritize, and sequence the client's behavioral targets;

(2) treat the client's behavioral targets;

(3) assist the client in applying dialectical behavior therapy skills to the client's natural
environment through telephone coaching outside of treatment sessions;

(4) measure the client's progress toward dialectical behavior therapy targets;

(5) help the client manage mental health crises and life-threatening behaviors; and

(6) help the client learn and apply effective behaviors when working with other treatment
providers.

(e) Group skills training combines individualized psychotherapeutic and psychiatric
rehabilitative interventions conducted in a group setting to reduce the client's suicidal and
other dysfunctional coping behaviors and restore function. Group skills training must teach
the client adaptive skills in the following areas: (1) mindfulness; (2) interpersonal
effectiveness; (3) emotional regulation; and (4) distress tolerance.

(f) Group skills training must be provided by two mental health professionals or by a
mental health professional co-facilitating with a clinical trainee or a mental health practitioner.
Individual skills training must be provided by a mental health professional, a clinical trainee,
or a mental health practitioner.

(g) Before a program provides dialectical behavior therapy to a client, the commissioner
must certify the program as a dialectical behavior therapy provider. To qualify for
certification as a dialectical behavior therapy provider, a provider must:

(1) allow the commissioner to inspect the provider's program;

(2) provide evidence to the commissioner that the program's policies, procedures, and
practices meet the requirements of this subdivision and chapter 245I;

(3) be enrolled as a MHCP provider; and

(4) have a manual that outlines the program's policies, procedures, and practices that
meet the requirements of this subdivision.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 38.

Minnesota Statutes 2020, section 256B.0757, subdivision 1, is amended to read:


Subdivision 1.

Provision of coverage.

(a) The commissioner shall provide medical
assistance coverage ofnew text begin behavioralnew text end health home services for eligible individuals with chronic
conditions who select a designated provider as the individual'snew text begin behavioralnew text end health home.

(b) The commissioner shall implement this section in compliance with the requirements
of the state option to providenew text begin behavioralnew text end health homes for enrollees with chronic conditions,
as provided under the Patient Protection and Affordable Care Act, Public Law 111-148,
sections 2703 and 3502. Terms used in this section have the meaning provided in that act.

(c) The commissioner shall establishnew text begin behavioralnew text end health homes to serve populations with
serious mental illness who meet the eligibility requirements described under subdivision 2.
Thenew text begin behavioralnew text end health home services provided bynew text begin behavioralnew text end health homes shall focus on
both the behavioral and the physical health of these populations.

Sec. 39.

Minnesota Statutes 2020, section 256B.0757, subdivision 2, is amended to read:


Subd. 2.

Eligible individual.

(a) The commissioner may elect to developnew text begin behavioralnew text end
health home models in accordance with United States Code, title 42, section 1396w-4.

(b) An individual is eligible fornew text begin behavioralnew text end health home services under this section if
the individual is eligible for medical assistance under this chapter and has a condition that
meets the definition of mental illness as described in section 245.462, subdivision 20,
paragraph (a), or emotional disturbance as defined in section 245.4871, subdivision 15,
clause (2). The commissioner shall establish criteria for determining continued eligibility.

Sec. 40.

Minnesota Statutes 2020, section 256B.0757, subdivision 3, is amended to read:


Subd. 3.

new text beginBehavioral new text endhealth home services.

(a)new text begin Behavioralnew text end health home services means
comprehensive and timely high-quality services that are provided by anew text begin behavioralnew text end health
home. These services include:

(1) comprehensive care management;

(2) care coordination and health promotion;

(3) comprehensive transitional care, including appropriate follow-up, from inpatient to
other settings;

(4) patient and family support, including authorized representatives;

(5) referral to community and social support services, if relevant; and

(6) use of health information technology to link services, as feasible and appropriate.

(b) The commissioner shall maximize the number and type of services included in this
subdivision to the extent permissible under federal law, including physician, outpatient,
mental health treatment, and rehabilitation services necessary for comprehensive transitional
care following hospitalization.

Sec. 41.

Minnesota Statutes 2020, section 256B.0757, subdivision 4, is amended to read:


Subd. 4.

Designated provider.

new text begin Behavioralnew text end health home services are voluntary and an
eligible individual may choose any designated provider. The commissioner shall establish
designated providers to serve asnew text begin behavioralnew text end health homes and provide the services described
in subdivision 3 to individuals eligible under subdivision 2. The commissioner shall apply
for grants as provided under section 3502 of the Patient Protection and Affordable Care Act
to establishnew text begin behavioralnew text end health homes and provide capitated payments to designated providers.
For purposes of this section, "designated provider" means a provider, clinical practice or
clinical group practice, rural clinic, community health center, community mental health
center, or any other entity that is determined by the commissioner to be qualified to be anew text begin
behavioral
new text end health home for eligible individuals. This determination must be based on
documentation evidencing that the designated provider has the systems and infrastructure
in place to providenew text begin behavioralnew text end health home services and satisfies the qualification standards
established by the commissioner in consultation with stakeholders and approved by the
Centers for Medicare and Medicaid Services.

Sec. 42.

Minnesota Statutes 2020, section 256B.0757, subdivision 8, is amended to read:


Subd. 8.

Evaluation and continued development.

(a) For continued certification under
this section,new text begin behavioralnew text end health homes must meet process, outcome, and quality standards
developed and specified by the commissioner. The commissioner shall collect data fromnew text begin
behavioral
new text end health homes as necessary to monitor compliance with certification standards.

(b) The commissioner may contract with a private entity to evaluate patient and family
experiences, health care utilization, and costs.

(c) The commissioner shall utilize findings from the implementation of behavioral health
homes to determine populations to serve under subsequent health home models for individuals
with chronic conditions.

Sec. 43.

Minnesota Statutes 2021 Supplement, section 256B.0911, subdivision 3a, is
amended to read:


Subd. 3a.

Assessment and support planning.

(a) Persons requesting assessment, services
planning, or other assistance intended to support community-based living, including persons
who need assessment deleted text beginin orderdeleted text end 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. The commissioner shall provide at least a
90-day notice to lead agencies prior to the effective date of this requirement. Assessments
must be conducted according to paragraphs (b) to (r).

(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 person-centered community support
plan that meets the individual's needs and preferences.

(d) Except as provided in paragraph (r), the assessment must be conducted by a certified
assessor 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 deleted text beginelderly waiverdeleted text end customized
livingnew text begin services under chapter 256S or section 256B.49new text end 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.new text begin The certified assessor must
consider the content of the submitted nursing assessment or report prior to finalizing the
person's assessment or reassessment.
new text end 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 256Snew text begin or
customized living services under section 256B.49
new text end, a provider who submitted information
under paragraph (d) shall receive the final written community support plan when available
and the Residential Services Workbooknew text begin or customized living toolnew text end.

(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:

(i) all available options for case management services and providers;

(ii) all available options for employment services, settings, and providers;

(iii) all available options for living arrangements;

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

(v) 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) A person may request assistance in identifying community supports without
participating in a complete assessment. Upon a request for assistance identifying community
support, the person 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:

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

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

(3) between day services and employment services; and

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

(j) The lead agency must give the person receiving long-term care consultation services
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);

(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
or the lead agency's final decisions regarding public programs eligibility 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;
and

(10) documentation that available options for employment services, independent living,
and self-directed services and supports were described to the individual.

(k) An assessment that is completed as part of an eligibility determination for multiple
programs 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 the 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 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) If a person who receives home and community-based waiver services under section
256B.0913, 256B.092, or 256B.49 or chapter 256S temporarily enters for 121 days or fewer
a hospital, institution of mental disease, nursing facility, intensive residential treatment
services program, transitional care unit, or inpatient substance use disorder treatment setting,
the person may return to the community with home and community-based waiver services
under the same waiver, without requiring an assessment or reassessment under this section,
unless the person's annual reassessment is otherwise due. Nothing in this paragraph shall
change annual long-term care consultation reassessment requirements, payment for
institutional or treatment services, medical assistance financial eligibility, or any other law.

(o) 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,
licensed adult foster care home that is either not the primary residence of the license holder
or in which the license holder is not the primary caregiver, family adult foster care residence,
customized living setting, or supervised living facility to determine if that person would
prefer to be served in a community-living setting as defined in section 256B.49, subdivision
23
, 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). The certified
assessor shall offer the person, through a person-centered planning process, the option to
receive alternative housing and service options.

(p) 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 describe to the person through a person-centered planning process the option
to receive employment services.

(q) 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 describe to the person through a person-centered planning process the option
to receive self-directed services and supports.

(r) All assessments performed according to this subdivision must be face-to-face unless
the assessment is a reassessment meeting the requirements of this paragraph. Remote
reassessments conducted by interactive video or telephone may substitute for face-to-face
reassessments. For services provided by the developmental disabilities waiver under section
256B.092, and the community access for disability inclusion, community alternative care,
and brain injury waiver programs under section 256B.49, remote reassessments may be
substituted for two consecutive reassessments if followed by a face-to-face reassessment.
For services provided by alternative care under section 256B.0913, essential community
supports under section 256B.0922, and the elderly waiver under chapter 256S, remote
reassessments may be substituted for one reassessment if followed by a face-to-face
reassessment. A remote reassessment is permitted only if the person being reassesseddeleted text begin,deleted text end or
the person's legal representativedeleted text begin, and the lead agency case manager both agree that there is
no change in the person's condition, there is no need for a change in service, and that a
remote reassessment is appropriate
deleted text endnew text begin makes an informed choice for a remote assessmentnew text end. The
person being reassessed, or the person's legal representative, has the right to refuse a remote
reassessment at any time. During a remote reassessment, if the certified assessor determines
a face-to-face reassessment is necessary in order to complete the assessment, the lead agency
shall schedule a face-to-face reassessment. All other requirements of a face-to-face
reassessment shall apply to a remote reassessment, including updates to a person's support
plan.

Sec. 44.

Minnesota Statutes 2021 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 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 must verify continued eligibility, offer alternatives as warranted, and provide
an opportunity for quality assurance of service delivery. 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) Concurrently with a reassessment, a lead agency must at its expense provide each
individual an opportunity to provide a confidential performance assessment of the person's
case manager if the person is receiving case management services from an agency under a
contract with the lead agency.
new text end

Sec. 45.

Minnesota Statutes 2021 Supplement, 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
who are eight years of age or older and under 26 years of age 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 use disorder" 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) "Standard diagnostic assessment" means the assessment described in section 245I.10,
subdivision 6
.

(d) "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.

(e) "Mental health professional" means a staff person who is qualified according to
section 245I.04, subdivision 2.

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

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

(h) "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.

deleted text begin 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.
deleted text end

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

(j) "Family peer specialist" means a staff person who is qualified under section
256B.0616.

Sec. 46.

Minnesota Statutes 2021 Supplement, 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 must use team treatment, not an individual treatment model.

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

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

(d) The level of care assessment as defined in section 245I.02, subdivision 19, and
functional assessment as defined in section 245I.02, subdivision 17, must be updated at
least every deleted text begin90 daysdeleted text endnew text begin six monthsnew text end or prior to discharge from the service, whichever comes
first.

(e) The treatment team must complete an individual treatment plan for each client,
according to section 245I.10, subdivisions 7 and 8, and the individual treatment plan must:

(1) 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. For clients under the age of
18, the treatment team must consult with parents and guardians in developing the treatment
plan;

(2) if a need for substance use disorder treatment is indicated by validated assessment:

(i) identify goals, objectives, and strategies of substance use disorder treatment;

(ii) develop a schedule for accomplishing substance use disorder treatment goals and
objectives; and

(iii) identify the individuals responsible for providing substance use disorder treatment
services and supports;new text begin and
new text end

(3) 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" servicesdeleted text begin; anddeleted text endnew text begin.
new text end

deleted text begin (4) notwithstanding section 245I.10, subdivision 8, be reviewed at least every 90 days
and revised to document treatment progress or, if progress is not documented, to document
changes in treatment.
deleted text end

(f) 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.

(g) 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.

(h) The treatment team shall provide interventions to promote positive interpersonal
relationships.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 47.

Minnesota Statutes 2021 Supplement, 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.

new text begin (b) "Advanced certification" means a person who has completed advanced certification
in an approved modality under subdivision 13, paragraph (b).
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end "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.

deleted text begin (c)deleted text endnew text begin (d)new text end "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 or interpersonal interaction; functional communication, including nonverbal
or social communication; and restrictive or 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) behavioral challenges and self-regulation;

(ii) cognition;

(iii) learning and play;

(iv) self-care; or

(v) safety.

deleted text begin (d)deleted text endnew text begin (e)new text end "Person" means a person under 21 years of age.

deleted text begin (e)deleted text endnew text begin (f)new text end "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.

deleted text begin (f)deleted text endnew text begin (g)new text end "Commissioner" means the commissioner of human services, unless otherwise
specified.

deleted text begin (g)deleted text endnew text begin (h)new text end "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.

deleted text begin (h)deleted text endnew text begin (i)new text end "Department" means the Department of Human Services, unless otherwise
specified.

deleted text begin (i)deleted text endnew text begin (j)new text end "Early intensive developmental and behavioral intervention benefit" or "EIDBI
benefit" means a variety of individualized, intensive treatment modalities approved and
published by the commissioner that are based in behavioral and developmental science
consistent with best practices on effectiveness.

deleted text begin (j)deleted text endnew text begin (k)new text end "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.

deleted text begin (k)deleted text endnew text begin (l)new text end "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.

deleted text begin (l)deleted text endnew text begin (m)new text end "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.

deleted text begin (m)deleted text endnew text begin (n)new text end "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.

deleted text begin (n)deleted text endnew text begin (o)new text end "Mental health professional" means a staff person who is qualified according to
section 245I.04, subdivision 2.

deleted text begin (o)deleted text endnew text begin (p)new text end "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.

deleted text begin (p)deleted text endnew text begin (q)new text end "Qualified EIDBI provider" means a person who is a QSP or a level I, level II,
or level III treatment provider.

Sec. 48.

Minnesota Statutes 2020, section 256B.0949, subdivision 8, is amended to read:


Subd. 8.

Refining the benefit with stakeholders.

new text beginBefore making revisions to the EIDBI
benefit or proposing statutory changes to this section,
new text endthe commissioner must deleted text beginrefine the
details of the benefit in consultation
deleted text endnew text begin consultnew text end with stakeholders and consider recommendations
from the Department of Human Services Early Intensive Developmental and Behavioral
Intervention Advisory Council, the early intensive developmental and behavioral intervention
learning collaborative, and the Departments of Health, Education, Employment and Economic
Development, and Human Services. deleted text beginThe details mustdeleted text endnew text begin Revisions and proposed statutory
changes subject to this subdivision
new text end include, but are not limited to, the following components:

(1) a definition of the qualifications, standards, and roles of the treatment team, including
recommendations after stakeholder consultation on whether board-certified behavior analysts
and other professionals certified in other treatment approaches recognized by the department
or trained in ASD or a related condition and child development should be added as
professionals qualified to provide EIDBI clinical supervision or other functions under
medical assistance;

(2) refinement of uniform parameters for CMDE and ongoing ITP progress monitoring
standards;

(3) the design of an effective and consistent process for assessing the person's and the
person's legal representative's and the person's caregiver's preferences and options to
participate in the person's early intervention treatment and efficacy of methods to involve
and educate the person's legal representative and caregiver in the treatment of the person;

(4) formulation of a collaborative process in which professionals have opportunities to
collectively inform provider standards and qualifications; standards for CMDE; medical
necessity determination; efficacy of treatment apparatus, including modality, intensity,
frequency, and duration; and ITP progress monitoring processes to support quality
improvement of EIDBI services;

(5) coordination of this benefit and its interaction with other services provided by the
Departments of Human Services, Health, Employment and Economic Development, and
Education;

(6) evaluation, on an ongoing basis, of EIDBI services outcomes and efficacy of treatment
modalities provided to people under this benefit; and

(7) as provided under subdivision 17, determination of the availability of qualified EIDBI
providers with necessary expertise and training in ASD or a related condition throughout
the state to assess whether there are sufficient professionals to provide timely access and
prevent delay in the CMDE and treatment of a person with ASD or a related condition.

Sec. 49.

Minnesota Statutes 2021 Supplement, section 256B.0949, subdivision 13, is
amended to read:


Subd. 13.

Covered services.

(a) The services described in paragraphs (b) to (l) 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, including nonverbal or social
communication, social or interpersonal interaction, restrictive or repetitive behaviors,
hyperreactivity or hyporeactivity to sensory input, behavioral challenges and self-regulation,
cognition, learning and play, self-care, and safety.

(b) EIDBI treatment must be delivered consistent with the standards of an approved
modality, as published by the commissioner. EIDBI modalities include:

(1) applied behavior analysis (ABA);

(2) developmental individual-difference relationship-based model (DIR/Floortime);

(3) early start Denver model (ESDM);

(4) PLAY project;

(5) relationship development intervention (RDI); or

(6) additional modalities not listed in clauses (1) to (5) upon approval by the
commissioner.

(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 modalitynew text begin, including an EIDBI provider with advanced
certification overseeing implementation,
new text end must document the required qualifications to meet
fidelity to the specific modelnew text begin in a manner determined by the commissionernew text end.

(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.

(e) 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.

(f) 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 current
treatment protocol to support the outcomes outlined in the ITP.

(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.

(1) Individual intervention is treatment by protocol administered by a single qualified
EIDBI provider delivered to one person.

(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 begin (3) Higher provider ratio intervention is treatment with protocol modification provided
by two or more qualified EIDBI providers delivered to one person in an environment that
meets the person's needs and under the direction of the QSP or level I provider.
new text end

(h) 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
provide oversight and ongoing evaluation of a person's treatment and progress on targeted
goals and objectives and integrate and coordinate 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 provider
or a level II provider.

(i) 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
provider, or level II provider.

(j) A coordinated care conference is a voluntary 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
deleted text begin must be provided by the QSP anddeleted text end may include the CMDE provider deleted text beginordeleted text endnew text begin, QSP,new text end a level I
providernew text begin,new text end or a level II provider.

(k) 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 in-person 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.

(l) Medical assistance covers medically necessary EIDBI services and consultations
delivered deleted text beginby a licensed health care providerdeleted text end via telehealth, as defined under section
256B.0625, subdivision 3b, in the same manner as if the service or consultation was delivered
in person.

Sec. 50.

Minnesota Statutes 2020, section 256B.49, subdivision 23, is amended to read:


Subd. 23.

Community-living settings.

(a) For the purposes of this chapter,
"community-living settings" means a single-family home or multifamily dwelling unit where
a service recipient or a service recipient's family owns or rents, and maintains control over
the individual unit as demonstrated by a lease agreement. Community-living settings does
not include a home or dwelling unit that the service provider owns, operates, or leases or
in which the service provider has a direct or indirect financial interest.

(b) To ensure a service recipient or the service recipient's family maintains control over
the home or dwelling unit, community-living settings are subject to the following
requirements:

(1) service recipients must not be required to receive services or share services;

(2) service recipients must not be required to have a disability or specific diagnosis to
live in the community-living setting;

(3) service recipients may hire service providers of their choice;

(4) service recipients may choose whether to share their household and with whom;

(5) the home or multifamily dwelling unit must include living, sleeping, bathing, and
cooking areas;

(6) service recipients must have lockable access and egress;

(7) service recipients must be free to receive visitors and leave the settings at times and
for durations of their own choosing;

(8) leases must comply with chapter 504B;

(9) landlords must not charge different rents to tenants who are receiving home and
community-based services; and

(10) access to the greater community must be easily facilitated based on the service
recipient's needs and preferences.

(c) Nothing in this section prohibits a service recipient from having another person or
entity not affiliated with the service provider cosign a lease. Nothing in this section prohibits
a service recipient, during any period in which a service provider has cosigned the service
recipient's lease, from modifying services with an existing cosigning service provider and,
subject to the approval of the landlord, maintaining a lease cosigned by the service provider.
Nothing in this section prohibits a service recipient, during any period in which a service
provider has cosigned the service recipient's lease, from terminating services with the
cosigning service provider, receiving services from a new service provider, and, subject to
the approval of the landlord, maintaining a lease cosigned by the new service provider.

(d) A lease cosigned by a service provider meets the requirements of paragraph (a) if
the service recipient and service provider develop and implement a transition plan which
must provide that, within two years of cosigning the initial lease, the service provider shall
transfer the lease to the service recipient and other cosigners, if any.

(e) In the event the landlord has not approved the transfer of the lease within two years
of the service provider cosigning the initial lease, the service provider must submit a
time-limited extension request to the commissioner of human services to continue the
cosigned lease arrangement. The extension request must include:

(1) the reason the landlord denied the transfer;

(2) the plan to overcome the denial to transfer the lease;

(3) the length of time needed to successfully transfer the lease, not to exceed an additional
two years;

new text begin (4) a description of the information provided to the person to help the person make an
informed choice about entering into a time-limited cosigned lease extension with the service
provider;
new text end

deleted text begin (4)deleted text endnew text begin new text endnew text begin(5)new text end a description of how the transition plan was followed, what occurred that led to
the landlord denying the transfer, and what changes in circumstances or condition, if any,
the service recipient experienced; and

deleted text begin (5)deleted text endnew text begin new text endnew text begin(6)new text end a revised transition plan to transfer the cosigned lease between the service provider
and the service recipient to the service recipient.

The commissioner must approve an extension within sufficient time to ensure the continued
occupancy by the service recipient.

new text begin (f) In the event the landlord has not approved the transfer of the lease within the timelines
of an approved time-limited extension request, the service provider must submit another
time-limited extension request to the commissioner of human services to continue the
cosigned lease arrangement. A time-limited extension request submitted under this paragraph
must include the same information required for an initial time-limited extension request
under paragraph (e). The commissioner must approve or deny an extension within 60 days.
new text end

new text begin (g) The commissioner may grant a service recipient no more than three additional
time-limited extensions under paragraph (f).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 51.

Minnesota Statutes 2021 Supplement, section 256B.49, subdivision 28, is amended
to read:


Subd. 28.

Customized living moratorium for brain injury and community access
for disability inclusion waivers.

(a) Notwithstanding section 245A.03, subdivision 2,
paragraph (a), clause (23), to prevent new development of customized living settings that
otherwise meet the residential program definition under section 245A.02, subdivision 14,
the commissioner shall not enroll new customized living settings serving four or fewer
people in a single-family home to deliver customized living services as defined under the
brain injury or community access for disability inclusion waiver plans under this section.

(b) The commissioner may approve an exception to paragraph (a) whennew text begin:
new text end

new text begin (1)new text end an existing customized living setting changes ownership at the same addressnew text begin; or
new text end

new text begin (2) an existing customized living setting relocates under the same ownership to a different
address, provided the setting to which the customized services are relocated complies with
the home and community-based services rule requirements. The exception under this clause
is available until March 16, 2023, unless federal approval is obtained to permanently allow
this exception
new text end.

(c) Customized living settings operational on or before June 30, 2021, are considered
existing customized living settings.

(d) For any new customized living settings serving four or fewer people in a single-family
home to deliver customized living services as defined in paragraph (a) deleted text beginanddeleted text end that was not
operational on or before June 30, 2021,new text begin or that was operational on or before June 30, 2021,
but relocated under the same ownership to a different address without receiving an exception
under paragraph (b), clause (2),
new text end the authorizing lead agency is financially responsible for
all home and community-based service payments in the setting.

(e) For purposes of this subdivision, "operational" means customized living services are
authorized and delivered to a person in the customized living setting.

new text begin EFFECTIVE DATE. new text end

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

Sec. 52.

Minnesota Statutes 2020, section 256G.02, subdivision 6, is amended to read:


Subd. 6.

Excluded time.

"Excluded time" means:

(1) any period an applicant spends in a hospital, sanitarium, nursing home, shelter other
than an emergency shelter, halfway house, foster home, community residential setting
licensed under chapter 245D, semi-independent living domicile or services program,
residential facility offering care, board and lodging facility or other institution for the
hospitalization or care of human beings, as defined in section 144.50, 144A.01, or 245A.02,
subdivision 14
; maternity home, battered women's shelter, or correctional facility; or any
facility based on an emergency hold under section 253B.05, subdivisions 1 and 2;

(2) any period an applicant spends on a placement basis in a training and habilitation
program, including: a rehabilitation facility or work or employment program as defined in
section 268A.01; semi-independent living services provided under section 252.275, and
chapter 245D; or day training and habilitation programs deleted text beginanddeleted text endnew text begin;
new text end

new text begin (3) any period an applicant is receiving new text endassisted living servicesnew text begin, integrated community
supports, or day support services
new text end; and

deleted text begin (3)deleted text endnew text begin (4)new text end any placement for a person with an indeterminate commitment, including
independent living.

Sec. 53.

Minnesota Statutes 2020, section 256K.26, subdivision 2, is amended to read:


Subd. 2.

Implementation.

The commissioner, in consultation with the commissioners
of the Department of Corrections and the Minnesota Housing Finance Agency, counties,
new text begin Tribes, new text endproviders and funders of supportive housing and services, shall develop application
requirements and make funds available according to this section, with the goal of providing
maximum flexibility in program design.

Sec. 54.

Minnesota Statutes 2020, section 256K.26, subdivision 6, is amended to read:


Subd. 6.

Outcomes.

Projects will be selected to further the following outcomes:

(1) reduce the number of Minnesota individuals and families that experience long-term
homelessness;

(2) increase the number of housing opportunities with supportive services;

(3) develop integrated, cost-effective service models that address the multiple barriers
to obtaining housing stability faced by people experiencing long-term homelessness,
including abuse, neglect, chemical dependency, disability, chronic health problems, or other
factors including ethnicity and race that may result in poor outcomes or service disparities;

(4) encourage partnerships among counties, new text beginTribes, new text endcommunity agencies, schools, and
other providers so that the service delivery system is seamless for people experiencing
long-term homelessness;

(5) increase employability, self-sufficiency, and other social outcomes for individuals
and families experiencing long-term homelessness; and

(6) reduce inappropriate use of emergency health care, shelter, deleted text beginchemical dependencydeleted text endnew text begin
substance use disorder treatment
new text end, foster care, child protection, corrections, and similar
services used by people experiencing long-term homelessness.

Sec. 55.

Minnesota Statutes 2020, section 256K.26, subdivision 7, is amended to read:


Subd. 7.

Eligible services.

Services eligible for funding under this section are all services
needed to maintain households in permanent supportive housing, as determined by the
deleted text begin county ordeleted text end countiesnew text begin or Tribesnew text end administering the project or projects.

Sec. 56.

Minnesota Statutes 2021 Supplement, section 256P.01, subdivision 6a, is amended
to read:


Subd. 6a.

Qualified professional.

(a) For illness, injury, or incapacity, a "qualified
professional" means a licensed physician, physician assistant, advanced practice registered
nurse, physical therapist, occupational therapist, or licensed chiropractor, according to their
scope of practice.

(b) For developmental disability, learning disability, and intelligence testing, a "qualified
professional" means a licensed physician, physician assistant, advanced practice registered
nurse, licensed independent clinical social worker, licensed psychologist, certified school
psychologist, or certified psychometrist working under the supervision of a licensed
psychologist.

(c) For mental health, a "qualified professional" means a licensed physician, advanced
practice registered nurse, or qualified mental health professional under section 245I.04,
subdivision 2
.

(d) For substance use disorder, a "qualified professional" means a licensed physician, a
qualified mental health professional under section deleted text begin245.462, subdivision 18, clauses (1) to
(6)
deleted text endnew text begin 245I.04, subdivision 2new text end, or an individual as defined in section 245G.11, subdivision 3,
4, or 5.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, 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. 57.

Minnesota Statutes 2020, section 256Q.06, is amended by adding a subdivision
to read:


new text begin Subd. 6. new text end

new text begin Account creation. new text end

new text begin If an eligible individual is unable to establish the eligible
individual's own ABLE account, an ABLE account may be established on behalf of the
eligible individual by the eligible individual's agent under a power of attorney or, if none,
by the eligible individual's conservator or legal guardian, spouse, parent, sibling, or
grandparent or a representative payee appointed for the eligible individual by the Social
Security Administration, in that order.
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. 58.

Laws 2020, First Special Session chapter 7, section 1, subdivision 1, as amended
by Laws 2021, First Special Session chapter 7, article 2, section 71, is amended to read:


Subdivision 1.

Waivers and modifications; federal funding extension.

When the
peacetime emergency declared by the governor in response to the COVID-19 outbreak
expires, is terminated, or is rescinded by the proper authority, the following waivers and
modifications to human services programs issued by the commissioner of human services
pursuant to Executive Orders 20-11 and 20-12 deleted text beginthat are required to comply with federal lawdeleted text end
may remain in effect for the time period set out in applicable federal law or for the time
period set out in any applicable federally approved waiver or state plan amendment,
whichever is later:

(1) CV15: allowing telephone or video visits for waiver programs;

(2) CV17: preserving health care coverage for Medical Assistance and MinnesotaCare;

(3) CV18: implementation of federal changes to the Supplemental Nutrition Assistance
Program;

(4) CV20: eliminating cost-sharing for COVID-19 diagnosis and treatment;

(5) CV24: allowing telephone or video use for targeted case management visits;

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

(7) CV37: implementation of federal changes to the Supplemental Nutrition Assistance
Program;

(8) CV39: implementation of federal changes to the Supplemental Nutrition Assistance
Program;

(9) CV42: implementation of federal changes to the Supplemental Nutrition Assistance
Program;

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

(11) CV44: allowing remote delivery of adult day services;

(12) CV59: modifying eligibility period for the federally funded Refugee Cash Assistance
Program;

(13) CV60: modifying eligibility period for the federally funded Refugee Social Services
Program; and

(14) CV109: providing 15 percent increase for Minnesota Food Assistance Program and
Minnesota Family Investment Program maximum food benefits.

Sec. 59.

Laws 2021, First Special Session chapter 7, article 11, section 38, is amended to
read:


Sec. 38. DIRECTION TO THE COMMISSIONER; SUBSTANCE USE DISORDER
TREATMENT PAPERWORK REDUCTION.

(a) The commissioner of human services, in consultation with counties, tribes, managed
care organizations, substance use disorder treatment professional associations, and other
relevant stakeholders, shall develop, assess, and recommend systems improvements to
minimize regulatory paperwork and improve systems for substance use disorder programs
licensed under Minnesota Statutes, chapter 245A, and regulated under Minnesota Statutes,
chapters 245F and 245G, and Minnesota Rules, chapters 2960 and 9530. The commissioner
of human services shall make available any resources needed from other divisions within
the department to implement systems improvements.

(b) The commissioner of health shall make available needed information and resources
from the Division of Health Policy.

(c) The Office of MN.IT Services shall provide advance consultation and implementation
of the changes needed in data systems.

(d) The commissioner of human services shall contract with a vendor that has experience
with developing statewide system changes for multiple states at the payer and provider
levels. If the commissioner, after exercising reasonable diligence, is unable to secure a
vendor with the requisite qualifications, the commissioner may select the best qualified
vendor available. When developing recommendations, the commissioner shall consider
input from all stakeholders. The commissioner's recommendations shall maximize benefits
for clients and utility for providers, regulatory agencies, and payers.

(e) The commissioner of human services and the contracted vendor shall follow the
recommendations from the report issued in response to Laws 2019, First Special Session
chapter 9, article 6, section 76.

(f) deleted text beginBy December 15, 2022deleted text endnew text begin Within two years of contracting with a qualified vendor
according to paragraph (d)
new text end, the commissioner of human services shall take steps to implement
paperwork reductions and systems improvements within the commissioner's authority and
submit to the chairs and ranking minority members of the legislative committees with
jurisdiction over health and human services a report that includes recommendations for
changes in statutes that would further enhance systems improvements to reduce paperwork.
The report shall include a summary of the approaches developed and assessed by the
commissioner of human services and stakeholders and the results of any assessments
conducted.

Sec. 60. new text beginDIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
INFORMED CHOICE UPON CLOSURE.
new text end

new text begin The commissioner of human services shall direct department staff, lead agency staff,
and lead agency partners to ensure that solutions to workforce shortages in licensed home
and community-based disability settings are consistent with the state's policy priority of
informed choice and the integration mandate under the state's Olmstead Plan. Specifically,
the commissioner shall direct department staff, lead agency staff, and lead agency partners
to ensure that when a licensed setting cannot continue providing services as a result of
staffing shortages, a person who had been receiving services in that setting is not discharged
to a more restrictive setting than the person was in previously and the person receives an
informed choice process about how and where the person will receive services following
the suspension or closure of the program or setting in which the person had previously been
receiving services.
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. 61. new text beginDIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; HOME
AND COMMUNITY-BASED SERVICES RULE STATEWIDE TRANSITION PLAN.
new text end

new text begin By September 1, 2022, the commissioner of human services shall submit for approval
an amendment to Minnesota's home and community-based services rule statewide transition
plan to modify the residential tiered standards for BI, CAC, CADI, and DD waivers to
specify that an existing customized living setting that relocates under the same ownership
to a different address must be treated as a Tier 1 customized living setting, provided the
setting to which the customized services are relocated complies with the home and
community-based services rule requirements. The commissioner shall inform the revisor
of statutes when federal approval is obtained.
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. 62. new text beginREVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall change the term "chemical dependency" or similar terms to
"substance use disorder" wherever the term appears in Minnesota Statutes. The revisor may
make grammatical changes related to the term change.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 63. new text beginREPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2020, sections 254A.04; and 254B.14, subdivisions 1, 2, 3, 4,
and 6,
new text end new text begin are repealed.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2021 Supplement, section 254B.14, subdivision 5, new text end new text begin is repealed.
new text end

ARTICLE 9

CONTINUING CARE FOR OLDER ADULTS POLICY

Section 1.

Minnesota Statutes 2020, section 245A.14, subdivision 14, is amended to read:


Subd. 14.

Attendance records for publicly funded services.

(a) A child care center
licensed under this chapter and according to Minnesota Rules, chapter 9503, must maintain
documentation of actual attendance for each child receiving care for which the license holder
is reimbursed by a governmental program. The records must be accessible to the
commissioner during the program's hours of operation, they must be completed on the actual
day of attendance, and they must include:

(1) the first and last name of the child;

(2) the time of day that the child was dropped off; and

(3) the time of day that the child was picked up.

(b) A family child care provider licensed under this chapter and according to Minnesota
Rules, chapter 9502, must maintain documentation of actual attendance for each child
receiving care for which the license holder is reimbursed for the care of that child by a
governmental program. The records must be accessible to the commissioner during the
program's hours of operation, they must be completed on the actual day of attendance, and
they must include:

(1) the first and last name of the child;

(2) the time of day that the child was dropped off; and

(3) the time of day that the child was picked up.

(c) An adult day services program licensed under this chapter and according to Minnesota
Rules, parts 9555.5105 to 9555.6265, must maintain documentation of actual attendance
for each adult day service recipient for which the license holder is reimbursed by a
governmental program. The records must be accessible to the commissioner during the
program's hours of operation, they must be completed on the actual day of attendance, and
they must include:

(1) the first, middle, and last name of the recipient;

(2) the time of day that the recipient was dropped off; and

(3) the time of day that the recipient was picked up.

(d) deleted text beginThe commissioner shall not issue a correction for attendance record errors that occur
before August 1, 2013.
deleted text endnew text begin Adult day services programs licensed under this chapter that are
designated for remote adult day services must maintain documentation of actual participation
for each adult day service recipient for whom the license holder is reimbursed by a
governmental program. The records must be accessible to the commissioner during the
program's hours of operation, must be completed on the actual day service is provided, and
must include the:
new text end

new text begin (1) first, middle, and last name of the recipient;
new text end

new text begin (2) time of day the remote services started;
new text end

new text begin (3) time of day that the remote services ended; and
new text end

new text begin (4) means by which the remote services were provided, through audio remote services
or through audio and video remote services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 2.

new text begin [245A.70] REMOTE ADULT DAY SERVICES.
new text end

new text begin (a) For the purposes of sections 245A.70 to 245A.75, the following terms have the
meanings given.
new text end

new text begin (b) "Adult day care" and "adult day services" have the meanings given in section 245A.02,
subdivision 2a.
new text end

new text begin (c) "Remote adult day services" means an individualized and coordinated set of services
provided via live two-way communication by an adult day care or adult day services center.
new text end

new text begin (d) "Live two-way communication" means real-time audio or audio and video
transmission of information between a participant and an actively involved staff member.
new text end

Sec. 3.

new text begin [245A.71] APPLICABILITY AND SCOPE.
new text end

new text begin Subdivision 1. new text end

new text begin Licensing requirements. new text end

new text begin Adult day care centers or adult day services
centers that provide remote adult day services must be licensed under this chapter and
comply with the requirements set forth in this section.
new text end

new text begin Subd. 2. new text end

new text begin Standards for licensure. new text end

new text begin License holders seeking to provide remote adult day
services must submit a request in the manner prescribed by the commissioner. Remote adult
day services must not be delivered until approved by the commissioner. The designation to
provide remote services is voluntary for license holders. Upon approval, the designation of
approval for remote adult day services shall be printed on the center's license, and identified
on the commissioner's public website.
new text end

new text begin Subd. 3. new text end

new text begin Federal requirements. new text end

new text begin Adult day care centers or adult day services centers
that provide remote adult day services to participants receiving alternative care under section
256B.0913, essential community supports under section 256B.0922, or home and
community-based services waivers under chapter 256S or section 256B.092 or 256B.49,
must comply with federally approved waiver plans.
new text end

new text begin Subd. 4. new text end

new text begin Service limitations. new text end

new text begin Remote adult day services must be provided during the
days and hours of in-person services specified on the license of the adult day care center.
new text end

Sec. 4.

new text begin [245A.72] RECORD REQUIREMENTS.
new text end

new text begin Adult day centers and adult day services centers providing remote adult day services
must comply with participant record requirements set forth in Minnesota Rules, part
9555.9660. The center must document how remote services will help a participant reach
the short- and long-term objectives in the participant's plan of care.
new text end

Sec. 5.

new text begin [245A.73] REMOTE ADULT DAY SERVICES STAFF.
new text end

new text begin Subdivision 1. new text end

new text begin Staff ratios. new text end

new text begin (a) A staff person who provides remote adult day services
without two-way interactive video must only provide services to one participant at a time.
new text end

new text begin (b) A staff person who provides remote adult day services through two-way interactive
video must not provide services to more than eight participants at one time.
new text end

new text begin Subd. 2. new text end

new text begin Staff training. new text end

new text begin A center licensed under section 245A.71 must document training
provided to each staff person regarding the provision of remote services in the staff person's
record. The training must be provided prior to a staff person delivering remote adult day
services without supervision. The training must include:
new text end

new text begin (1) how to use the equipment, technology, and devices required to provide remote adult
day services via live two-way communication;
new text end

new text begin (2) orientation and training on each participant's plan of care as directly related to remote
adult day services; and
new text end

new text begin (3) direct observation by a manager or supervisor of the staff person while providing
supervised remote service delivery sufficient to assess staff competency.
new text end

Sec. 6.

new text begin [245A.74] INDIVIDUAL SERVICE PLANNING.
new text end

new text begin Subdivision 1. new text end

new text begin Eligibility. new text end

new text begin (a) A person must be eligible for and receiving in-person
adult day services to receive remote adult day services from the same provider. The same
provider must deliver both in-person adult day services and remote adult day services to a
participant.
new text end

new text begin (b) The license holder must update the participant's plan of care according to Minnesota
Rules, part 9555.9700.
new text end

new text begin (c) For a participant who chooses to receive remote adult day services, the license holder
must document in the participant's plan of care the participant's proposed schedule and
frequency for receiving both in-person and remote services. The license holder must also
document in the participant's plan of care that remote services:
new text end

new text begin (1) are chosen as a service delivery method by the participant or legal representative;
new text end

new text begin (2) will meet the participant's assessed needs;
new text end

new text begin (3) are provided within the scope of adult day services; and
new text end

new text begin (4) will help the participant achieve identified short- and long-term objectives specific
to the provision of remote adult day services.
new text end

new text begin Subd. 2. new text end

new text begin Participant daily service limitations. new text end

new text begin In a 24-hour period, a participant may
receive:
new text end

new text begin (1) a combination of in-person adult day services and remote adult day services on the
same day but not at the same time;
new text end

new text begin (2) a combination of in-person and remote adult day services that does not exceed 12
hours in total; and
new text end

new text begin (3) up to six hours of remote adult day services.
new text end

new text begin Subd. 3. new text end

new text begin Minimum in-person requirement. new text end

new text begin A participant who receives remote services
must receive services in person as assigned in the participant's plan of care at least quarterly.
new text end

Sec. 7.

new text begin [245A.75] SERVICE AND PROGRAM REQUIREMENTS.
new text end

new text begin Remote adult day services must be in the scope of adult day services provided in
Minnesota Rules, part 9555.9710, subparts 3 to 7.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

ARTICLE 10

CHILDREN AND FAMILY SERVICES POLICY

Section 1.

Minnesota Statutes 2020, section 242.19, subdivision 2, is amended to read:


Subd. 2.

Dispositions.

When a child has been committed to the commissioner of
corrections by a juvenile court, upon a finding of delinquency, the commissioner may for
the purposes of treatment and rehabilitation:

(1) order the child's confinement to the Minnesota Correctional Facility-Red Wing,
which shall accept the child, or to a group foster home under the control of the commissioner
of corrections, or to private facilities or facilities established by law or incorporated under
the laws of this state that may care for delinquent children;

(2) order the child's release on parole under such supervisions and conditions as the
commissioner believes conducive to law-abiding conduct, treatment and rehabilitation;

(3) order reconfinement or renewed parole as often as the commissioner believes to be
desirable;

(4) revoke or modify any order, except an order of discharge, as often as the commissioner
believes to be desirable;

(5) discharge the child when the commissioner is satisfied that the child has been
rehabilitated and that such discharge is consistent with the protection of the public;

(6) if the commissioner finds that the child is eligible for probation or parole and it
appears from the commissioner's investigation that conditions in the child's or the guardian's
home are not conducive to the child's treatment, rehabilitation, or law-abiding conduct, refer
the child, together with the commissioner's findings, to a local social services agency or a
licensed child-placing agency for placement in a foster care or, when appropriate, for
initiation of child in need of protection or services proceedings as provided in sections
260C.001 to 260C.421. The commissioner of corrections shall reimburse local social services
agencies for foster care costs they incur for the child while on probation or parole to the
extent that funds for this purpose are made available to the commissioner by the legislature.
The juvenile court deleted text beginshalldeleted text end new text beginmaynew text end order the parents of a child on probation or parole to pay the
costs of foster care under section 260B.331, subdivision 1,new text begin if the local social services agency
has determined that requiring reimbursement is in the child's best interests,
new text end according to
their ability to pay, and to the extent that the commissioner of corrections has not reimbursed
the local social services agency.

Sec. 2.

Minnesota Statutes 2020, section 256E.33, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

(a) The definitions in this subdivision apply to this section.

(b) "Transitional housing" means housing designed for independent living and provided
to a homeless person or family at a rental rate of at least 25 percent of the family income
for a period of up to deleted text begin24deleted text endnew text begin 36new text end months. If a transitional housing program is associated with a
licensed facility or shelter, it must be located in a separate facility or a specified section of
the main facility where residents can be responsible for their own meals and other daily
needs.

(c) "Support services" means an assessment service that identifies the needs of individuals
for independent living and arranges or provides for the appropriate educational, social, legal,
advocacy, child care, employment, financial, health care, or information and referral services
to meet these needs.

Sec. 3.

Minnesota Statutes 2020, section 256E.33, subdivision 2, is amended to read:


Subd. 2.

Establishment and administration.

A transitional housing program is
established to be administered by the commissioner. The commissioner may make grants
to eligible recipients or enter into agreements with community action agencies or other
public or private nonprofit agencies to make grants to eligible recipients to initiate, maintain,
or expand programs to provide transitional housing and support services for persons in need
of transitional housing, which may include up to six months of follow-up support services
for persons who complete transitional housing as they stabilize in permanent housing. The
commissioner must ensure that money appropriated to implement this section is distributed
as soon as practicable. The commissioner may make grants directly to eligible recipients.
The commissioner may new text beginextend new text enduse deleted text beginup to ten percent of the appropriation available fordeleted text endnew text begin ofnew text end
this program for persons needing assistance longer than deleted text begin24deleted text endnew text begin 36new text end months.

Sec. 4.

Minnesota Statutes 2020, section 256E.35, subdivision 1, is amended to read:


Subdivision 1.

Establishment.

The Minnesota family assets for independence initiative
is established to provide incentives for low-income families to accrue assets for education,
housing, vehiclesnew text begin, emergenciesnew text end, and economic development purposes.

Sec. 5.

Minnesota Statutes 2020, section 256E.35, subdivision 2, is amended to read:


Subd. 2.

Definitions.

(a) The definitions in this subdivision apply to this section.

(b) "Eligible educational institution" means the following:

(1) an institution of higher education described in section 101 or 102 of the Higher
Education Act of 1965; or

(2) an area vocational education school, as defined in subparagraph (C) or (D) of United
States Code, title 20, chapter 44, section 2302 (3) (the Carl D. Perkins Vocational and
Applied Technology Education Act), which is located within any state, as defined in United
States Code, title 20, chapter 44, section 2302 (30). This clause is applicable only to the
extent section 2302 is in effect on August 1, 2008.

(c) "Family asset account" means a savings account opened by a household participating
in the Minnesota family assets for independence initiative.

(d) "Fiduciary organization" means:

(1) a community action agency that has obtained recognition under section 256E.31;

(2) a federal community development credit union deleted text beginserving the seven-county metropolitan
area
deleted text end; deleted text beginor
deleted text end

(3) a women-oriented economic development agency deleted text beginserving the seven-county
metropolitan area
deleted text endnew text begin;
new text end

new text begin (4) a federally recognized Tribal nation; or
new text end

new text begin (5) a nonprofit organization, as defined under section 501(c)(3) of the Internal Revenue
Code
new text end.

(e) "Financial coach" means a person who:

(1) has completed an intensive financial literacy training workshop that includes
curriculum on budgeting to increase savings, debt reduction and asset building, building a
good credit rating, and consumer protection;

(2) participates in ongoing statewide family assets for independence in Minnesota (FAIM)
network training meetings under FAIM program supervision; and

(3) provides financial coaching to program participants under subdivision 4a.

(f) "Financial institution" means a bank, bank and trust, savings bank, savings association,
or credit union, the deposits of which are insured by the Federal Deposit Insurance
Corporation or the National Credit Union Administration.

(g) "Household" means all individuals who share use of a dwelling unit as primary
quarters for living and eating separate from other individuals.

(h) "Permissible use" means:

(1) postsecondary educational expenses at an eligible educational institution as defined
in paragraph (b), including books, supplies, and equipment required for courses of instruction;

(2) acquisition costs of acquiring, constructing, or reconstructing a residence, including
any usual or reasonable settlement, financing, or other closing costs;

(3) business capitalization expenses for expenditures on capital, plant, equipment, working
capital, and inventory expenses of a legitimate business pursuant to a business plan approved
by the fiduciary organization;

(4) acquisition costs of a principal residence within the meaning of section 1034 of the
Internal Revenue Code of 1986 which do not exceed 100 percent of the average area purchase
price applicable to the residence determined according to section 143(e)(2) and (3) of the
Internal Revenue Code of 1986; deleted text beginand
deleted text end

(5) acquisition costs of a personal vehicle only if approved by the fiduciary organizationnew text begin;
new text end

new text begin (6) contributions to an emergency savings account; and
new text end

new text begin (7) contributions to a Minnesota 529 savings plannew text end.

Sec. 6.

Minnesota Statutes 2020, section 256E.35, subdivision 4a, is amended to read:


Subd. 4a.

Financial coaching.

A financial coach shall provide the following to program
participants:

(1) financial education relating to budgeting, debt reduction, asset-specific trainingnew text begin,
credit building
new text end, and financial stability activities;

(2) asset-specific training related to buying a home or vehicle, acquiring postsecondary
education, deleted text beginordeleted text end starting or expanding a small businessnew text begin, saving for emergencies, or saving for
a child's education
new text end; and

(3) financial stability education and training to improve and sustain financial security.

Sec. 7.

Minnesota Statutes 2020, section 256E.35, subdivision 6, is amended to read:


Subd. 6.

Withdrawal; matching; permissible uses.

(a) To receive a match, a
participating household must transfer funds withdrawn from a family asset account to its
matching fund custodial account held by the fiscal agent, according to the family asset
agreement. The fiscal agent must determine if the match request is for a permissible use
consistent with the household's family asset agreement.

(b) The fiscal agent must ensure the household's custodial account contains the applicable
matching funds to match the balance in the household's account, including interest, on at
least a quarterly basis and at the time of an approved withdrawal. Matches must be a
contribution of $3 from state grant or TANF funds for every $1 of funds withdrawn from
the family asset account not to exceed a $6,000 lifetime limit.

(c) Notwithstanding paragraph (b), if funds are appropriated for the Federal Assets for
Independence Act of 1998, and a participating fiduciary organization is awarded a grant
under that act, participating households with that fiduciary organization must be provided
matches as follows:

(1) from state grant and TANF funds, a matching contribution of $1.50 for every $1 of
funds withdrawn from the family asset account not to exceed a deleted text begin$3,000deleted text endnew text begin $4,500new text end lifetime limit;
and

(2) from nonstate funds, a matching contribution of not less than $1.50 for every $1 of
funds withdrawn from the family asset account not to exceed a deleted text begin$3,000deleted text endnew text begin $4,500new text end lifetime limit.

(d) Upon receipt of transferred custodial account funds, the fiscal agent must make a
direct payment to the vendor of the goods or services for the permissible use.

Sec. 8.

Minnesota Statutes 2020, section 256E.35, subdivision 7, is amended to read:


Subd. 7.

Program reporting.

The fiscal agent on behalf of each fiduciary organization
participating in a family assets for independence initiative must report quarterly to the
commissioner of human services identifying the participants with accounts, the number of
accounts, the amount of savings and matches for each participant's account, the uses of the
account, and the number of businesses, homes, vehicles, and educational services paid for
with money from the account, new text beginand the amount of contributions to Minnesota 529 savings
plans and emergency savings accounts,
new text endas well as other information that may be required
for the commissioner to administer the program and meet federal TANF reporting
requirements.

Sec. 9.

Minnesota Statutes 2020, section 256K.45, subdivision 6, is amended to read:


Subd. 6.

Funding.

Funds appropriated for this section may be expended on programs
described under subdivisions 3 to 5new text begin and 8new text end, technical assistance, and capacity building to
meet the greatest need on a statewide basis. The commissioner will provide outreach,
technical assistance, and program development support to increase capacity to new and
existing service providers to better meet needs statewide, particularly in areas where services
for homeless youth have not been established, especially in greater Minnesota.

Sec. 10.

Minnesota Statutes 2020, section 256K.45, is amended by adding a subdivision
to read:


new text begin Subd. 7. new text end

new text begin Awarding of grants. new text end

new text begin (a) Grants awarded under this section shall not be used
for any activity other than the authorized activities under this section, and the commissioner
shall not create additional eligibility criteria or restrictions on the grant money.
new text end

new text begin (b) Grants shall be awarded under this section only after a review of the grant recipient's
application materials, including past performance and utilization of grant money. The
commissioner shall not reduce an existing grant award amount unless the commissioner
first determines that the grant recipient has failed to meet performance measures or has used
grant money improperly.
new text end

new text begin (c) For grants awarded pursuant to a two-year grant contract, the commissioner shall
permit grant recipients to carry over any unexpended amount from the first contract year
to the second contract year.
new text end

Sec. 11.

Minnesota Statutes 2020, section 256K.45, is amended by adding a subdivision
to read:


new text begin Subd. 8. new text end

new text begin Provider repair or improvement grants. new text end

new text begin (a) Providers that serve homeless
youth under this section may apply for a grant of up to $100,000 under this subdivision to
make minor or mechanical repairs or improvements to a facility providing services to
homeless youth or youth at risk of homelessness.
new text end

new text begin (b) Grant applications under this subdivision must include a description of the repairs
or improvements and the estimated cost of the repairs or improvements.
new text end

new text begin (c) Grantees under this subdivision cannot receive grant funds under this subdivision
for two consecutive years.
new text end

Sec. 12.

Minnesota Statutes 2020, section 256N.26, subdivision 12, is amended to read:


Subd. 12.

Treatment of Supplemental Security Income.

If a child placed in foster
care receives benefits through Supplemental Security Income (SSI) at the time of foster
care placement or subsequent to placement in foster care, the financially responsible agency
may apply to be the payee for the child for the duration of the child's placement in foster
care. new text beginThe child must be provided notice if the financially responsible agency applies to be
the payee for the child.
new text endIf a child continues to be eligible for SSI after finalization of the
adoption or transfer of permanent legal and physical custody and is determined to be eligible
for a payment under Northstar Care for Children, a permanent caregiver may choose to
receive payment from both programs simultaneously. new text beginThe child must be provided notice if
a permanent caregiver applies to receive payment for the child and when the permanent
caregiver is confirmed to receive the child's SSI.
new text endThe permanent caregiver is responsible to
report the amount of the payment to the Social Security Administration and the SSI payment
will be reduced as required by the Social Security Administration.

Sec. 13.

Minnesota Statutes 2021 Supplement, section 256P.02, subdivision 1a, is amended
to read:


Subd. 1a.

Exemption.

Participants who qualify for child care assistance programs under
chapter 119B are exempt from this section, except that the personal property identified in
subdivision 2 is counted toward the asset limit of the child care assistance program under
chapter 119B.new text begin Vehicles under subdivision 3 and accounts under subdivision 4 are not counted
toward the asset limit of the child care assistance program under chapter 119B.
new text end

Sec. 14.

Minnesota Statutes 2021 Supplement, section 256P.02, subdivision 2, is amended
to read:


Subd. 2.

Personal property limitations.

The equity value of an assistance unit's personal
property listed in clauses (1) to (5) must not exceed $10,000 for applicants and participants.
For purposes of this subdivision, personal property is limited to:

(1) cash;

(2) bank accountsnew text begin not excluded under subdivision 4new text end;

(3) liquid stocks and bonds that can be readily accessed without a financial penalty;

(4) vehicles not excluded under subdivision 3; and

(5) the full value of business accounts used to pay expenses not related to the business.

Sec. 15.

Minnesota Statutes 2020, section 256P.02, is amended by adding a subdivision
to read:


new text begin Subd. 4. new text end

new text begin Account exception. new text end

new text begin Family asset accounts under section 256E.35 and individual
development accounts authorized under the Assets for Independence Act, Title IV of the
Community Opportunities, Accountability, and Training and Educational Services Human
Services Reauthorization Act of 1998, Public Law 105-285, shall be excluded when
determining the equity value of personal property.
new text end

Sec. 16.

Minnesota Statutes 2020, section 256P.04, subdivision 11, is amended to read:


Subd. 11.

Participant's completion of household report form.

(a) When a participant
is required to complete a household report form, the following paragraphs apply.

(b) If the agency receives an incomplete household report form, the agency must
immediately deleted text beginreturn the incomplete form and clearly state what the participant must do for
the form to be complete
deleted text endnew text begin contact the participant by phone or in writing to acquire the necessary
information to complete the form
new text end.

(c) The automated eligibility system must send a notice of proposed termination of
assistance to the participant if a complete household report form is not received by the
agency. The automated notice must be mailed to the participant by approximately the 16th
of the month. When a participant submits an incomplete form on or after the date a notice
of proposed termination has been sent, the termination is valid unless the participant submits
a complete form before the end of the month.

(d) The submission of a household report form is considered to have continued the
participant's application for assistance if a complete household report form is received within
a calendar month after the month in which the form was due. Assistance shall be paid for
the period beginning with the first day of that calendar month.

(e) An agency must allow good cause exemptions for a participant required to complete
a household report form when any of the following factors cause a participant to fail to
submit a completed household report form before the end of the month in which the form
is due:

(1) an employer delays completion of employment verification;

(2) the agency does not help a participant complete the household report form when the
participant asks for help;

(3) a participant does not receive a household report form due to a mistake on the part
of the department or the agency or a reported change in address;

(4) a participant is ill or physically or mentally incapacitated; or

(5) some other circumstance occurs that a participant could not avoid with reasonable
care which prevents the participant from providing a completed household report form
before the end of the month in which the form is due.

Sec. 17.

Minnesota Statutes 2021 Supplement, section 256P.06, subdivision 3, is amended
to read:


Subd. 3.

Income inclusions.

The following must be included in determining the income
of an assistance unit:

(1) earned income; and

(2) unearned income, which includes:

(i) interest and dividends from investments and savings;

(ii) capital gains as defined by the Internal Revenue Service from any sale of real property;

(iii) proceeds from rent and contract for deed payments in excess of the principal and
interest portion owed on property;

(iv) income from trusts, excluding special needs and supplemental needs trusts;

(v) interest income from loans made by the participant or household;

(vi) cash prizes and winnings;

(vii) unemployment insurance income that is received by an adult member of the
assistance unit unless the individual receiving unemployment insurance income is:

(A) 18 years of age and enrolled in a secondary school; or

(B) 18 or 19 years of age, a caregiver, and is enrolled in school at least half-time;

(viii) retirement, survivors, and disability insurance payments;

(ix) nonrecurring income over $60 per quarter unless the nonrecurring income is: (A)
from tax refunds, tax rebates, or tax credits; (B) a reimbursement, rebate, award, grant, or
refund of personal or real property or costs or losses incurred when these payments are
made by: a public agency; a court; solicitations through public appeal; a federal, state, or
local unit of government; or a disaster assistance organization; (C) provided as an in-kind
benefit; or (D) earmarked and used for the purpose for which it was intended, subject to
verification requirements under section 256P.04;

(x) retirement benefits;

(xi) cash assistance benefits, as defined by each program in chapters 119B, 256D, 256I,
and 256J;

(xii) Tribal per capita payments unless excluded by federal and state law;

deleted text begin (xiii) income and payments from service and rehabilitation programs that meet or exceed
the state's minimum wage rate;
deleted text end

deleted text begin (xiv)deleted text endnew text begin (xiii)new text end income from members of the United States armed forces unless excluded
from income taxes according to federal or state law;

deleted text begin (xv)deleted text endnew text begin (xiv)new text end all child support payments for programs under chapters 119B, 256D, and 256I;

deleted text begin (xvi)deleted text endnew text begin (xv)new text end the amount of child support received that exceeds $100 for assistance units
with one child and $200 for assistance units with two or more children for programs under
chapter 256J;

deleted text begin (xvii)deleted text endnew text begin (xvi)new text end spousal support; and

deleted text begin (xviii)deleted text endnew text begin (xvii)new text end workers' compensation.

Sec. 18.

Minnesota Statutes 2020, section 260.012, is amended to read:


260.012 DUTY TO ENSURE PLACEMENT PREVENTION AND FAMILY
REUNIFICATION; REASONABLE EFFORTS.

(a) Once a child alleged to be in need of protection or services is under the court's
jurisdiction, the court shall ensure that reasonable efforts, including culturally appropriate
servicesnew text begin and practicesnew text end, by the social services agency are made to prevent placement or to
eliminate the need for removal and to reunite the child with the child's family at the earliest
possible time, and the court must ensure that the responsible social services agency makes
reasonable efforts to finalize an alternative permanent plan for the child as provided in
paragraph (e). In determining reasonable efforts to be made with respect to a child and in
making those reasonable efforts, the child's best interests, health, and safety must be of
paramount concern. Reasonable efforts to prevent placement and for rehabilitation and
reunification are always required except upon a determination by the court that a petition
has been filed stating a prima facie case that:

(1) the parent has subjected a child to egregious harm as defined in section 260C.007,
subdivision 14
;

(2) the parental rights of the parent to another child have been terminated involuntarily;

(3) the child is an abandoned infant under section 260C.301, subdivision 2, paragraph
(a), clause (2);

(4) the parent's custodial rights to another child have been involuntarily transferred to a
relative under Minnesota Statutes 2010, section 260C.201, subdivision 11, paragraph (d),
clause (1), section 260C.515, subdivision 4, or a similar law of another jurisdiction;

(5) the parent has committed sexual abuse as defined in section 260E.03, against the
child or another child of the parent;

(6) the parent has committed an offense that requires registration as a predatory offender
under section 243.166, subdivision 1b, paragraph (a) or (b); or

(7) the provision of services or further services for the purpose of reunification is futile
and therefore unreasonable under the circumstances.

(b) When the court makes one of the prima facie determinations under paragraph (a),
either permanency pleadings under section 260C.505, or a termination of parental rights
petition under sections 260C.141 and 260C.301 must be filed. A permanency hearing under
sections 260C.503 to 260C.521 must be held within 30 days of this determination.

(c) In the case of an Indian child, in proceedings under sections 260B.178, 260C.178,
260C.201, 260C.202, 260C.204, 260C.301, or 260C.503 to 260C.521, the juvenile court
must make findings and conclusions consistent with the Indian Child Welfare Act of 1978,
United States Code, title 25, section 1901 et seq., as to the provision of active efforts. In
cases governed by the Indian Child Welfare Act of 1978, United States Code, title 25, section
1901, the responsible social services agency must provide active efforts as required under
United States Code, title 25, section 1911(d).

(d) "Reasonable efforts to prevent placement" means:

(1) the agency has made reasonable efforts to prevent the placement of the child in foster
care by working with the family to develop and implement a safety plannew text begin that is individualized
to the needs of the child and the child's family and may include support persons from the
child's extended family, kin network, and community
new text end; or

(2) new text beginthe agency has demonstrated to the court that, new text endgiven the particular circumstances of
the child and family at the time of the child's removal, there are no services or efforts
available deleted text beginwhichdeleted text endnew text begin thatnew text end could allow the child to safely remain in the home.

(e) "Reasonable efforts to finalize a permanent plan for the child" means due diligence
by the responsible social services agency to:

(1) reunify the child with the parent or guardian from whom the child was removed;

(2) assess a noncustodial parent's ability to provide day-to-day care for the child and,
where appropriate, provide services necessary to enable the noncustodial parent to safely
provide the care, as required by section 260C.219;

(3) conduct a relative search to identify and provide notice to adult relativesnew text begin, and engage
relatives in case planning and permanency planning,
new text end as required under section 260C.221;

new text begin (4) consider placing the child with relatives in the order specified in section 260C.212,
subdivision 2, paragraph (a);
new text end

deleted text begin (4)deleted text endnew text begin (5)new text end place siblings removed from their home in the same home for foster care or
adoption, or transfer permanent legal and physical custody to a relative. Visitation between
siblings who are not in the same foster care, adoption, or custodial placement or facility
shall be consistent with section 260C.212, subdivision 2; and

deleted text begin (5)deleted text endnew text begin (6)new text end when the child cannot return to the parent or guardian from whom the child was
removed, to plan for and finalize a safe and legally permanent alternative home for the child,
and considers permanent alternative homes for the child inside or outside of the state,
preferably new text beginwith a relative in the order specified in section 260C.212, subdivision 2, paragraph
(a),
new text endthrough adoption or transfer of permanent legal and physical custody of the child.

(f) Reasonable efforts are made upon the exercise of due diligence by the responsible
social services agency to use culturally appropriate and available services to meet the
new text begin individualized new text endneeds of the child and the child's family. Services may include those provided
by the responsible social services agency and other culturally appropriate services available
in the community. new text beginThe responsible social services agency must select services for a child
and the child's family by collaborating with the child's family and, if appropriate, the child.
new text end At each stage of the proceedings deleted text beginwheredeleted text endnew text begin whennew text end the court is required to review the
appropriateness of the responsible social services agency's reasonable efforts as described
in paragraphs (a), (d), and (e), the social services agency has the burden of demonstrating
that:

(1) deleted text beginitdeleted text end new text beginthe agency new text endhas made reasonable efforts to prevent placement of the child in foster
carenew text begin, including that the agency considered or established a safety plan according to paragraph
(d), clause (1)
new text end;

(2) deleted text beginitdeleted text endnew text begin the agencynew text end has made reasonable efforts to eliminate the need for removal of the
child from the child's home and to reunify the child with the child's family at the earliest
possible time;

new text begin (3) the agency has made reasonable efforts to finalize a permanent plan for the child
pursuant to paragraph (e);
new text end

deleted text begin (3) itdeleted text end new text begin(4) the agency new text endhas made reasonable efforts to finalize an alternative permanent
home for the child, and deleted text beginconsidersdeleted text endnew text begin considerednew text end permanent alternative homes for the child
deleted text begin inside or outsidedeleted text endnew text begin in or outnew text end of the statenew text begin, preferably with a relative in the order specified in
section 260C.212, subdivision 2, paragraph (a)
new text end; or

deleted text begin (4)deleted text endnew text begin (5)new text end reasonable efforts to prevent placement and to reunify the child with the parent
or guardian are not required. The agency may meet this burden by stating facts in a sworn
petition filed under section 260C.141, by filing an affidavit summarizing the agency's
reasonable efforts or factsnew text begin thatnew text end the agency believes demonstrate new text beginthat new text endthere is no need for
reasonable efforts to reunify the parent and child, or through testimony or a certified report
required under juvenile court rules.

(g) Once the court determines that reasonable efforts for reunification are not required
because the court has made one of the prima facie determinations under paragraph (a), the
court may only require new text beginthe agency to make new text endreasonable efforts for reunification after a hearing
according to section 260C.163, deleted text beginwheredeleted text endnew text begin ifnew text end the court findsnew text begin thatnew text end there is not clear and convincing
evidence of the facts upon which the court based deleted text beginitsdeleted text endnew text begin the court'snew text end prima facie determination.
deleted text begin In this case whendeleted text endnew text begin Ifnew text end there is clear and convincing evidence that the child is in need of
protection or services, the court may find the child in need of protection or services and
order any of the dispositions available under section 260C.201, subdivision 1. Reunification
of a child with a parent is not required if the parent has been convicted of:

(1) a violation of, or an attempt or conspiracy to commit a violation of, sections 609.185
to 609.20; 609.222, subdivision 2; or 609.223 in regard to another child of the parent;

(2) a violation of section 609.222, subdivision 2; or 609.223, in regard to the child;

(3) a violation of, or an attempt or conspiracy to commit a violation of, United States
Code, title 18, section 1111(a) or 1112(a), in regard to another child of the parent;

(4) committing sexual abuse as defined in section 260E.03, against the child or another
child of the parent; or

(5) an offense that requires registration as a predatory offender under section 243.166,
subdivision 1b
, paragraph (a) or (b).

(h) The juvenile court, in proceedings under sections 260B.178, 260C.178, 260C.201,
260C.202, 260C.204, 260C.301, or 260C.503 to 260C.521, shall make findings and
conclusions as to the provision of reasonable efforts. When determining whether reasonable
efforts have been madenew text begin by the agencynew text end, the court shall consider whether services to the child
and family were:

new text begin (1) selected in collaboration with the child's family and, if appropriate, the child;
new text end

new text begin (2) tailored to the individualized needs of the child and child's family;
new text end

deleted text begin (1)deleted text endnew text begin (3)new text end relevant to the safety deleted text beginanddeleted text endnew text begin,new text end protectionnew text begin, and well-beingnew text end of the child;

deleted text begin (2)deleted text endnew text begin (4)new text end adequate to meet the new text beginindividualized new text endneeds of the child and family;

deleted text begin (3)deleted text endnew text begin (5)new text end culturally appropriate;

deleted text begin (4)deleted text endnew text begin (6)new text end available and accessible;

deleted text begin (5)deleted text endnew text begin (7)new text end consistent and timely; and

deleted text begin (6)deleted text endnew text begin (8)new text end realistic under the circumstances.

In the alternative, the court may determine that new text beginthe new text endprovision of services or further services
for the purpose of rehabilitation is futile and therefore unreasonable under the circumstances
or that reasonable efforts are not required as provided in paragraph (a).

(i) This section does not prevent out-of-home placement for new text beginthe new text endtreatment of a child with
a mental disability when it is determined to be medically necessary as a result of the child's
diagnostic assessment or new text beginthe child's new text endindividual treatment plan indicates that appropriate and
necessary treatment cannot be effectively provided outside of a residential or inpatient
treatment program and the level or intensity of supervision and treatment cannot be
effectively and safely provided in the child's home or community and it is determined that
a residential treatment setting is the least restrictive setting that is appropriate to the needs
of the child.

(j) If continuation of reasonable efforts to prevent placement or reunify the child with
the parent or guardian from whom the child was removed is determined by the court to be
inconsistent with the permanent plan for the child or upon the court making one of the prima
facie determinations under paragraph (a), reasonable efforts must be made to place the child
in a timely manner in a safe and permanent home and to complete whatever steps are
necessary to legally finalize the permanent placement of the child.

(k) Reasonable efforts to place a child for adoption or in another permanent placement
may be made concurrently with reasonable efforts to prevent placement or to reunify the
child with the parent or guardian from whom the child was removed. When the responsible
social services agency decides to concurrently make reasonable efforts for both reunification
and permanent placement away from the parent under paragraph (a), the agency shall disclose
deleted text begin itsdeleted text endnew text begin the agency'snew text end decision and both plans for concurrent reasonable efforts to all parties and
the court. When the agency discloses deleted text beginitsdeleted text endnew text begin the agency'snew text end decision to proceed deleted text beginondeleted text endnew text begin withnew text end both plans
for reunification and permanent placement away from the parent, the court's review of the
agency's reasonable efforts shall include the agency's efforts under both plans.

Sec. 19.

Minnesota Statutes 2020, section 260B.331, subdivision 1, is amended to read:


Subdivision 1.

Care, examination, or treatment.

(a)(1) Whenever legal custody of a
child is transferred by the court to a local social services agency, or

(2) whenever legal custody is transferred to a person other than the local social services
agency, but under the supervision of the local social services agency, and

(3) whenever a child is given physical or mental examinations or treatment under order
of the court, and no provision is otherwise made by law for payment for the care,
examination, or treatment of the child, these costs are a charge upon the welfare funds of
the county in which proceedings are held upon certification of the judge of juvenile court.

(b) The court deleted text beginshalldeleted text endnew text begin maynew text end order, and the local social services agency deleted text beginshalldeleted text endnew text begin maynew text end require,
the parents or custodian of a child, while the child is under the age of 18, to use deleted text beginthe totaldeleted text end
income and resources attributable to the child for the period of care, examination, or
treatment, except for clothing and personal needs allowance as provided in section 256B.35,
to reimburse the county for the cost of care, examination, or treatment. Income and resources
attributable to the child include, but are not limited to, Social Security benefits, Supplemental
Security Income (SSI), veterans benefits, railroad retirement benefits and child support.
When the child is over the age of 18, and continues to receive care, examination, or treatment,
the court deleted text beginshalldeleted text endnew text begin maynew text end order, and the local social services agency deleted text beginshalldeleted text endnew text begin maynew text end require,
reimbursement from the child for the cost of care, examination, or treatment from the income
and resources attributable to the child less the clothing and personal needs allowance.new text begin The
local social services agency shall determine whether requiring reimbursement, either through
child support or parental fees, for the cost of care, examination, or treatment from income
and resources attributable to the child is in the child's best interests. In determining whether
to require reimbursement, the local social services agency shall consider:
new text end

new text begin (1) whether requiring reimbursement would compromise a parent's ability to meet the
child's treatment and rehabilitation needs before the child returns to the parent's home;
new text end

new text begin (2) whether requiring reimbursement would compromise the parent's ability to meet the
child's needs after the child returns home; and
new text end

new text begin (3) whether redirecting existing child support payments or changing the representative
payee of social security benefits to the local social services agency would limit the parent's
ability to maintain financial stability for the child upon the child's return home.
new text end

(c) If the income and resources attributable to the child are not enough to reimburse the
county for the full cost of the care, examination, or treatment, the court deleted text beginshalldeleted text endnew text begin maynew text end inquire
into the ability of the parents to deleted text beginsupport the childdeleted text endnew text begin reimburse the county for the cost of care,
examination, or treatment
new text end and, after giving the parents a reasonable opportunity to be heard,
the court deleted text beginshalldeleted text endnew text begin maynew text end order, and the local social services agency deleted text beginshalldeleted text endnew text begin maynew text end require, the parents
to contribute to the cost of care, examination, or treatment of the child. deleted text beginExcept in delinquency
cases where the victim is a member of the child's immediate family,
deleted text end When determining the
amount to be contributed by the parents, the court shall use a fee schedule based upon ability
to pay that is established by the local social services agency and approved by the
commissioner of human services. deleted text beginIn delinquency cases where the victim is a member of the
child's immediate family,
deleted text end The court shall deleted text beginuse the fee schedule but may alsodeleted text end take into account
deleted text begin the seriousness of the offense and any expenses which the parents have incurred as a result
of the offense
deleted text endnew text begin any expenses that the parents may have incurred as a result of the offense,
including but not limited to co-payments for mental health treatment and attorney's fees
new text end.
The income of a stepparent who has not adopted a child shall be excluded in calculating
the parental contribution under this section.new text begin The local social services agency shall determine
whether requiring reimbursement from the parents, either through child support or parental
fees, for the cost of care, examination, or treatment from income and resources attributable
to the child is in the child's best interests. In determining whether to require reimbursement,
the local social services agency shall consider:
new text end

new text begin (1) whether requiring reimbursement would compromise a parent's ability to meet the
child's treatment and rehabilitation needs before the child returns to the parent's home;
new text end

new text begin (2) whether requiring reimbursement would compromise the parent's ability to meet the
child's needs after the child returns home; and
new text end

new text begin (3) whether requiring reimbursement would compromise the parent's ability to meet the
needs of the family.
new text end

(d)new text begin If the local social services agency determines that requiring reimbursement is in the
child's best interests,
new text end the court shall order the amount of reimbursement attributable to the
parents or custodian, or attributable to the child, or attributable to both sources, withheld
under chapter 518A from the income of the parents or the custodian of the child. A parent
or custodian who fails to pay without good reason may be proceeded against for contempt,
or the court may inform the county attorney, who shall proceed to collect the unpaid sums,
or both procedures may be used.

(e) If the court orders a physical or mental examination for a child, the examination is
a medically necessary service for purposes of determining whether the service is covered
by a health insurance policy, health maintenance contract, or other health coverage plan.
Court-ordered treatment shall be subject to policy, contract, or plan requirements for medical
necessity. Nothing in this paragraph changes or eliminates benefit limits, conditions of
coverage, co-payments or deductibles, provider restrictions, or other requirements in the
policy, contract, or plan that relate to coverage of other medically necessary services.

Sec. 20.

Minnesota Statutes 2020, section 260C.001, subdivision 3, is amended to read:


Subd. 3.

Permanency, termination of parental rights, and adoption.

The purpose of
the laws relating to permanency, termination of parental rights, and children who come
under the guardianship of the commissioner of human services is to ensure that:

(1) when required and appropriate, reasonable efforts have been made by the social
services agency to reunite the child with the child's parents in a home that is safe and
permanent;

(2) if placement with the parents is not reasonably foreseeable, to secure for the child a
safe and permanent placement according to the requirements of section 260C.212, subdivision
2, preferably deleted text beginwith adoptive parentsdeleted text endnew text begin with a relative through an adoption or a transfer of
permanent legal and physical custody
new text end or, if that is not possible or in the best interests of the
child, deleted text begina fit and willing relative through transfer of permanent legal and physical custody to
that relative
deleted text endnew text begin with a nonrelative caregiver through adoptionnew text end; and

(3) when a child is under the guardianship of the commissioner of human services,
reasonable efforts are made to finalize an adoptive home for the child in a timely manner.

Nothing in this section requires reasonable efforts to prevent placement or to reunify
the child with the parent or guardian to be made in circumstances where the court has
determined that the child has been subjected to egregious harm, when the child is an
abandoned infant, the parent has involuntarily lost custody of another child through a
proceeding under section 260C.515, subdivision 4, or similar law of another state, the
parental rights of the parent to a sibling have been involuntarily terminated, or the court has
determined that reasonable efforts or further reasonable efforts to reunify the child with the
parent or guardian would be futile.

The paramount consideration in all proceedings for permanent placement of the child
under sections 260C.503 to 260C.521, or the termination of parental rights is the best interests
of the child. In proceedings involving an American Indian child, as defined in section
260.755, subdivision 8, the best interests of the child must be determined consistent with
the Indian Child Welfare Act of 1978, United States Code, title 25, section 1901, et seq.

Sec. 21.

Minnesota Statutes 2020, section 260C.007, subdivision 27, is amended to read:


Subd. 27.

Relative.

"Relative" means a person related to the child by blood, marriage,
or adoption; the legal parent, guardian, or custodian of the child's siblings; or an individual
who is an important friend new text beginof the child or of the child's parent or custodian, including an
individual
new text endwith whom the child has resided or had significant contactnew text begin or who has a significant
relationship to the child or the child's parent or custodian
new text end.

Sec. 22.

Minnesota Statutes 2020, section 260C.151, subdivision 6, is amended to read:


Subd. 6.

Immediate custody.

If the court makes individualized, explicit findings, based
on the notarized petition or sworn affidavit, that there are reasonable grounds to believe
new text begin that new text endthe child is in surroundings or conditions deleted text beginwhichdeleted text endnew text begin thatnew text end endanger the child's health, safety,
or welfare that require that responsibility for the child's care and custody be immediately
assumed by the responsible social services agency and that continuation of the child in the
custody of the parent or guardian is contrary to the child's welfare, the court may order that
the officer serving the summons take the child into immediate custody for placement of the
child in foster carenew text begin, preferably with a relativenew text end. In ordering that responsibility for the care,
custody, and control of the child be assumed by the responsible social services agency, the
court is ordering emergency protective care as that term is defined in the juvenile court
rules.

Sec. 23.

Minnesota Statutes 2020, section 260C.152, subdivision 5, is amended to read:


Subd. 5.

Notice to foster parents and preadoptive parents and relatives.

The foster
parents, if any, of a child and any preadoptive parent or relative providing care for the child
must be provided notice of and a right to be heard in any review or hearing to be held with
respect to the child. Any other relative may also request, and must be granted, a notice and
the deleted text beginopportunitydeleted text endnew text begin rightnew text end to be heard under this section. This subdivision does not require that
a foster parent, preadoptive parent, deleted text beginordeleted text end relative providing care for the childnew text begin, or any other
relative
new text end be made a party to a review or hearing solely on the basis of the notice and right to
be heard.

Sec. 24.

Minnesota Statutes 2020, section 260C.175, subdivision 2, is amended to read:


Subd. 2.

Notice to parent or custodiannew text begin and child; emergency placement with
relative
new text end.

deleted text beginWheneverdeleted text endnew text begin (a) At the time thatnew text end a peace officer takes a child into custody fornew text begin relative
placement or
new text end shelter care deleted text beginor relative placementdeleted text end pursuant to subdivision 1, section 260C.151,
subdivision 5
, or section 260C.154, the officer shall notify the new text beginchild's new text endparent or custodiannew text begin
and the child, if the child is ten years of age or older,
new text end that under section 260C.181, subdivision
2
, the parent or custodiannew text begin or the childnew text end may request deleted text beginthatdeleted text endnew text begin to placenew text end the child deleted text beginbe placeddeleted text end with a
relative deleted text beginor a designated caregiver under chapter 257Adeleted text endnew text begin as defined in section 260C.007,
subdivision 27,
new text end instead of in a shelter care facility.

new text begin (b) When a child who is not alleged to be delinquent is taken into custody pursuant to
subdivision 1, clause (1) or (2), item (ii), and placement with an identified relative is
requested, the peace officer shall coordinate with the responsible social services agency to
ensure the child's safety and well-being and comply with section 260C.181, subdivision 2.
new text end

new text begin (c) new text endThe officer also shall give the parent or custodian of the child a list of names,
addresses, and telephone numbers of social services agencies that offer child welfare services.
If the parent or custodian was not present when the child was removed from the residence,
the list shall be left with an adult on the premises or left in a conspicuous place on the
premises if no adult is present. If the officer has reason to believe the parent or custodian
is not able to read and understand English, the officer must provide a list that is written in
the language of the parent or custodian. The list shall be prepared by the commissioner of
human services. The commissioner shall prepare lists for each county and provide each
county with copies of the list without charge. The list shall be reviewed annually by the
commissioner and updated if it is no longer accurate. Neither the commissioner nor any
peace officer or the officer's employer shall be liable to any person for mistakes or omissions
in the list. The list does not constitute a promise that any agency listed will deleted text beginin factdeleted text end assist the
parent or custodian.

Sec. 25.

Minnesota Statutes 2020, section 260C.176, subdivision 2, is amended to read:


Subd. 2.

Reasons for detention.

(a) If the child is not released as provided in subdivision
1, the person taking the child into custody shall notify the court as soon as possible of the
detention of the child and the reasons for detention.

(b) No child taken into custody and placed in anew text begin relative's home ornew text end shelter care facility
deleted text begin or relative's homedeleted text end by a peace officer pursuant to section 260C.175, subdivision 1, clause
(1) or (2), item (ii), may be held in custody longer than 72 hours, excluding Saturdays,
Sundays and holidays, unless a petition has been filed and the judge or referee determines
pursuant to section 260C.178 that the child shall remain in custody or unless the court has
made a finding of domestic abuse perpetrated by a minor after a hearing under Laws 1997,
chapter 239, article 10, sections 2 to 26, in which case the court may extend the period of
detention for an additional seven days, within which time the social services agency shall
conduct an assessment and shall provide recommendations to the court regarding voluntary
services or file a child in need of protection or services petition.

Sec. 26.

Minnesota Statutes 2020, section 260C.178, subdivision 1, is amended to read:


Subdivision 1.

Hearing and release requirements.

(a) If a child was taken into custody
under section 260C.175, subdivision 1, clause (1) or (2), item (ii), the court shall hold a
hearing within 72 hours of the timenew text begin thatnew text end the child was taken into custody, excluding
Saturdays, Sundays, and holidays, to determine whether the child should continuenew text begin to benew text end in
custody.

(b) Unless there is reason to believe that the child would endanger self or others or not
return for a court hearing, or that the child's health or welfare would be immediately
endangered, the child shall be released to the custody of a parent, guardian, custodian, or
other suitable person, subject to reasonable conditions of release including, but not limited
to, a requirement that the child undergo a chemical use assessment as provided in section
260C.157, subdivision 1.

(c) If the court determines new text beginthat new text endthere is reason to believe that the child would endanger
self or others or not return for a court hearing, or that the child's health or welfare would be
immediately endangered if returned to the care of the parent or guardian who has custody
and from whom the child was removed, the court shall order the childnew text begin:
new text end

new text begin (1) into the care of the child's noncustodial parent and order the noncustodial parent to
comply with any conditions that the court determines appropriate to ensure the safety and
care of the child, including requiring the noncustodial parent to cooperate with paternity
establishment proceedings if the noncustodial parent has not been adjudicated the child's
father; or
new text end

new text begin (2)new text end into foster care as defined in section 260C.007, subdivision 18, under the legal
responsibility of the responsible social services agency or responsible probation or corrections
agency for the purposes of protective care as that term is used in the juvenile court rules deleted text beginor
into the home of a noncustodial parent and order the noncustodial parent to comply with
any conditions the court determines to be appropriate to the safety and care of the child,
including cooperating with paternity establishment proceedings in the case of a man who
has not been adjudicated the child's father
deleted text end. The court shall not give the responsible social
services legal custody and order a trial home visit at any time prior to adjudication and
disposition under section 260C.201, subdivision 1, paragraph (a), clause (3), but may order
the child returned to the care of the parent or guardian who has custody and from whom the
child was removed and order the parent or guardian to comply with any conditions the court
determines to be appropriate to meet the safety, health, and welfare of the child.

(d) In determining whether the child's health or welfare would be immediately
endangered, the court shall consider whether the child would reside with a perpetrator of
domestic child abuse.

(e) The court, before determining whether a child should be placed in or continue in
foster care under the protective care of the responsible agency, shall also make a
determination, consistent with section 260.012 as to whether reasonable efforts were made
to prevent placement or whether reasonable efforts to prevent placement are not required.
In the case of an Indian child, the court shall determine whether active efforts, according
to section 260.762 and the Indian Child Welfare Act of 1978, United States Code, title 25,
section 1912(d), were made to prevent placement. The court shall enter a finding that the
responsible social services agency has made reasonable efforts to prevent placement when
the agency establishes either:

(1) that deleted text beginitdeleted text end new text beginthe agency new text endhas actually provided services or made efforts in an attempt to
prevent the child's removal but that such services or efforts have not proven sufficient to
permit the child to safely remain in the home; or

(2) that there are no services or other efforts that could be made at the time of the hearing
that could safely permit the child to remain home or to return home. new text beginThe court shall not
make a reasonable efforts determination under this clause unless the court is satisfied that
the agency has sufficiently demonstrated to the court that there were no services or other
efforts that the agency was able to provide at the time of the hearing enabling the child to
safely remain home or to safely return home.
new text endWhen reasonable efforts to prevent placement
are required and there are services or other efforts that could be ordered deleted text beginwhichdeleted text endnew text begin thatnew text end would
permit the child to safely return home, the court shall order the child returned to the care of
the parent or guardian and the services or efforts put in place to ensure the child's safety.
When the court makes a prima facie determination that one of the circumstances under
paragraph (g) exists, the court shall determine that reasonable efforts to prevent placement
and to return the child to the care of the parent or guardian are not required.

new text begin (f) new text endIf the court finds the social services agency's preventive or reunification efforts have
not been reasonable but further preventive or reunification efforts could not permit the child
to safely remain at home, the court may nevertheless authorize or continue the removal of
the child.

deleted text begin (f)deleted text endnew text begin (g)new text end The court may not order or continue the foster care placement of the child unless
the court makes explicit, individualized findings that continued custody of the child by the
parent or guardian would be contrary to the welfare of the child and that placement is in the
best interest of the child.

deleted text begin (g)deleted text endnew text begin (h)new text end At the emergency removal hearing, or at any time during the course of the
proceeding, and upon notice and request of the county attorney, the court shall determine
whether a petition has been filed stating a prima facie case that:

(1) the parent has subjected a child to egregious harm as defined in section 260C.007,
subdivision 14
;

(2) the parental rights of the parent to another child have been involuntarily terminated;

(3) the child is an abandoned infant under section 260C.301, subdivision 2, paragraph
(a), clause (2);

(4) the parents' custodial rights to another child have been involuntarily transferred to a
relative under Minnesota Statutes 2010, section 260C.201, subdivision 11, paragraph (e),
clause (1); section 260C.515, subdivision 4; or a similar law of another jurisdiction;

(5) the parent has committed sexual abuse as defined in section 260E.03, against the
child or another child of the parent;

(6) the parent has committed an offense that requires registration as a predatory offender
under section 243.166, subdivision 1b, paragraph (a) or (b); or

(7) the provision of services or further services for the purpose of reunification is futile
and therefore unreasonable.

deleted text begin (h)deleted text endnew text begin (i)new text end When a petition to terminate parental rights is required under section 260C.301,
subdivision 4, or 260C.503, subdivision 2, but the county attorney has determined not to
proceed with a termination of parental rights petition, and has instead filed a petition to
transfer permanent legal and physical custody to a relative under section 260C.507, the
court shall schedule a permanency hearing within 30 days of the filing of the petition.

deleted text begin (i)deleted text endnew text begin (j)new text end If the county attorney has filed a petition under section 260C.307, the court shall
schedule a trial under section 260C.163 within 90 days of the filing of the petition except
when the county attorney determines that the criminal case shall proceed to trial first under
section 260C.503, subdivision 2, paragraph (c).

deleted text begin (j)deleted text endnew text begin (k)new text end If the court determines the child should be ordered into foster care and the child's
parent refuses to give information to the responsible social services agency regarding the
child's father or relatives of the child, the court may order the parent to disclose the names,
addresses, telephone numbers, and other identifying information to the responsible social
services agency for the purpose of complying with sectionsnew text begin 260C.150,new text end 260C.151, 260C.212,
260C.215, new text begin260C.219, new text endand 260C.221.

deleted text begin (k)deleted text endnew text begin (l)new text end If a child ordered into foster care has siblings, whether full, half, or step, who are
also ordered into foster care, the court shall inquire of the responsible social services agency
of the efforts to place the children together as required by section 260C.212, subdivision 2,
paragraph (d), if placement together is in each child's best interests, unless a child is in
placement for treatment or a child is placed with a previously noncustodial parent who is
not a parent to all siblings. If the children are not placed together at the time of the hearing,
the court shall inquire at each subsequent hearing of the agency's reasonable efforts to place
the siblings together, as required under section 260.012. If any sibling is not placed with
another sibling or siblings, the agency must develop a plan to facilitate visitation or ongoing
contact among the siblings as required under section 260C.212, subdivision 1, unless it is
contrary to the safety or well-being of any of the siblings to do so.

deleted text begin (l)deleted text endnew text begin (m)new text end When the court has ordered the child into new text beginthe care of a noncustodial parent or in
new text end foster care deleted text beginor into the home of a noncustodial parentdeleted text end, the court may order a chemical
dependency evaluation, mental health evaluation, medical examination, and parenting
assessment for the parent as necessary to support the development of a plan for reunification
required under subdivision 7 and section 260C.212, subdivision 1, or the child protective
services plan under section 260E.26, and Minnesota Rules, part 9560.0228.

Sec. 27.

Minnesota Statutes 2020, section 260C.181, subdivision 2, is amended to read:


Subd. 2.

Least restrictive setting.

Notwithstanding the provisions of subdivision 1, if
the child had been taken into custody pursuant to section 260C.175, subdivision 1, clause
(1) or (2), item (ii), and is not alleged to be delinquent, the child shall be detained in the
least restrictive setting consistent with the child's health and welfare and in closest proximity
to the child's family as possible. Placement may be with a child's relativedeleted text begin, a designated
caregiver under chapter 257A,
deleted text end ornew text begin, if no placement is available with a relative,new text end in a shelter
care facility. The placing officer shall comply with this section and shall document why a
less restrictive setting will or will not be in the best interests of the child for placement
purposes.

Sec. 28.

Minnesota Statutes 2020, section 260C.193, subdivision 3, is amended to read:


Subd. 3.

Best interests of the child.

(a) The policy of the state is to ensure that the best
interests of children in foster care, who experience new text begina new text endtransfer of permanent legal and physical
custody to a relative under section 260C.515, subdivision 4, or adoption under this chapter,
are met bynew text begin:
new text end

new text begin (1) considering placement of a child with relatives in the order specified in section
260C.212, subdivision 2, paragraph (a); and
new text end

new text begin (2)new text end requiring individualized determinations under section 260C.212, subdivision 2,
paragraph (b), of the needs of the child and of how the selected home will serve the needs
of the child.

(b) No later than three months after a child is ordered new text beginto be new text endremoved from the care of a
parent in the hearing required under section 260C.202, the court shall review and enter
findings regarding whether the responsible social services agency deleted text beginmadedeleted text end:

(1) deleted text begindiligent effortsdeleted text end new text beginexercised due diligencenew text end to identify deleted text beginanddeleted text endnew text begin,new text end search fornew text begin, notify, and engagenew text end
relatives as required under section 260C.221; and

(2) new text beginmade a placement consistent with section 260C.212, subdivision 2, that is based on
new text end an individualized determination deleted text beginas required under section 260C.212, subdivision 2,deleted text end new text beginof the
child's needs
new text endto select a home that meets the needs of the child.

(c) If the court finds new text beginthat new text endthe agency has not deleted text beginmade effortsdeleted text end new text beginexercised due diligencenew text end as
required under section 260C.221, deleted text beginanddeleted text end new text beginthe court shall order the agency to make reasonable
efforts. If
new text endthere is a relative who qualifies to be licensed to provide family foster care under
chapter 245A, the court may order the child new text beginto be new text endplaced with the relative consistent with
the child's best interests.

(d) If the agency's efforts under section 260C.221 are found new text beginby the court new text endto be sufficient,
the court shall order the agency to continue to appropriately engage relatives who responded
to the notice under section 260C.221 in placement and case planning decisions and to
appropriately engage relatives who subsequently come to the agency's attention.new text begin A court's
finding that the agency has made reasonable efforts under this paragraph does not relieve
the agency of the duty to continue notifying relatives who come to the agency's attention
and engaging and considering relatives who respond to the notice under section 260C.221
in child placement and case planning decisions.
new text end

(e) If the child's birth parent deleted text beginor parentsdeleted text end explicitly deleted text beginrequestdeleted text endnew text begin requestsnew text end that a new text beginspecific new text endrelative
deleted text begin or important frienddeleted text end not be considerednew text begin for placement of the childnew text end, the court shall honor that
request if it is consistent with the best interests of the child and consistent with the
requirements of section 260C.221.new text begin The court shall not waive relative search, notice, and
consideration requirements, unless section 260C.139 applies.
new text end If the child's birth parent deleted text beginor
parents express
deleted text endnew text begin expressesnew text end a preference for placing the child in a foster or adoptive home of
the same or a similar religious background deleted text begintodeleted text endnew text begin asnew text end that of the birth parent or parents, the court
shall order placement of the child with an individual who meets the birth parent's religious
preference.

(f) Placement of a child deleted text begincannotdeleted text endnew text begin must notnew text end be delayed or denied based on race, color, or
national origin of the foster parent or the child.

(g) Whenever possible, siblings requiring foster care placement deleted text beginshoulddeleted text endnew text begin shallnew text end be placed
together unless it is determined not to be in the best interests ofnew text begin one or more of thenew text end siblings
after weighing the benefits of separate placement against the benefits of sibling connections
for each sibling. new text beginThe agency shall consider section 260C.008 when making this determination.
new text end If siblings were not placed together according to section 260C.212, subdivision 2, paragraph
(d), the responsible social services agency shall report to the court the efforts made to place
the siblings together and why the efforts were not successful. If the court is not satisfied
that the agency has made reasonable efforts to place siblings together, the court must order
the agency to make further reasonable efforts. If siblings are not placed together, the court
shall order the responsible social services agency to implement the plan for visitation among
siblings required as part of the out-of-home placement plan under section 260C.212.

(h) This subdivision does not affect the Indian Child Welfare Act, United States Code,
title 25, sections 1901 to 1923, and the Minnesota Indian Family Preservation Act, sections
260.751 to 260.835.

Sec. 29.

Minnesota Statutes 2020, section 260C.201, subdivision 1, is amended to read:


Subdivision 1.

Dispositions.

(a) If the court finds that the child is in need of protection
or services or neglected and in foster care, deleted text beginitdeleted text endnew text begin the courtnew text end shall enter an order making any of
the following dispositions of the case:

(1) place the child under the protective supervision of the responsible social services
agency or child-placing agency in the home of a parent of the child under conditions
prescribed by the court directed to the correction of the child's need for protection or services:

(i) the court may order the child into the home of a parent who does not otherwise have
legal custody of the child, however, an order under this section does not confer legal custody
on that parent;

(ii) if the court orders the child into the home of a father who is not adjudicated, the
father must cooperate with paternity establishment proceedings regarding the child in the
appropriate jurisdiction as one of the conditions prescribed by the court for the child to
continue in the father's home; and

(iii) the court may order the child into the home of a noncustodial parent with conditions
and may also order both the noncustodial and the custodial parent to comply with the
requirements of a case plan under subdivision 2; or

(2) transfer legal custody to one of the following:

(i) a child-placing agency; or

(ii) the responsible social services agency. In making a foster care placement deleted text beginfordeleted text endnew text begin ofnew text end a
child whose custody has been transferred under this subdivision, the agency shall make an
individualized determination of how the placement is in the child's best interests using thenew text begin
placement
new text end considerationnew text begin ordernew text end for relativesdeleted text begin,deleted text endnew text begin andnew text end the best interest factors in section 260C.212,
subdivision 2deleted text begin, paragraph (b)deleted text end
, and may include a child colocated with a parent in a licensed
residential family-based substance use disorder treatment program under section 260C.190;
or

(3) order a trial home visit without modifying the transfer of legal custody to the
responsible social services agency under clause (2). Trial home visit means the child is
returned to the care of the parent or guardian from whom the child was removed for a period
not to exceed six months. During the period of the trial home visit, the responsible social
services agency:

(i) shall continue to have legal custody of the child, which means new text beginthat new text endthe agency may
see the child in the parent's home, at school, in a child care facility, or other setting as the
agency deems necessary and appropriate;

(ii) shall continue to have the ability to access information under section 260C.208;

(iii) shall continue to provide appropriate services to both the parent and the child during
the period of the trial home visit;

(iv) without previous court order or authorization, may terminate the trial home visit in
order to protect the child's health, safety, or welfare and may remove the child to foster care;

(v) shall advise the court and parties within three days of the termination of the trial
home visit when a visit is terminated by the responsible social services agency without a
court order; and

(vi) shall prepare a report for the court when the trial home visit is terminated whether
by the agency or court order deleted text beginwhichdeleted text endnew text begin thatnew text end describes the child's circumstances during the trial
home visit and recommends appropriate orders, if any, for the court to enter to provide for
the child's safety and stability. In the event a trial home visit is terminated by the agency
by removing the child to foster care without prior court order or authorization, the court
shall conduct a hearing within ten days of receiving notice of the termination of the trial
home visit by the agency and shall order disposition under this subdivision or commence
permanency proceedings under sections 260C.503 to 260C.515. The time period for the
hearing may be extended by the court for good cause shown and if it is in the best interests
of the child as long as the total time the child spends in foster care without a permanency
hearing does not exceed 12 months;

(4) if the child has been adjudicated as a child in need of protection or services because
the child is in need of special services or care to treat or ameliorate a physical or mental
disability or emotional disturbance as defined in section 245.4871, subdivision 15, the court
may order the child's parent, guardian, or custodian to provide it. The court may order the
child's health plan company to provide mental health services to the child. Section 62Q.535
applies to an order for mental health services directed to the child's health plan company.
If the health plan, parent, guardian, or custodian fails or is unable to provide this treatment
or care, the court may order it provided. Absent specific written findings by the court that
the child's disability is the result of abuse or neglect by the child's parent or guardian, the
court shall not transfer legal custody of the child for the purpose of obtaining special
treatment or care solely because the parent is unable to provide the treatment or care. If the
court's order for mental health treatment is based on a diagnosis made by a treatment
professional, the court may order that the diagnosing professional not provide the treatment
to the child if it finds that such an order is in the child's best interests; or

(5) if the court believes that the child has sufficient maturity and judgment and that it is
in the best interests of the child, the court may order a child 16 years old or older to be
allowed to live independently, either alone or with others as approved by the court under
supervision the court considers appropriate, if the county board, after consultation with the
court, has specifically authorized this dispositional alternative for a child.

(b) If the child was adjudicated in need of protection or services because the child is a
runaway or habitual truant, the court may order any of the following dispositions in addition
to or as alternatives to the dispositions authorized under paragraph (a):

(1) counsel the child or the child's parents, guardian, or custodian;

(2) place the child under the supervision of a probation officer or other suitable person
in the child's own home under conditions prescribed by the court, including reasonable rules
for the child's conduct and the conduct of the parents, guardian, or custodian, designed for
the physical, mental, and moral well-being and behavior of the child;

(3) subject to the court's supervision, transfer legal custody of the child to one of the
following:

(i) a reputable person of good moral character. No person may receive custody of two
or more unrelated children unless licensed to operate a residential program under sections
245A.01 to 245A.16; or

(ii) a county probation officer for placement in a group foster home established under
the direction of the juvenile court and licensed pursuant to section 241.021;

(4) require the child to pay a fine of up to $100. The court shall order payment of the
fine in a manner that will not impose undue financial hardship upon the child;

(5) require the child to participate in a community service project;

(6) order the child to undergo a chemical dependency evaluation and, if warranted by
the evaluation, order participation by the child in a drug awareness program or an inpatient
or outpatient chemical dependency treatment program;

(7) if the court believes that it is in the best interests of the child or of public safety that
the child's driver's license or instruction permit be canceled, the court may order the
commissioner of public safety to cancel the child's license or permit for any period up to
the child's 18th birthday. If the child does not have a driver's license or permit, the court
may order a denial of driving privileges for any period up to the child's 18th birthday. The
court shall forward an order issued under this clause to the commissioner, who shall cancel
the license or permit or deny driving privileges without a hearing for the period specified
by the court. At any time before the expiration of the period of cancellation or denial, the
court may, for good cause, order the commissioner of public safety to allow the child to
apply for a license or permit, and the commissioner shall so authorize;

(8) order that the child's parent or legal guardian deliver the child to school at the
beginning of each school day for a period of time specified by the court; or

(9) require the child to perform any other activities or participate in any other treatment
programs deemed appropriate by the court.

To the extent practicable, the court shall enter a disposition order the same day it makes
a finding that a child is in need of protection or services or neglected and in foster care, but
in no event more than 15 days after the finding unless the court finds that the best interests
of the child will be served by granting a delay. If the child was under eight years of age at
the time the petition was filed, the disposition order must be entered within ten days of the
finding and the court may not grant a delay unless good cause is shown and the court finds
the best interests of the child will be served by the delay.

(c) If a child who is 14 years of age or older is adjudicated in need of protection or
services because the child is a habitual truant and truancy procedures involving the child
were previously dealt with by a school attendance review board or county attorney mediation
program under section 260A.06 or 260A.07, the court shall order a cancellation or denial
of driving privileges under paragraph (b), clause (7), for any period up to the child's 18th
birthday.

(d) In the case of a child adjudicated in need of protection or services because the child
has committed domestic abuse and been ordered excluded from the child's parent's home,
the court shall dismiss jurisdiction if the court, at any time, finds the parent is able or willing
to provide an alternative safe living arrangement for the child, as defined in Laws 1997,
chapter 239, article 10, section 2.

(e) When a parent has complied with a case plan ordered under subdivision 6 and the
child is in the care of the parent, the court may order the responsible social services agency
to monitor the parent's continued ability to maintain the child safely in the home under such
terms and conditions as the court determines appropriate under the circumstances.

Sec. 30.

Minnesota Statutes 2020, section 260C.201, subdivision 2, is amended to read:


Subd. 2.

Written findings.

(a) Any order for a disposition authorized under this section
shall contain written findings of fact to support the disposition and case plan ordered and
shall also set forth in writing the following information:

(1) why the best interests and safety of the child are served by the disposition and case
plan ordered;

(2) what alternative dispositions or services under the case plan were considered by the
court and why such dispositions or services were not appropriate in the instant case;

(3) when legal custody of the child is transferred, the appropriateness of the particular
placement made or to be made by the placing agency using thenew text begin relative and sibling placement
considerations and best interest
new text end factors in section 260C.212, subdivision 2deleted text begin, paragraph (b)deleted text end,
or the appropriateness of a child colocated with a parent in a licensed residential family-based
substance use disorder treatment program under section 260C.190;

(4) whether reasonable efforts to finalize the permanent plan for the child consistent
with section 260.012 were made including reasonable efforts:

(i) to prevent the child's placement and to reunify the child with the parent or guardian
from whom the child was removed at the earliest time consistent with the child's safety.
The court's findings must include a brief description of what preventive and reunification
efforts were made and why further efforts could not have prevented or eliminated the
necessity of removal or that reasonable efforts were not required under section 260.012 or
260C.178, subdivision 1;

(ii) to identify and locate any noncustodial or nonresident parent of the child and to
assess such parent's ability to provide day-to-day care of the child, and, where appropriate,
provide services necessary to enable the noncustodial or nonresident parent to safely provide
day-to-day care of the child as required under section 260C.219, unless such services are
not required under section 260.012 or 260C.178, subdivision 1deleted text begin;deleted text endnew text begin. The court's findings must
include a description of the agency's efforts to:
new text end

new text begin (A) identify and locate the child's noncustodial or nonresident parent;
new text end

new text begin (B) assess the noncustodial or nonresident parent's ability to provide day-to-day care of
the child; and
new text end

new text begin (C) if appropriate, provide services necessary to enable the noncustodial or nonresident
parent to safely provide the child's day-to-day care, including efforts to engage the
noncustodial or nonresident parent in assuming care and responsibility of the child;
new text end

(iii) to make the diligent search for relatives and provide the notices required under
section 260C.221; a finding made pursuant to a hearing under section 260C.202 that the
agency has made diligent efforts to conduct a relative search and has appropriately engaged
relatives who responded to the notice under section 260C.221 and other relatives, who came
to the attention of the agency after notice under section 260C.221 was sent, in placement
and case planning decisions fulfills the requirement of this item;

(iv) to identify and make a foster care placement new text beginof the child, considering the order in
section 260C.212, subdivision 2, paragraph (a),
new text endin the home of an unlicensed relative,
according to the requirements of section 245A.035, a licensed relative, or other licensed
foster care providernew text begin,new text end who will commit to being the permanent legal parent or custodian for
the child in the event reunification cannot occur, but who will actively support the
reunification plan for the childnew text begin. If the court finds that the agency has not appropriately
considered relatives for placement of the child, the court shall order the agency to comply
with section 260C.212, subdivision 2, paragraph (a). The court may order the agency to
continue considering relatives for placement of the child regardless of the child's current
placement setting
new text end; and

(v) to place siblings together in the same home or to ensure visitation is occurring when
siblings are separated in foster care placement and visitation is in the siblings' best interests
under section 260C.212, subdivision 2, paragraph (d); and

(5) if the child has been adjudicated as a child in need of protection or services because
the child is in need of special services or care to treat or ameliorate a mental disability or
emotional disturbance as defined in section 245.4871, subdivision 15, the written findings
shall also set forth:

(i) whether the child has mental health needs that must be addressed by the case plan;

(ii) what consideration was given to the diagnostic and functional assessments performed
by the child's mental health professional and to health and mental health care professionals'
treatment recommendations;

(iii) what consideration was given to the requests or preferences of the child's parent or
guardian with regard to the child's interventions, services, or treatment; and

(iv) what consideration was given to the cultural appropriateness of the child's treatment
or services.

(b) If the court finds that the social services agency's preventive or reunification efforts
have not been reasonable but that further preventive or reunification efforts could not permit
the child to safely remain at home, the court may nevertheless authorize or continue the
removal of the child.

(c) If the child has been identified by the responsible social services agency as the subject
of concurrent permanency planning, the court shall review the reasonable efforts of the
agency to develop a permanency plan for the child that includes a primary plan deleted text beginwhichdeleted text endnew text begin thatnew text end
is for reunification with the child's parent or guardian and a secondary plan deleted text beginwhichdeleted text endnew text begin thatnew text end is
for an alternative, legally permanent home for the child in the event reunification cannot
be achieved in a timely manner.

Sec. 31.

Minnesota Statutes 2020, section 260C.202, is amended to read:


260C.202 COURT REVIEW OF FOSTER CARE.

(a) If the court orders a child placed in foster care, the court shall review the out-of-home
placement plan and the child's placement at least every 90 days as required in juvenile court
rules to determine whether continued out-of-home placement is necessary and appropriate
or whether the child should be returned home. This review is not required if the court has
returned the child home, ordered the child permanently placed away from the parent under
sections 260C.503 to 260C.521, or terminated rights under section 260C.301. Court review
for a child permanently placed away from a parent, including where the child is under
guardianship of the commissioner, shall be governed by section 260C.607. When a child
is placed in a qualified residential treatment program setting as defined in section 260C.007,
subdivision 26d, the responsible social services agency must submit evidence to the court
as specified in section 260C.712.

(b) No later than three months after the child's placement in foster care, the court shall
review agency efforts new text beginto search for and notify relatives new text endpursuant to section 260C.221, and
order that the new text beginagency's new text endefforts new text beginbegin immediately, or new text endcontinuenew text begin,new text end if the agency has failed to
performnew text begin, or has not adequately performed,new text end the duties under that section. The court must
order the agency to continue to appropriately engage relatives who responded to the notice
under section 260C.221 in placement and case planning decisions and to new text beginconsider relatives
for foster care placement consistent with section 260C.221. Notwithstanding a court's finding
that the agency has made reasonable efforts to search for and notify relatives under section
260C.221, the court may order the agency to continue making reasonable efforts to search
for, notify,
new text endengage deleted text beginotherdeleted text endnew text begin, and considernew text end relatives who came to the agency's attention after
new text begin sending the initial new text endnotice under section 260C.221 deleted text beginwas sentdeleted text end.

(c) The court shall review the out-of-home placement plan and may modify the plan as
provided under section 260C.201, subdivisions 6 and 7.

(d) When the court deleted text beginorders transfer ofdeleted text endnew text begin transfers thenew text end custodynew text begin of a childnew text end to a responsible
social services agency resulting in foster care or protective supervision with a noncustodial
parent under subdivision 1, the court shall notify the parents of the provisions of sections
260C.204 and 260C.503 to 260C.521, as required under juvenile court rules.

(e) When a child remains in or returns to foster care pursuant to section 260C.451 and
the court has jurisdiction pursuant to section 260C.193, subdivision 6, paragraph (c), the
court shall at least annually conduct the review required under section 260C.203.

Sec. 32.

Minnesota Statutes 2020, section 260C.203, is amended to read:


260C.203 ADMINISTRATIVE OR COURT REVIEW OF PLACEMENTS.

(a) Unless the court is conducting the reviews required under section 260C.202, there
shall be an administrative review of the out-of-home placement plan of each child placed
in foster care no later than 180 days after the initial placement of the child in foster care
and at least every six months thereafter if the child is not returned to the home of the parent
or parents within that time. The out-of-home placement plan must be monitored and updated
new text begin by the responsible social services agency new text endat each administrative review. The administrative
review shall be conducted by the responsible social services agency using a panel of
appropriate persons at least one of whom is not responsible for the case management of, or
the delivery of services to, either the child or the parents who are the subject of the review.
The administrative review shall be open to participation by the parent or guardian of the
child and the child, as appropriate.

(b) As an alternative to the administrative review required in paragraph (a), the court
may, as part of any hearing required under the Minnesota Rules of Juvenile Protection
Procedure, conduct a hearing to monitor and update the out-of-home placement plan pursuant
to the procedure and standard in section 260C.201, subdivision 6, paragraph (d). The party
requesting review of the out-of-home placement plan shall give parties to the proceeding
notice of the request to review and update the out-of-home placement plan. A court review
conducted pursuant to section 260C.141, subdivision 2; 260C.193; 260C.201, subdivision
1; 260C.202; 260C.204; 260C.317; or 260D.06 shall satisfy the requirement for the review
so long as the other requirements of this section are met.

(c) As appropriate to the stage of the proceedings and relevant court orders, the
responsible social services agency or the court shall review:

(1) the safety, permanency needs, and well-being of the child;

(2) the continuing necessity for and appropriateness of the placementnew text begin, including whether
the placement is consistent with the child's best interests and other placement considerations,
including relative and sibling placement considerations under section 260C.212, subdivision
2
new text end;

(3) the extent of compliance with the out-of-home placement plannew text begin required under section
260C.212, subdivisions 1 and 1a, including services and resources that the agency has
provided to the child and child's parents, services and resources that other agencies and
individuals have provided to the child and child's parents, and whether the out-of-home
placement plan is individualized to the needs of the child and child's parents
new text end;

(4) the extent of progress that has been made toward alleviating or mitigating the causes
necessitating placement in foster care;

(5) the projected date by which the child may be returned to and safely maintained in
the home or placed permanently away from the care of the parent or parents or guardian;
and

(6) the appropriateness of the services provided to the child.

(d) When a child is age 14 or older:

(1) in addition to any administrative review conducted by the responsible social services
agency, at the in-court review required under section 260C.317, subdivision 3, clause (3),
or 260C.515, subdivision 5 or 6, the court shall review the independent living plan required
under section 260C.212, subdivision 1, paragraph (c), clause (12), and the provision of
services to the child related to the well-being of the child as the child prepares to leave foster
care. The review shall include the actual plans related to each item in the plan necessary to
the child's future safety and well-being when the child is no longer in foster care; and

(2) consistent with the requirements of the independent living plan, the court shall review
progress toward or accomplishment of the following goals:

(i) the child has obtained a high school diploma or its equivalent;

(ii) the child has completed a driver's education course or has demonstrated the ability
to use public transportation in the child's community;

(iii) the child is employed or enrolled in postsecondary education;

(iv) the child has applied for and obtained postsecondary education financial aid for
which the child is eligible;

(v) the child has health care coverage and health care providers to meet the child's
physical and mental health needs;

(vi) the child has applied for and obtained disability income assistance for which the
child is eligible;

(vii) the child has obtained affordable housing with necessary supports, which does not
include a homeless shelter;

(viii) the child has saved sufficient funds to pay for the first month's rent and a damage
deposit;

(ix) the child has an alternative affordable housing plan, which does not include a
homeless shelter, if the original housing plan is unworkable;

(x) the child, if male, has registered for the Selective Service; and

(xi) the child has a permanent connection to a caring adult.

Sec. 33.

Minnesota Statutes 2020, section 260C.204, is amended to read:


260C.204 PERMANENCY PROGRESS REVIEW FOR CHILDREN IN FOSTER
CARE FOR SIX MONTHS.

(a) When a child continues in placement out of the home of the parent or guardian from
whom the child was removed, no later than six months after the child's placement the court
shall conduct a permanency progress hearing to review:

(1) the progress of the case, the parent's progress on the case plan or out-of-home
placement plan, whichever is applicable;

(2) the agency's reasonable, or in the case of an Indian child, active efforts for
reunification and its provision of services;

(3) the agency's reasonable efforts to finalize the permanent plan for the child under
section 260.012, paragraph (e), and to make a placement as required under section 260C.212,
subdivision 2
, in a home that will commit to being the legally permanent family for the
child in the event the child cannot return home according to the timelines in this section;
and

(4) in the case of an Indian child, active efforts to prevent the breakup of the Indian
family and to make a placement according to the placement preferences under United States
Code, title 25, chapter 21, section 1915.

(b) When a child is placed in a qualified residential treatment program setting as defined
in section 260C.007, subdivision 26d, the responsible social services agency must submit
evidence to the court as specified in section 260C.712.

(c) The court shall ensure that notice of the hearing is sent to any relative who:

(1) responded to the agency's notice provided under section 260C.221, indicating an
interest in participating in planning for the child or being a permanency resource for the
child and who has kept the court apprised of the relative's address; or

(2) asked to be notified of court proceedings regarding the child as is permitted in section
260C.152, subdivision 5.

(d)(1) If the parent or guardian has maintained contact with the child and is complying
with the court-ordered out-of-home placement plan, and if the child would benefit from
reunification with the parent, the court may either:

(i) return the child home, if the conditions deleted text beginwhichdeleted text endnew text begin thatnew text end led to the out-of-home placement
have been sufficiently mitigated that it is safe and in the child's best interests to return home;
or

(ii) continue the matter up to a total of six additional months. If the child has not returned
home by the end of the additional six months, the court must conduct a hearing according
to sections 260C.503 to 260C.521.

(2) If the court determines that the parent or guardian is not complyingnew text begin, is not making
progress with or engaging
new text end with new text beginservices in new text endthe out-of-home placement plannew text begin,new text end or is not
maintaining regular contact with the child as outlined in the visitation plan required as part
of the out-of-home placement plan under section 260C.212, the court may order the
responsible social services agency:

(i) to develop a plan for legally permanent placement of the child away from the parent;

(ii) to consider, identify, recruit, and support one or more permanency resources from
the child's relatives and foster parentnew text begin, consistent with section 260C.212, subdivision 2,
paragraph (a),
new text end to be the legally permanent home in the event the child cannot be returned
to the parent. Any relative or the child's foster parent may ask the court to order the agency
to consider them for permanent placement of the child in the event the child cannot be
returned to the parent. A relative or foster parent who wants to be considered under this
item shall cooperate with the background study required under section 245C.08, if the
individual has not already done so, and with the home study process required under chapter
245A for providing child foster care and for adoption under section 259.41. The home study
referred to in this item shall be a single-home study in the form required by the commissioner
of human services or similar study required by the individual's state of residence when the
subject of the study is not a resident of Minnesota. The court may order the responsible
social services agency to make a referral under the Interstate Compact on the Placement of
Children when necessary to obtain a home study for an individual who wants to be considered
for transfer of permanent legal and physical custody or adoption of the child; and

(iii) to file a petition to support an order for the legally permanent placement plan.

(e) Following the review under this section:

(1) if the court has either returned the child home or continued the matter up to a total
of six additional months, the agency shall continue to provide services to support the child's
return home or to make reasonable efforts to achieve reunification of the child and the parent
as ordered by the court under an approved case plan;

(2) if the court orders the agency to develop a plan for the transfer of permanent legal
and physical custody of the child to a relative, a petition supporting the plan shall be filed
in juvenile court within 30 days of the hearing required under this section and a trial on the
petition held within 60 days of the filing of the pleadings; or

(3) if the court orders the agency to file a termination of parental rights, unless the county
attorney can show cause why a termination of parental rights petition should not be filed,
a petition for termination of parental rights shall be filed in juvenile court within 30 days
of the hearing required under this section and a trial on the petition held within 60 days of
the filing of the petition.

Sec. 34.

Minnesota Statutes 2021 Supplement, section 260C.212, subdivision 1, is amended
to read:


Subdivision 1.

Out-of-home placement; plan.

(a) An out-of-home placement plan shall
be prepared within 30 days after any child is placed in foster care by court order or a
voluntary placement agreement between the responsible social services agency and the
child's parent pursuant to section 260C.227 or chapter 260D.

(b) An out-of-home placement plan means a written document deleted text beginwhichdeleted text endnew text begin individualized to
the needs of the child and the child's parents or guardians that
new text end is prepared by the responsible
social services agency jointly with deleted text beginthe parent or parents or guardian of the childdeleted text endnew text begin the child's
parents or guardians
new text end and in consultation with the child's guardian ad litemdeleted text begin,deleted text endnew text begin;new text end the child's tribe,
if the child is an Indian childdeleted text begin,deleted text endnew text begin;new text end the child's foster parent or representative of the foster care
facilitydeleted text begin,deleted text endnew text begin;new text end and, deleted text beginwheredeleted text endnew text begin whennew text end appropriate, the child. When a child is age 14 or older, the child
may include two other individuals on the team preparing the child's out-of-home placement
plan. The child may select one member of the case planning team to be designated as the
child's advisor and to advocate with respect to the application of the reasonable and prudent
parenting standards. The responsible social services agency may reject an individual selected
by the child if the agency has good cause to believe that the individual would not act in the
best interest of the child. For a child in voluntary foster care for treatment under chapter
260D, preparation of the out-of-home placement plan shall additionally include the child's
mental health treatment provider. For a child 18 years of age or older, the responsible social
services agency shall involve the child and the child's parents as appropriate. As appropriate,
the plan shall be:

(1) submitted to the court for approval under section 260C.178, subdivision 7;

(2) ordered by the court, either as presented or modified after hearing, under section
260C.178, subdivision 7, or 260C.201, subdivision 6; and

(3) signed by the parent or parents or guardian of the child, the child's guardian ad litem,
a representative of the child's tribe, the responsible social services agency, and, if possible,
the child.

(c) The out-of-home placement plan shall be explained new text beginby the responsible social services
agency
new text endto all persons involved in deleted text beginitsdeleted text endnew text begin the plan'snew text end implementation, including the child who has
signed the plan, and shall set forth:

(1) a description of the foster care home or facility selected, including how the
out-of-home placement plan is designed to achieve a safe placement for the child in the
least restrictive, most family-likedeleted text begin,deleted text end setting available deleted text beginwhichdeleted text endnew text begin thatnew text end is in close proximity to the
home of the deleted text beginparent ordeleted text endnew text begin child'snew text end parents or deleted text beginguardian of the childdeleted text endnew text begin guardiansnew text end when the case plan
goal is reunificationdeleted text begin,deleted text endnew text begin;new text end and how the placement is consistent with the best interests and special
needs of the child according to the factors under subdivision 2, paragraph (b);

(2) the specific reasons for the placement of the child in foster care, and when
reunification is the plan, a description of the problems or conditions in the home of the
parent or parents deleted text beginwhichdeleted text endnew text begin thatnew text end necessitated removal of the child from home and the changes
the parent or parents must make for the child to safely return home;

(3) a description of the services offered and provided to prevent removal of the child
from the home and to reunify the family including:

(i) the specific actions to be taken by the parent or parents of the child to eliminate or
correct the problems or conditions identified in clause (2), and the time period during which
the actions are to be taken; and

(ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made to
achieve a safe and stable home for the child including social and other supportive services
to be provided or offered to the parent or parents or guardian of the child, the child, and the
residential facility during the period the child is in the residential facility;

(4) a description of any services or resources that were requested by the child or the
child's parent, guardian, foster parent, or custodian since the date of the child's placement
in the residential facility, and whether those services or resources were provided and if not,
the basis for the denial of the services or resources;

(5) the visitation plan for the parent or parents or guardian, other relatives as defined in
section 260C.007, subdivision 26b or 27, and siblings of the child if the siblings are not
placed together in foster care, and whether visitation is consistent with the best interest of
the child, during the period the child is in foster care;

(6) when a child cannot return to or be in the care of either parent, documentation of
steps to finalize adoption as the permanency plan for the child through reasonable efforts
to place the child for adoptionnew text begin pursuant to section 260C.605new text end. At a minimum, the
documentation must include consideration of whether adoption is in the best interests of
the childdeleted text begin,deleted text endnew text begin andnew text end child-specific recruitment efforts such as new text begina new text endrelative searchnew text begin, consideration of
relatives for adoptive placement,
new text end and the use of state, regional, and national adoption
exchanges to facilitate orderly and timely placements in and outside of the state. A copy of
this documentation shall be provided to the court in the review required under section
260C.317, subdivision 3, paragraph (b);

(7) when a child cannot return to or be in the care of either parent, documentation of
steps to finalize the transfer of permanent legal and physical custody to a relative as the
permanency plan for the child. This documentation must support the requirements of the
kinship placement agreement under section 256N.22 and must include the reasonable efforts
used to determine that it is not appropriate for the child to return home or be adopted, and
reasons why permanent placement with a relative through a Northstar kinship assistance
arrangement is in the child's best interest; how the child meets the eligibility requirements
for Northstar kinship assistance payments; agency efforts to discuss adoption with the child's
relative foster parent and reasons why the relative foster parent chose not to pursue adoption,
if applicable; and agency efforts to discuss with the child's parent or parents the permanent
transfer of permanent legal and physical custody or the reasons why these efforts were not
made;

(8) efforts to ensure the child's educational stability while in foster care for a child who
attained the minimum age for compulsory school attendance under state law and is enrolled
full time in elementary or secondary school, or instructed in elementary or secondary
education at home, or instructed in an independent study elementary or secondary program,
or incapable of attending school on a full-time basis due to a medical condition that is
documented and supported by regularly updated information in the child's case plan.
Educational stability efforts include:

(i) efforts to ensure that the child remains in the same school in which the child was
enrolled prior to placement or upon the child's move from one placement to another, including
efforts to work with the local education authorities to ensure the child's educational stability
and attendance; or

(ii) if it is not in the child's best interest to remain in the same school that the child was
enrolled in prior to placement or move from one placement to another, efforts to ensure
immediate and appropriate enrollment for the child in a new school;

(9) the educational records of the child including the most recent information available
regarding:

(i) the names and addresses of the child's educational providers;

(ii) the child's grade level performance;

(iii) the child's school record;

(iv) a statement about how the child's placement in foster care takes into account
proximity to the school in which the child is enrolled at the time of placement; and

(v) any other relevant educational information;

(10) the efforts by the responsible social services agency to ensure the oversight and
continuity of health care services for the foster child, including:

(i) the plan to schedule the child's initial health screens;

(ii) how the child's known medical problems and identified needs from the screens,
including any known communicable diseases, as defined in section 144.4172, subdivision
2, shall be monitored and treated while the child is in foster care;

(iii) how the child's medical information shall be updated and shared, including the
child's immunizations;

(iv) who is responsible to coordinate and respond to the child's health care needs,
including the role of the parent, the agency, and the foster parent;

(v) who is responsible for oversight of the child's prescription medications;

(vi) how physicians or other appropriate medical and nonmedical professionals shall be
consulted and involved in assessing the health and well-being of the child and determine
the appropriate medical treatment for the child; and

(vii) the responsibility to ensure that the child has access to medical care through either
medical insurance or medical assistance;

(11) the health records of the child including information available regarding:

(i) the names and addresses of the child's health care and dental care providers;

(ii) a record of the child's immunizations;

(iii) the child's known medical problems, including any known communicable diseases
as defined in section 144.4172, subdivision 2;

(iv) the child's medications; and

(v) any other relevant health care information such as the child's eligibility for medical
insurance or medical assistance;

(12) an independent living plan for a child 14 years of age or older, developed in
consultation with the child. The child may select one member of the case planning team to
be designated as the child's advisor and to advocate with respect to the application of the
reasonable and prudent parenting standards in subdivision 14. The plan should include, but
not be limited to, the following objectives:

(i) educational, vocational, or employment planning;

(ii) health care planning and medical coverage;

(iii) transportation including, where appropriate, assisting the child in obtaining a driver's
license;

(iv) money management, including the responsibility of the responsible social services
agency to ensure that the child annually receives, at no cost to the child, a consumer report
as defined under section 13C.001 and assistance in interpreting and resolving any inaccuracies
in the report;

(v) planning for housing;

(vi) social and recreational skills;

(vii) establishing and maintaining connections with the child's family and community;
and

(viii) regular opportunities to engage in age-appropriate or developmentally appropriate
activities typical for the child's age group, taking into consideration the capacities of the
individual child;

(13) for a child in voluntary foster care for treatment under chapter 260D, diagnostic
and assessment information, specific services relating to meeting the mental health care
needs of the child, and treatment outcomes;

(14) for a child 14 years of age or older, a signed acknowledgment that describes the
child's rights regarding education, health care, visitation, safety and protection from
exploitation, and court participation; receipt of the documents identified in section 260C.452;
and receipt of an annual credit report. The acknowledgment shall state that the rights were
explained in an age-appropriate manner to the child; and

(15) for a child placed in a qualified residential treatment program, the plan must include
the requirements in section 260C.708.

(d) The parent or parents or guardian and the child each shall have the right to legal
counsel in the preparation of the case plan and shall be informed of the right at the time of
placement of the child. The child shall also have the right to a guardian ad litem. If unable
to employ counsel from their own resources, the court shall appoint counsel upon the request
of the parent or parents or the child or the child's legal guardian. The parent or parents may
also receive assistance from any person or social services agency in preparation of the case
plan.

new text begin (e) new text endAfter the plan has been agreed upon by the parties involved or approved or ordered
by the court, the foster parents shall be fully informed of the provisions of the case plan and
shall be provided a copy of the plan.

new text begin (f) new text endUpon the child's discharge from foster care, the responsible social services agency
must provide the child's parent, adoptive parent, or permanent legal and physical custodian,
and the child, if the child is 14 years of age or older, with a current copy of the child's health
and education record. If a child meets the conditions in subdivision 15, paragraph (b), the
agency must also provide the child with the child's social and medical history. The responsible
social services agency may give a copy of the child's health and education record and social
and medical history to a child who is younger than 14 years of age, if it is appropriate and
if subdivision 15, paragraph (b), applies.

Sec. 35.

Minnesota Statutes 2021 Supplement, section 260C.212, subdivision 2, is amended
to read:


Subd. 2.

Placement decisions based on best interests of the child.

(a) The policy of
the state of Minnesota is to ensure that the child's best interests are met by requiring an
individualized determination of the needs of the child new text beginin consideration of paragraphs (a) to
(f),
new text endand of how the selected placement will serve the new text begincurrent and future new text endneeds of the child
being placed. The authorized child-placing agency shall place a child, released by court
order or by voluntary release by the parent or parents, in a family foster home selected by
considering placement with relatives deleted text beginand important friendsdeleted text end in the following order:

(1) with an individual who is related to the child by blood, marriage, or adoption,
including the legal parent, guardian, or custodian of the child's deleted text beginsiblingsdeleted text endnew text begin siblingnew text end; or

(2) with an individual who is an important friend deleted text beginwith whom the child has resided or
had significant contact
deleted text endnew text begin of the child or the child's parent or custodian, including an individual
with whom the child has resided or had significant contact or who has a significant
relationship to the child or the child's parent or custodian
new text end.

For an Indian child, the agency shall follow the order of placement preferences in the Indian
Child Welfare Act of 1978, United States Code, title 25, section 1915.

(b) Among the factors the agency shall consider in determining the new text begincurrent and future
new text end needs of the child are the following:

(1) the child's current functioning and behaviors;

(2) the medical needs of the child;

(3) the educational needs of the child;

(4) the developmental needs of the child;

(5) the child's history and past experience;

(6) the child's religious and cultural needs;

(7) the child's connection with a community, school, and faith community;

(8) the child's interests and talents;

(9) the child's deleted text beginrelationship to current caretakers,deleted text endnew text begin current and long-term needs regarding
relationships with
new text end parents, siblings, deleted text beginanddeleted text end relativesnew text begin, and other caretakersnew text end;

(10) the reasonable preference of the child, if the court, or the child-placing agency in
the case of a voluntary placement, deems the child to be of sufficient age to express
preferences; and

(11) for an Indian child, the best interests of an Indian child as defined in section 260.755,
subdivision 2a
.

new text begin When placing a child in foster care or in a permanent placement based on an individualized
determination of the child's needs, the agency must not use one factor in this paragraph to
the exclusion of all others, and the agency shall consider that the factors in paragraph (b)
may be interrelated.
new text end

(c) Placement of a child cannot be delayed or denied based on race, color, or national
origin of the foster parent or the child.

(d) Siblings should be placed together for foster care and adoption at the earliest possible
time unless it is documented that a joint placement would be contrary to the safety or
well-being of any of the siblings or unless it is not possible after reasonable efforts by the
responsible social services agency. In cases where siblings cannot be placed together, the
agency is required to provide frequent visitation or other ongoing interaction between
siblings unless the agency documents that the interaction would be contrary to the safety
or well-being of any of the siblings.

(e) Except for emergency placement as provided for in section 245A.035, the following
requirements must be satisfied before the approval of a foster or adoptive placement in a
related or unrelated home: (1) a completed background study under section 245C.08; and
(2) a completed review of the written home study required under section 260C.215,
subdivision 4
, clause (5), or 260C.611, to assess the capacity of the prospective foster or
adoptive parent to ensure the placement will meet the needs of the individual child.

(f) The agency must determine whether colocation with a parent who is receiving services
in a licensed residential family-based substance use disorder treatment program is in the
child's best interests according to paragraph (b) and include that determination in the child's
case plan under subdivision 1. The agency may consider additional factors not identified
in paragraph (b). The agency's determination must be documented in the child's case plan
before the child is colocated with a parent.

(g) The agency must establish a juvenile treatment screening team under section 260C.157
to determine whether it is necessary and appropriate to recommend placing a child in a
qualified residential treatment program, as defined in section 260C.007, subdivision 26d.

Sec. 36.

Minnesota Statutes 2020, section 260C.212, subdivision 4a, is amended to read:


Subd. 4a.

Monthly caseworker visits.

(a) Every child in foster care or on a trial home
visit shall be visited by the child's caseworker or another person who has responsibility for
visitation of the child on a monthly basis, with the majority of visits occurring in the child's
residence. The responsible social services agency may designate another person responsible
for monthly case visits. For the purposes of this section, the following definitions apply:

(1) "visit" is defined as a face-to-face contact between a child and the child's caseworker;

(2) "visited on a monthly basis" is defined as at least one visit per calendar month;

(3) "the child's caseworker" is defined as the person who has responsibility for managing
the child's foster care placement case as assigned by the responsible social services agency;

(4) "another person" means the professional staff whom the responsible social services
agency has assigned in the out-of-home placement plan or case plan. Another person must
be professionally trained to assess the child's safety, permanency, well-being, and case
progress. The agency may not designate the guardian ad litem, the child foster care provider,
residential facility staff, or a qualified individual as defined in section 260C.007,
subdivision26b
, as another person; and

(5) "the child's residence" is defined as the home where the child is residing, and can
include the foster home, child care institution, or the home from which the child was removed
if the child is on a trial home visit.

(b) Caseworker visits shall be of sufficient substance and duration to address issues
pertinent to case planning and service delivery to ensure the safety, permanency, and
well-being of the child, including whether the child is enrolled and attending school as
required by law.

new text begin (c) Every effort shall be made by the responsible social services agency and professional
staff to have the monthly visit with the child outside the presence of the child's parents,
foster parents, or facility staff. There may be situations related to the child's needs when a
caseworker visit cannot occur with the child alone. The reason the caseworker visit occurred
in the presence of others must be documented in the case record and may include:
new text end

new text begin (1) that the child exhibits intense emotion or behavior indicating that visiting without
the presence of the parent, foster parent, or facility staff would be traumatic for the child;
new text end

new text begin (2) that despite a caseworker's efforts, the child declines to visit with the caseworker
outside the presence of the parent, foster parent, or facility staff; and
new text end

new text begin (3) that the child has a specific developmental delay, physical limitation, incapacity,
medical device, or significant medical need, such that the parent, foster parent, or facility
staff is required to be present with the child during the visit.
new text end

Sec. 37.

Minnesota Statutes 2020, section 260C.221, is amended to read:


260C.221 RELATIVE SEARCHnew text begin AND ENGAGEMENT; PLACEMENT
CONSIDERATION
new text end.

new text begin Subdivision 1. new text end

new text begin Relative search requirements. new text end

(a) The responsible social services agency
shall exercise due diligence to identify and notify adult relatives new text beginof a child as well as current
caregivers of the child's sibling,
new text endprior to placement or within 30 days after the child's removal
from the parentnew text begin, regardless of whether a child is placed in a relative's home, as required
under subdivision 2
new text end. deleted text beginThe county agency shall consider placement with a relative under this
section without delay and whenever the child must move from or be returned to foster care.
deleted text end
The relative search required by this section shall be comprehensive in scope. deleted text beginAfter a finding
that the agency has made reasonable efforts to conduct the relative search under this
paragraph, the agency has the continuing responsibility to appropriately involve relatives,
who have responded to the notice required under this paragraph, in planning for the child
and to continue to consider relatives according to the requirements of section 260C.212,
subdivision 2
. At any time during the course of juvenile protection proceedings, the court
may order the agency to reopen its search for relatives when it is in the child's best interest
to do so.
deleted text end

(b) The relative search required by this section shall include both maternal and paternal
adult relatives of the child; all adult grandparents; all legal parents, guardians, or custodians
of the child's siblings; and any other adult relatives suggested by the child's parents, subject
to the exceptions due to family violence in new text beginsubdivision 5, new text endparagraph deleted text begin(c)deleted text endnew text begin (b)new text end. The search shall
also include getting information from the child in an age-appropriate manner about who the
child considers to be family members and important friends with whom the child has resided
or had significant contact. The relative search required under this section must fulfill the
agency's duties under the Indian Child Welfare Act regarding active efforts to prevent the
breakup of the Indian family under United States Code, title 25, section 1912(d), and to
meet placement preferences under United States Code, title 25, section 1915.

new text begin (c) The responsible social services agency has a continuing responsibility to search for
and identify relatives of a child and send the notice to relatives that is required under
subdivision 2, unless the court has relieved the agency of this duty under subdivision 5,
paragraph (e).
new text end

new text begin Subd. 2. new text end

new text begin Relative notice requirements. new text end

new text begin(a) The agency may provide oral or written
notice to a child's relatives. In the child's case record, the agency must document providing
the required notice to each of the child's relatives.
new text endThenew text begin responsible social services agency
must notify
new text end relatives deleted text beginmust be notifieddeleted text end:

(1) of the need for a foster home for the child, the option to become a placement resource
for the child, new text beginthe order of placement that the agency will consider under section 260C.212,
subdivision 2, paragraph (a),
new text endand the possibility of the need for a permanent placement for
the child;

(2) of their responsibility to keep the responsible social services agency and the court
informed of their current address in order to receive notice in the event that a permanent
placement is sought for the child and to receive notice of the permanency progress review
hearing under section 260C.204. A relative who fails to provide a current address to the
responsible social services agency and the court forfeits the right to receive notice of the
possibility of permanent placement and of the permanency progress review hearing under
section 260C.204new text begin, until the relative provides a current address to the responsible social
services agency and the court
new text end. A decision by a relative not to be identified as a potential
permanent placement resource or participate in planning for the child deleted text beginat the beginning of
the case
deleted text end shall not affect whether the relative is considered for placement ofnew text begin, or as a
permanency resource for,
new text end the child with that relative deleted text beginlaterdeleted text endnew text begin at any time in the case, and shall
not be the sole basis for the court to rule out the relative as the child's placement or
permanency resource
new text end;

(3) that the relative may participate in the care and planning for the child, new text beginas specified
in subdivision 3,
new text endincluding that the opportunity for such participation may be lost by failing
to respond to the notice sent under this subdivisiondeleted text begin. "Participate in the care and planning"
includes, but is not limited to, participation in case planning for the parent and child,
identifying the strengths and needs of the parent and child, supervising visits, providing
respite and vacation visits for the child, providing transportation to appointments, suggesting
other relatives who might be able to help support the case plan, and to the extent possible,
helping to maintain the child's familiar and regular activities and contact with friends and
relatives
deleted text end;

(4) of the family foster care licensing new text beginand adoption home study new text endrequirements, including
how to complete an application and how to request a variance from licensing standards that
do not present a safety or health risk to the child in the home under section 245A.04 and
supports that are available for relatives and children who reside in a family foster home;
deleted text begin and
deleted text end

(5) of the relatives' right to ask to be notified of any court proceedings regarding the
child, to attend the hearings, and of a relative's right deleted text beginor opportunitydeleted text end to be heard by the court
as required under section 260C.152, subdivision 5deleted text begin.deleted text endnew text begin;
new text end

new text begin (6) that regardless of the relative's response to the notice sent under this subdivision, the
agency is required to establish permanency for a child, including planning for alternative
permanency options if the agency's reunification efforts fail or are not required; and
new text end

new text begin (7) that by responding to the notice, a relative may receive information about participating
in a child's family and permanency team if the child is placed in a qualified residential
treatment program as defined in section 260C.007, subdivision 26d.
new text end

new text begin (b) The responsible social services agency shall send the notice required under paragraph
(a) to relatives who become known to the responsible social services agency, except for
relatives that the agency does not contact due to safety reasons under subdivision 5, paragraph
(b). The responsible social services agency shall continue to send notice to relatives
notwithstanding a court's finding that the agency has made reasonable efforts to conduct a
relative search.
new text end

new text begin (c) The responsible social services agency is not required to send the notice under
paragraph (a) to relatives who become known to the agency after an adoption placement
agreement has been fully executed under section 260C.613, subdivision 1. If such a relative
wishes to be considered for adoptive placement of the child, the agency shall inform the
relative of the relative's ability to file a motion for an order for adoptive placement under
section 260C.607, subdivision 6.
new text end

new text begin Subd. 3. new text end

new text begin Relative engagement requirements. new text end

new text begin (a) A relative who responds to the notice
under subdivision 2 has the opportunity to participate in care and planning for a child, which
must not be limited based solely on the relative's prior inconsistent participation or
nonparticipation in care and planning for the child. Care and planning for a child may include
but is not limited to:
new text end

new text begin (1) participating in case planning for the child and child's parent, including identifying
services and resources that meet the individualized needs of the child and child's parent. A
relative's participation in case planning may be in person, via phone call, or by electronic
means;
new text end

new text begin (2) identifying the strengths and needs of the child and child's parent;
new text end

new text begin (3) asking the responsible social services agency to consider the relative for placement
of the child according to subdivision 4;
new text end

new text begin (4) acting as a support person for the child, the child's parents, and the child's current
caregiver;
new text end

new text begin (5) supervising visits;
new text end

new text begin (6) providing respite care for the child and having vacation visits with the child;
new text end

new text begin (7) providing transportation;
new text end

new text begin (8) suggesting other relatives who may be able to participate in the case plan or that the
agency may consider for placement of the child. The agency shall send a notice to each
relative identified by other relatives according to subdivision 2, paragraph (b), unless a
relative received this notice earlier in the case;
new text end

new text begin (9) helping to maintain the child's familiar and regular activities and contact with the
child's friends and relatives, including providing supervision of the child at family gatherings
and events; and
new text end

new text begin (10) participating in the child's family and permanency team if the child is placed in a
qualified residential treatment program as defined in section 260C.007, subdivision 26d.
new text end

new text begin (b) The responsible social services agency shall make reasonable efforts to contact and
engage relatives who respond to the notice required under this section. Upon a request by
a relative or party to the proceeding, the court may conduct a review of the agency's
reasonable efforts to contact and engage relatives who respond to the notice. If the court
finds that the agency did not make reasonable efforts to contact and engage relatives who
respond to the notice, the court may order the agency to make reasonable efforts to contact
and engage relatives who respond to the notice in care and planning for the child.
new text end

new text begin Subd. 4. new text end

new text begin Placement considerations. new text end

new text begin (a) The responsible social services agency shall
consider placing a child with a relative under this section without delay and when the child:
new text end

new text begin (1) enters foster care;
new text end

new text begin (2) must be moved from the child's current foster setting;
new text end

new text begin (3) must be permanently placed away from the child's parent; or
new text end

new text begin (4) returns to foster care after permanency has been achieved for the child.
new text end

new text begin (b) The agency shall consider placing a child with relatives:
new text end

new text begin (1) in the order specified in section 260C.212, subdivision 2, paragraph (a); and
new text end

new text begin (2) based on the child's best interests using the factors in section 260C.212, subdivision
2.
new text end

new text begin (c) The agency shall document how the agency considered relatives in the child's case
record.
new text end

new text begin (d) Any relative who requests to be a placement option for a child in foster care has the
right to be considered for placement of the child according to section 260C.212, subdivision
2, paragraph (a), unless the court finds that placing the child with a specific relative would
endanger the child, sibling, parent, guardian, or any other family member under subdivision
5, paragraph (b).
new text end

new text begin (e) When adoption is the responsible social services agency's permanency goal for the
child, the agency shall consider adoptive placement of the child with a relative in the order
specified under section 260C.212, subdivision 2, paragraph (a).
new text end

new text begin Subd. 5. new text end

new text begin Data disclosure; court review. new text end

deleted text begin(c)deleted text endnew text begin (a)new text end A responsible social services agency
may disclose private data, as defined in section 13.02 and chapter 260E, to relatives of the
child for the purpose of locating and assessing a suitable placement and may use any
reasonable means of identifying and locating relatives including the Internet or other
electronic means of conducting a search. The agency shall disclose data that is necessary
to facilitate possible placement with relatives and to ensure that the relative is informed of
the needs of the child so the relative can participate in planning for the child and be supportive
of services to the child and family.

new text begin (b) new text endIf the child's parent refuses to give the responsible social services agency information
sufficient to identify the maternal and paternal relatives of the child, the agency shall ask
the juvenile court to order the parent to provide the necessary informationnew text begin and shall use
other resources to identify the child's maternal and paternal relatives
new text end. If a parent makes an
explicit request that a specific relative not be contacted or considered for placement due to
safety reasonsnew text begin,new text end including past family or domestic violence, the agency shall bring the parent's
request to the attention of the court to determine whether the parent's request is consistent
with the best interests of the child deleted text beginanddeleted text endnew text begin.new text end The agency shall not contact the specific relative
when the juvenile court finds that contacting new text beginor placing the child with new text endthe specific relative
would endanger the parent, guardian, child, sibling, or any family member.new text begin Unless section
260C.139 applies to the child's case, a court shall not waive or relieve the responsible social
services agency of reasonable efforts to:
new text end

new text begin (1) conduct a relative search;
new text end

new text begin (2) notify relatives;
new text end

new text begin (3) contact and engage relatives in case planning; and
new text end

new text begin (4) consider relatives for placement of the child.
new text end

new text begin (c) Notwithstanding chapter 13, the agency shall disclose data to the court about particular
relatives that the agency has identified, contacted, or considered for the child's placement
for the court to review the agency's due diligence.
new text end

(d) At a regularly scheduled hearing not later than three months after the child's placement
in foster care and as required in deleted text beginsectiondeleted text endnew text begin sections 260C.193 andnew text end 260C.202, the agency shall
report to the court:

(1) deleted text beginitsdeleted text endnew text begin the agency'snew text end efforts to identify maternal and paternal relatives of the child and to
engage the relatives in providing support for the child and family, and document that the
relatives have been provided the notice required under deleted text beginparagraph (a)deleted text endnew text begin subdivision 2new text end; and

(2) deleted text beginitsdeleted text endnew text begin the agency'snew text end decision regarding placing the child with a relative as required under
section 260C.212, subdivision 2deleted text begin, and to askdeleted text endnew text begin. If the responsible social services agency decides
that relative placement is not in the child's best interests at the time of the hearing, the agency
shall inform the court of the agency's decision, including:
new text end

new text begin (i) why the agency decided against relative placement of the child; and
new text end

new text begin (ii) the agency's efforts to engagenew text end relatives deleted text beginto visit or maintain contact with the child in
order
deleted text endnew text begin as required under subdivision 3new text end to support family connections for the childdeleted text begin, when
placement with a relative is not possible or appropriate
deleted text end.

deleted text begin (e) Notwithstanding chapter deleted text end deleted text begin 13 deleted text end deleted text begin , the agency shall disclose data about particular relatives
identified, searched for, and contacted for the purposes of the court's review of the agency's
due diligence.
deleted text end

deleted text begin (f)deleted text endnew text begin (e)new text end When the court is satisfied that the agency has exercised due diligence to identify
relatives and provide the notice required in deleted text beginparagraph (a)deleted text endnew text begin subdivision 2new text end, the court may find
that new text beginthe agency made new text endreasonable efforts deleted text beginhave been madedeleted text end to conduct a relative search to
identify and provide notice to adult relatives as required under section 260.012, paragraph
(e), clause (3). new text beginA finding under this paragraph does not relieve the responsible social services
agency of the ongoing duty to contact, engage, and consider relatives under this section nor
is it a basis for the court to rule out any relative from being a foster care or permanent
placement option for the child. The agency has the continuing responsibility to:
new text end

new text begin (1) involve relatives who respond to the notice in planning for the child; and
new text end

new text begin (2) continue considering relatives for the child's placement while taking the child's short-
and long-term permanency goals into consideration, according to the requirements of section
260C.212, subdivision 2.
new text end

new text begin (f) At any time during the course of juvenile protection proceedings, the court may order
the agency to reopen the search for relatives when it is in the child's best interests.
new text end

new text begin (g) new text endIf the court is not satisfied that the agency has exercised due diligence to identify
relatives and provide the notice required in deleted text beginparagraph (a)deleted text endnew text begin subdivision 2new text end, the court may order
the agency to continue its search and notice efforts and to report back to the court.

deleted text begin (g) When the placing agency determines that permanent placement proceedings are
necessary because there is a likelihood that the child will not return to a parent's care, the
agency must send the notice provided in paragraph (h), may ask the court to modify the
duty of the agency to send the notice required in paragraph (h), or may ask the court to
completely relieve the agency of the requirements of paragraph (h). The relative notification
requirements of paragraph (h) do not apply when the child is placed with an appropriate
relative or a foster home that has committed to adopting the child or taking permanent legal
and physical custody of the child and the agency approves of that foster home for permanent
placement of the child. The actions ordered by the court under this section must be consistent
with the best interests, safety, permanency, and welfare of the child.
deleted text end

(h) deleted text beginUnless required under the Indian Child Welfare Act or relieved of this duty by the
court under paragraph (f),
deleted text end When the agency determines that it is necessary to prepare for
permanent placement determination proceedings, or in anticipation of filing a termination
of parental rights petition, the agency shall send notice to deleted text beginthedeleted text end relativesnew text begin who responded to a
notice under this section sent at any time during the case
new text end, any adult with whom the child is
currently residing, any adult with whom the child has resided for one year or longer in the
past, and any adults who have maintained a relationship or exercised visitation with the
child as identified in the agency case plan. The notice must state that a permanent home is
sought for the child and that the individuals receiving the notice may indicate to the agency
their interest in providing a permanent home. The notice must state that within 30 days of
receipt of the notice an individual receiving the notice must indicate to the agency the
individual's interest in providing a permanent home for the child or that the individual may
lose the opportunity to be considered for a permanent placement.new text begin A relative's failure to
respond or timely respond to the notice is not a basis for ruling out the relative from being
a permanent placement option for the child should the relative request to be considered for
permanent placement at a later date.
new text end

Sec. 38.

Minnesota Statutes 2020, section 260C.331, subdivision 1, is amended to read:


Subdivision 1.

Care, examination, or treatment.

(a) Except where parental rights are
terminated,

(1) whenever legal custody of a child is transferred by the court to a responsible social
services agency,

(2) whenever legal custody is transferred to a person other than the responsible social
services agency, but under the supervision of the responsible social services agency, or

(3) whenever a child is given physical or mental examinations or treatment under order
of the court, and no provision is otherwise made by law for payment for the care,
examination, or treatment of the child, these costs are a charge upon the welfare funds of
the county in which proceedings are held upon certification of the judge of juvenile court.

(b) The court deleted text beginshalldeleted text endnew text begin maynew text end order, and the responsible social services agency deleted text beginshalldeleted text endnew text begin maynew text end
require, the parents or custodian of a child, while the child is under the age of 18, to use deleted text beginthe
total
deleted text end income and resources attributable to the child for the period of care, examination, or
treatment, except for clothing and personal needs allowance as provided in section 256B.35,
to reimburse the county for the cost of care, examination, or treatment. Income and resources
attributable to the child include, but are not limited to, Social Security benefits, Supplemental
Security Income (SSI), veterans benefits, railroad retirement benefits and child support.
When the child is over the age of 18, and continues to receive care, examination, or treatment,
the court deleted text beginshalldeleted text endnew text begin maynew text end order, and the responsible social services agency deleted text beginshalldeleted text endnew text begin maynew text end require,
reimbursement from the child for the cost of care, examination, or treatment from the income
and resources attributable to the child less the clothing and personal needs allowance. Income
does not include earnings from a child over the age of 18 who is working as part of a plan
under section 260C.212, subdivision 1, paragraph (c), clause (12), to transition from foster
care, or the income and resources deleted text beginfrom sources other than Supplemental Security Income
and child support
deleted text end that are needed to complete the requirements listed in section 260C.203.new text begin
The responsible social services agency shall determine whether requiring reimbursement,
either through child support or parental fees, for the cost of care, examination, or treatment
from the parents or custodian of a child is in the child's best interests. In determining whether
to require reimbursement, the responsible social services agency shall consider:
new text end

new text begin (1) whether requiring reimbursement would compromise the parent's ability to meet the
requirements of the reunification plan;
new text end

new text begin (2) whether requiring reimbursement would compromise the parent's ability to meet the
child's needs after reunification; and
new text end

new text begin (3) whether redirecting existing child support payments or changing the representative
payee of social security benefits to the responsible social services agency would limit the
parent's ability to maintain financial stability for the child.
new text end

(c) If the income and resources attributable to the child are not enough to reimburse the
county for the full cost of the care, examination, or treatment, the court deleted text beginshalldeleted text endnew text begin maynew text end inquire
into the ability of the parents to deleted text beginsupport the childdeleted text endnew text begin reimburse the county for the cost of care,
examination, or treatment
new text end and, after giving the parents a reasonable opportunity to be heard,
the court deleted text beginshalldeleted text endnew text begin maynew text end order, and the responsible social services agency deleted text beginshalldeleted text endnew text begin maynew text end require, the
parents to contribute to the cost of care, examination, or treatment of the child. When
determining the amount to be contributed by the parents, the court shall use a fee schedule
based upon ability to pay that is established by the responsible social services agency and
approved by the commissioner of human services. The income of a stepparent who has not
adopted a child shall be excluded in calculating the parental contribution under this section.new text begin
In determining whether to require reimbursement, the responsible social services agency
shall consider:
new text end

new text begin (1) whether requiring reimbursement would compromise the parent's ability to meet the
requirements of the reunification plan;
new text end

new text begin (2) whether requiring reimbursement would compromise the parent's ability to meet the
child's needs after reunification; and
new text end

new text begin (3) whether requiring reimbursement would compromise the parent's ability to meet the
needs of the family.
new text end

(d)new text begin If the responsible social services agency determines that reimbursement is in the
child's best interest,
new text end the court shall order the amount of reimbursement attributable to the
parents or custodian, or attributable to the child, or attributable to both sources, withheld
under chapter 518A from the income of the parents or the custodian of the child. A parent
or custodian who fails to pay without good reason may be proceeded against for contempt,
or the court may inform the county attorney, who shall proceed to collect the unpaid sums,
or both procedures may be used.

(e) If the court orders a physical or mental examination for a child, the examination is
a medically necessary service for purposes of determining whether the service is covered
by a health insurance policy, health maintenance contract, or other health coverage plan.
Court-ordered treatment shall be subject to policy, contract, or plan requirements for medical
necessity. Nothing in this paragraph changes or eliminates benefit limits, conditions of
coverage, co-payments or deductibles, provider restrictions, or other requirements in the
policy, contract, or plan that relate to coverage of other medically necessary services.

(f) Notwithstanding paragraph (b), (c), or (d), a parent, custodian, or guardian of the
child is not required to use income and resources attributable to the child to reimburse the
county for costs of care and is not required to contribute to the cost of care of the child
during any period of time when the child is returned to the home of that parent, custodian,
or guardian pursuant to a trial home visit under section 260C.201, subdivision 1, paragraph
(a).

Sec. 39.

Minnesota Statutes 2020, section 260C.513, is amended to read:


260C.513 PERMANENCY DISPOSITIONS WHEN CHILD CANNOT RETURN
HOME.

(a) deleted text beginTermination of parental rights and adoption, or guardianship to the commissioner of
human services through a consent to adopt, are preferred permanency options for a child
who cannot return home. If the court finds that termination of parental rights and guardianship
to the commissioner is not in the child's best interests, the court may transfer permanent
legal and physical custody of the child to a relative when that order is in the child's best
interests
deleted text endnew text begin In determining a permanency disposition under section 260C.515 for a child who
cannot return home, the court shall give preference to a permanency disposition that will
result in the child being placed in the permanent care of a relative through a termination of
parental rights and adoption, guardianship to the commissioner of human services through
a consent to adopt, or a transfer of permanent legal and physical custody, consistent with
the best interests of the child and section 260C.212, subdivision 2, paragraph (a). If a relative
is not available to accept placement or the court finds that a permanent placement with a
relative is not in the child's best interests, the court may consider a permanency disposition
that may result in the child being permanently placed in the care of a nonrelative caregiver,
including adoption
new text end.

(b) When the court has determined that permanent placement of the child away from
the parent is necessary, the court shall consider permanent alternative homes that are available
both inside and outside the state.

Sec. 40.

Minnesota Statutes 2021 Supplement, section 260C.605, subdivision 1, is amended
to read:


Subdivision 1.

Requirements.

(a) Reasonable efforts to finalize the adoption of a child
under the guardianship of the commissioner shall be made by the responsible social services
agency responsible for permanency planning for the child.

(b) Reasonable efforts to make a placement in a home according to the placement
considerations under section 260C.212, subdivision 2, with a relative or foster parent who
will commit to being the permanent resource for the child in the event the child cannot be
reunified with a parent are required under section 260.012 and may be made concurrently
with reasonable, or if the child is an Indian child, active efforts to reunify the child with the
parent.

(c) Reasonable efforts under paragraph (b) must begin as soon as possible when the
child is in foster care under this chapter, but not later than the hearing required under section
260C.204.

(d) Reasonable efforts to finalize the adoption of the child include:

new text begin (1) considering the child's preference for an adoptive family;
new text end

deleted text begin (1)deleted text endnew text begin (2)new text end using age-appropriate engagement strategies to plan for adoption with the child;

deleted text begin (2)deleted text endnew text begin (3)new text end identifying an appropriate prospective adoptive parent for the child by updating
the child's identified needs using the factors in section 260C.212, subdivision 2;

deleted text begin (3)deleted text endnew text begin (4)new text end making an adoptive placement that meets the child's needs by:

(i) completing or updating the relative search required under section 260C.221 and giving
notice of the need for an adoptive home for the child to:

(A) relatives who have kept the agency or the court apprised of their whereabouts deleted text beginand
who have indicated an interest in adopting the child
deleted text end; or

(B) relatives of the child who are located in an updated search;

(ii) an updated search is required whenever:

(A) there is no identified prospective adoptive placement for the child notwithstanding
a finding by the court that the agency made diligent efforts under section 260C.221, in a
hearing required under section 260C.202;

(B) the child is removed from the home of an adopting parent; or

(C) the court determines new text beginthat new text enda relative search by the agency is in the best interests of
the child;

(iii) engaging the child's new text beginrelatives or current or former new text endfoster deleted text beginparent and the child's
relatives identified as an adoptive resource during the search conducted under section
260C.221,
deleted text endnew text begin parentsnew text end to commit to being the prospective adoptive parent of the childnew text begin, and
considering the child's relatives for adoptive placement of the child in the order specified
under section 260C.212, subdivision 2, paragraph (a)
new text end; or

(iv) when there is no identified prospective adoptive parent:

(A) registering the child on the state adoption exchange as required in section 259.75
unless the agency documents to the court an exception to placing the child on the state
adoption exchange reported to the commissioner;

(B) reviewing all families with approved adoption home studies associated with the
responsible social services agency;

(C) presenting the child to adoption agencies and adoption personnel who may assist
with finding an adoptive home for the child;

(D) using newspapers and other media to promote the particular child;

(E) using a private agency under grant contract with the commissioner to provide adoption
services for intensive child-specific recruitment efforts; and

(F) making any other efforts or using any other resources reasonably calculated to identify
a prospective adoption parent for the child;

deleted text begin (4)deleted text endnew text begin (5)new text end updating and completing the social and medical history required under sections
260C.212, subdivision 15, and 260C.609;

deleted text begin (5)deleted text endnew text begin (6)new text end making, and keeping updated, appropriate referrals required by section 260.851,
the Interstate Compact on the Placement of Children;

deleted text begin (6)deleted text endnew text begin (7)new text end giving notice regarding the responsibilities of an adoptive parent to any prospective
adoptive parent as required under section 259.35;

deleted text begin (7)deleted text endnew text begin (8)new text end offering the adopting parent the opportunity to apply for or decline adoption
assistance under chapter 256N;

deleted text begin (8)deleted text endnew text begin (9)new text end certifying the child for adoption assistance, assessing the amount of adoption
assistance, and ascertaining the status of the commissioner's decision on the level of payment
if the adopting parent has applied for adoption assistance;

deleted text begin (9)deleted text endnew text begin (10)new text end placing the child with siblings. If the child is not placed with siblings, the agency
must document reasonable efforts to place the siblings together, as well as the reason for
separation. The agency may not cease reasonable efforts to place siblings together for final
adoption until the court finds further reasonable efforts would be futile or that placement
together for purposes of adoption is not in the best interests of one of the siblings; and

deleted text begin (10)deleted text endnew text begin (11)new text end working with the adopting parent to file a petition to adopt the child and with
the court administrator to obtain a timely hearing to finalize the adoption.

Sec. 41.

Minnesota Statutes 2020, section 260C.607, subdivision 2, is amended to read:


Subd. 2.

Notice.

Notice of review hearings shall be given by the court to:

(1) the responsible social services agency;

(2) the child, if the child is age ten and older;

(3) the child's guardian ad litem;

(4) counsel appointed for the child pursuant to section 260C.163, subdivision 3;

(5) relatives of the child who have kept the court informed of their whereabouts as
required in section 260C.221 and who have responded to the agency's notice under section
260C.221, deleted text beginindicating a willingness to provide an adoptive home for the childdeleted text end unless the
relative has been previously ruled out by the court as a suitable deleted text beginfoster parent ordeleted text end permanency
resource for the child;

(6) the current foster or adopting parent of the child;

(7) any foster or adopting parents of siblings of the child; and

(8) the Indian child's tribe.

Sec. 42.

Minnesota Statutes 2020, section 260C.607, subdivision 5, is amended to read:


Subd. 5.

Required placement by responsible social services agency.

(a) No petition
for adoption shall be filed for a child under the guardianship of the commissioner unless
the child sought to be adopted has been placed for adoption with the adopting parent by the
responsible social services agencynew text begin as required under section 260C.613, subdivision 1new text end. The
court may order the agency to make an adoptive placement using standards and procedures
under subdivision 6.

(b) Any relative or the child's foster parent who believes the responsible agency has not
reasonably considered the relative's or foster parent's request to be considered for adoptive
placement as required under section 260C.212, subdivision 2, and who wants to be considered
for adoptive placement of the child shall bring a request for consideration to the attention
of the court during a review required under this section. The child's guardian ad litem and
the child may also bring a request for a relative or the child's foster parent to be considered
for adoptive placement. After hearing from the agency, the court may order the agency to
take appropriate action regarding the relative's or foster parent's request for consideration
under section 260C.212, subdivision 2, paragraph (b).

Sec. 43.

Minnesota Statutes 2021 Supplement, section 260C.607, subdivision 6, is amended
to read:


Subd. 6.

Motion and hearing to order adoptive placement.

(a) At any time after the
district court orders the child under the guardianship of the commissioner of human services,
but not later than 30 days after receiving notice required under section 260C.613, subdivision
1, paragraph (c), that the agency has made an adoptive placement, a relative or the child's
foster parent may file a motion for an order for adoptive placement of a child who is under
the guardianship of the commissioner if the relative or the child's foster parent:

(1) has an adoption home study under section 259.41 new text beginor 260C.611 new text endapproving the relative
or foster parent for adoption deleted text beginand hasdeleted text endnew text begin. If the relative or foster parent does not have an adoption
home study, an affidavit attesting to efforts to complete an adoption home study may be
filed with the motion. The affidavit must be signed by the relative or foster parent and the
responsible social services agency or licensed child-placing agency completing the adoption
home study. The relative or foster parent must also have
new text end been a resident of Minnesota for
at least six months before filing the motion; the court may waive the residency requirement
for the moving party if there is a reasonable basis to do so; or

(2) is not a resident of Minnesota, but has an approved adoption home study by an agency
licensed or approved to complete an adoption home study in the state of the individual's
residence and the study is filed with the motion for adoptive placement.new text begin If the relative or
foster parent does not have an adoption home study in the relative or foster parent's state
of residence, an affidavit attesting to efforts to complete an adoption home study may be
filed with the motion instead. The affidavit must be signed by the relative or foster parent
and the agency completing the adoption home study.
new text end

(b) The motion shall be filed with the court conducting reviews of the child's progress
toward adoption under this section. The motion and supporting documents must make a
prima facie showing that the agency has been unreasonable in failing to make the requested
adoptive placement. The motion must be served according to the requirements for motions
under the Minnesota Rules of Juvenile Protection Procedure and shall be made on all
individuals and entities listed in subdivision 2.

(c) If the motion and supporting documents do not make a prima facie showing for the
court to determine whether the agency has been unreasonable in failing to make the requested
adoptive placement, the court shall dismiss the motion. If the court determines a prima facie
basis is made, the court shall set the matter for evidentiary hearing.

(d) At the evidentiary hearing, the responsible social services agency shall proceed first
with evidence about the reason for not making the adoptive placement proposed by the
moving party. new text beginWhen the agency presents evidence regarding the child's current relationship
with the identified adoptive placement resource, the court must consider the agency's efforts
to support the child's relationship with the moving party consistent with section 260C.221.
new text end The moving party then has the burden of proving by a preponderance of the evidence that
the agency has been unreasonable in failing to make the adoptive placement.

new text begin (e) The court shall review and enter findings regarding whether the agency, in making
an adoptive placement decision for the child:
new text end

new text begin (1) considered relatives for adoptive placement in the order specified under section
260C.212, subdivision 2, paragraph (a); and
new text end

new text begin (2) assessed how the identified adoptive placement resource and the moving party are
each able to meet the child's current and future needs, based on an individualized
determination of the child's needs, as required under sections 260C.212, subdivision 2, and
260C.613, subdivision 1, paragraph (b).
new text end

deleted text begin (e)deleted text endnew text begin (f)new text end At the conclusion of the evidentiary hearing, if the court finds that the agency has
been unreasonable in failing to make the adoptive placement and that the deleted text beginrelative or the
child's foster parent
deleted text endnew text begin moving partynew text end is the most suitable adoptive home to meet the child's
needs using the factors in section 260C.212, subdivision 2, paragraph (b), the court maynew text begin:
new text end

new text begin (1)new text end order the responsible social services agency to make an adoptive placement in the
home of the deleted text beginrelative or the child's foster parent.deleted text endnew text begin moving party if the moving party has an
approved adoption home study; or
new text end

new text begin (2) order the responsible social services agency to place the child in the home of the
moving party upon approval of an adoption home study. The agency must promote and
support the child's ongoing visitation and contact with the moving party until the child is
placed in the moving party's home. The agency must provide an update to the court after
90 days, including progress and any barriers encountered. If the moving party does not have
an approved adoption home study within 180 days, the moving party and the agency must
inform the court of any barriers to obtaining the approved adoption home study during a
review hearing under this section. If the court finds that the moving party is unable to obtain
an approved adoption home study, the court must dismiss the order for adoptive placement
under this subdivision and order the agency to continue making reasonable efforts to finalize
the adoption of the child as required under section 260C.605.
new text end

deleted text begin (f)deleted text endnew text begin (g)new text end If, in order to ensure that a timely adoption may occur, the court orders the
responsible social services agency to make an adoptive placement under this subdivision,
the agency shall:

(1) make reasonable efforts to obtain a fully executed adoption placement agreementnew text begin,
including assisting the moving party with the adoption home study process
new text end;

(2) work with the moving party regarding eligibility for adoption assistance as required
under chapter 256N; and

(3) if the moving party is not a resident of Minnesota, timely refer the matter for approval
of the adoptive placement through the Interstate Compact on the Placement of Children.

deleted text begin (g)deleted text endnew text begin (h)new text end Denial or granting of a motion for an order for adoptive placement after an
evidentiary hearing is an order which may be appealed by the responsible social services
agency, the moving party, the child, when age ten or over, the child's guardian ad litem,
and any individual who had a fully executed adoption placement agreement regarding the
child at the time the motion was filed if the court's order has the effect of terminating the
adoption placement agreement. An appeal shall be conducted according to the requirements
of the Rules of Juvenile Protection Procedure.

Sec. 44.

Minnesota Statutes 2020, section 260C.613, subdivision 1, is amended to read:


Subdivision 1.

Adoptive placement decisions.

(a) The responsible social services agency
has exclusive authority to make an adoptive placement of a child under the guardianship of
the commissioner. The child shall be considered placed for adoption when the adopting
parent, the agency, and the commissioner have fully executed an adoption placement
agreement on the form prescribed by the commissioner.

(b) The responsible social services agency shall use an individualized determination of
the child's currentnew text begin and futurenew text end needsnew text begin,new text end pursuant to section 260C.212, subdivision 2, paragraph
(b), to determine the most suitable adopting parent for the child in the child's best interests.new text begin
The responsible social services agency must consider adoptive placement of the child with
relatives in the order specified in section 260C.212, subdivision 2, paragraph (a).
new text end

(c) The responsible social services agency shall notify the court and parties entitled to
notice under section 260C.607, subdivision 2, when there is a fully executed adoption
placement agreement for the child.

(d) In the event an adoption placement agreement terminates, the responsible social
services agency shall notify the court, the parties entitled to notice under section 260C.607,
subdivision 2
, and the commissioner that the agreement and the adoptive placement have
terminated.

Sec. 45.

Minnesota Statutes 2020, section 260C.613, subdivision 5, is amended to read:


Subd. 5.

Required record keeping.

The responsible social services agency shall
document, in the records required to be kept under section 259.79, the reasons for the
adoptive placement decision regarding the child, including the individualized determination
of the child's needs based on the factors in section 260C.212, subdivision 2, paragraph (b)deleted text begin,deleted text endnew text begin;
the agency's consideration of relatives in the order specified in section 260C.212, subdivision
2, paragraph (a);
new text end and the assessment of how the selected adoptive placement meets the
identified needs of the child. The responsible social services agency shall retain in the
records required to be kept under section 259.79, copies of all out-of-home placement plans
made since the child was ordered under guardianship of the commissioner and all court
orders from reviews conducted pursuant to section 260C.607.

Sec. 46.

Minnesota Statutes 2021 Supplement, section 260E.20, subdivision 2, is amended
to read:


Subd. 2.

Face-to-face contact.

(a) Upon receipt of a screened in report, the local welfare
agency shall conduct a face-to-face contact with the child reported to be maltreated and
with the child's primary caregiver sufficient to complete a safety assessment and ensure the
immediate safety of the child.new text begin When it is possible and the report alleges substantial
endangerment or sexual abuse, the local welfare agency or agency responsible for assessing
or investigating the report is not required to provide notice before conducting the initial
face-to-face contact with the child and the child's primary caregiver.
new text end

(b) The face-to-face contact with the child and primary caregiver shall occur immediately
if sexual abuse or substantial child endangerment is alleged and within five calendar days
for all other reports. If the alleged offender was not already interviewed as the primary
caregiver, the local welfare agency shall also conduct a face-to-face interview with the
alleged offender in the early stages of the assessment or investigation. Face-to-face contact
with the child and primary caregiver in response to a report alleging sexual abuse or
substantial child endangerment may be postponed for no more than five calendar days if
the child is residing in a location that is confirmed to restrict contact with the alleged offender
as established in guidelines issued by the commissioner, or if the local welfare agency is
pursuing a court order for the child's caregiver to produce the child for questioning under
section 260E.22, subdivision 5.

(c) At the initial contact with the alleged offender, the local welfare agency or the agency
responsible for assessing or investigating the report must inform the alleged offender of the
complaints or allegations made against the individual in a manner consistent with laws
protecting the rights of the person who made the report. The interview with the alleged
offender may be postponed if it would jeopardize an active law enforcement investigation.

(d) The local welfare agency or the agency responsible for assessing or investigating
the report must provide the alleged offender with an opportunity to make a statement. The
alleged offender may submit supporting documentation relevant to the assessment or
investigation.

Sec. 47.

Minnesota Statutes 2020, section 260E.22, subdivision 2, is amended to read:


Subd. 2.

Child interview procedure.

(a) The interview may take place at school or at
any facility or other place where the alleged victim or other children might be found or the
child may be transported to, and the interview may be conducted at a place appropriate for
the interview of a child designated by the local welfare agency or law enforcement agency.

(b)new text begin When it is possible and the report alleges substantial endangerment or sexual abuse,new text end
the interview may take place outside the presence of the alleged offender deleted text beginor parent, legal
custodian, guardian, or school official.
deleted text endnew text begin and may take place prior to any interviews of the
alleged offender.
new text end

deleted text begin (c) For a family assessment, it is the preferred practice to request a parent or guardian's
deleted text end deleted text begin permission to interview the child before conducting the child interview, unless doing so
deleted text end deleted text begin would compromise the safety assessment.
deleted text end

Sec. 48.

Minnesota Statutes 2020, section 260E.24, subdivision 2, is amended to read:


Subd. 2.

Determination after family assessment.

After conducting a family assessment,
the local welfare agency shall determine whether child protective services are needed to
address the safety of the child and other family members and the risk of subsequent
maltreatment.new text begin The local welfare agency must document the information collected under
section 260E.20, subdivision 3, related to the completed family assessment in the child's or
family's case notes.
new text end

Sec. 49.

Minnesota Statutes 2020, section 268.19, subdivision 1, is amended to read:


Subdivision 1.

Use of data.

(a) Except as provided by this section, data gathered from
any person under the administration of the Minnesota Unemployment Insurance Law are
private data on individuals or nonpublic data not on individuals as defined in section 13.02,
subdivisions 9 and 12, and may not be disclosed except according to a district court order
or section 13.05. A subpoena is not considered a district court order. These data may be
disseminated to and used by the following agencies without the consent of the subject of
the data:

(1) state and federal agencies specifically authorized access to the data by state or federal
law;

(2) any agency of any other state or any federal agency charged with the administration
of an unemployment insurance program;

(3) any agency responsible for the maintenance of a system of public employment offices
for the purpose of assisting individuals in obtaining employment;

(4) the public authority responsible for child support in Minnesota or any other state in
accordance with section 256.978;

(5) human rights agencies within Minnesota that have enforcement powers;

(6) the Department of Revenue to the extent necessary for its duties under Minnesota
laws;

(7) public and private agencies responsible for administering publicly financed assistance
programs for the purpose of monitoring the eligibility of the program's recipients;

(8) the Department of Labor and Industry and the Commerce Fraud Bureau in the
Department of Commerce for uses consistent with the administration of their duties under
Minnesota law;

(9) the Department of Human Services and the Office of Inspector General and its agents
within the Department of Human Services, including county fraud investigators, for
investigations related to recipient or provider fraud and employees of providers when the
provider is suspected of committing public assistance fraud;

(10) local and state welfare agencies for monitoring the eligibility of the data subject
for assistance programs, or for any employment or training program administered by those
agencies, whether alone, in combination with another welfare agency, or in conjunction
with the department or to monitor and evaluate the statewide Minnesota family investment
program new text beginand other cash assistance programs, the Supplemental Nutrition Assistance Program
(SNAP), and the Supplemental Nutrition Assistance Program Employment and Training
program
new text endby providing data on recipients and former recipients of Supplemental Nutrition
Assistance Program deleted text begin(SNAP)deleted text end benefits, cash assistance under chapter 256, 256D, 256J, or
256K, child care assistance under chapter 119B, or medical programs under chapter 256B
or 256L or formerly codified under chapter 256D;

(11) local and state welfare agencies for the purpose of identifying employment, wages,
and other information to assist in the collection of an overpayment debt in an assistance
program;

(12) local, state, and federal law enforcement agencies for the purpose of ascertaining
the last known address and employment location of an individual who is the subject of a
criminal investigation;

(13) the United States Immigration and Customs Enforcement has access to data on
specific individuals and specific employers provided the specific individual or specific
employer is the subject of an investigation by that agency;

(14) the Department of Health for the purposes of epidemiologic investigations;

(15) the Department of Corrections for the purposes of case planning and internal research
for preprobation, probation, and postprobation employment tracking of offenders sentenced
to probation and preconfinement and postconfinement employment tracking of committed
offenders;

(16) the state auditor to the extent necessary to conduct audits of job opportunity building
zones as required under section 469.3201; and

(17) the Office of Higher Education for purposes of supporting program improvement,
system evaluation, and research initiatives including the Statewide Longitudinal Education
Data System.

(b) Data on individuals and employers that are collected, maintained, or used by the
department in an investigation under section 268.182 are confidential as to data on individuals
and protected nonpublic data not on individuals as defined in section 13.02, subdivisions 3
and 13, and must not be disclosed except under statute or district court order or to a party
named in a criminal proceeding, administrative or judicial, for preparation of a defense.

(c) Data gathered by the department in the administration of the Minnesota unemployment
insurance program must not be made the subject or the basis for any suit in any civil
proceedings, administrative or judicial, unless the action is initiated by the department.

Sec. 50.

Minnesota Statutes 2020, section 477A.0126, is amended by adding a subdivision
to read:


new text begin Subd. 3a. new text end

new text begin Transfer of withheld aid amounts. new text end

new text begin (a) For aid payable in 2023 and later, the
commissioner must transfer the total amount of the aid reductions under subdivision 3,
paragraph (d), for that year to the Board of Regents of the University of Minnesota for the
Tribal and Training Certification Partnership in the College of Education and Human Service
Professions at the University of Minnesota, Duluth.
new text end

new text begin (b) In order to support consistent training and county compliance with the Indian Child
Welfare Act and the Minnesota Indian Family Preservation Act, the Tribal Training and
Certification Partnership must use funds transferred under this subdivision to (1) enhance
training on the Indian Child Welfare Act and Minnesota Indian Family Preservation Act
for county workers and state guardians ad litem, and (2) build indigenous child welfare
training for the Tribal child welfare workforce.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for aid payable in 2023 and later.
new text end

Sec. 51.

Minnesota Statutes 2020, section 477A.0126, subdivision 7, is amended to read:


Subd. 7.

Appropriation.

(a) $5,000,000 is annually appropriated to the commissioner
of revenue from the general fund to pay aidnew text begin and make transfers requirednew text end under this section.

(b) $390,000 is appropriated annually from the general fund to the commissioner of
human services to implement subdivision 6.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for aid payable in 2023 and later.
new text end

Sec. 52.

Minnesota Statutes 2020, section 518A.43, subdivision 1, is amended to read:


Subdivision 1.

General factors.

Among other reasons, deviation from the presumptive
child support obligation computed under section 518A.34 is intended to encourage prompt
and regular payments of child support and to prevent either parent or the joint children from
living in poverty. In addition to the child support guidelines and other factors used to calculate
the child support obligation under section 518A.34, the court must take into consideration
the following factors in setting or modifying child support or in determining whether to
deviate upward or downward from the presumptive child support obligation:

(1) all earnings, income, circumstances, and resources of each parent, including real and
personal property, but excluding income from excess employment of the obligor or obligee
that meets the criteria of section 518A.29, paragraph (b);

(2) the extraordinary financial needs and resources, physical and emotional condition,
and educational needs of the child to be supported;

(3) the standard of living the child would enjoy if the parents were currently living
together, but recognizing that the parents now have separate households;

(4) whether the child resides in a foreign country for more than one year that has a
substantially higher or lower cost of living than this country;

(5) which parent receives the income taxation dependency exemption and the financial
benefit the parent receives from it;

(6) the parents' debts as provided in subdivision 2; deleted text beginand
deleted text end

(7) the obligor's total payments for court-ordered child support exceed the limitations
set forth in section 571.922deleted text begin.deleted text endnew text begin; and
new text end

new text begin (8) in cases involving court-ordered out-of-home placement, whether ordering and
redirecting a child support obligation to reimburse the county for the cost of care,
examination, or treatment would compromise the parent's ability to meet the requirements
of a reunification plan or the parent's ability to meet the child's needs after reunification.
new text end

Sec. 53.

Laws 2021, First Special Session chapter 7, article 10, section 1, the effective
date, is amended to read:


EFFECTIVE DATE.

This section is effective June 1, deleted text begin2022deleted text endnew text begin 2023new text end.

Sec. 54.

Laws 2021, First Special Session chapter 7, article 10, section 3, is amended to
read:


Sec. 3. LEGISLATIVE TASK FORCE; CHILD PROTECTION.

(a) A legislative task force is created to:

deleted text begin (1) review the efforts being made to implement the recommendations of the Governor's
Task Force on the Protection of Children;
deleted text end

deleted text begin (2) expand the efforts into related areas of the child welfare system;
deleted text end

deleted text begin (3) work with the commissioner of human services and community partners to establish
and evaluate child protection grants to address disparities in child welfare pursuant to
Minnesota Statutes, section 256E.28;
deleted text end

deleted text begin (4) review and recommend alternatives to law enforcement responding to a maltreatment
report by removing the child and evaluate situations in which it may be appropriate for a
social worker or other child protection worker to remove the child from the home;
deleted text end

deleted text begin (5)deleted text endnew text begin (1)new text end evaluate current statutes governing mandatory reporters, consider the modification
of mandatory reporting requirements for private or public youth recreation programs, and,
if necessary, introduce legislation by February 15, deleted text begin2022deleted text endnew text begin 2023new text end, to implement appropriate
modifications;new text begin and
new text end

deleted text begin (6) evaluate and consider the intersection of educational neglect and the child protection
system; and
deleted text end

deleted text begin (7)deleted text endnew text begin (2)new text end identify additional areas within the child welfare system that need to be addressed
by the legislature.

(b) Members of the legislative task force shall include:

(1) six members from the house of representatives appointed by the speaker of the house,
including three from the majority party and three from the minority party; and

(2) six members from the senate, including three members appointed by the senate
majority leader and three members appointed by the senate minority leader.

(c) Members of the task force shall serve a term that expires on December 31 of the
deleted text begin even-numbereddeleted text endnew text begin odd-numberednew text end year following the year they are appointed. The speaker of
the house and the majority leader of the senate shall each appoint a chair and vice-chair
from the membership of the task force. The chair shall rotate after each meeting. The task
force must meet at least quarterly.

(d) Initial appointments to the task force shall be made by July 15, deleted text begin2021deleted text endnew text begin 2022new text end. The chair
shall convene the first meeting of the task force by August 15, deleted text begin2021deleted text endnew text begin 2022new text end.

(e) The task force may provide oversight and monitoring of:

(1) the efforts by the Department of Human Services, counties, and Tribes to implement
laws related to child protection;

(2) efforts by the Department of Human Services, counties, and Tribes to implement the
recommendations of the Governor's Task Force on the Protection of Children;

(3) efforts by agencies including but not limited to the Department of Education, the
Housing Finance Agency, the Department of Corrections, and the Department of Public
Safety, to work with the Department of Human Services to assure safety and well-being for
children at risk of harm or children in the child welfare system; and

(4) efforts by the Department of Human Services, other agencies, counties, and Tribes
to implement best practices to ensure every child is protected from maltreatment and neglect
and to ensure every child has the opportunity for healthy development.

deleted text begin (f) The task force, in cooperation with the commissioner of human services, shall issue
a report to the legislature and governor by February 1, 2024. The report must contain
information on the progress toward implementation of changes to the child protection system,
recommendations for additional legislative changes and procedures affecting child protection
and child welfare, and funding needs to implement recommended changes.
deleted text end

deleted text begin (g)deleted text endnew text begin (f)new text end This section expires December 31, deleted text begin2024deleted text endnew text begin 2025new text end.

Sec. 55.

Laws 2021, First Special Session chapter 8, article 6, section 1, subdivision 7, is
amended to read:


Subd. 7.

Report.

(a) No later than February 1, 2022, the task force shall submit an initial
report to the chairs and ranking minority members of the house of representatives and senate
committees and divisions with jurisdiction over housing and preventing homelessness on
its findings and recommendations.

(b) No later than deleted text beginAugust 31deleted text endnew text begin December 15new text end, 2022, the task force shall submit a final report
to the chairs and ranking minority members of the house of representatives and senate
committees and divisions with jurisdiction over housing and preventing homelessness on
its findings and recommendations.

ARTICLE 11

OPERATIONS AND LICENSING POLICY

Section 1.

Minnesota Statutes 2020, section 245G.06, is amended by adding a subdivision
to read:


new text begin Subd. 2a. new text end

new text begin Client record documentation requirements. new text end

new text begin (a) The license holder must
document in the client record any significant event that occurs at the program within 24
hours of the event. A significant event is an event that impacts the client's treatment plan
or the client's relationship with other clients, staff, or the client's family.
new text end

new text begin (b) A residential treatment program must document in the client record the following
items within 24 hours that each occurs:
new text end

new text begin (1) medical and other appointments the client attended if known by the provider;
new text end

new text begin (2) concerns related to medications that are not documented in the medication
administration record; and
new text end

new text begin (3) concerns related to attendance for treatment services, including the reason for any
client absence from a treatment service.
new text end

Sec. 2.

Minnesota Statutes 2020, section 245G.06, subdivision 3, is amended to read:


Subd. 3.

deleted text beginDocumentation of treatment services;deleted text end Treatment plan review.

(a) deleted text beginA review
of all treatment services must be documented weekly and include a review of:
deleted text end

deleted text begin (1) care coordination activities;
deleted text end

deleted text begin (2) medical and other appointments the client attended;
deleted text end

deleted text begin (3) issues related to medications that are not documented in the medication administration
record; and
deleted text end

deleted text begin (4) issues related to attendance for treatment services, including the reason for any client
absence from a treatment service.
deleted text end

deleted text begin (b) A note must be entered immediately following any significant event. A significant
event is an event that impacts the client's relationship with other clients, staff, the client's
family, or the client's treatment plan.
deleted text end

deleted text begin (c)deleted text end A treatment plan review must be entered in a client's file deleted text beginweekly or after each treatment
service, whichever is less frequent, by the staff member providing the service
deleted text endnew text begin by an alcohol
and drug counselor at least every 28 calendar days; when there is a significant change in
the client's situation, functioning, or service methods; or at the request of the client
new text end. The
review must indicate the span of time covered by the review and each of the six dimensions
listed in section 245G.05, subdivision 2, paragraph (c). The review must:

(1) deleted text beginindicate the date, type, and amount of each treatment service provided and the client's
response to each service;
deleted text end

deleted text begin (2)deleted text end address each goal in the treatment plan and whether the methods to address the goals
are effective;

deleted text begin (3)deleted text endnew text begin (2)new text end include monitoring of any physical and mental health problems;

deleted text begin (4)deleted text endnew text begin (3)new text end document the participation of others;

deleted text begin (5)deleted text endnew text begin (4)new text end document staff recommendations for changes in the methods identified in the
treatment plan and whether the client agrees with the change; and

deleted text begin (6)deleted text endnew text begin (5)new text end include a review and evaluation of the individual abuse prevention plan according
to section 245A.65.

deleted text begin (d)deleted text endnew text begin (b)new text end Each entry in a client's record must be accurate, legible, signed, and dated. A late
entry must be clearly labeled "late entry." A correction to an entry must be made in a way
in which the original entry can still be read.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 3.

Laws 2021, First Special Session chapter 7, article 2, section 74, is amended by
adding a subdivision to read:


new text begin Subd. 4a. new text end

new text begin Furnishing and analyzing data. new text end

new text begin In the event the Department of Human
Services is unable to furnish or analyze the relevant data on the background studies,
disqualifications, set-asides, and other relevant topics under this section, the department
may use an outside organization to analyze and furnish the relevant data to the task force.
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 12

DIRECT CARE AND TREATMENT POLICY

Section 1.

Minnesota Statutes 2020, section 253B.18, subdivision 6, is amended to read:


Subd. 6.

Transfer.

(a) A patient who is a person who has a mental illness and is
dangerous to the public 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 another state-operated treatment program. 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.

(b) 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.

new text begin (c) If a committed person has been transferred out of a secure treatment facility pursuant
to this subdivision, that committed person may voluntarily return to a secure treatment
facility for a period of up to 60 days with the consent of the head of the treatment facility.
new text end

new text begin (d) If the committed person is not returned to the original, nonsecure transfer facility
within 60 days of being readmitted to a secure treatment facility, the transfer is revoked and
the committed person must remain in a secure treatment facility. The committed person
must immediately be notified in writing of the revocation.
new text end

new text begin (e) Within 15 days of receiving notice of the revocation, the committed person may
petition the special review board for a review of the revocation. The special review board
shall review the circumstances of the revocation and shall recommend to the commissioner
whether or not the revocation should be upheld. The special review board may also
recommend a new transfer at the time of the revocation hearing.
new text end

new text begin (f) No action by the special review board is required if the transfer has not been revoked
and the committed person is returned to the original, nonsecure transfer facility with no
substantive change to the conditions of the transfer ordered under this subdivision.
new text end

new text begin (g) The head of the treatment facility may revoke a transfer made under this subdivision
and require a committed person to return to a secure treatment facility if:
new text end

new text begin (1) remaining in a nonsecure setting does not provide a reasonable degree of safety to
the committed person or others; or
new text end

new text begin (2) the committed person has regressed clinically and the facility to which the committed
person was transferred does not meet the committed person's needs.
new text end

new text begin (h) Upon the revocation of the transfer, the committed person must be immediately
returned to a secure treatment facility. A report documenting the reasons for revocation
must be issued by the head of the treatment facility within seven days after the committed
person is returned to the secure treatment facility. Advance notice to the committed person
of the revocation is not required.
new text end

new text begin (i) The committed person must be provided a copy of the revocation report and informed,
orally and in writing, of the rights of a committed person under this section. The revocation
report must be served upon the committed person, the committed person's counsel, and the
designated agency. The report must outline the specific reasons for the revocation, including
but not limited to the specific facts upon which the revocation is based.
new text end

new text begin (j) If a committed person's transfer is revoked, the committed person may re-petition for
transfer according to subdivision 5.
new text end

new text begin (k) A committed person aggrieved by a transfer revocation decision may petition the
special review board within seven business days after receipt of the revocation report for a
review of the revocation. The matter must be scheduled within 30 days. The special review
board shall review the circumstances leading to the revocation and, after considering the
factors in paragraph (b), shall recommend to the commissioner whether or not the revocation
shall be upheld. The special review board may also recommend a new transfer out of a
secure treatment facility at the time of the revocation hearing.
new text end

Sec. 2. new text beginREPEALER.
new text end

new text begin Minnesota Statutes 2020, sections 246.0136; 252.025, subdivision 7; and 252.035, new text end new text begin are
repealed.
new text end

ARTICLE 13

DEPARTMENT OF HEALTH

Section 1.

Minnesota Statutes 2020, section 103I.005, subdivision 17a, is amended to
read:


Subd. 17a.

deleted text beginTemporary boringdeleted text endnew text begin Submerged closed loop heat exchangernew text end.

deleted text begin"Temporary
boring"
deleted text endnew text begin "Submerged closed loop heat exchanger"new text end means deleted text beginan excavation that is 15 feet or
more in depth, is sealed within 72 hours of the time of construction, and is drilled, cored,
washed, driven, dug, jetted, or otherwise constructed to
deleted text endnew text begin a heating and cooling system thatnew text end:

(1) deleted text beginconduct physical, chemical, or biological testing of groundwater, including
groundwater quality monitoring
deleted text endnew text begin is installed in a water supply wellnew text end;

(2) deleted text beginmonitor or measure physical, chemical, radiological, or biological parameters of
earth materials or earth fluids, including hydraulic conductivity, bearing capacity, or
resistance
deleted text endnew text begin utilizes the convective flow of groundwater as the primary medium of heat
exchange
new text end;

(3) deleted text beginmeasure groundwater levels, including use of a piezometerdeleted text endnew text begin contains potable water
as the heat transfer fluid
new text end; and

(4) deleted text begindetermine groundwater flow direction or velocitydeleted text endnew text begin operates using nonconsumptive
recirculation
new text end.

new text begin A submerged closed loop heat exchanger also includes submersible pumps, a heat exchanger
device, piping, and other necessary appurtenances.
new text end

Sec. 2.

Minnesota Statutes 2020, section 103I.005, is amended by adding a subdivision
to read:


new text begin Subd. 17b. new text end

new text begin Temporary boring. new text end

new text begin "Temporary boring" means an excavation that is 15
feet or more in depth, is sealed within 72 hours of the time of construction, and is drilled,
cored, washed, driven, dug, jetted, or otherwise constructed to:
new text end

new text begin (1) conduct physical, chemical, or biological testing of groundwater, including
groundwater quality monitoring;
new text end

new text begin (2) monitor or measure physical, chemical, radiological, or biological parameters of
earth materials or earth fluids, including hydraulic conductivity, bearing capacity, or
resistance;
new text end

new text begin (3) measure groundwater levels, including use of a piezometer; and
new text end

new text begin (4) determine groundwater flow direction or velocity.
new text end

Sec. 3.

Minnesota Statutes 2020, section 103I.005, subdivision 20a, is amended to read:


Subd. 20a.

Water supply well.

"Water supply well" means a well that is not a dewatering
well or environmental well and includes wells used:

(1) for potable water supply;

(2) for irrigation;

(3) for agricultural, commercial, or industrial water supply;

(4) for heating or cooling; deleted text beginand
deleted text end

(5) new text beginfor containing a submerged closed loop heat exchanger; and
new text end

new text begin (6) new text endfor testing water yield for irrigation, commercial or industrial uses, residential supply,
or public water supply.

Sec. 4.

new text begin [103I.631] INSTALLATION OF A SUBMERGED CLOSED LOOP HEAT
EXCHANGER.
new text end

new text begin Subdivision 1. new text end

new text begin Installation. new text end

new text begin Notwithstanding any other provision of law, the
commissioner must allow the installation of a submerged closed loop heat exchanger in a
water supply well. A project may consist of more than one water supply well on a particular
site.
new text end

new text begin Subd. 2. new text end

new text begin Setbacks. new text end

new text begin Water supply wells used only for the nonpotable purpose of providing
heating and cooling using a submerged closed loop heat exchanger are exempt from isolation
distance requirements greater than ten feet.
new text end

new text begin Subd. 3. new text end

new text begin Construction. new text end

new text begin The screened interval of a water supply well constructed to
contain a submerged closed loop heat exchanger completed within a single aquifer may be
designed and constructed using any combination of screen, casing, leader, riser, sump, or
other piping combinations, so long as the screen configuration does not interconnect aquifers.
new text end

new text begin Subd. 4. new text end

new text begin Permits. new text end

new text begin A submerged closed loop heat exchanger is not subject to the permit
requirements in this chapter.
new text end

new text begin Subd. 5. new text end

new text begin Variances. new text end

new text begin A variance is not required to install or operate a submerged closed
loop heat exchanger.
new text end

Sec. 5.

Minnesota Statutes 2020, section 144.057, subdivision 1, is amended to read:


Subdivision 1.

Background studies required.

new text begin(a) Except as specified in paragraph (b),
new text end the commissioner of health shall contract with the commissioner of human services to
conduct background studies of:

(1) individuals providing services that have direct contact, as defined under section
245C.02, subdivision 11, with patients and residents in hospitals, boarding care homes,
outpatient surgical centers licensed under sections 144.50 to 144.58; nursing homes and
home care agencies licensed under chapter 144A; assisted living facilities and assisted living
facilities with dementia care licensed under chapter 144G; and board and lodging
establishments that are registered to provide supportive or health supervision services under
section 157.17;

(2) individuals specified in section 245C.03, subdivision 1, who perform direct contact
services in a nursing home or a home care agency licensed under chapter 144A; an assisted
living facility or assisted living facility with dementia care licensed under chapter 144G;
or a boarding care home licensed under sections 144.50 to 144.58. If the individual under
study resides outside Minnesota, the study must include a check for substantiated findings
of maltreatment of adults and children in the individual's state of residence when the
information is made available by that state, and must include a check of the National Crime
Information Center database;

(3) all other employees in assisted living facilities or assisted living facilities with
dementia care licensed under chapter 144G, nursing homes licensed under chapter 144A,
and boarding care homes licensed under sections 144.50 to 144.58. A disqualification of
an individual in this section shall disqualify the individual from positions allowing direct
contact or access to patients or residents receiving services. "Access" means physical access
to a client or the client's personal property without continuous, direct supervision as defined
in section 245C.02, subdivision 8, when the employee's employment responsibilities do not
include providing direct contact services;

(4) individuals employed by a supplemental nursing services agency, as defined under
section 144A.70, who are providing services in health care facilities; deleted text beginand
deleted text end

(5) controlling persons of a supplemental nursing services agency, as defined under
section 144A.70deleted text begin.deleted text endnew text begin; and
new text end

new text begin (6) license applicants, owners, managerial officials, and controlling individuals who are
required under section 144A.476, subdivision 1, or 144G.13, subdivision 1, to undergo a
background study under chapter 245C, regardless of the licensure status of the license
applicant, owner, managerial official, or controlling individual.
new text end

new text begin (b) The commissioner of human services shall not conduct a background study on any
individual identified in paragraph (a), clauses (1) to (5), if the individual has a valid license
issued by a health-related licensing board as defined in section 214.01, subdivision 2, and
has completed the criminal background check as required in section 214.075. An entity that
is affiliated with individuals who meet the requirements of this paragraph must separate
those individuals from the entity's roster for NETStudy 2.0.
new text end

new text begin (c) new text endIf a facility or program is licensed by the Department of Human Services and subject
to the background study provisions of chapter 245C and is also licensed by the Department
of Health, the Department of Human Services is solely responsible for the background
studies of individuals in the jointly licensed programs.

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 2020, section 144.1222, subdivision 2d, is amended to read:


Subd. 2d.

Hot tubs on rental deleted text beginhouseboatsdeleted text endnew text begin propertynew text end.

(a) A deleted text beginhot waterdeleted text endnew text begin spanew text end pool intended
for seated recreational use, including a hot tub or whirlpool, that is located on a houseboat
that is rented to the public is not a public pool and is exempt from the requirements for
public pools undernew text begin this section andnew text end Minnesota Rules, chapter 4717.

(b) new text beginA spa pool intended for seated recreational use, including a hot tub or whirlpool,
that is located on the property of a stand-alone single-unit rental property that is rented to
the public by the property owner or through a resort and the spa pool is only intended to be
used by the occupants of the rental property, is not a public pool and is exempt from the
requirements for public pools under this section and Minnesota Rules, chapter 4717.
new text end

new text begin (c) new text endA deleted text beginhot waterdeleted text endnew text begin spanew text end pool under this subdivision must be conspicuously posted with the
following notice to renters:

"NOTICE

This spa is exempt from state and local sanitary requirements that prevent disease
transmission.

USE AT YOUR OWN RISK

This notice is required under Minnesota Statutes, section 144.1222, subdivision 2d."

Sec. 7.

Minnesota Statutes 2021 Supplement, section 144.551, subdivision 1, is amended
to read:


Subdivision 1.

Restricted construction or modification.

(a) The following construction
or modification may not be commenced:

(1) any erection, building, alteration, reconstruction, modernization, improvement,
extension, lease, or other acquisition by or on behalf of a hospital that increases the bed
capacity of a hospital, relocates hospital beds from one physical facility, complex, or site
to another, or otherwise results in an increase or redistribution of hospital beds within the
state; and

(2) the establishment of a new hospital.

(b) This section does not apply to:

(1) construction or relocation within a county by a hospital, clinic, or other health care
facility that is a national referral center engaged in substantial programs of patient care,
medical research, and medical education meeting state and national needs that receives more
than 40 percent of its patients from outside the state of Minnesota;

(2) a project for construction or modification for which a health care facility held an
approved certificate of need on May 1, 1984, regardless of the date of expiration of the
certificate;

(3) a project for which a certificate of need was denied before July 1, 1990, if a timely
appeal results in an order reversing the denial;

(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200,
section 2;

(5) a project involving consolidation of pediatric specialty hospital services within the
Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number
of pediatric specialty hospital beds among the hospitals being consolidated;

(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds to
an existing licensed hospital that will allow for the reconstruction of a new philanthropic,
pediatric-orthopedic hospital on an existing site and that will not result in a net increase in
the number of hospital beds. Upon completion of the reconstruction, the licenses of both
hospitals must be reinstated at the capacity that existed on each site before the relocation;

(7) the relocation or redistribution of hospital beds within a hospital building or
identifiable complex of buildings provided the relocation or redistribution does not result
in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds from
one physical site or complex to another; or (iii) redistribution of hospital beds within the
state or a region of the state;

(8) relocation or redistribution of hospital beds within a hospital corporate system that
involves the transfer of beds from a closed facility site or complex to an existing site or
complex provided that: (i) no more than 50 percent of the capacity of the closed facility is
transferred; (ii) the capacity of the site or complex to which the beds are transferred does
not increase by more than 50 percent; (iii) the beds are not transferred outside of a federal
health systems agency boundary in place on July 1, 1983; (iv) the relocation or redistribution
does not involve the construction of a new hospital building; and (v) the transferred beds
are used first to replace within the hospital corporate system the total number of beds
previously used in the closed facility site or complex for mental health services and substance
use disorder services. Only after the hospital corporate system has fulfilled the requirements
of this item may the remainder of the available capacity of the closed facility site or complex
be transferred for any other purpose;

(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice
County that primarily serves adolescents and that receives more than 70 percent of its
patients from outside the state of Minnesota;

(10) a project to replace a hospital or hospitals with a combined licensed capacity of
130 beds or less if: (i) the new hospital site is located within five miles of the current site;
and (ii) the total licensed capacity of the replacement hospital, either at the time of
construction of the initial building or as the result of future expansion, will not exceed 70
licensed hospital beds, or the combined licensed capacity of the hospitals, whichever is less;

(11) the relocation of licensed hospital beds from an existing state facility operated by
the commissioner of human services to a new or existing facility, building, or complex
operated by the commissioner of human services; from one regional treatment center site
to another; or from one building or site to a new or existing building or site on the same
campus;

(12) the construction or relocation of hospital beds operated by a hospital having a
statutory obligation to provide hospital and medical services for the indigent that does not
result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27
beds, of which 12 serve mental health needs, may be transferred from Hennepin County
Medical Center to Regions Hospital under this clause;

(13) a construction project involving the addition of up to 31 new beds in an existing
nonfederal hospital in Beltrami County;

(14) a construction project involving the addition of up to eight new beds in an existing
nonfederal hospital in Otter Tail County with 100 licensed acute care beds;

(15) a construction project involving the addition of 20 new hospital beds in an existing
hospital in Carver County serving the southwest suburban metropolitan area;

(16) a project for the construction or relocation of up to 20 hospital beds for the operation
of up to two psychiatric facilities or units for children provided that the operation of the
facilities or units have received the approval of the commissioner of human services;

(17) a project involving the addition of 14 new hospital beds to be used for rehabilitation
services in an existing hospital in Itasca County;

(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin County
that closed 20 rehabilitation beds in 2002, provided that the beds are used only for
rehabilitation in the hospital's current rehabilitation building. If the beds are used for another
purpose or moved to another location, the hospital's licensed capacity is reduced by 20 beds;

(19) a critical access hospital established under section 144.1483, clause (9), and section
1820 of the federal Social Security Act, United States Code, title 42, section 1395i-4, that
delicensed beds since enactment of the Balanced Budget Act of 1997, Public Law 105-33,
to the extent that the critical access hospital does not seek to exceed the maximum number
of beds permitted such hospital under federal law;

(20) notwithstanding section 144.552, a project for the construction of a new hospital
in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:

(i) the project, including each hospital or health system that will own or control the entity
that will hold the new hospital license, is approved by a resolution of the Maple Grove City
Council as of March 1, 2006;

(ii) the entity that will hold the new hospital license will be owned or controlled by one
or more not-for-profit hospitals or health systems that have previously submitted a plan or
plans for a project in Maple Grove as required under section 144.552, and the plan or plans
have been found to be in the public interest by the commissioner of health as of April 1,
2005;

(iii) the new hospital's initial inpatient services must include, but are not limited to,
medical and surgical services, obstetrical and gynecological services, intensive care services,
orthopedic services, pediatric services, noninvasive cardiac diagnostics, behavioral health
services, and emergency room services;

(iv) the new hospital:

(A) will have the ability to provide and staff sufficient new beds to meet the growing
needs of the Maple Grove service area and the surrounding communities currently being
served by the hospital or health system that will own or control the entity that will hold the
new hospital license;

(B) will provide uncompensated care;

(C) will provide mental health services, including inpatient beds;

(D) will be a site for workforce development for a broad spectrum of health-care-related
occupations and have a commitment to providing clinical training programs for physicians
and other health care providers;

(E) will demonstrate a commitment to quality care and patient safety;

(F) will have an electronic medical records system, including physician order entry;

(G) will provide a broad range of senior services;

(H) will provide emergency medical services that will coordinate care with regional
providers of trauma services and licensed emergency ambulance services in order to enhance
the continuity of care for emergency medical patients; and

(I) will be completed by December 31, 2009, unless delayed by circumstances beyond
the control of the entity holding the new hospital license; and

(v) as of 30 days following submission of a written plan, the commissioner of health
has not determined that the hospitals or health systems that will own or control the entity
that will hold the new hospital license are unable to meet the criteria of this clause;

(21) a project approved under section 144.553;

(22) a project for the construction of a hospital with up to 25 beds in Cass County within
a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's license holder
is approved by the Cass County Board;

(23) a project for an acute care hospital in Fergus Falls that will increase the bed capacity
from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16 and closing
a separately licensed 13-bed skilled nursing facility;

(24) notwithstanding section 144.552, a project for the construction and expansion of a
specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for patients
who are under 21 years of age on the date of admission. The commissioner conducted a
public interest review of the mental health needs of Minnesota and the Twin Cities
metropolitan area in 2008. No further public interest review shall be conducted for the
construction or expansion project under this clause;

(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if the
commissioner finds the project is in the public interest after the public interest review
conducted under section 144.552 is complete;

(26)(i) a project for a 20-bed psychiatric hospital, within an existing facility in the city
of Maple Grove, exclusively for patients who are under 21 years of age on the date of
admission, if the commissioner finds the project is in the public interest after the public
interest review conducted under section 144.552 is complete;

(ii) this project shall serve patients in the continuing care benefit program under section
256.9693. The project may also serve patients not in the continuing care benefit program;
and

(iii) if the project ceases to participate in the continuing care benefit program, the
commissioner must complete a subsequent public interest review under section 144.552. If
the project is found not to be in the public interest, the license must be terminated six months
from the date of that finding. If the commissioner of human services terminates the contract
without cause or reduces per diem payment rates for patients under the continuing care
benefit program below the rates in effect for services provided on December 31, 2015, the
project may cease to participate in the continuing care benefit program and continue to
operate without a subsequent public interest review;

(27) a project involving the addition of 21 new beds in an existing psychiatric hospital
in Hennepin County that is exclusively for patients who are under 21 years of age on the
date of admission;

(28) a project to add 55 licensed beds in an existing safety net, level I trauma center
hospital in Ramsey County as designated under section 383A.91, subdivision 5, of which
15 beds are to be used for inpatient mental health and 40 are to be used for other services.
In addition, five unlicensed observation mental health beds shall be added;

(29) upon submission of a plan to the commissioner for public interest review under
section 144.552 and the addition of the 15 inpatient mental health beds specified in clause
(28), to its bed capacity, a project to add 45 licensed beds in an existing safety net, level I
trauma center hospital in Ramsey County as designated under section 383A.91, subdivision
5. Five of the 45 additional beds authorized under this clause must be designated for use
for inpatient mental health and must be added to the hospital's bed capacity before the
remaining 40 beds are added. Notwithstanding section 144.552, the hospital may add licensed
beds under this clause prior to completion of the public interest review, provided the hospital
submits its plan by the 2021 deadline and adheres to the timelines for the public interest
review described in section 144.552; deleted text beginor
deleted text end

(30) upon submission of a plan to the commissioner for public interest review under
section 144.552, a project to add up to 30 licensed beds in an existing psychiatric hospital
in Hennepin County that exclusively provides care to patients who are under 21 years of
age on the date of admission. Notwithstanding section 144.552, the psychiatric hospital
may add licensed beds under this clause prior to completion of the public interest review,
provided the hospital submits its plan by the 2021 deadline and adheres to the timelines for
the public interest review described in section 144.552deleted text begin.deleted text endnew text begin;
new text end

new text begin (31) any project to add licensed beds in a hospital that: (i) is designated as a critical
access hospital under section 144.1483, clause (9), and United States Code, title 42, section
1395i-4; (ii) has a licensed bed capacity of fewer than 25 beds; and (iii) has an attached
nursing home, so long as the total number of licensed beds in the hospital after the bed
addition does not exceed 25 beds. Notwithstanding section 144.552, a public interest review
is not required for a project authorized under this clause; or
new text end

new text begin (32) upon submission of a plan to the commissioner for public interest review under
section 144.552, a project to add 22 licensed beds at a Minnesota freestanding children's
hospital in St. Paul that is part of an independent pediatric health system with freestanding
inpatient hospitals located in Minneapolis and St. Paul. The beds shall be utilized for pediatric
inpatient behavioral health services. Notwithstanding section 144.552, the hospital may add
licensed beds under this clause prior to completion of the public interest review, provided
the hospital submits its plan by the 2022 deadline and adheres to the timelines for the public
interest review described in section 144.552.
new text end

Sec. 8.

Minnesota Statutes 2020, section 144A.75, subdivision 12, is amended to read:


Subd. 12.

Palliative care.

"Palliative care" means deleted text beginthe total active care of patients whose
disease is not responsive to curative treatment. Control of pain, of other symptoms, and of
psychological, social, and spiritual problems is paramount
deleted text endnew text begin specialized medical care for
individuals living with a serious illness or life-limiting condition
new text end. new text beginThis type of care is focused
on reducing the pain, symptoms, and stress of a serious illness or condition. Palliative care
is a team-based approach to care, providing essential support at any age or stage of a serious
illness or condition, and is often provided together with curative treatment.
new text endThe goal of
palliative care is deleted text beginthe achievement of the best quality of life for patients and their familiesdeleted text endnew text begin
to improve quality of life for both the patient and the patient's family or care partner
new text end.

Sec. 9.

new text begin [144G.195] CHANGE IN LOCATION; NEW LICENSE NOT REQUIRED.
new text end

new text begin Subdivision 1. new text end

new text begin Move to new location. new text end

new text begin (a) An assisted living facility with a licensed
resident capacity of six residents or fewer may operate under the facility's current license
if the facility moves to a new location no more than once during the period the current
license is valid. A facility governed by this paragraph is not required to apply for a new
license solely because of the move to a new location, and the facility's current license remains
valid until the expiration date specified on the license.
new text end

new text begin (b) A facility that moves to a new location more than once during the period the current
license is valid must apply for a new license prior to providing assisted living services at
the second new location.
new text end

new text begin Subd. 2. new text end

new text begin Survey. new text end

new text begin The commissioner shall conduct a survey of an assisted living facility
governed by subdivision 1, paragraph (a), within six months after the licensee begins
providing assisted living services at the new location.
new text end

new text begin Subd. 3. new text end

new text begin Notice. new text end

new text begin A licensee must notify the commissioner in writing of the facility's new
address at least 60 calendar days before the licensee begins providing assisted living services
at the new location.
new text end

Sec. 10.

Minnesota Statutes 2021 Supplement, section 144G.45, subdivision 4, is amended
to read:


Subd. 4.

Design requirements.

(a) All assisted living facilities with six or more residents
must meet the provisions relevant to assisted living facilities in the 2018 edition of the
Facility Guidelines Institute "Guidelines for Design and Construction of Residential Health,
Care and Support Facilities" and of adopted rules. This minimum design standard must be
met for all new licensesnew text begin with a licensed resident capacity of six or more,new text end or new construction.
In addition to the guidelines, assisted living facilities shall provide the option of a bath in
addition to a shower for all residents.

(b) If the commissioner decides to update the edition of the guidelines specified in
paragraph (a) for purposes of this subdivision, the commissioner must notify the chairs and
ranking minority members of the legislative committees and divisions with jurisdiction over
health care and public safety of the planned update by January 15 of the year in which the
new edition will become effective. Following notice from the commissioner, the new edition
shall become effective for assisted living facilities beginning August 1 of that year, unless
provided otherwise in law. The commissioner shall, by publication in the State Register,
specify a date by which facilities must comply with the updated edition. The date by which
facilities must comply shall not be sooner than six months after publication of the
commissioner's notice in the State Register.

Sec. 11.

Minnesota Statutes 2021 Supplement, section 144G.45, subdivision 5, is amended
to read:


Subd. 5.

Assisted living facilities; Life Safety Code.

(a) All assisted living facilities
with six or more residents must meet the applicable provisions of the 2018 edition of the
NFPA Standard 101, Life Safety Code, Residential Board and Care Occupancies chapter.
The minimum design standard shall be met for all new licensesnew text begin with a licensed resident
capacity of six or more,
new text end or new construction.

(b) If the commissioner decides to update the Life Safety Code for purposes of this
subdivision, the commissioner must notify the chairs and ranking minority members of the
legislative committees and divisions with jurisdiction over health care and public safety of
the planned update by January 15 of the year in which the new Life Safety Code will become
effective. Following notice from the commissioner, the new edition shall become effective
for assisted living facilities beginning August 1 of that year, unless provided otherwise in
law. The commissioner shall, by publication in the State Register, specify a date by which
facilities must comply with the updated Life Safety Code. The date by which facilities must
comply shall not be sooner than six months after publication of the commissioner's notice
in the State Register.

Sec. 12.

Minnesota Statutes 2020, section 144G.45, subdivision 6, is amended to read:


Subd. 6.

New construction; plans.

(a) For all new licensurenew text begin for a facility with a proposed
licensed resident capacity of six or more
new text end andnew text begin all newnew text end construction beginning on or after
August 1, 2021, the following must be provided to the commissioner:

(1) architectural and engineering plans and specifications for new construction must be
prepared and signed by architects and engineers who are registered in Minnesota. Final
working drawings and specifications for proposed construction must be submitted to the
commissioner for review and approval;

(2) final architectural plans and specifications must include elevations and sections
through the building showing types of construction, and must indicate dimensions and
assignments of rooms and areas, room finishes, door types and hardware, elevations and
details of nurses' work areas, utility rooms, toilet and bathing areas, and large-scale layouts
of dietary and laundry areas. Plans must show the location of fixed equipment and sections
and details of elevators, chutes, and other conveying systems. Fire walls and smoke partitions
must be indicated. The roof plan must show all mechanical installations. The site plan must
indicate the proposed and existing buildings, topography, roadways, walks and utility service
lines; and

(3) final mechanical and electrical plans and specifications must address the complete
layout and type of all installations, systems, and equipment to be provided. Heating plans
must include heating elements, piping, thermostatic controls, pumps, tanks, heat exchangers,
boilers, breeching, and accessories. Ventilation plans must include room air quantities,
ducts, fire and smoke dampers, exhaust fans, humidifiers, and air handling units. Plumbing
plans must include the fixtures and equipment fixture schedule; water supply and circulating
piping, pumps, tanks, riser diagrams, and building drains; the size, location, and elevation
of water and sewer services; and the building fire protection systems. Electrical plans must
include fixtures and equipment, receptacles, switches, power outlets, circuits, power and
light panels, transformers, and service feeders. Plans must show location of nurse call signals,
cable lines, fire alarm stations, and fire detectors and emergency lighting.

(b) Unless construction is begun within one year after approval of the final working
drawing and specifications, the drawings must be resubmitted for review and approval.

(c) The commissioner must be notified within 30 days before completion of construction
so that the commissioner can make arrangements for a final inspection by the commissioner.

(d) At least one set of complete life safety plans, including changes resulting from
remodeling or alterations, must be kept on file in the facility.

Sec. 13.

Minnesota Statutes 2020, section 144G.45, subdivision 7, is amended to read:


Subd. 7.

Variance or waiver.

(a) A facility may request that the commissioner grant a
variance or waiver from the provisions of this section or section 144G.81, subdivision 5. A
request for a waiver must be submitted to the commissioner in writing. Each request must
contain:

(1) the specific requirement for which the variance or waiver is requested;

(2) the reasons for the request;

(3) the alternative measures that will be taken if a variance or waiver is granted;

(4) the length of time for which the variance or waiver is requested; and

(5) other relevant information deemed necessary by the commissioner to properly evaluate
the request for the waiver.

(b) The decision to grant or deny a variance or waiver must be based on the
commissioner's evaluation of the following criteria:

(1) whether the waiver will adversely affect the health, treatment, comfort, safety, or
well-being of a resident;

(2) whether the alternative measures to be taken, if any, are equivalent to or superior to
those permitted under section 144G.81, subdivision 5; deleted text beginand
deleted text end

(3) whether compliance with the requirements would impose an undue burden on the
facilitynew text begin; and
new text end

new text begin (4) notwithstanding clauses (1) to (3), when an existing building is proposed to be
repurposed to meet a critical community need for additional assisted living facility capacity,
whether the waiver will adequately protect the health and safety of the residents
new text end.

(c) The commissioner must notify the facility in writing of the decision. If a variance or
waiver is granted, the notification must specify the period of time for which the variance
or waiver is effective and the alternative measures or conditions, if any, to be met by the
facility.

(d) Alternative measures or conditions attached to a variance or waiver have the force
and effect of this chapter and are subject to the issuance of correction orders and fines in
accordance with sections 144G.30, subdivision 7, and 144G.31. The amount of fines for a
violation of this subdivision is that specified for the specific requirement for which the
variance or waiver was requested.

(e) A request for renewal of a variance or waiver must be submitted in writing at least
45 days before its expiration date. Renewal requests must contain the information specified
in paragraph (b). A variance or waiver must be renewed by the commissioner if the facility
continues to satisfy the criteria in paragraph (a) and demonstrates compliance with the
alternative measures or conditions imposed at the time the original variance or waiver was
granted.

(f) The commissioner must deny, revoke, or refuse to renew a variance or waiver if it
is determined that the criteria in paragraph (a) are not met. The facility must be notified in
writing of the reasons for the decision and informed of the right to appeal the decision.

(g) A facility may contest the denial, revocation, or refusal to renew a variance or waiver
by requesting a contested case hearing under chapter 14. The facility must submit, within
15 days of the receipt of the commissioner's decision, a written request for a hearing. The
request for hearing must set forth in detail the reasons why the facility contends the decision
of the commissioner should be reversed or modified. At the hearing, the facility has the
burden of proving by a preponderance of the evidence that the facility satisfied the criteria
specified in paragraph (b), except in a proceeding challenging the revocation of a variance
or waiver.

new text begin EFFECTIVE DATE. new text end

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

Sec. 14.

Minnesota Statutes 2021 Supplement, section 144G.81, subdivision 3, is amended
to read:


Subd. 3.

Assisted living facilities with dementia care and secured dementia care
unit; Life Safety Code.

(a) All assisted living facilities with dementia care and a secured
dementia care unit must meet the applicable provisions of the 2018 edition of the NFPA
Standard 101, Life Safety Code, Healthcare (limited care) chapter. The minimum design
standards shall be met for all new licensesnew text begin with a licensed resident capacity of six or more,new text end
or new construction.

(b) If the commissioner decides to update the Life Safety Code for purposes of this
subdivision, the commissioner must notify the chairs and ranking minority members of the
legislative committees and divisions with jurisdiction over health care and public safety of
the planned update by January 15 of the year in which the new Life Safety Code will become
effective. Following notice from the commissioner, the new edition shall become effective
for assisted living facilities with dementia care and a secured dementia care unit beginning
August 1 of that year, unless provided otherwise in law. The commissioner shall, by
publication in the State Register, specify a date by which these facilities must comply with
the updated Life Safety Code. The date by which these facilities must comply shall not be
sooner than six months after publication of the commissioner's notice in the State Register.

Sec. 15.

new text begin [145.267] FETAL ALCOHOL SPECTRUM DISORDERS PREVENTION
GRANTS.
new text end

new text begin (a) The commissioner of health 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 toxin-free babies born.
The grant recipient must compile the information in the subgrant reports and submit a
summary report to the commissioner of health by February 15 of each year.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2023.
new text end

Sec. 16.

Minnesota Statutes 2020, section 145.4716, is amended by adding a subdivision
to read:


new text begin Subd. 4. new text end

new text begin Funding. new text end

new text begin Funds appropriated for this section shall not be used for any activity
other than the authorized activities under this section, and the commissioner shall not create
additional eligibility criteria or restrictions on the funds. The commissioner must prioritize
providing trauma-informed, culturally inclusive services for sexually exploited youth or
youth at risk of sexual exploitation under this section.
new text end

Sec. 17.

Minnesota Statutes 2021 Supplement, section 245C.03, subdivision 5a, is amended
to read:


Subd. 5a.

Facilities serving children or adults licensed or regulated by the
Department of Health.

(a) new text beginExcept as specified in paragraph (b), new text endthe commissioner shall
conduct background studies of:

(1) individuals providing services who have direct contact, as defined under section
245C.02, subdivision 11, with patients and residents in hospitals, boarding care homes,
outpatient surgical centers licensed under sections 144.50 to 144.58; nursing homes and
home care agencies licensed under chapter 144A; assisted living facilities and assisted living
facilities with dementia care licensed under chapter 144G; and board and lodging
establishments that are registered to provide supportive or health supervision services under
section 157.17;

(2) individuals specified in subdivision 2 who provide direct contact services in a nursing
home or a home care agency licensed under chapter 144A; an assisted living facility or
assisted living facility with dementia care licensed under chapter 144G; or a boarding care
home licensed under sections 144.50 to 144.58. If the individual undergoing a study resides
outside of Minnesota, the study must include a check for substantiated findings of
maltreatment of adults and children in the individual's state of residence when the state
makes the information available;

(3) all other employees in assisted living facilities or assisted living facilities with
dementia care licensed under chapter 144G, nursing homes licensed under chapter 144A,
and boarding care homes licensed under sections 144.50 to 144.58. A disqualification of
an individual in this section shall disqualify the individual from positions allowing direct
contact with or access to patients or residents receiving services. "Access" means physical
access to a client or the client's personal property without continuous, direct supervision as
defined in section 245C.02, subdivision 8, when the employee's employment responsibilities
do not include providing direct contact services;

(4) individuals employed by a supplemental nursing services agency, as defined under
section 144A.70, who are providing services in health care facilities; deleted text beginand
deleted text end

(5) controlling persons of a supplemental nursing services agency, as defined by section
144A.70deleted text begin.deleted text endnew text begin; and
new text end

new text begin (6) license applicants, owners, managerial officials, and controlling individuals who are
required under section 144A.476, subdivision 1, or 144G.13, subdivision 1, to undergo a
background study under this chapter, regardless of the licensure status of the license applicant,
owner, managerial official, or controlling individual.
new text end

(b) new text beginThe commissioner of human services shall not conduct a background study on any
individual identified in paragraph (a), clauses (1) to (5), if the individual has a valid license
issued by a health-related licensing board as defined in section 214.01, subdivision 2, and
has completed the criminal background check as required in section 214.075. An entity that
is affiliated with individuals who meet the requirements of this paragraph must separate
those individuals from the entity's roster for NETStudy 2.0.
new text end

new text begin (c) new text endIf a facility or program is licensed by the Department of Human Services and the
Department of Health and is subject to the background study provisions of this chapter, the
Department of Human Services is solely responsible for the background studies of individuals
in the jointly licensed program.

deleted text begin (c)deleted text endnew text begin (d)new text end The commissioner of health shall review and make decisions regarding
reconsideration requests, including whether to grant variances, according to the procedures
and criteria in this chapter. The commissioner of health shall inform the requesting individual
and the Department of Human Services of the commissioner of health's decision regarding
the reconsideration. The commissioner of health's decision to grant or deny a reconsideration
of a disqualification is a final administrative agency action.

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 2020, section 245C.31, subdivision 1, is amended to read:


Subdivision 1.

Board determines disciplinary or corrective action.

(a) deleted text beginWhen the
subject of a background study is regulated by a health-related licensing board as defined in
chapter
deleted text enddeleted text begin214deleted text enddeleted text begin, and the commissioner determines that the regulated individual is responsible
for substantiated maltreatment under section 626.557 or chapter
deleted text enddeleted text begin260Edeleted text enddeleted text begin, instead of the
commissioner making a decision regarding disqualification, the board shall make a
determination whether to impose disciplinary or corrective action under chapter
deleted text enddeleted text begin214deleted text endnew text begin The
commissioner shall notify a health-related licensing board as defined in section 214.01,
subdivision 2, if the commissioner determines that an individual who is licensed by the
health-related licensing board and who is included on the board's roster list provided in
accordance with subdivision 3a is responsible for substantiated maltreatment under section
626.557 or chapter 260E, in accordance with subdivision 2. Upon receiving notification,
the health-related licensing board shall make a determination as to whether to impose
disciplinary or corrective action under chapter 214
new text end.

(b) This section does not apply to a background study of an individual regulated by a
health-related licensing board if the individual's study is related to child foster care, adult
foster care, or family child care licensure.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective February 1, 2023.
new text end

Sec. 19.

Minnesota Statutes 2020, section 245C.31, subdivision 2, is amended to read:


Subd. 2.

Commissioner's notice to board.

deleted text begin(a)deleted text end The commissioner shall notify deleted text beginthedeleted text endnew text begin anew text end
health-related licensing board:

(1) deleted text beginupon completion of a background study that producesdeleted text endnew text begin ofnew text end a record showing that the
individual new text beginlicensed by the board new text endwas determined to have been responsible for substantiated
maltreatment;

(2) upon the commissioner's completion of an investigation that determined deleted text beginthedeleted text endnew text begin annew text end
individual new text beginlicensed by the board new text endwas responsible for substantiated maltreatment; or

(3) upon receipt from another agency of a finding of substantiated maltreatment for
which deleted text beginthedeleted text endnew text begin annew text end individual new text beginlicensed by the board new text endwas responsible.

deleted text begin (b) The commissioner's notice to the health-related licensing board shall indicate whether
deleted text end deleted text begin the commissioner would have disqualified the individual for the substantiated maltreatment
deleted text end deleted text begin if the individual were not regulated by the board.
deleted text end

deleted text begin (c) The commissioner shall concurrently send the notice under this subdivision to the
deleted text end deleted text begin individual who is the subject of the deleted text end deleted text begin background study deleted text end deleted text begin .
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective February 1, 2023.
new text end

Sec. 20.

Minnesota Statutes 2020, section 245C.31, is amended by adding a subdivision
to read:


new text begin Subd. 3a. new text end

new text begin Agreements with health-related licensing boards. new text end

new text begin The commissioner and
each health-related licensing board shall enter into an agreement in order for each board to
provide the commissioner with a daily roster list of individuals who have a license issued
by the board in active status. The list must include for each licensed individual the individual's
name, aliases, date of birth, and license number; the date the license was issued; status of
the license; and the last four digits of the individual's social security number.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 21. new text beginDIRECTION TO COMMISSIONER OF HEALTH; J-1 VISA WAIVER
PROGRAM RECOMMENDATION.
new text end

new text begin (a) For purposes of this section:
new text end

new text begin (1) "Department of Health recommendation" means a recommendation from the state
Department of Health that a foreign medical graduate should be considered for a J-1 visa
waiver under the J-1 visa waiver program; and
new text end

new text begin (2) "J-1 visa waiver program" means a program administered by the United States
Department of State under United States Code, title 8, section 1184(l), in which a waiver
is sought for the requirement that a foreign medical graduate with a J-1 visa must return to
the graduate's home country for two years at the conclusion of the graduate's medical study
before applying for employment authorization in the United States.
new text end

new text begin (b) In administering the program to issue Department of Health recommendations for
purposes of the J-1 visa waiver program, the commissioner of health shall allow an applicant
to submit to the commissioner evidence that the foreign medical graduate for whom the
waiver is sought is licensed to practice medicine in Minnesota in place of evidence that the
foreign medical graduate has passed steps 1, 2, and 3 of the United States Medical Licensing
Examination.
new text end

Sec. 22. new text beginTEMPORARY ASSISTED LIVING STAFF TRAINING REQUIREMENTS.
new text end

new text begin (a) Notwithstanding Minnesota Statutes, section 144G.60, subdivision 4, paragraphs (a)
and (b), a person who registers for, completes, and passes the American Health Care
Association's eight-hour online temporary nurse aide training course may be employed by
a licensed assisted living facility to provide assisted living services or perform delegated
nursing tasks. Assisted living facilities must maintain documentation that a person employed
under the authority of this section to provide assisted living services or perform delegated
nursing tasks completed the required training program.
new text end

new text begin (b) Whenever providing assisted living services, a person employed under the authority
of this section must be directly supervised by another employee who meets the requirements
of Minnesota Statutes, section 144G.60, subdivision 4, paragraph (a). If, during employment,
the person meets the requirements of Minnesota Statutes, section 144G.60, subdivision 4,
paragraph (a), the supervision described in this paragraph is no longer required.
new text end

new text begin (c) Whenever performing delegated nursing tasks, a person employed under the authority
of this section must be directly supervised by another employee who meets the requirements
of Minnesota Statutes, section 144G.60, subdivision 4, paragraph (b). If, during employment,
the person meets the requirements of Minnesota Statutes, section 144G.60, subdivision 4,
paragraph (b), the supervision described in this paragraph is no longer required.
new text end

new text begin (d) This section expires four months after the expiration of the blanket federal waiver
of the nurse aides training and certification requirements under Code of Federal Regulations,
title 42, section 483.35(d), by the Centers for Medicare and Medicaid Services as authorized
by section 1135 of the Social Security Act.
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. new text beginREPEALER.
new text end

new text begin Minnesota Statutes 2020, section 254A.21, new text end new text begin is repealed effective July 1, 2023.
new text end

ARTICLE 14

HEALTH-RELATED LICENSING BOARDS AND SCOPE OF PRACTICE

Section 1.

Minnesota Statutes 2020, section 144.051, subdivision 6, is amended to read:


Subd. 6.

Release of private or confidential data.

For providers regulated pursuant to
sections 144A.43 to 144A.482new text begin, 148.5185,new text end and chapter 144G, the department may release
private or confidential data, except Social Security numbers, to the appropriate state, federal,
or local agency and law enforcement office to enhance investigative or enforcement efforts
or further a public health protective process. Types of offices include Adult Protective
Services, Office of the Ombudsman for Long-Term Care and Office of the Ombudsman for
Mental Health and Developmental Disabilities, the health licensing boards, Department of
Human Services, county or city attorney's offices, police, and local or county public health
offices.

Sec. 2.

Minnesota Statutes 2020, section 144E.01, subdivision 1, is amended to read:


Subdivision 1.

Membership.

(a) The Emergency Medical Services Regulatory Board
consists of the following members, all of whom must work in Minnesota, except for the
deleted text begin persondeleted text endnew text begin personsnew text end listed in clause deleted text begin(14)deleted text endnew text begin (8)new text end:

(1) an emergency physician certified by the American Board of Emergency Physicians;

(2) a deleted text beginrepresentative of Minnesota hospitalsdeleted text endnew text begin hospital administrator who does not have
direct oversight or management of a licensed ambulance service
new text end;

(3) a representative of deleted text beginfire chiefsdeleted text endnew text begin a licensed ambulance service with a base of operation
located in a fire department
new text end;

(4) a deleted text beginfull-time firefighter who serves as an emergency medical responder on or within
a nontransporting or nonregistered agency and who is a member of a professional firefighter's
union
deleted text endnew text begin representative of a licensed ambulance service with a base of operation located in a
hospital
new text end;

(5) a deleted text beginvolunteer firefighter who serves as an emergency medical responder on or within
a nontransporting or nonregistered agency
deleted text endnew text begin representative of a licensed ambulance service
owned by a municipality
new text end;

(6) deleted text beginandeleted text endnew text begin a volunteer ambulancenew text end attendant currently practicing on a licensed ambulance
service who is a paramedic deleted text beginordeleted text endnew text begin ,new text end annew text begin advancednew text end emergency medical techniciannew text begin, or an emergency
medical technician
new text end;

(7) an deleted text beginambulance director for a licensed ambulance servicedeleted text endnew text begin emergency medical technician
instructor who meets the requirements of section 144E.283 and is affiliated with an education
program approved by the board under section 144E.285
new text end;

deleted text begin (8) a representative of sheriffs;
deleted text end

deleted text begin (9) a member of a community health board to represent community health services;
deleted text end

deleted text begin (10) two representatives of regional emergency medical services programs, one of whom
must be from the metropolitan regional emergency medical services program;
deleted text end

deleted text begin (11) a registered nurse currently practicing in a hospital emergency department;
deleted text end

deleted text begin (12) a pediatrician, certified by the American Board of Pediatrics, with experience in
emergency medical services;
deleted text end

deleted text begin (13) a family practice physician who is currently involved in emergency medical services;
deleted text end

deleted text begin (14) adeleted text endnew text begin (8) threenew text end public deleted text beginmemberdeleted text endnew text begin membersnew text end who deleted text beginresidesdeleted text endnew text begin residenew text end in Minnesota; and

deleted text begin (15)deleted text endnew text begin (9)new text end the commissioners of health and public safety or their designees.

(b) The governor shall appoint members under paragraph (a). Appointments under
paragraph (a), clauses (1) to deleted text begin(9) and (11) to (13)deleted text endnew text begin (8)new text end, are subject to the advice and consent
of the senate. In making appointments under paragraph (a), clauses (1) to deleted text begin(9) and (11) to
(13)
deleted text endnew text begin (8)new text end, the governor shall consider recommendations of the American College of Emergency
Physicians, the Minnesota Hospital Association, the Minnesota and State Fire Chief's
Association, the Minnesota Ambulance Association, the Minnesota Emergency Medical
Services Association, the Minnesota State Sheriff's Association, the Association of Minnesota
Counties, the Minnesota Nurses Association, and the Minnesota chapter of the Academy
of Pediatrics.

(c) At least deleted text beginsevendeleted text endnew text begin fivenew text end members appointed under paragraph (a)new text begin, clauses (1) to (8),new text end must
reside outside of the seven-county metropolitan area, as defined in section 473.121.

Sec. 3.

Minnesota Statutes 2020, section 144E.01, subdivision 4, is amended to read:


Subd. 4.

Compensation; terms.

new text begin(a) new text endMembership terms, compensation, and removal of
members appointed under subdivision 1, are governed by section 15.0575.

new text begin (b) Notwithstanding section 15.0575, subdivision 2, the terms of members shall be three
years.
new text end

new text begin (c) A member of the board may not serve more than two terms.
new text end

Sec. 4.

Minnesota Statutes 2020, section 144E.35, is amended to read:


144E.35 REIMBURSEMENT TO deleted text beginNONPROFITdeleted text end AMBULANCE SERVICESnew text begin FOR
VOLUNTEER EDUCATION COSTS
new text end.

Subdivision 1.

Repayment for volunteer education.

A licensed ambulance service
shall be reimbursed by the board for the necessary expense of the initial education of a
volunteer ambulance attendant upon successful completion by the attendant of an EMT
education course, or a continuing education course for EMT care, or both, which has been
approved by the board, pursuant to section 144E.285. Reimbursement may include tuition,
transportation, food, lodging, hourly payment for the time spent in the education course,
and other necessary expenditures, except that in no instance shall a volunteer ambulance
attendant be reimbursed more than deleted text begin$600deleted text endnew text begin $900new text end for successful completion of an initial
education course, and deleted text begin$275deleted text endnew text begin $375new text end for successful completion of a continuing education course.

Subd. 2.

Reimbursement provisions.

Reimbursement deleted text beginwilldeleted text endnew text begin mustnew text end be paid under provisions
of this section when documentation is provided the board that the individual has served for
one year from the date of the final certification exam as an active member of a Minnesota
licensed ambulance service.

Sec. 5.

Minnesota Statutes 2020, section 147.01, subdivision 7, is amended to read:


Subd. 7.

Physician application and license fees.

(a) The board may charge the following
nonrefundable application and license fees processed pursuant to sections 147.02, 147.03,
147.037, 147.0375, and 147.38:

(1) physician application fee, $200;

(2) physician annual registration renewal fee, $192;

(3) physician endorsement to other states, $40;

(4) physician emeritus license, $50;

deleted text begin (5) physician temporary license, $60;
deleted text end

deleted text begin (6)deleted text endnew text begin (5)new text end physician late fee, $60;

deleted text begin (7)deleted text endnew text begin (6)new text end duplicate license fee, $20;

deleted text begin (8)deleted text endnew text begin (7)new text end certification letter fee, $25;

deleted text begin (9)deleted text endnew text begin (8)new text end education or training program approval fee, $100;

deleted text begin (10)deleted text endnew text begin (9)new text end report creation and generation fee, $60 per hour;

deleted text begin (11)deleted text endnew text begin (10)new text end examination administration fee (half day), $50;

deleted text begin (12)deleted text endnew text begin (11)new text end examination administration fee (full day), $80;

deleted text begin (13)deleted text endnew text begin (12)new text end fees developed by the Interstate Commission for determining physician
qualification to register and participate in the interstate medical licensure compact, as
established in rules authorized in and pursuant to section 147.38, not to exceed $1,000; and

deleted text begin (14)deleted text endnew text begin (13)new text end verification fee, $25.

(b) The board may prorate the initial annual license fee. All licensees are required to
pay the full fee upon license renewal. The revenue generated from the fee must be deposited
in an account in the state government special revenue fund.

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 2020, section 147.03, subdivision 1, is amended to read:


Subdivision 1.

Endorsement; reciprocity.

(a) The board may issue a license to practice
medicine to any person who satisfies the requirements in paragraphs (b) to (e).

(b) The applicant shall satisfy all the requirements established in section 147.02,
subdivision 1
, paragraphs (a), (b), (d), (e), and (f)new text begin, or section 147.037, subdivision 1,
paragraphs (a) to (e)
new text end.

(c) The applicant shall:

(1) have passed an examination prepared and graded by the Federation of State Medical
Boards, the National Board of Medical Examiners, or the United States Medical Licensing
Examination (USMLE) program in accordance with section 147.02, subdivision 1, paragraph
(c), clause (2); the National Board of Osteopathic Medical Examiners; or the Medical Council
of Canada; and

(2) have a current license from the equivalent licensing agency in another state or Canada
and, if the examination in clause (1) was passed more than ten years ago, either:

(i) pass the Special Purpose Examination of the Federation of State Medical Boards with
a score of 75 or better within three attempts; or

(ii) have a current certification by a specialty board of the American Board of Medical
Specialties, of the American Osteopathic Association, the Royal College of Physicians and
Surgeons of Canada, or of the College of Family Physicians of Canada; or

(3) if the applicant fails to meet the requirement established in section 147.02, subdivision
1, paragraph (c), clause (2), because the applicant failed to pass each of steps one, two, and
three of the USMLE within the required three attempts, the applicant may be granted a
license provided the applicant:

(i) has passed each of steps one, two, and three with passing scores as recommended by
the USMLE program within no more than four attempts for any of the three steps;

(ii) is currently licensed in another state; and

(iii) has current certification by a specialty board of the American Board of Medical
Specialties, the American Osteopathic Association Bureau of Professional Education, the
Royal College of Physicians and Surgeons of Canada, or the College of Family Physicians
of Canada.

(d) The applicant must not be under license suspension or revocation by the licensing
board of the state or jurisdiction in which the conduct that caused the suspension or revocation
occurred.

(e) The applicant must not have engaged in conduct warranting disciplinary action against
a licensee, or have been subject to disciplinary action other than as specified in paragraph
(d). If an applicant does not satisfy the requirements stated in this paragraph, the board may
issue a license only on the applicant's showing that the public will be protected through
issuance of a license with conditions or limitations the board considers appropriate.

(f) Upon the request of an applicant, the board may conduct the final interview of the
applicant by teleconference.

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 2020, section 147.03, subdivision 2, is amended to read:


Subd. 2.

Temporary permit.

new text begin(a) An applicant for licensure under this section may
request the board issue a temporary permit in accordance with this subdivision. Upon receipt
of the application for licensure, a request for a temporary permit, and a nonrefundable
physician application fee specified under section 147.01, subdivision 7,
new text endthe board may issue
a temporary permit to practice medicine deleted text begintodeleted text endnew text begin asnew text end a physician deleted text begineligible for licensure under this
section only if the application for licensure is complete, all requirements in subdivision 1
have been met, and a nonrefundable fee set by the board has been paid
deleted text endnew text begin if the applicant is:
new text end

new text begin (1) currently licensed in good standing to practice medicine as a physician in another
state, territory, or Canadian province; and
new text end

new text begin (2) not the subject of a pending investigation or disciplinary action in any state, territory,
or Canadian province
new text end.

deleted text begin The permit remainsdeleted text endnew text begin (b) A temporary permit issued under this subdivision is nonrenewable
and
new text end valid deleted text beginonlydeleted text end until deleted text beginthe meeting of the board at whichdeleted text end a decision is made on the physician's
application for licensurenew text begin or for 90 days, whichever occurs firstnew text end.

new text begin (c) The board may revoke a temporary permit issued under this subdivision if the
physician is the subject of an investigation or disciplinary action or is disqualified for
licensure for any other reason.
new text end

new text begin (d) Notwithstanding section 13.41, subdivision 2, the board may release information
regarding action taken by the board pursuant to this subdivision.
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. 8.

Minnesota Statutes 2020, section 147.037, is amended to read:


147.037 LICENSING OF FOREIGN MEDICAL SCHOOL GRADUATESdeleted text begin;
TEMPORARY PERMIT
deleted text end.

Subdivision 1.

Requirements.

The board shall issue a license to practice medicine to
any person who satisfies the requirements in paragraphs (a) to (g).

(a) The applicant shall satisfy all the requirements established in section 147.02,
subdivision 1
, paragraphs (a), (e), (f), (g), and (h).

(b) The applicant shall present evidence satisfactory to the board that the applicant is a
graduate of a medical or osteopathic school approved by the board as equivalent to accredited
United States or Canadian schools based upon its faculty, curriculum, facilities, accreditation,
or other relevant data. If the applicant is a graduate of a medical or osteopathic program
that is not accredited by the Liaison Committee for Medical Education or the American
Osteopathic Association, the applicant may use the Federation of State Medical Boards'
Federation Credentials Verification Service (FCVS) or its successor. If the applicant uses
this service as allowed under this paragraph, the physician application fee may be less than
$200 but must not exceed the cost of administering this paragraph.

(c) The applicant shall present evidence satisfactory to the board that the applicant has
been awarded a certificate by the Educational Council for Foreign Medical Graduates, and
the applicant has a working ability in the English language sufficient to communicate with
patients and physicians and to engage in the practice of medicine.

(d) The applicant shall present evidence satisfactory to the board of the completion of
one year of graduate, clinical medical training in a program accredited by a national
accrediting organization approved by the board or other graduate training approved in
advance by the board as meeting standards similar to those of a national accrediting
organization. This requirement does not apply:

(1) to an applicant who is admitted as a permanent immigrant to the United States on or
before October 1, 1991, as a person of exceptional ability in the sciences according to Code
of Federal Regulations, title 20, section 656.22(d); or

(2) to an applicant holding a valid license to practice medicine in another country and
issued a permanent immigrant visa after October 1, 1991, as a person of extraordinary ability
in the field of science or as an outstanding professor or researcher according to Code of
Federal Regulations, title 8, section 204.5(h) and (i), or a temporary nonimmigrant visa as
a person of extraordinary ability in the field of science according to Code of Federal
Regulations, title 8, section 214.2(o),

provided that a person under clause (1) or (2) is admitted pursuant to rules of the United
States Department of Labor.

(e) The applicant must:

(1) have passed an examination prepared and graded by the Federation of State Medical
Boards, the United States Medical Licensing Examination program in accordance with
section 147.02, subdivision 1, paragraph (c), clause (2), or the Medical Council of Canada;
and

(2) if the examination in clause (1) was passed more than ten years ago, either:

(i) pass the Special Purpose Examination of the Federation of State Medical Boards with
a score of 75 or better within three attempts; or

(ii) have a current certification by a specialty board of the American Board of Medical
Specialties, of the American Osteopathic Association, of the Royal College of Physicians
and Surgeons of Canada, or of the College of Family Physicians of Canada; or

(3) if the applicant fails to meet the requirement established in section 147.02, subdivision
1, paragraph (c), clause (2), because the applicant failed to pass each of steps one, two, and
three of the USMLE within the required three attempts, the applicant may be granted a
license provided the applicant:

(i) has passed each of steps one, two, and three with passing scores as recommended by
the USMLE program within no more than four attempts for any of the three steps;

(ii) is currently licensed in another state; and

(iii) has current certification by a specialty board of the American Board of Medical
Specialties, the American Osteopathic Association, the Royal College of Physicians and
Surgeons of Canada, or the College of Family Physicians of Canada.

(f) The applicant must not be under license suspension or revocation by the licensing
board of the state or jurisdiction in which the conduct that caused the suspension or revocation
occurred.

(g) The applicant must not have engaged in conduct warranting disciplinary action
against a licensee, or have been subject to disciplinary action other than as specified in
paragraph (f). If an applicant does not satisfy the requirements stated in this paragraph, the
board may issue a license only on the applicant's showing that the public will be protected
through issuance of a license with conditions or limitations the board considers appropriate.

deleted text begin Subd. 1a. deleted text end

deleted text begin Temporary permit. deleted text end

deleted text begin The board may issue a temporary permit to practice
medicine to a physician eligible for licensure under this section only if the application for
licensure is complete, all requirements in subdivision 1 have been met, and a nonrefundable
fee set by the board has been paid. The permit remains valid only until the meeting of the
board at which a decision is made on the physician's application for licensure.
deleted text end

Subd. 2.

Medical school review.

The board may contract with any qualified person or
organization for the performance of a review or investigation, including site visits if
necessary, of any medical or osteopathic school prior to approving the school under section
147.02, subdivision 1, paragraph (b), or subdivision 1, paragraph (b), of this section. To the
extent possible, the board shall require the school being reviewed to pay the costs of the
review or investigation.

new text begin EFFECTIVE DATE. new text end

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

Sec. 9.

new text begin [147A.025] TEMPORARY PERMIT.
new text end

new text begin (a) An applicant for licensure under section 147A.02 may request the board issue a
temporary permit in accordance with this section. Upon receipt of the application for
licensure, a request for a temporary permit, and a nonrefundable physician assistant
application fee as specified under section 147A.28, the board may issue a temporary permit
to practice as a physician assistant if the applicant is:
new text end

new text begin (1) currently licensed in good standing to practice as a physician assistant in another
state, territory, or Canadian province; and
new text end

new text begin (2) not subject to a pending investigation or disciplinary action in any state, territory, or
Canadian province.
new text end

new text begin (b) A temporary permit issued under this section is nonrenewable and valid until a
decision is made on the physician assistant's application for licensure or for 90 days,
whichever occurs first.
new text end

new text begin (c) The board may revoke the temporary permit that has been issued under this section
if the applicant is the subject of an investigation or disciplinary action or is disqualified for
licensure for any other reason.
new text end

new text begin (d) Notwithstanding section 13.41, subdivision 2, the board may release information
regarding any action taken by the board pursuant to this section.
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. 10.

Minnesota Statutes 2020, section 147A.28, is amended to read:


147A.28 PHYSICIAN ASSISTANT APPLICATION AND LICENSE FEES.

(a) The board may charge the following nonrefundable fees:

(1) physician assistant application fee, $120;

deleted text begin (2) physician assistant annual registration renewal fee (prescribing authority), $135;
deleted text end

deleted text begin (3)deleted text endnew text begin (2)new text end physician assistant annual deleted text beginregistrationdeleted text endnew text begin licensenew text end renewal fee deleted text begin(no prescribing
authority)
deleted text end, $115;

deleted text begin (4) physician assistant temporary registration, $115;
deleted text end

deleted text begin (5) physician assistant temporary permit, $60;
deleted text end

deleted text begin (6)deleted text endnew text begin (3)new text end physician assistant locum tenens permit, $25;

deleted text begin (7)deleted text endnew text begin (4)new text end physician assistant late fee, $50;

deleted text begin (8)deleted text endnew text begin (5)new text end duplicate license fee, $20;

deleted text begin (9)deleted text endnew text begin (6)new text end certification letter fee, $25;

deleted text begin (10)deleted text endnew text begin (7)new text end education or training program approval fee, $100;

deleted text begin (11)deleted text endnew text begin (8)new text end report creation and generation fee, $60 per hour; and

deleted text begin (12)deleted text endnew text begin (9)new text end verification fee, $25.

(b) The board may prorate the initial annual license fee. All licensees are required to
pay the full fee upon license renewal. The revenue generated from the fees must be deposited
in an account in the state government special revenue fund.

new text begin EFFECTIVE DATE. new text end

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

Sec. 11.

Minnesota Statutes 2020, section 147C.15, subdivision 3, is amended to read:


Subd. 3.

Temporary permit.

new text begin(a) An applicant for licensure under this section may
request the board issue a temporary permit in accordance with this subdivision. Upon receipt
of the application for licensure, a request for a temporary permit, and a nonrefundable
respiratory therapist application fee as specified under section 147C.40, subdivision 5,
new text endthe
board may issue a temporary permit to practice as a respiratory therapist deleted text beginto an applicant
eligible for licensure under this section
deleted text end if the deleted text beginapplication for licensure is complete, all
applicable requirements in this section have been met, and a nonrefundable fee set by the
board has been paid
deleted text endnew text begin applicant is:
new text end

new text begin (1) currently licensed to practice as a respiratory therapist in another state, territory, or
Canadian province; and
new text end

new text begin (2) not subject to a pending investigation or disciplinary action in any state, territory, or
Canadian province
new text end.

deleted text begin Thedeleted text endnew text begin (b) A temporarynew text end permit deleted text beginremainsdeleted text endnew text begin issued under this subdivision is nonrenewable and new text end
valid deleted text beginonlydeleted text end until deleted text beginthe meeting of the board at whichdeleted text end a decision is made on the respiratory
therapist's application for licensurenew text begin or for 90 days, whichever occurs firstnew text end.

new text begin (c) The board may revoke a temporary permit that has been issued under this subdivision
if the applicant is the subject of an investigation or disciplinary action or is disqualified for
licensure for any other reason.
new text end

new text begin (d) Notwithstanding section 13.41, subdivision 2, the board may release information
regarding any action taken by a board pursuant to this section.
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. 12.

Minnesota Statutes 2020, section 147C.40, subdivision 5, is amended to read:


Subd. 5.

Respiratory therapist application and license fees.

(a) The board may charge
the following nonrefundable fees:

(1) respiratory therapist application fee, $100;

(2) respiratory therapist annual registration renewal fee, $90;

(3) respiratory therapist inactive status fee, $50;

(4) respiratory therapist temporary registration fee, $90;

deleted text begin (5) respiratory therapist temporary permit, $60;
deleted text end

deleted text begin (6)deleted text endnew text begin (5)new text end respiratory therapist late fee, $50;

deleted text begin (7)deleted text endnew text begin (6)new text end duplicate license fee, $20;

deleted text begin (8)deleted text endnew text begin (7)new text end certification letter fee, $25;

deleted text begin (9)deleted text endnew text begin (8)new text end education or training program approval fee, $100;

deleted text begin (10)deleted text endnew text begin (9)new text end report creation and generation fee, $60 per hour; and

deleted text begin (11)deleted text endnew text begin (10)new text end verification fee, $25.

(b) The board may prorate the initial annual license fee. All licensees are required to
pay the full fee upon license renewal. The revenue generated from the fees must be deposited
in an account in the state government special revenue fund.

new text begin EFFECTIVE DATE. new text end

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

Sec. 13.

Minnesota Statutes 2020, section 148.212, subdivision 1, is amended to read:


Subdivision 1.

Issuance.

Upon receipt of the applicable licensure or reregistration fee
and permit fee, and in accordance with rules of the board, the board may issue a nonrenewable
temporary permit to practice professional or practical nursing to an applicant for licensure
or reregistration who is not the subject of a pending investigation or disciplinary action, nor
disqualified for any other reason, under the following circumstances:

(a) The applicant for licensure by endorsement under section 148.211, subdivision 2, is
currently licensed to practice professional or practical nursing in another state, territory, or
Canadian province. The permit is valid until the date of board action on the application or
for deleted text begin60deleted text endnew text begin 90new text end days, whichever comes first.

(b) The applicant for licensure by endorsement under section 148.211, subdivision 2,
or for reregistration under section 148.231, subdivision 5, is currently registered in a formal,
structured refresher course or its equivalent for nurses that includes clinical practice.

new text begin EFFECTIVE DATE. new text end

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

Sec. 14.

new text begin [148.2855] NURSE LICENSURE COMPACT.
new text end

new text begin The Nurse Licensure Compact is enacted into law and entered into with all other
jurisdictions legally joining in it, in the form substantially as follows:
new text end

new text begin ARTICLE 1
new text end

new text begin DEFINITIONS
new text end

new text begin As used in this compact:
new text end

new text begin (a) "Adverse action" means any administrative, civil, equitable, or criminal action
permitted by a state's law that is imposed by a licensing board or other authority against a
nurse, including actions against an individual's license or multistate licensure privilege such
as revocation, suspension, probation, monitoring of the licensee, limitation on the licensee's
practice, or any other encumbrance on licensure affecting a nurse's authorization to practice,
including issuance of a cease and desist action.
new text end

new text begin (b) "Alternative program" means a nondisciplinary monitoring program approved by a
licensing board.
new text end

new text begin (c) "Coordinated licensure information system" means an integrated process for collecting,
storing, and sharing information on nurse licensure and enforcement activities related to
nurse licensure laws that is administered by a nonprofit organization composed of and
controlled by licensing boards.
new text end

new text begin (d) "Current significant investigative information" means:
new text end

new text begin (1) investigative information that a licensing board, after a preliminary inquiry that
includes notification and an opportunity for the nurse to respond, if required by state law,
has reason to believe is not groundless and, if proved true, would indicate more than a minor
infraction; or
new text end

new text begin (2) investigative information that indicates that the nurse represents an immediate threat
to public health and safety, regardless of whether the nurse has been notified and had an
opportunity to respond.
new text end

new text begin (e) "Encumbrance" means a revocation or suspension of, or any limitation on, the full
and unrestricted practice of nursing imposed by a licensing board.
new text end

new text begin (f) "Home state" means the party state that is the nurse's primary state of residence.
new text end

new text begin (g) "Licensing board" means a party state's regulatory body responsible for issuing nurse
licenses.
new text end

new text begin (h) "Multistate license" means a license to practice as a registered or a licensed
practical/vocational nurse (LPN/VN) issued by a home state licensing board that authorizes
the licensed nurse to practice in all party states under a multistate licensure privilege.
new text end

new text begin (i) "Multistate licensure privilege" means a legal authorization associated with a multistate
license permitting the practice of nursing as either a registered nurse (RN) or LPN/VN in
a remote state.
new text end

new text begin (j) "Nurse" means an RN or LPN/VN, as those terms are defined by each party state's
practice laws.
new text end

new text begin (k) "Party state" means any state that has adopted this compact.
new text end

new text begin (l) "Remote state" means a party state other than the home state.
new text end

new text begin (m) "Single-state license" means a nurse license issued by a party state that authorizes
practice only within the issuing state and does not include a multistate licensure privilege
to practice in any other party state.
new text end

new text begin (n) "State" means a state, territory, or possession of the United States and the District
of Columbia.
new text end

new text begin (o) "State practice laws" means a party state's laws, rules, and regulations that govern
the practice of nursing, define the scope of nursing practice, and create the methods and
grounds for imposing discipline. State practice laws do not include requirements necessary
to obtain and retain a license, except for qualifications or requirements of the home state.
new text end

new text begin ARTICLE 2
new text end

new text begin GENERAL PROVISIONS AND JURISDICTION
new text end

new text begin (a) A multistate license to practice registered or licensed practical/vocational nursing
issued by a home state to a resident in that state will be recognized by each party state as
authorizing a nurse to practice as an RN or LPN/VN under a multistate licensure privilege
in each party state.
new text end

new text begin (b) A state must implement procedures for considering the criminal history records of
applicants for initial multistate license or licensure by endorsement. The procedures shall
include the submission of fingerprints or other biometric-based information by applicants
for the purpose of obtaining an applicant's criminal history record information from the
Federal Bureau of Investigation and the agency responsible for retaining that state's criminal
records.
new text end

new text begin (c) Each party state shall require the following for an applicant to obtain or retain a
multistate license in the home state:
new text end

new text begin (1) meets the home state's qualifications for licensure or renewal of licensure, as well
as all other applicable state laws;
new text end

new text begin (2)(i) has graduated or is eligible to graduate from a licensing board-approved RN or
LPN/VN prelicensure education program; or
new text end

new text begin (ii) has graduated from a foreign RN or LPN/VN prelicensure education program that:
new text end

new text begin (A) has been approved by the authorized accrediting body in the applicable country; and
new text end

new text begin (B) has been verified by an independent credentials review agency to be comparable to
a licensing board-approved prelicensure education program;
new text end

new text begin (3) has, if a graduate of a foreign prelicensure education program not taught in English
or if English is not the individual's native language, successfully passed an English
proficiency examination that includes the components of reading, speaking, writing, and
listening;
new text end

new text begin (4) has successfully passed an NCLEX-RN or NCLEX-PN Examination or recognized
predecessor, as applicable;
new text end

new text begin (5) is eligible for or holds an active, unencumbered license;
new text end

new text begin (6) has submitted, in connection with an application for initial licensure or licensure by
endorsement, fingerprints or other biometric data for the purpose of obtaining criminal
history record information from the Federal Bureau of Investigation and the agency
responsible for retaining that state's criminal records;
new text end

new text begin (7) has not been convicted or found guilty, or has entered into an agreed disposition, of
a felony offense under applicable state or federal criminal law;
new text end

new text begin (8) has not been convicted or found guilty, or has entered into an agreed disposition, of
a misdemeanor offense related to the practice of nursing as determined on a case-by-case
basis;
new text end

new text begin (9) is not currently enrolled in an alternative program;
new text end

new text begin (10) is subject to self-disclosure requirements regarding current participation in an
alternative program; and
new text end

new text begin (11) has a valid United States Social Security number.
new text end

new text begin (d) All party states shall be authorized, in accordance with existing state due process
law, to take adverse action against a nurse's multistate licensure privilege such as revocation,
suspension, probation, or any other action that affects a nurse's authorization to practice
under a multistate licensure privilege, including cease and desist actions. If a party state
takes such action, it shall promptly notify the administrator of the coordinated licensure
information system. The administrator of the coordinated licensure information system shall
promptly notify the home state of any such actions by remote states.
new text end

new text begin (e) A nurse practicing in a party state must comply with the state practice laws of the
state in which the client is located at the time service is provided. The practice of nursing
is not limited to patient care, but shall include all nursing practice as defined by the state
practice laws of the party state in which the client is located. The practice of nursing in a
party state under a multistate licensure privilege shall subject a nurse to the jurisdiction of
the licensing board, the courts, and the laws of the party state in which the client is located
at the time service is provided.
new text end

new text begin (f) Individuals not residing in a party state shall continue to be able to apply for a party
state's single-state license as provided under the laws of each party state. However, the
single-state license granted to these individuals will not be recognized as granting the
privilege to practice nursing in any other party state. Nothing in this compact shall affect
the requirements established by a party state for the issuance of a single-state license.
new text end

new text begin (g) Any nurse holding a home state multistate license, on the effective date of this
compact, may retain and renew the multistate license issued by the nurse's then-current
home state, provided that:
new text end

new text begin (1) a nurse, who changes primary state of residence after this compact's effective date,
must meet all applicable paragraph (c) requirements to obtain a multistate license from a
new home state; or
new text end

new text begin (2) a nurse who fails to satisfy the multistate licensure requirements in paragraph (c)
due to a disqualifying event occurring after this compact's effective date shall be ineligible
to retain or renew a multistate license, and the nurse's multistate license shall be revoked
or deactivated in accordance with applicable rules adopted by the Interstate Commission
of Nurse Licensure Compact Administrators ("Commission").
new text end

new text begin ARTICLE 3
new text end

new text begin APPLICATIONS FOR LICENSURE IN A PARTY STATE
new text end

new text begin (a) Upon application for a multistate license, the licensing board in the issuing party
state shall ascertain, through the coordinated licensure information system, whether the
applicant has ever held or is the holder of a license issued by any other state, whether there
are any encumbrances on any license or multistate licensure privilege held by the applicant,
whether any adverse action has been taken against any license or multistate licensure privilege
held by the applicant, and whether the applicant is currently participating in an alternative
program.
new text end

new text begin (b) A nurse may hold a multistate license issued by the home state in only one party
state at a time.
new text end

new text begin (c) If a nurse changes primary state of residence by moving between two party states,
the nurse must apply for licensure in the new home state, and the multistate license issued
by the prior home state will be deactivated in accordance with applicable rules adopted by
the commission:
new text end

new text begin (1) the nurse may apply for licensure in advance of a change in primary state of residence;
and
new text end

new text begin (2) a multistate license shall not be issued by the new home state until the nurse provides
satisfactory evidence of a change in primary state of residence to the new home state and
satisfies all applicable requirements to obtain a multistate license from the new home state.
new text end

new text begin (d) If a nurse changes primary state of residence by moving from a party state to a
nonparty state, the multistate license issued by the prior home state will convert to a
single-state license, valid only in the former home state.
new text end

new text begin ARTICLE 4
new text end

new text begin ADDITIONAL AUTHORITIES INVESTED IN PARTY STATE LICENSING BOARDS
new text end

new text begin (a) In addition to the other powers conferred by state law, a licensing board shall have
the authority to:
new text end

new text begin (1) take adverse action against a nurse's multistate licensure privilege to practice within
that party state:
new text end

new text begin (i) only the home state shall have the power to take adverse action against a nurse's
license issued by the home state; and
new text end

new text begin (ii) for purposes of taking adverse action, the home state licensing board shall give the
same priority and effect to reported conduct received from a remote state as it would if the
conduct occurred within the home state. In so doing, the home state shall apply its own state
laws to determine appropriate action;
new text end

new text begin (2) issue cease and desist orders or impose an encumbrance on a nurse's authority to
practice within that party state;
new text end

new text begin (3) complete any pending investigations of a nurse who changes primary state of residence
during the course of the investigations. The licensing board shall also have the authority to
take appropriate action and shall promptly report the conclusions of the investigations to
the administrator of the coordinated licensure information system. The administrator of the
coordinated licensure information system shall promptly notify the new home state of any
such actions;
new text end

new text begin (4) issue subpoenas for hearings and investigations that require the attendance and
testimony of witnesses, as well as the production of evidence. Subpoenas issued by a licensing
board in a party state for the attendance and testimony of witnesses or the production of
evidence from another party state shall be enforced in the latter state by any court of
competent jurisdiction according to the practice and procedure of that court applicable to
subpoenas issued in proceedings pending before it. The issuing authority shall pay any
witness fees, travel expenses, mileage, and other fees required by the service statutes of the
state in which the witnesses or evidence are located;
new text end

new text begin (5) obtain and submit, for each nurse licensure applicant, fingerprint or other
biometric-based information to the Federal Bureau of Investigation for criminal background
checks, receive the results of the Federal Bureau of Investigation record search on criminal
background checks, and use the results in making licensure decisions;
new text end

new text begin (6) if otherwise permitted by state law, recover from the affected nurse the costs of
investigations and disposition of cases resulting from any adverse action taken against that
nurse; and
new text end

new text begin (7) take adverse action based on the factual findings of the remote state, provided that
the licensing board follows its own procedures for taking such adverse action.
new text end

new text begin (b) If adverse action is taken by the home state against a nurse's multistate license, the
nurse's multistate licensure privilege to practice in all other party states shall be deactivated
until all encumbrances have been removed from the multistate license. All home state
disciplinary orders that impose adverse action against a nurse's multistate license shall
include a statement that the nurse's multistate licensure privilege is deactivated in all party
states during the pendency of the order.
new text end

new text begin (c) Nothing in this compact shall override a party state's decision that participation in
an alternative program may be used in lieu of adverse action. The home state licensing board
shall deactivate the multistate licensure privilege under the multistate license of any nurse
for the duration of the nurse's participation in an alternative program.
new text end

new text begin ARTICLE 5
new text end

new text begin COORDINATED LICENSURE INFORMATION SYSTEM AND EXCHANGE OF
INFORMATION
new text end

new text begin (a) All party states shall participate in a coordinated licensure information system of
RNs and LPNs. The system will include information on the licensure and disciplinary history
of each nurse, as submitted by party states, to assist in the coordination of nurse licensure
and enforcement efforts.
new text end

new text begin (b) The commission, in consultation with the administrator of the coordinated licensure
information system, shall formulate necessary and proper procedures for the identification,
collection, and exchange of information under this compact.
new text end

new text begin (c) All licensing boards shall promptly report to the coordinated licensure information
system any adverse action, any current significant investigative information, denials of
applications, including the reasons for the denials, and nurse participation in alternative
programs known to the licensing board, regardless of whether the participation is deemed
nonpublic or confidential under state law.
new text end

new text begin (d) Current significant investigative information and participation in nonpublic or
confidential alternative programs shall be transmitted through the coordinated licensure
information system only to party state licensing boards.
new text end

new text begin (e) Notwithstanding any other provision of law, all party state licensing boards
contributing information to the coordinated licensure information system may designate
information that shall not be shared with nonparty states or disclosed to other entities or
individuals without the express permission of the contributing state.
new text end

new text begin (f) Any personally identifiable information obtained from the coordinated licensure
information system by a party state licensing board shall not be shared with nonparty states
or disclosed to other entities or individuals except to the extent permitted by the laws of the
party state contributing the information.
new text end

new text begin (g) Any information contributed to the coordinated licensure information system that is
subsequently required to be expunged by the laws of the party state contributing that
information shall also be expunged from the coordinated licensure information system.
new text end

new text begin (h) The compact administrator of each party state shall furnish a uniform data set to the
compact administrator of each other party state, which shall include, at a minimum:
new text end

new text begin (1) identifying information;
new text end

new text begin (2) licensure data;
new text end

new text begin (3) information related to alternative program participation; and
new text end

new text begin (4) other information that may facilitate the administration of this compact, as determined
by commission rules.
new text end

new text begin (i) The compact administrator of a party state shall provide all investigative documents
and information requested by another party state.
new text end

new text begin ARTICLE 6
new text end

new text begin ESTABLISHMENT OF THE INTERSTATE COMMISSION OF NURSE LICENSURE
COMPACT ADMINISTRATORS
new text end

new text begin (a) The party states hereby create and establish a joint public entity known as the Interstate
Commission of Nurse Licensure Compact Administrators:
new text end

new text begin (1) the commission is an instrumentality of the party states;
new text end

new text begin (2) venue is proper, and judicial proceedings by or against the commission shall be
brought solely and exclusively in a court of competent jurisdiction where the principal office
of the commission is located. The commission may waive venue and jurisdictional defenses
to the extent it adopts or consents to participate in alternative dispute resolution proceedings;
and
new text end

new text begin (3) nothing in this compact shall be construed to be a waiver of sovereign immunity.
new text end

new text begin (b) Membership, voting, and meetings:
new text end

new text begin (1) each party state shall have and be limited to one administrator. The head of the state
licensing board or designee shall be the administrator of this compact for each party state.
Any administrator may be removed or suspended from office as provided by the laws of
the state from which the administrator is appointed. Any vacancy occurring in the commission
shall be filled in accordance with the laws of the party state in which the vacancy exists;
new text end

new text begin (2) each administrator shall be entitled to one vote with regard to the promulgation of
rules and creation of bylaws and shall otherwise have an opportunity to participate in the
business and affairs of the commission. An administrator shall vote in person or by such
other means as provided in the bylaws. The bylaws may provide for an administrator's
participation in meetings by telephone or other means of communication;
new text end

new text begin (3) the commission shall meet at least once during each calendar year. Additional
meetings shall be held as set forth in the bylaws or rules of the commission;
new text end

new text begin (4) all meetings shall be open to the public, and public notice of meetings shall be given
in the same manner as required under the rulemaking provisions in article 7;
new text end

new text begin (5) the commission may convene in a closed, nonpublic meeting if the commission must
discuss:
new text end

new text begin (i) noncompliance of a party state with its obligations under this compact;
new text end

new text begin (ii) the employment, compensation, discipline, or other personnel matters, practices, or
procedures related to specific employees or other matters related to the commission's internal
personnel practices and procedures;
new text end

new text begin (iii) current, threatened, or reasonably anticipated litigation;
new text end

new text begin (iv) negotiation of contracts for the purchase or sale of goods, services, or real estate;
new text end

new text begin (v) accusing any person of a crime or formally censuring any person;
new text end

new text begin (vi) disclosure of trade secrets or commercial or financial information that is privileged
or confidential;
new text end

new text begin (vii) disclosure of information of a personal nature where disclosure would constitute a
clearly unwarranted invasion of personal privacy;
new text end

new text begin (viii) disclosure of investigatory records compiled for law enforcement purposes;
new text end

new text begin (ix) disclosure of information related to any reports prepared by or on behalf of the
commission for the purpose of investigation of compliance with this compact; or
new text end

new text begin (x) matters specifically exempted from disclosure by federal or state statute; and
new text end

new text begin (6) if a meeting or portion of a meeting is closed pursuant to this provision, the
commission's legal counsel or designee shall certify that the meeting may be closed and
shall reference each relevant exempting provision. The commission shall keep minutes that
fully and clearly describe all matters discussed in a meeting and shall provide a full and
accurate summary of actions taken and the reasons therefore, including a description of the
views expressed. All documents considered in connection with an action shall be identified
in the minutes. All minutes and documents of a closed meeting shall remain under seal,
subject to release by a majority vote of the commission or order of a court of competent
jurisdiction.
new text end

new text begin (c) The commission shall, by a majority vote of the administrators, prescribe bylaws or
rules to govern its conduct as may be necessary or appropriate to carry out the purposes and
exercise the powers of this compact, including but not limited to:
new text end

new text begin (1) establishing the fiscal year of the commission;
new text end

new text begin (2) providing reasonable standards and procedures:
new text end

new text begin (i) for the establishment and meetings of other committees; and
new text end

new text begin (ii) governing any general or specific delegation of any authority or function of the
commission;
new text end

new text begin (3) providing reasonable procedures for calling and conducting meetings of the
commission, ensuring reasonable advance notice of all meetings and providing an opportunity
for attendance of the meetings by interested parties, with enumerated exceptions designed
to protect the public's interest, the privacy of individuals, and proprietary information,
including trade secrets. The commission may meet in closed session only after a majority
of the administrators vote to close a meeting in whole or in part. As soon as practicable, the
commission must make public a copy of the vote to close the meeting revealing the vote of
each administrator, with no proxy votes allowed;
new text end

new text begin (4) establishing the titles, duties, and authority and reasonable procedures for the election
of the officers of the commission;
new text end

new text begin (5) providing reasonable standards and procedures for the establishment of the personnel
policies and programs of the commission. Notwithstanding any civil service or other similar
laws of any party state, the bylaws shall exclusively govern the personnel policies and
programs of the commission; and
new text end

new text begin (6) providing a mechanism for winding up the operations of the commission and the
equitable disposition of any surplus funds that may exist after the termination of this compact
after the payment or reserving of all of its debts and obligations.
new text end

new text begin (d) The commission shall publish its bylaws, rules, and any amendments in a convenient
form on the website of the commission.
new text end

new text begin (e) The commission shall maintain its financial records in accordance with the bylaws.
new text end

new text begin (f) The commission shall meet and take actions consistent with the provisions of this
compact and the bylaws.
new text end

new text begin (g) The commission shall have the following powers:
new text end

new text begin (1) to promulgate uniform rules to facilitate and coordinate implementation and
administration of this compact. The rules shall have the force and effect of law and shall
be binding in all party states;
new text end

new text begin (2) to bring and prosecute legal proceedings or actions in the name of the commission,
provided that the standing of any licensing board to sue or be sued under applicable law
shall not be affected;
new text end

new text begin (3) to purchase and maintain insurance and bonds;
new text end

new text begin (4) to borrow, accept, or contract for services of personnel, including but not limited to
employees of a party state or nonprofit organizations;
new text end

new text begin (5) to cooperate with other organizations that administer state compacts related to the
regulation of nursing, including but not limited to sharing administrative or staff expenses,
office space, or other resources;
new text end

new text begin (6) to hire employees, elect or appoint officers, fix compensation, define duties, grant
such individuals appropriate authority to carry out the purposes of this compact, and establish
the commission's personnel policies and programs relating to conflicts of interest,
qualifications of personnel, and other related personnel matters;
new text end

new text begin (7) to accept any and all appropriate donations, grants, and gifts of money, equipment,
supplies, materials, and services, and to receive, utilize, and dispose of the same; provided
that at all times the commission shall avoid any appearance of impropriety or conflict of
interest;
new text end

new text begin (8) to lease, purchase, accept appropriate gifts or donations of, or otherwise to own,
hold, improve, or use any property, whether real, personal, or mixed; provided that at all
times the commission shall avoid any appearance of impropriety;
new text end

new text begin (9) to sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose
of any property, whether real, personal, or mixed;
new text end

new text begin (10) to establish a budget and make expenditures;
new text end

new text begin (11) to borrow money;
new text end

new text begin (12) to appoint committees, including advisory committees comprised of administrators,
state nursing regulators, state legislators or their representatives, and consumer
representatives, and other such interested persons;
new text end

new text begin (13) to provide and receive information from, and to cooperate with, law enforcement
agencies;
new text end

new text begin (14) to adopt and use an official seal; and
new text end

new text begin (15) to perform other functions as may be necessary or appropriate to achieve the purposes
of this compact consistent with the state regulation of nurse licensure and practice.
new text end

new text begin (h) Financing of the commission:
new text end

new text begin (1) the commission shall pay or provide for the payment of the reasonable expenses of
its establishment, organization, and ongoing activities;
new text end

new text begin (2) the commission may also levy on and collect an annual assessment from each party
state to cover the cost of its operations, activities, and staff in its annual budget as approved
each year. The aggregate annual assessment amount, if any, shall be allocated based on a
formula to be determined by the commission, which shall promulgate a rule that is binding
upon all party states;
new text end

new text begin (3) the commission shall not incur obligations of any kind prior to securing the funds
adequate to meet the same; nor shall the commission pledge the credit of any of the party
states, except by and with the authority of the party state; and
new text end

new text begin (4) the commission shall keep accurate accounts of all receipts and disbursements. The
receipts and disbursements of the commission shall be subject to the audit and accounting
procedures established under its bylaws. However, all receipts and disbursements of funds
handled by the commission shall be audited yearly by a certified or licensed public
accountant, and the report of the audit shall be included in and become part of the annual
report of the commission.
new text end

new text begin (i) Qualified immunity, defense, and indemnification:
new text end

new text begin (1) the administrators, officers, executive director, employees, and representatives of
the commission shall be immune from suit and liability, either personally or in their official
capacity, for any claim for damage to or loss of property or personal injury or other civil
liability caused by or arising out of any actual or alleged act, error, or omission that occurred,
or that the person against whom the claim is made had a reasonable basis for believing
occurred, within the scope of commission employment, duties, or responsibilities; provided
that nothing in this paragraph shall be construed to protect any such person from suit or
liability for any damage, loss, injury, or liability caused by the intentional, willful, or wanton
misconduct of that person;
new text end

new text begin (2) the commission shall defend any administrator, officer, executive director, employee,
or representative of the commission in any civil action seeking to impose liability arising
out of any actual or alleged act, error, or omission that occurred within the scope of
commission employment, duties, or responsibilities, or that the person against whom the
claim is made had a reasonable basis for believing occurred within the scope of commission
employment, duties, or responsibilities; provided that nothing herein shall be construed to
prohibit that person from retaining the person's counsel; and provided further that the actual
or alleged act, error, or omission did not result from that person's intentional, willful, or
wanton misconduct; and
new text end

new text begin (3) the commission shall indemnify and hold harmless any administrator, officer,
executive director, employee, or representative of the commission for the amount of any
settlement or judgment obtained against that person arising out of any actual or alleged act,
error, or omission that occurred within the scope of commission employment, duties, or
responsibilities, or that the person had a reasonable basis for believing occurred within the
scope of commission employment, duties, or responsibilities, provided that the actual or
alleged act, error, or omission did not result from the intentional, willful, or wanton
misconduct of that person.
new text end

new text begin ARTICLE 7
new text end

new text begin RULEMAKING
new text end

new text begin (a) The commission shall exercise its rulemaking powers pursuant to this article and the
rules adopted thereunder. Rules and amendments shall become binding as of the date
specified in each rule or amendment and shall have the same force and effect as provisions
of this compact.
new text end

new text begin (b) Rules or amendments to the rules shall be adopted at a regular or special meeting of
the commission.
new text end

new text begin (c) Prior to promulgation and adoption of a final rule or rules by the commission, and
at least 60 days in advance of the meeting at which the rule will be considered and voted
on, the commission shall file a notice of proposed rulemaking:
new text end

new text begin (1) on the website of the commission; and
new text end

new text begin (2) on the website of each licensing board or the publication in which the state would
otherwise publish proposed rules.
new text end

new text begin (d) The notice of proposed rulemaking shall include:
new text end

new text begin (1) the proposed time, date, and location of the meeting in which the rule will be
considered and voted on;
new text end

new text begin (2) the text of the proposed rule or amendment, and the reason for the proposed rule;
new text end

new text begin (3) a request for comments on the proposed rule from any interested person; and
new text end

new text begin (4) the manner in which interested persons may submit notice to the commission of their
intention to attend the public hearing and any written comments.
new text end

new text begin (e) Prior to adoption of a proposed rule, the commission shall allow persons to submit
written data, facts, opinions, and arguments that shall be made available to the public.
new text end

new text begin (f) The commission shall grant an opportunity for a public hearing before it adopts a
rule or amendment.
new text end

new text begin (g) The commission shall publish the place, time, and date of the scheduled public
hearing:
new text end

new text begin (1) hearings shall be conducted in a manner providing each person who wishes to
comment a fair and reasonable opportunity to comment orally or in writing. All hearings
will be recorded and a copy will be made available upon request; and
new text end

new text begin (2) nothing in this section shall be construed as requiring a separate hearing on each
rule. Rules may be grouped for the convenience of the commission at hearings required by
this section.
new text end

new text begin (h) If no person appears at the public hearing, the commission may proceed with
promulgation of the proposed rule.
new text end

new text begin (i) Following the scheduled hearing date or by the close of business on the scheduled
hearing date if the hearing was not held, the commission shall consider all written and oral
comments received.
new text end

new text begin (j) The commission shall, by majority vote of all administrators, take final action on the
proposed rule and shall determine the effective date of the rule, if any, based on the
rulemaking record and the full text of the rule.
new text end

new text begin (k) Upon determination that an emergency exists, the commission may consider and
adopt an emergency rule without prior notice or opportunity for comment or hearing,
provided that the usual rulemaking procedures provided in this compact and in this section
shall be retroactively applied to the rule as soon as reasonably possible, in no event later
than 90 days after the effective date of the rule. For the purposes of this provision, an
emergency rule is one that must be adopted immediately in order to:
new text end

new text begin (1) meet an imminent threat to public health, safety, or welfare;
new text end

new text begin (2) prevent a loss of commission or party state funds; or
new text end

new text begin (3) meet a deadline for the promulgation of an administrative rule that is required by
federal law or rule.
new text end

new text begin (l) The commission may direct revisions to a previously adopted rule or amendment for
purposes of correcting typographical errors, errors in format, errors in consistency, or
grammatical errors. Public notice of any revisions shall be posted on the website of the
commission. The revision shall be subject to challenge by any person for a period of 30
days after posting. The revision may be challenged only on grounds that the revision results
in a material change to a rule. A challenge shall be made in writing and delivered to the
commission before the end of the notice period. If no challenge is made, the revision will
take effect without further action. If the revision is challenged, the revision shall not take
effect without the approval of the commission.
new text end

new text begin ARTICLE 8
new text end

new text begin OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT
new text end

new text begin (a) Oversight:
new text end

new text begin (1) each party state shall enforce this compact and take all actions necessary and
appropriate to effectuate this compact's purposes and intent; and
new text end

new text begin (2) the commission shall be entitled to receive service of process in any proceeding that
may affect the powers, responsibilities, or actions of the commission and shall have standing
to intervene in such a proceeding for all purposes. Failure to provide service of process in
the proceeding to the commission shall render a judgment or order void as to the commission,
this compact, or promulgated rules.
new text end

new text begin (b) Default, technical assistance, and termination:
new text end

new text begin (1) if the commission determines that a party state has defaulted in the performance of
its obligations or responsibilities under this compact or the promulgated rules, the commission
shall:
new text end

new text begin (i) provide written notice to the defaulting state and other party states of the nature of
the default, the proposed means of curing the default, or any other action to be taken by the
commission; and
new text end

new text begin (ii) provide remedial training and specific technical assistance regarding the default;
new text end

new text begin (2) if a state in default fails to cure the default, the defaulting state's membership in this
compact may be terminated upon an affirmative vote of a majority of the administrators,
and all rights, privileges, and benefits conferred by this compact may be terminated on the
effective date of termination. A cure of the default does not relieve the offending state of
obligations or liabilities incurred during the period of default;
new text end

new text begin (3) termination of membership in this compact shall be imposed only after all other
means of securing compliance have been exhausted. Notice of intent to suspend or terminate
shall be given by the commission to the governor of the defaulting state and to the executive
officer of the defaulting state's licensing board and each of the party states;
new text end

new text begin (4) a state whose membership in this compact has been terminated is responsible for all
assessments, obligations, and liabilities incurred through the effective date of termination,
including obligations that extend beyond the effective date of termination;
new text end

new text begin (5) the commission shall not bear any costs related to a state that is found to be in default
or whose membership in this compact has been terminated, unless agreed upon in writing
between the commission and the defaulting state; and
new text end

new text begin (6) the defaulting state may appeal the action of the commission by petitioning the U.S.
District Court for the District of Columbia or the federal district in which the commission
has its principal offices. The prevailing party shall be awarded all costs of the litigation,
including reasonable attorney fees.
new text end

new text begin (c) Dispute resolution:
new text end

new text begin (1) upon request by a party state, the commission shall attempt to resolve disputes related
to the compact that arise among party states and between party and nonparty states;
new text end

new text begin (2) the commission shall promulgate a rule providing for both mediation and binding
dispute resolution for disputes, as appropriate; and
new text end

new text begin (3) in the event the commission cannot resolve disputes among party states arising under
this compact:
new text end

new text begin (i) the party states may submit the issues in dispute to an arbitration panel, that will be
comprised of individuals appointed by the compact administrator in each of the affected
party states and an individual mutually agreed upon by the compact administrators of all
the party states involved in the dispute; and
new text end

new text begin (ii) the decision of a majority of the arbitrators shall be final and binding.
new text end

new text begin (d) Enforcement:
new text end

new text begin (1) the commission, in the reasonable exercise of its discretion, shall enforce the
provisions and rules of this compact;
new text end

new text begin (2) by majority vote, the commission may initiate legal action in the U.S. District Court
for the District of Columbia or the federal district in which the commission has its principal
offices against a party state that is in default to enforce compliance with this compact and
its promulgated rules and bylaws. The relief sought may include both injunctive relief and
damages. In the event judicial enforcement is necessary, the prevailing party shall be awarded
all costs of the litigation, including reasonable attorney fees; and
new text end

new text begin (3) the remedies herein shall not be the exclusive remedies of the commission. The
commission may pursue any other remedies available under federal or state law.
new text end

new text begin ARTICLE 9
new text end

new text begin EFFECTIVE DATE, WITHDRAWAL, AND AMENDMENT
new text end

new text begin (a) This compact shall become effective and binding on July 1, 2022. All party states to
this compact that also were parties to the prior Nurse Licensure Compact that was superseded
by this compact shall be deemed to have withdrawn from the prior compact within six
months after the effective date of this compact.
new text end

new text begin (b) Each party state to this compact shall continue to recognize a nurse's multistate
licensure privilege to practice in that party state issued under the prior compact until the
party state has withdrawn from the prior compact.
new text end

new text begin (c) Any party state may withdraw from this compact by legislative enactment. A party
state's withdrawal shall not take effect until six months after enactment of the repealing
statute.
new text end

new text begin (d) A party state's withdrawal or termination shall not affect the continuing requirement
of the withdrawing or terminated state's licensing board to report adverse actions and
significant investigations occurring prior to the effective date of the withdrawal or
termination.
new text end

new text begin (e) Nothing in this compact shall be construed to invalidate or prevent any nurse licensure
agreement or other cooperative arrangement between a party state and a nonparty state that
is made in accordance with the other provisions of this compact.
new text end

new text begin (f) This compact may be amended by the party states. No amendment to this compact
shall become effective and binding upon the party states unless and until it is enacted into
the laws of all party states.
new text end

new text begin (g) Representatives of nonparty states to this compact shall be invited to participate in
the activities of the commission on a nonvoting basis prior to the adoption of this compact
by all states.
new text end

new text begin ARTICLE 10
new text end

new text begin CONSTRUCTION AND SEVERABILITY
new text end

new text begin This compact shall be liberally construed so as to effectuate the purposes thereof. This
compact shall be severable, and if any phrase, clause, sentence, or provision of this compact
is declared to be contrary to the constitution of any party state or of the United States, or if
the applicability thereof to any government, agency, person, or circumstance is held invalid,
the validity of the remainder of this compact and the applicability thereof to any government,
agency, person, or circumstance shall not be affected thereby. If this compact is held to be
contrary to the constitution of any party state, this compact shall remain in full force and
effect for the remaining party states and in full force and effect for the party state affected
as to all severable matters.
new text end

Sec. 15.

new text begin [148.2856] APPLICATION OF NURSE LICENSURE COMPACT TO
EXISTING LAWS.
new text end

new text begin (a) Section 148.2855 does not supersede existing state labor laws.
new text end

new text begin (b) If the board takes action against an individual's multistate privilege, the action must
be adjudicated following the procedures in sections 14.50 to 14.62 and must be subject to
the judicial review provided for in sections 14.63 to 14.69.
new text end

new text begin (c) The board may take action against an individual's multistate privilege based on the
grounds listed in section 148.261, subdivision 1, and any other statute authorizing or requiring
the board to take corrective or disciplinary action.
new text end

new text begin (d) The board may take all forms of disciplinary action provided in section 148.262,
subdivision 1, and corrective action provided in section 214.103, subdivision 6, against an
individual's multistate privilege.
new text end

new text begin (e) The cooperation requirements of section 148.265 apply to individuals who practice
professional or practical nursing in Minnesota under section 148.2855.
new text end

new text begin (f) Complaints against individuals who practice professional or practical nursing in
Minnesota under section 148.2855 must be addressed according to sections 214.10 and
214.103.
new text end

Sec. 16.

new text begin [148.5185] AUDIOLOGY AND SPEECH-LANGUAGE PATHOLOGY
INTERSTATE COMPACT.
new text end

new text begin Section 1. Definitions
new text end

new text begin As used in this Compact, and except as otherwise provided, the following definitions
shall apply:
new text end

new text begin A. "Active duty military" means full-time duty status in the active uniformed service of
the United States, including members of the National Guard and Reserve on active duty
orders pursuant to 10 U.S.C. sections 1209 and 1211.
new text end

new text begin B. "Adverse action" means any administrative, civil, equitable, or criminal action
permitted by a state's laws which is imposed by a licensing board or other authority against
an audiologist or speech-language pathologist, including actions against an individual's
license or privilege to practice such as revocation, suspension, probation, monitoring of the
licensee, or restriction on the licensee's practice.
new text end

new text begin C. "Alternative program" means a non-disciplinary monitoring process approved by an
audiology or speech-language pathology licensing board to address impaired practitioners.
new text end

new text begin D. "Audiologist" means an individual who is licensed by a state to practice audiology.
new text end

new text begin E. "Audiology" means the care and services provided by a licensed audiologist as set
forth in the member state's statutes and rules.
new text end

new text begin F. "Audiology and Speech-Language Pathology Compact Commission" or "Commission"
means the national administrative body whose membership consists of all states that have
enacted the Compact.
new text end

new text begin G. "Audiology and speech-language pathology licensing board," "audiology licensing
board," "speech-language pathology licensing board," or "licensing board" means the agency
of a state that is responsible for the licensing and regulation of audiologists or
speech-language pathologists or both.
new text end

new text begin H. "Compact privilege" means the authorization granted by a remote state to allow a
licensee from another member state to practice as an audiologist or speech-language
pathologist in the remote state under its laws and rules. The practice of audiology or
speech-language pathology occurs in the member state where the patient, client, or student
is located at the time of the patient, client, or student encounter.
new text end

new text begin I. "Current significant investigative information" means investigative information that
a licensing board, after an inquiry or investigation that includes notification and an
opportunity for the audiologist or speech-language pathologist to respond, if required by
state law, has reason to believe is not groundless and, if proved true, would indicate more
than a minor infraction.
new text end

new text begin J. "Data system" means a repository of information about licensees, including, but not
limited to, continuing education, examination, licensure, investigation, compact privilege,
and adverse action.
new text end

new text begin K. "Encumbered license" means a license in which an adverse action restricts the practice
of audiology or speech-language pathology by the licensee and said adverse action has been
reported to the National Practitioners Data Bank (NPDB).
new text end

new text begin L. "Executive Committee" means a group of directors elected or appointed to act on
behalf of, and within the powers granted to them by, the Commission.
new text end

new text begin M. "Home state" means the member state that is the licensee's primary state of residence.
new text end

new text begin N. "Impaired practitioner" means individuals whose professional practice is adversely
affected by substance abuse, addiction, or other health-related conditions.
new text end

new text begin O. "Licensee" means an individual who currently holds an authorization from the state
licensing board to practice as an audiologist or speech-language pathologist.
new text end

new text begin P. "Member state" means a state that has enacted the Compact.
new text end

new text begin Q. "Privilege to practice" means a legal authorization permitting the practice of audiology
or speech-language pathology in a remote state.
new text end

new text begin R. "Remote state" means a member state other than the home state where a licensee is
exercising or seeking to exercise the compact privilege.
new text end

new text begin S. "Rule" means a regulation, principle, or directive promulgated by the Commission
that has the force of law.
new text end

new text begin T. "Single-state license" means an audiology or speech-language pathology license
issued by a member state that authorizes practice only within the issuing state and does not
include a privilege to practice in any other member state.
new text end

new text begin U. "Speech-language pathologist" means an individual who is licensed by a state to
practice speech-language pathology.
new text end

new text begin V. "Speech-language pathology" means the care and services provided by a licensed
speech-language pathologist as set forth in the member state's statutes and rules.
new text end

new text begin W. "State" means any state, commonwealth, district, or territory of the United States of
America that regulates the practice of audiology and speech-language pathology.
new text end

new text begin X. "State practice laws" means a member state's laws, rules, and regulations that govern
the practice of audiology or speech-language pathology, define the scope of audiology or
speech-language pathology practice, and create the methods and grounds for imposing
discipline.
new text end

new text begin Y. "Telehealth" means the application of telecommunication technology to deliver
audiology or speech-language pathology services at a distance for assessment, intervention,
or consultation.
new text end

new text begin Section 2. State Participation in the Compact
new text end

new text begin A. A license issued to an audiologist or speech-language pathologist by a home state to
a resident in that state shall be recognized by each member state as authorizing an audiologist
or speech-language pathologist to practice audiology or speech-language pathology, under
a privilege to practice, in each member state.
new text end

new text begin B. A state must implement or utilize procedures for considering the criminal history
records of applicants for initial privilege to practice. These procedures shall include the
submission of fingerprints or other biometric-based information by applicants for the purpose
of obtaining an applicant's criminal history record information from the Federal Bureau of
Investigation and the agency responsible for retaining that state's criminal records.
new text end

new text begin 1. A member state must fully implement a criminal background check requirement,
within a time frame established by rule, by receiving the results of the Federal Bureau of
Investigation record search on criminal background checks and use the results in making
licensure decisions.
new text end

new text begin 2. Communication between a member state and the Commission and among member
states regarding the verification of eligibility for licensure through the Compact shall not
include any information received from the Federal Bureau of Investigation relating to a
federal criminal records check performed by a member state under Public Law 92-544.
new text end

new text begin C. Upon application for a privilege to practice, the licensing board in the issuing remote
state shall ascertain, through the data system, whether the applicant has ever held, or is the
holder of, a license issued by any other state, whether there are any encumbrances on any
license or privilege to practice held by the applicant, and whether any adverse action has
been taken against any license or privilege to practice held by the applicant.
new text end

new text begin D. Each member state shall require an applicant to obtain or retain a license in the home
state and meet the home state's qualifications for licensure or renewal of licensure, as well
as all other applicable state laws.
new text end

new text begin E. For an audiologist:
new text end

new text begin 1. Must meet one of the following educational requirements:
new text end

new text begin a. On or before December 31, 2007, has graduated with a master's degree or doctoral
degree in audiology, or equivalent degree regardless of degree name, from a program that
is accredited by an accrediting agency recognized by the Council for Higher Education
Accreditation, or its successor, or by the United States Department of Education and operated
by a college or university accredited by a regional or national accrediting organization
recognized by the board; or
new text end

new text begin b. On or after January 1, 2008, has graduated with a doctoral degree in audiology, or
equivalent degree regardless of degree name, from a program that is accredited by an
accrediting agency recognized by the Council for Higher Education Accreditation, or its
successor, or by the United States Department of Education and operated by a college or
university accredited by a regional or national accrediting organization recognized by the
board; or
new text end

new text begin c. Has graduated from an audiology program that is housed in an institution of higher
education outside of the United States (a) for which the program and institution have been
approved by the authorized accrediting body in the applicable country and (b) the degree
program has been verified by an independent credentials review agency to be comparable
to a state licensing board-approved program;
new text end

new text begin 2. Has completed a supervised clinical practicum experience from an accredited
educational institution or its cooperating programs as required by the board;
new text end

new text begin 3. Has successfully passed a national examination approved by the Commission;
new text end

new text begin 4. Holds an active, unencumbered license;
new text end

new text begin 5. Has not been convicted or found guilty, and has not entered into an agreed disposition,
of a felony related to the practice of audiology, under applicable state or federal criminal
law; and
new text end

new text begin 6. Has a valid United States Social Security or National Practitioner Identification
number.
new text end

new text begin F. For a speech-language pathologist:
new text end

new text begin 1. Must meet one of the following educational requirements:
new text end

new text begin a. Has graduated with a master's degree from a speech-language pathology program that
is accredited by an organization recognized by the United States Department of Education
and operated by a college or university accredited by a regional or national accrediting
organization recognized by the board; or
new text end

new text begin b. Has graduated from a speech-language pathology program that is housed in an
institution of higher education outside of the United States (a) for which the program and
institution have been approved by the authorized accrediting body in the applicable country
and (b) the degree program has been verified by an independent credentials review agency
to be comparable to a state licensing board-approved program;
new text end

new text begin 2. Has completed a supervised clinical practicum experience from an educational
institution or its cooperating programs as required by the Commission;
new text end

new text begin 3. Has completed a supervised postgraduate professional experience as required by the
Commission;
new text end

new text begin 4. Has successfully passed a national examination approved by the Commission;
new text end

new text begin 5. Holds an active, unencumbered license;
new text end

new text begin 6. Has not been convicted or found guilty, and has not entered into an agreed disposition,
of a felony related to the practice of speech-language pathology, under applicable state or
federal criminal law; and
new text end

new text begin 7. Has a valid United States Social Security or National Practitioner Identification
number.
new text end

new text begin G. The privilege to practice is derived from the home state license.
new text end

new text begin H. An audiologist or speech-language pathologist practicing in a member state must
comply with the state practice laws of the state in which the client is located at the time
service is provided. The practice of audiology and speech-language pathology shall include
all audiology and speech-language pathology practice as defined by the state practice laws
of the member state in which the client is located. The practice of audiology and
speech-language pathology in a member state under a privilege to practice shall subject an
audiologist or speech-language pathologist to the jurisdiction of the licensing board, the
courts and the laws of the member state in which the client is located at the time service is
provided.
new text end

new text begin I. Individuals not residing in a member state shall continue to be able to apply for a
member state's single-state license as provided under the laws of each member state.
However, the single-state license granted to these individuals shall not be recognized as
granting the privilege to practice audiology or speech-language pathology in any other
member state. Nothing in this Compact shall affect the requirements established by a member
state for the issuance of a single-state license.
new text end

new text begin J. Member states may charge a fee for granting a compact privilege.
new text end

new text begin K. Member states must comply with the bylaws and rules and regulations of the
Commission.
new text end

new text begin Section 3. Compact Privilege
new text end

new text begin A. To exercise the compact privilege under the terms and provisions of the Compact,
the audiologist or speech-language pathologist shall:
new text end

new text begin 1. Hold an active license in the home state;
new text end

new text begin 2. Have no encumbrance on any state license;
new text end

new text begin 3. Be eligible for a compact privilege in any member state in accordance with Section
2;
new text end

new text begin 4. Have not had any adverse action against any license or compact privilege within the
previous two years from date of application;
new text end

new text begin 5. Notify the Commission that the licensee is seeking the compact privilege within a
remote state(s);
new text end

new text begin 6. Pay any applicable fees, including any state fee, for the compact privilege; and
new text end

new text begin 7. Report to the Commission adverse action taken by any non-member state within 30
days from the date the adverse action is taken.
new text end

new text begin B. For the purposes of the compact privilege, an audiologist or speech-language
pathologist shall only hold one home state license at a time.
new text end

new text begin C. Except as provided in Section 5, if an audiologist or speech-language pathologist
changes primary state of residence by moving between two member states, the audiologist
or speech-language pathologist must apply for licensure in the new home state, and the
license issued by the prior home state shall be deactivated in accordance with applicable
rules adopted by the Commission.
new text end

new text begin D. The audiologist or speech-language pathologist may apply for licensure in advance
of a change in primary state of residence.
new text end

new text begin E. A license shall not be issued by the new home state until the audiologist or
speech-language pathologist provides satisfactory evidence of a change in primary state of
residence to the new home state and satisfies all applicable requirements to obtain a license
from the new home state.
new text end

new text begin F. If an audiologist or speech-language pathologist changes primary state of residence
by moving from a member state to a non-member state, the license issued by the prior home
state shall convert to a single-state license, valid only in the former home state.
new text end

new text begin G. The compact privilege is valid until the expiration date of the home state license. The
licensee must comply with the requirements of Section 3A to maintain the compact privilege
in the remote state.
new text end

new text begin H. A licensee providing audiology or speech-language pathology services in a remote
state under the compact privilege shall function within the laws and regulations of the remote
state.
new text end

new text begin I. A licensee providing audiology or speech-language pathology services in a remote
state is subject to that state's regulatory authority. A remote state may, in accordance with
due process and that state's laws, remove a licensee's compact privilege in the remote state
for a specific period of time, impose fines, or take any other necessary actions to protect
the health and safety of its citizens.
new text end

new text begin J. If a home state license is encumbered, the licensee shall lose the compact privilege in
any remote state until the following occur:
new text end

new text begin 1. The home state license is no longer encumbered; and
new text end

new text begin 2. Two years have elapsed from the date of the adverse action.
new text end

new text begin K. Once an encumbered license in the home state is restored to good standing, the licensee
must meet the requirements of Section 3A to obtain a compact privilege in any remote state.
new text end

new text begin L. Once the requirements of Section 3J have been met, the licensee must meet the
requirements in Section 3A to obtain a compact privilege in a remote state.
new text end

new text begin Section 4. Compact Privilege to Practice Telehealth
new text end

new text begin Member states shall recognize the right of an audiologist or speech-language pathologist,
licensed by a home state in accordance with Section 2 and under rules promulgated by the
Commission, to practice audiology or speech-language pathology in a member state via
telehealth under a privilege to practice as provided in the Compact and rules promulgated
by the Commission.
new text end

new text begin Section 5. Active Duty Military Personnel or Their Spouses
new text end

new text begin Active duty military personnel, or their spouse, shall designate a home state where the
individual has a current license in good standing. The individual may retain the home state
designation during the period the service member is on active duty. Subsequent to designating
a home state, the individual shall only change their home state through application for
licensure in the new state.
new text end

new text begin Section 6. Adverse Actions
new text end

new text begin A. In addition to the other powers conferred by state law, a remote state shall have the
authority, in accordance with existing state due process law, to:
new text end

new text begin 1. Take adverse action against an audiologist's or speech-language pathologist's privilege
to practice within that member state.
new text end

new text begin 2. Issue subpoenas for both hearings and investigations that require the attendance and
testimony of witnesses as well as the production of evidence. Subpoenas issued by a licensing
board in a member state for the attendance and testimony of witnesses or the production of
evidence from another member state shall be enforced in the latter state by any court of
competent jurisdiction, according to the practice and procedure of that court applicable to
subpoenas issued in proceedings pending before it. The issuing authority shall pay any
witness fees, travel expenses, mileage and other fees required by the service statutes of the
state in which the witnesses or evidence are located.
new text end

new text begin B. Only the home state shall have the power to take adverse action against an audiologist's
or speech-language pathologist's license issued by the home state.
new text end

new text begin C. For purposes of taking adverse action, the home state shall give the same priority and
effect to reported conduct received from a member state as it would if the conduct had
occurred within the home state. In so doing, the home state shall apply its own state laws
to determine appropriate action.
new text end

new text begin D. The home state shall complete any pending investigations of an audiologist or
speech-language pathologist who changes primary state of residence during the course of
the investigations. The home state shall also have the authority to take appropriate action(s)
and shall promptly report the conclusions of the investigations to the administrator of the
data system. The administrator of the data system shall promptly notify the new home state
of any adverse actions.
new text end

new text begin E. If otherwise permitted by state law, the member state may recover from the affected
audiologist or speech-language pathologist the costs of investigations and disposition of
cases resulting from any adverse action taken against that audiologist or speech-language
pathologist.
new text end

new text begin F. The member state may take adverse action based on the factual findings of the remote
state, provided that the home state follows its own procedures for taking the adverse action.
new text end

new text begin G. Joint Investigations
new text end

new text begin 1. In addition to the authority granted to a member state by its respective audiology or
speech-language pathology practice act or other applicable state law, any member state may
participate with other member states in joint investigations of licensees.
new text end

new text begin 2. Member states shall share any investigative, litigation, or compliance materials in
furtherance of any joint or individual investigation initiated under the Compact.
new text end

new text begin H. If adverse action is taken by the home state against an audiologist's or speech-language
pathologist's license, the audiologist's or speech-language pathologist's privilege to practice
in all other member states shall be deactivated until all encumbrances have been removed
from the state license. All home state disciplinary orders that impose adverse action against
an audiologist's or speech-language pathologist's license shall include a statement that the
audiologist's or speech-language pathologist's privilege to practice is deactivated in all
member states during the pendency of the order.
new text end

new text begin I. If a member state takes adverse action, it shall promptly notify the administrator of
the data system. The administrator of the data system shall promptly notify the home state
of any adverse actions by remote states.
new text end

new text begin J. Nothing in this Compact shall override a member state's decision that participation in
an alternative program may be used in lieu of adverse action.
new text end

new text begin Section 7. Establishment of the Audiology and Speech-Language Pathology Compact
Commission
new text end

new text begin A. The Compact member states hereby create and establish a joint public agency known
as the Audiology and Speech-Language Pathology Compact Commission:
new text end

new text begin 1. The Commission is an instrumentality of the Compact states.
new text end

new text begin 2. Venue is proper and judicial proceedings by or against the Commission shall be
brought solely and exclusively in a court of competent jurisdiction where the principal office
of the Commission is located. The Commission may waive venue and jurisdictional defenses
to the extent it adopts or consents to participate in alternative dispute resolution proceedings.
new text end

new text begin 3. Nothing in this Compact shall be construed to be a waiver of sovereign immunity.
new text end

new text begin B. Membership, Voting, and Meetings
new text end

new text begin 1. Each member state shall have two delegates selected by that member state's licensing
board. The delegates shall be current members of the licensing board. One shall be an
audiologist and one shall be a speech-language pathologist.
new text end

new text begin 2. An additional five delegates, who are either a public member or board administrator
from a state licensing board, shall be chosen by the Executive Committee from a pool of
nominees provided by the Commission at Large.
new text end

new text begin 3. Any delegate may be removed or suspended from office as provided by the law of
the state from which the delegate is appointed.
new text end

new text begin 4. The member state board shall fill any vacancy occurring on the Commission, within
90 days.
new text end

new text begin 5. Each delegate shall be entitled to one vote with regard to the promulgation of rules
and creation of bylaws and shall otherwise have an opportunity to participate in the business
and affairs of the Commission.
new text end

new text begin 6. A delegate shall vote in person or by other means as provided in the bylaws. The
bylaws may provide for delegates' participation in meetings by telephone or other means
of communication.
new text end

new text begin 7. The Commission shall meet at least once during each calendar year. Additional
meetings shall be held as set forth in the bylaws.
new text end

new text begin C. The Commission shall have the following powers and duties:
new text end

new text begin 1. Establish the fiscal year of the Commission;
new text end

new text begin 2. Establish bylaws;
new text end

new text begin 3. Establish a Code of Ethics;
new text end

new text begin 4. Maintain its financial records in accordance with the bylaws;
new text end

new text begin 5. Meet and take actions as are consistent with the provisions of this Compact and the
bylaws;
new text end

new text begin 6. Promulgate uniform rules to facilitate and coordinate implementation and
administration of this Compact. The rules shall have the force and effect of law and shall
be binding in all member states;
new text end

new text begin 7. Bring and prosecute legal proceedings or actions in the name of the Commission,
provided that the standing of any state audiology or speech-language pathology licensing
board to sue or be sued under applicable law shall not be affected;
new text end

new text begin 8. Purchase and maintain insurance and bonds;
new text end

new text begin 9. Borrow, accept, or contract for services of personnel, including, but not limited to,
employees of a member state;
new text end

new text begin 10. Hire employees, elect or appoint officers, fix compensation, define duties, grant
individuals appropriate authority to carry out the purposes of the Compact, and establish
the Commission's personnel policies and programs relating to conflicts of interest,
qualifications of personnel, and other related personnel matters;
new text end

new text begin 11. Accept any and all appropriate donations and grants of money, equipment, supplies,
materials and services, and to receive, utilize and dispose of the same; provided that at all
times the Commission shall avoid any appearance of impropriety and/or conflict of interest;
new text end

new text begin 12. Lease, purchase, accept appropriate gifts or donations of, or otherwise own, hold,
improve or use, any property, real, personal, or mixed; provided that at all times the
Commission shall avoid any appearance of impropriety;
new text end

new text begin 13. Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of
any property real, personal, or mixed;
new text end

new text begin 14. Establish a budget and make expenditures;
new text end

new text begin 15. Borrow money;
new text end

new text begin 16. Appoint committees, including standing committees composed of members, and
other interested persons as may be designated in this Compact and the bylaws;
new text end

new text begin 17. Provide and receive information from, and cooperate with, law enforcement agencies;
new text end

new text begin 18. Establish and elect an Executive Committee; and
new text end

new text begin 19. Perform other functions as may be necessary or appropriate to achieve the purposes
of this Compact consistent with the state regulation of audiology and speech-language
pathology licensure and practice.
new text end

new text begin D. The Executive Committee
new text end

new text begin The Executive Committee shall have the power to act on behalf of the Commission
according to the terms of this Compact.
new text end

new text begin 1. The Executive Committee shall be composed of ten members:
new text end

new text begin a. Seven voting members who are elected by the Commission from the current
membership of the Commission;
new text end

new text begin b. Two ex-officios, consisting of one nonvoting member from a recognized national
audiology professional association and one nonvoting member from a recognized national
speech-language pathology association; and
new text end

new text begin c. One ex-officio, nonvoting member from the recognized membership organization of
the audiology and speech-language pathology licensing boards.
new text end

new text begin E. The ex-officio members shall be selected by their respective organizations.
new text end

new text begin 1. The Commission may remove any member of the Executive Committee as provided
in bylaws.
new text end

new text begin 2. The Executive Committee shall meet at least annually.
new text end

new text begin 3. The Executive Committee shall have the following duties and responsibilities:
new text end

new text begin a. Recommend to the entire Commission changes to the rules or bylaws, changes to this
Compact legislation, fees paid by Compact member states such as annual dues, and any
commission Compact fee charged to licensees for the compact privilege;
new text end

new text begin b. Ensure Compact administration services are appropriately provided, contractual or
otherwise;
new text end

new text begin c. Prepare and recommend the budget;
new text end

new text begin d. Maintain financial records on behalf of the Commission;
new text end

new text begin e. Monitor Compact compliance of member states and provide compliance reports to
the Commission;
new text end

new text begin f. Establish additional committees as necessary; and
new text end

new text begin g. Other duties as provided in rules or bylaws.
new text end

new text begin 4. Meetings of the Commission
new text end

new text begin All meetings shall be open to the public, and public notice of meetings shall be given
in the same manner as required under the rulemaking provisions in Section 9.
new text end

new text begin 5. The Commission or the Executive Committee or other committees of the Commission
may convene in a closed, non-public meeting if the Commission or Executive Committee
or other committees of the Commission must discuss:
new text end

new text begin a. Non-compliance of a member state with its obligations under the Compact;
new text end

new text begin b. The employment, compensation, discipline, or other matters, practices, or procedures
related to specific employees or other matters related to the Commission's internal personnel
practices and procedures;
new text end

new text begin c. Current, threatened, or reasonably anticipated litigation;
new text end

new text begin d. Negotiation of contracts for the purchase, lease, or sale of goods, services, or real
estate;
new text end

new text begin e. Accusing any person of a crime or formally censuring any person;
new text end

new text begin f. Disclosure of trade secrets or commercial or financial information that is privileged
or confidential;
new text end

new text begin g. Disclosure of information of a personal nature where disclosure would constitute a
clearly unwarranted invasion of personal privacy;
new text end

new text begin h. Disclosure of investigative records compiled for law enforcement purposes;
new text end

new text begin i. Disclosure of information related to any investigative reports prepared by or on behalf
of or for use of the Commission or other committee charged with responsibility of
investigation or determination of compliance issues pursuant to the Compact; or
new text end

new text begin j. Matters specifically exempted from disclosure by federal or member state statute.
new text end

new text begin 6. If a meeting, or portion of a meeting, is closed pursuant to this provision, the
Commission's legal counsel or designee shall certify that the meeting may be closed and
shall reference each relevant exempting provision.
new text end

new text begin 7. The Commission shall keep minutes that fully and clearly describe all matters discussed
in a meeting and shall provide a full and accurate summary of actions taken, and the reasons
therefore, including a description of the views expressed. All documents considered in
connection with an action shall be identified in minutes. All minutes and documents of a
closed meeting shall remain under seal, subject to release by a majority vote of the
Commission or order of a court of competent jurisdiction.
new text end

new text begin 8. Financing of the Commission
new text end

new text begin a. The Commission shall pay, or provide for the payment of, the reasonable expenses
of its establishment, organization, and ongoing activities.
new text end

new text begin b. The Commission may accept any and all appropriate revenue sources, donations, and
grants of money, equipment, supplies, materials, and services.
new text end

new text begin c. The Commission may levy on and collect an annual assessment from each member
state or impose fees on other parties to cover the cost of the operations and activities of the
Commission and its staff, which must be in a total amount sufficient to cover its annual
budget as approved each year for which revenue is not provided by other sources. The
aggregate annual assessment amount shall be allocated based upon a formula to be determined
by the Commission, which shall promulgate a rule binding upon all member states.
new text end

new text begin 9. The Commission shall not incur obligations of any kind prior to securing the funds
adequate to meet the same; nor shall the Commission pledge the credit of any of the member
states, except by and with the authority of the member state.
new text end

new text begin 10. The Commission shall keep accurate accounts of all receipts and disbursements. The
receipts and disbursements of the Commission shall be subject to the audit and accounting
procedures established under its bylaws. However, all receipts and disbursements of funds
handled by the Commission shall be audited yearly by a certified or licensed public
accountant, and the report of the audit shall be included in and become part of the annual
report of the Commission.
new text end

new text begin F. Qualified Immunity, Defense, and Indemnification
new text end

new text begin 1. The members, officers, executive director, employees and representatives of the
Commission shall be immune from suit and liability, either personally or in their official
capacity, for any claim for damage to or loss of property or personal injury or other civil
liability caused by or arising out of any actual or alleged act, error, or omission that occurred,
or that the person against whom the claim is made had a reasonable basis for believing
occurred within the scope of Commission employment, duties, or responsibilities; provided
that nothing in this paragraph shall be construed to protect any person from suit or liability
for any damage, loss, injury, or liability caused by the intentional or willful or wanton
misconduct of that person.
new text end

new text begin 2. The Commission shall defend any member, officer, executive director, employee, or
representative of the Commission in any civil action seeking to impose liability arising out
of any actual or alleged act, error, or omission that occurred within the scope of Commission
employment, duties, or responsibilities, or that the person against whom the claim is made
had a reasonable basis for believing occurred within the scope of Commission employment,
duties, or responsibilities; provided that nothing herein shall be construed to prohibit that
person from retaining his or her own counsel; and provided further, that the actual or alleged
act, error, or omission did not result from that person's intentional or willful or wanton
misconduct.
new text end

new text begin 3. The Commission shall indemnify and hold harmless any member, officer, executive
director, employee, or representative of the Commission for the amount of any settlement
or judgment obtained against that person arising out of any actual or alleged act, error or
omission that occurred within the scope of Commission employment, duties, or
responsibilities, or that person had a reasonable basis for believing occurred within the scope
of Commission employment, duties, or responsibilities, provided that the actual or alleged
act, error, or omission did not result from the intentional or willful or wanton misconduct
of that person.
new text end

new text begin Section 8. Data System
new text end

new text begin A. The Commission shall provide for the development, maintenance, and utilization of
a coordinated database and reporting system containing licensure, adverse action, and
investigative information on all licensed individuals in member states.
new text end

new text begin B. Notwithstanding any other provision of state law to the contrary, a member state shall
submit a uniform data set to the data system on all individuals to whom this Compact is
applicable as required by the rules of the Commission, including:
new text end

new text begin 1. Identifying information;
new text end

new text begin 2. Licensure data;
new text end

new text begin 3. Adverse actions against a license or compact privilege;
new text end

new text begin 4. Non-confidential information related to alternative program participation;
new text end

new text begin 5. Any denial of application for licensure, and the reason(s) for denial; and
new text end

new text begin 6. Other information that may facilitate the administration of this Compact, as determined
by the rules of the Commission.
new text end

new text begin C. Investigative information pertaining to a licensee in any member state shall only be
available to other member states.
new text end

new text begin D. The Commission shall promptly notify all member states of any adverse action taken
against a licensee or an individual applying for a license. Adverse action information
pertaining to a licensee in any member state shall be available to any other member state.
new text end

new text begin E. Member states contributing information to the data system may designate information
that may not be shared with the public without the express permission of the contributing
state.
new text end

new text begin F. Any information submitted to the data system that is subsequently required to be
expunged by the laws of the member state contributing the information shall be removed
from the data system.
new text end

new text begin Section 9. Rulemaking
new text end

new text begin A. The Commission shall exercise its rulemaking powers pursuant to the criteria set
forth in this Section and the rules adopted thereunder. Rules and amendments shall become
binding as of the date specified in each rule or amendment.
new text end

new text begin B. If a majority of the legislatures of the member states rejects a rule, by enactment of
a statute or resolution in the same manner used to adopt the Compact within four years of
the date of adoption of the rule, the rule shall have no further force and effect in any member
state.
new text end

new text begin C. Rules or amendments to the rules shall be adopted at a regular or special meeting of
the Commission.
new text end

new text begin D. Prior to promulgation and adoption of a final rule or rules by the Commission, and
at least 30 days in advance of the meeting at which the rule shall be considered and voted
upon, the Commission shall file a Notice of Proposed Rulemaking:
new text end

new text begin 1. On the website of the Commission or other publicly accessible platform; and
new text end

new text begin 2. On the website of each member state audiology or speech-language pathology licensing
board or other publicly accessible platform or the publication in which each state would
otherwise publish proposed rules.
new text end

new text begin E. The Notice of Proposed Rulemaking shall include:
new text end

new text begin 1. The proposed time, date, and location of the meeting in which the rule shall be
considered and voted upon;
new text end

new text begin 2. The text of the proposed rule or amendment and the reason for the proposed rule;
new text end

new text begin 3. A request for comments on the proposed rule from any interested person; and
new text end

new text begin 4. The manner in which interested persons may submit notice to the Commission of
their intention to attend the public hearing and any written comments.
new text end

new text begin F. Prior to the adoption of a proposed rule, the Commission shall allow persons to submit
written data, facts, opinions, and arguments, which shall be made available to the public.
new text end

new text begin G. The Commission shall grant an opportunity for a public hearing before it adopts a
rule or amendment if a hearing is requested by:
new text end

new text begin 1. At least 25 persons;
new text end

new text begin 2. A state or federal governmental subdivision or agency; or
new text end

new text begin 3. An association having at least 25 members.
new text end

new text begin H. If a hearing is held on the proposed rule or amendment, the Commission shall publish
the place, time, and date of the scheduled public hearing. If the hearing is held via electronic
means, the Commission shall publish the mechanism for access to the electronic hearing.
new text end

new text begin 1. All persons wishing to be heard at the hearing shall notify the executive director of
the Commission or other designated member in writing of their desire to appear and testify
at the hearing not less than five business days before the scheduled date of the hearing.
new text end

new text begin 2. Hearings shall be conducted in a manner providing each person who wishes to comment
a fair and reasonable opportunity to comment orally or in writing.
new text end

new text begin 3. All hearings shall be recorded. A copy of the recording shall be made available on
request.
new text end

new text begin 4. Nothing in this section shall be construed as requiring a separate hearing on each rule.
Rules may be grouped for the convenience of the Commission at hearings required by this
section.
new text end

new text begin I. Following the scheduled hearing date, or by the close of business on the scheduled
hearing date if the hearing was not held, the Commission shall consider all written and oral
comments received.
new text end

new text begin J. If no written notice of intent to attend the public hearing by interested parties is
received, the Commission may proceed with promulgation of the proposed rule without a
public hearing.
new text end

new text begin K. The Commission shall, by majority vote of all members, take final action on the
proposed rule and shall determine the effective date of the rule, if any, based on the
rulemaking record and the full text of the rule.
new text end

new text begin L. Upon determination that an emergency exists, the Commission may consider and
adopt an emergency rule without prior notice, opportunity for comment, or hearing, provided
that the usual rulemaking procedures provided in the Compact and in this section shall be
retroactively applied to the rule as soon as reasonably possible, in no event later than 90
days after the effective date of the rule. For the purposes of this provision, an emergency
rule is one that must be adopted immediately in order to:
new text end

new text begin 1. Meet an imminent threat to public health, safety, or welfare;
new text end

new text begin 2. Prevent a loss of Commission or member state funds; or
new text end

new text begin 3. Meet a deadline for the promulgation of an administrative rule that is established by
federal law or rule.
new text end

new text begin M. The Commission or an authorized committee of the Commission may direct revisions
to a previously adopted rule or amendment for purposes of correcting typographical errors,
errors in format, errors in consistency, or grammatical errors. Public notice of any revisions
shall be posted on the website of the Commission. The revision shall be subject to challenge
by any person for a period of 30 days after posting. The revision may be challenged only
on grounds that the revision results in a material change to a rule. A challenge shall be made
in writing and delivered to the chair of the Commission prior to the end of the notice period.
If no challenge is made, the revision shall take effect without further action. If the revision
is challenged, the revision may not take effect without the approval of the Commission.
new text end

new text begin Section 10. Oversight, Dispute Resolution, and Enforcement
new text end

new text begin A. Dispute Resolution
new text end

new text begin 1. Upon request by a member state, the Commission shall attempt to resolve disputes
related to the Compact that arise among member states and between member and non-member
states.
new text end

new text begin 2. The Commission shall promulgate a rule providing for both mediation and binding
dispute resolution for disputes as appropriate.
new text end

new text begin B. Enforcement
new text end

new text begin 1. The Commission, in the reasonable exercise of its discretion, shall enforce the
provisions and rules of this Compact.
new text end

new text begin 2. By majority vote, the Commission may initiate legal action in the United States District
Court for the District of Columbia or the federal district where the Commission has its
principal offices against a member state in default to enforce compliance with the provisions
of the Compact and its promulgated rules and bylaws. The relief sought may include both
injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing
member shall be awarded all costs of litigation, including reasonable attorney's fees.
new text end

new text begin 3. The remedies herein shall not be the exclusive remedies of the Commission. The
Commission may pursue any other remedies available under federal or state law.
new text end

new text begin Section 11. Date of Implementation of the Interstate Commission for Audiology and
Speech-Language Pathology Practice and Associated Rules, Withdrawal, and Amendment
new text end

new text begin A. The Compact shall come into effect on the date on which the Compact statute is
enacted into law in the tenth member state. The provisions, which become effective at that
time, shall be limited to the powers granted to the Commission relating to assembly and the
promulgation of rules. Thereafter, the Commission shall meet and exercise rulemaking
powers necessary to the implementation and administration of the Compact.
new text end

new text begin B. Any state that joins the Compact subsequent to the Commission's initial adoption of
the rules shall be subject to the rules as they exist on the date on which the Compact becomes
law in that state. Any rule that has been previously adopted by the Commission shall have
the full force and effect of law on the day the Compact becomes law in that state.
new text end

new text begin C. Any member state may withdraw from this Compact by enacting a statute repealing
the same.
new text end

new text begin 1. A member state's withdrawal shall not take effect until six months after enactment of
the repealing statute.
new text end

new text begin 2. Withdrawal shall not affect the continuing requirement of the withdrawing state's
audiology or speech-language pathology licensing board to comply with the investigative
and adverse action reporting requirements of this act prior to the effective date of withdrawal.
new text end

new text begin D. Nothing contained in this Compact shall be construed to invalidate or prevent any
audiology or speech-language pathology licensure agreement or other cooperative
arrangement between a member state and a non-member state that does not conflict with
the provisions of this Compact.
new text end

new text begin E. This Compact may be amended by the member states. No amendment to this Compact
shall become effective and binding upon any member state until it is enacted into the laws
of all member states.
new text end

new text begin Section 12. Construction and Severability
new text end

new text begin This Compact shall be liberally construed so as to effectuate the purposes thereof. The
provisions of this Compact shall be severable and if any phrase, clause, sentence, or provision
of this Compact is declared to be contrary to the constitution of any member state or of the
United States or the applicability thereof to any government, agency, person, or circumstance
is held invalid, the validity of the remainder of this Compact and the applicability thereof
to any government, agency, person, or circumstance shall not be affected thereby. If this
Compact shall be held contrary to the constitution of any member state, the Compact shall
remain in full force and effect as to the remaining member states and in full force and effect
as to the member state affected as to all severable matters.
new text end

new text begin Section 13. Binding Effect of Compact and Other Laws
new text end

new text begin A. Nothing herein prevents the enforcement of any other law of a member state that is
not inconsistent with the Compact.
new text end

new text begin B. All laws in a member state in conflict with the Compact are superseded to the extent
of the conflict.
new text end

new text begin C. All lawful actions of the Commission, including all rules and bylaws promulgated
by the Commission, are binding upon the member states.
new text end

new text begin D. All agreements between the Commission and the member states are binding in
accordance with their terms.
new text end

new text begin E. In the event any provision of the Compact exceeds the constitutional limits imposed
on the legislature of any member state, the provision shall be ineffective to the extent of the
conflict with the constitutional provision in question in that member state.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective on the date on which the compact statute
is enacted into law in the tenth member state in accordance with section 11 of this Compact.
new text end

Sec. 17.

new text begin [148.5186] APPLICATION OF AUDIOLOGY AND SPEECH-LANGUAGE
PATHOLOGY INTERSTATE COMPACT TO EXISTING LAWS.
new text end

new text begin Subdivision 1. new text end

new text begin Rulemaking. new text end

new text begin Rules developed by the Audiology and Speech-Language
Pathology Compact Commission under section 148.5185 are not subject to sections 14.05
to 14.389.
new text end

new text begin Subd. 2. new text end

new text begin Background studies. new text end

new text begin The commissioner of health is authorized to require an
audiologist or speech-language pathologist licensed in Minnesota as the home state to submit
to a criminal history background check under section 144.0572.
new text end

new text begin Subd. 3. new text end

new text begin Provision of data. new text end

new text begin All provisions of section 148.5185 authorizing or requiring
the commissioner to provide data to the Audiology and Speech-Language Pathology Compact
Commission are authorized by section 144.051, subdivision 6.
new text end

Sec. 18.

new text begin [148B.75] LICENSED PROFESSIONAL COUNSELOR INTERSTATE
COMPACT.
new text end

new text begin The licensed professional counselor interstate compact is enacted into law and entered
into with all other jurisdictions legally joining in it, in the form substantially specified in
this section.
new text end

new text begin ARTICLE I
new text end

new text begin DEFINITIONS
new text end

new text begin (a) As used in this compact, and except as otherwise provided, the following definitions
shall apply.
new text end

new text begin (b) "Active duty military" means full-time duty status in the active uniformed service
of the United States, including members of the national guard and reserve on active duty
orders pursuant to United States Code, title 10, chapters 1209 and 1211.
new text end

new text begin (c) "Adverse action" means any administrative, civil, equitable, or criminal action
permitted by a state's laws which is imposed by a licensing board or other authority against
a licensed professional counselor, including actions against an individual's license or privilege
to practice such as revocation, suspension, probation, monitoring of the licensee, limitation
on the licensee's practice, or any other encumbrance on licensure affecting a licensed
professional counselor's authorization to practice, including issuance of a cease and desist
action.
new text end

new text begin (d) "Alternative program" means a non-disciplinary monitoring or practice remediation
process approved by a professional counseling licensing board to address impaired
practitioners.
new text end

new text begin (e) "Continuing competence" and "continuing education" means a requirement, as a
condition of license renewal, to provide evidence of participation in, and completion of,
educational and professional activities relevant to practice or area of work.
new text end

new text begin (f) "Counseling compact commission" or "commission" means the national administrative
body whose membership consists of all states that have enacted the compact.
new text end

new text begin (g) "Current significant investigative information" means:
new text end

new text begin (1) investigative information that a licensing board, after a preliminary inquiry that
includes notification and an opportunity for the licensed professional counselor to respond,
if required by state law, has reason to believe is not groundless and, if proved true, would
indicate more than a minor infraction; or
new text end

new text begin (2) investigative information that indicates that the licensed professional counselor
represents an immediate threat to public health and safety regardless of whether the licensed
professional counselor has been notified and had an opportunity to respond.
new text end

new text begin (h) "Data system" means a repository of information about licensees, including but not
limited to continuing education, examination, licensure, investigative, privilege to practice,
and adverse action information.
new text end

new text begin (i) "Encumbered license" means a license in which an adverse action restricts the practice
of licensed professional counseling by the licensee and said adverse action has been reported
to the National Practitioners Data Bank (NPDB).
new text end

new text begin (j) "Encumbrance" means a revocation or suspension of, or any limitation on, the full
and unrestricted practice of licensed professional counseling by a licensing board.
new text end

new text begin (k) "Executive committee" means a group of directors elected or appointed to act on
behalf of, and within the powers granted to them by, the commission.
new text end

new text begin (l) "Home state" means the member state that is the licensee's primary state of residence.
new text end

new text begin (m) "Impaired practitioner" means an individual who has a condition that may impair
their ability to practice as a licensed professional counselor without some type of intervention
and may include but is not limited to alcohol and drug dependence, mental health impairment,
and neurological or physical impairment.
new text end

new text begin (n) "Investigative information" means information, records, and documents received or
generated by a professional counseling licensing board pursuant to an investigation.
new text end

new text begin (o) "Jurisprudence requirement," if required by a member state, means the assessment
of an individual's knowledge of the laws and rules governing the practice of professional
counseling in a state.
new text end

new text begin (p) "Licensed professional counselor" means a counselor licensed by a member state,
regardless of the title used by that state, to independently assess, diagnose, and treat
behavioral health conditions.
new text end

new text begin (q) "Licensee" means an individual who currently holds an authorization from the state
to practice as a licensed professional counselor.
new text end

new text begin (r) "Licensing board" means the agency of a state, or equivalent, that is responsible for
the licensing and regulation of licensed professional counselors.
new text end

new text begin (s) "Member state" means a state that has enacted the compact.
new text end

new text begin (t) "Privilege to practice" means a legal authorization, which is equivalent to a license,
permitting the practice of professional counseling in a remote state.
new text end

new text begin (u) "Professional counseling" means the assessment, diagnosis, and treatment of
behavioral health conditions by a licensed professional counselor.
new text end

new text begin (v) "Remote state" means a member state other than the home state, where a licensee is
exercising or seeking to exercise the privilege to practice.
new text end

new text begin (w) "Rule" means a regulation promulgated by the commission that has the force of law.
new text end

new text begin (x) "Single state license" means a licensed professional counselor license issued by a
member state that authorizes practice only within the issuing state and does not include a
privilege to practice in any other member state.
new text end

new text begin (y) "State" means any state, commonwealth, district, or territory of the United States
that regulates the practice of professional counseling.
new text end

new text begin (z) "Telehealth" means the application of telecommunication technology to deliver
professional counseling services remotely to assess, diagnose, and treat behavioral health
conditions.
new text end

new text begin (aa) "Unencumbered license" means a license that authorizes a licensed professional
counselor to engage in the full and unrestricted practice of professional counseling.
new text end

new text begin ARTICLE II
new text end

new text begin STATE PARTICIPATION IN THE COMPACT
new text end

new text begin (a) To participate in the compact, a state must currently:
new text end

new text begin (1) license and regulate licensed professional counselors;
new text end

new text begin (2) require licensees to pass a nationally recognized exam approved by the commission;
new text end

new text begin (3) require licensees to have a 60 semester-hour or 90 quarter-hour master's degree in
counseling or 60 semester-hours or 90 quarter-hours of graduate coursework including the
following topic areas:
new text end

new text begin (i) professional counseling orientation and ethical practice;
new text end

new text begin (ii) social and cultural diversity;
new text end

new text begin (iii) human growth and development;
new text end

new text begin (iv) career development;
new text end

new text begin (v) counseling and helping relationships;
new text end

new text begin (vi) group counseling and group work;
new text end

new text begin (vii) diagnosis and treatment; assessment and testing;
new text end

new text begin (viii) research and program evaluation; and
new text end

new text begin (ix) other areas as determined by the commission;
new text end

new text begin (4) require licensees to complete a supervised postgraduate professional experience as
defined by the commission; and
new text end

new text begin (5) have a mechanism in place for receiving and investigating complaints about licensees.
new text end

new text begin (b) A member state shall:
new text end

new text begin (1) participate fully in the commission's data system, including using the commission's
unique identifier as defined in rules;
new text end

new text begin (2) notify the commission, in compliance with the terms of the compact and rules, of
any adverse action or the availability of investigative information regarding a licensee;
new text end

new text begin (3) implement or utilize procedures for considering the criminal history records of
applicants for an initial privilege to practice. These procedures shall include the submission
of fingerprints or other biometric-based information by applicants for the purpose of obtaining
an applicant's criminal history record information from the Federal Bureau of Investigation
and the agency responsible for retaining that state's criminal records;
new text end

new text begin (i) a member state must fully implement a criminal background check requirement,
within a time frame established by rule, by receiving the results of the Federal Bureau of
Investigation record search and shall use the results in making licensure decisions; and
new text end

new text begin (ii) communication between a member state, the commission, and among member states
regarding the verification of eligibility for licensure through the compact shall not include
any information received from the Federal Bureau of Investigation relating to a federal
criminal records check performed by a member state under Public Law 92-544;
new text end

new text begin (4) comply with the rules of the commission;
new text end

new text begin (5) require an applicant to obtain or retain a license in the home state and meet the home
state's qualifications for licensure or renewal of licensure, as well as all other applicable
state laws;
new text end

new text begin (6) grant the privilege to practice to a licensee holding a valid unencumbered license in
another member state in accordance with the terms of the compact and rules; and
new text end

new text begin (7) provide for the attendance of the state's commissioner to the counseling compact
commission meetings.
new text end

new text begin (c) Member states may charge a fee for granting the privilege to practice.
new text end

new text begin (d) Individuals not residing in a member state shall continue to be able to apply for a
member state's single state license as provided under the laws of each member state. However,
the single state license granted to these individuals shall not be recognized as granting a
privilege to practice professional counseling in any other member state.
new text end

new text begin (e) Nothing in this compact shall affect the requirements established by a member state
for the issuance of a single state license.
new text end

new text begin (f) A license issued to a licensed professional counselor by a home state to a resident in
that state shall be recognized by each member state as authorizing a licensed professional
counselor to practice professional counseling, under a privilege to practice, in each member
state.
new text end

new text begin ARTICLE III
new text end

new text begin PRIVILEGE TO PRACTICE
new text end

new text begin (a) To exercise the privilege to practice under the terms and provisions of the compact,
the licensee shall:
new text end

new text begin (1) hold a license in the home state;
new text end

new text begin (2) have a valid United States Social Security number or national practitioner identifier;
new text end

new text begin (3) be eligible for a privilege to practice in any member state in accordance with this
article, paragraphs (d), (g), and (h);
new text end

new text begin (4) have not had any encumbrance or restriction against any license or privilege to
practice within the previous two years;
new text end

new text begin (5) notify the commission that the licensee is seeking the privilege to practice within a
remote state(s);
new text end

new text begin (6) pay any applicable fees, including any state fee, for the privilege to practice;
new text end

new text begin (7) meet any continuing competence or education requirements established by the home
state;
new text end

new text begin (8) meet any jurisprudence requirements established by the remote state in which the
licensee is seeking a privilege to practice; and
new text end

new text begin (9) report to the commission any adverse action, encumbrance, or restriction on license
taken by any nonmember state within 30 days from the date the action is taken.
new text end

new text begin (b) The privilege to practice is valid until the expiration date of the home state license.
The licensee must comply with the requirements of this article, paragraph (a), to maintain
the privilege to practice in the remote state.
new text end

new text begin (c) A licensee providing professional counseling in a remote state under the privilege
to practice shall adhere to the laws and regulations of the remote state.
new text end

new text begin (d) A licensee providing professional counseling services in a remote state is subject to
that state's regulatory authority. A remote state may, in accordance with due process and
that state's laws, remove a licensee's privilege to practice in the remote state for a specific
period of time, impose fines, or take any other necessary actions to protect the health and
safety of its citizens. The licensee may be ineligible for a privilege to practice in any member
state until the specific time for removal has passed and all fines are paid.
new text end

new text begin (e) If a home state license is encumbered, the licensee shall lose the privilege to practice
in any remote state until the following occur:
new text end

new text begin (1) the home state license is no longer encumbered; and
new text end

new text begin (2) have not had any encumbrance or restriction against any license or privilege to
practice within the previous two years.
new text end

new text begin (f) Once an encumbered license in the home state is restored to good standing, the
licensee must meet the requirements of this article, paragraph (a), to obtain a privilege to
practice in any remote state.
new text end

new text begin (g) If a licensee's privilege to practice in any remote state is removed, the individual
may lose the privilege to practice in all other remote states until the following occur:
new text end

new text begin (1) the specific period of time for which the privilege to practice was removed has ended;
new text end

new text begin (2) all fines have been paid; and
new text end

new text begin (3) have not had any encumbrance or restriction against any license or privilege to
practice within the previous two years.
new text end

new text begin (h) Once the requirements of this article, paragraph (g), have been met, the licensee must
meet the requirements in this article, paragraph (g), to obtain a privilege to practice in a
remote state.
new text end

new text begin ARTICLE IV
new text end

new text begin OBTAINING A NEW HOME STATE LICENSE BASED ON A PRIVILEGE TO
PRACTICE
new text end

new text begin (a) A licensed professional counselor may hold a home state license, which allows for
a privilege to practice in other member states, in only one member state at a time.
new text end

new text begin (b) If a licensed professional counselor changes primary state of residence by moving
between two member states:
new text end

new text begin (1) the licensed professional counselor shall file an application for obtaining a new home
state license based on a privilege to practice, pay all applicable fees, and notify the current
and new home state in accordance with applicable rules adopted by the commission;
new text end

new text begin (2) upon receipt of an application for obtaining a new home state license by virtue of a
privilege to practice, the new home state shall verify that the licensed professional counselor
meets the pertinent criteria outlined in article III via the data system, without need for
primary source verification, except for:
new text end

new text begin (i) a Federal Bureau of Investigation fingerprint-based criminal background check if not
previously performed or updated pursuant to applicable rules adopted by the commission
in accordance with Public Law 92-544;
new text end

new text begin (ii) other criminal background checks as required by the new home state; and
new text end

new text begin (iii) completion of any requisite jurisprudence requirements of the new home state;
new text end

new text begin (3) the former home state shall convert the former home state license into a privilege to
practice once the new home state has activated the new home state license in accordance
with applicable rules adopted by the commission;
new text end

new text begin (4) notwithstanding any other provision of this compact, if the licensed professional
counselor cannot meet the criteria in article V, the new home state may apply its requirements
for issuing a new single state license; and
new text end

new text begin (5) the licensed professional counselor shall pay all applicable fees to the new home
state in order to be issued a new home state license.
new text end

new text begin (c) If a licensed professional counselor changes primary state of residence by moving
from a member state to a nonmember state, or from a nonmember state to a member state,
the state criteria shall apply for issuance of a single state license in the new state.
new text end

new text begin (d) Nothing in this compact shall interfere with a licensee's ability to hold a single state
license in multiple states, however, for the purposes of this compact, a licensee shall have
only one home state license.
new text end

new text begin (e) Nothing in this compact shall affect the requirements established by a member state
for the issuance of a single state license.
new text end

new text begin ARTICLE V
new text end

new text begin ACTIVE DUTY MILITARY PERSONNEL OR THEIR SPOUSES
new text end

new text begin Active duty military personnel, or their spouse, shall designate a home state where the
individual has a current license in good standing. The individual may retain the home state
designation during the period the service member is on active duty. Subsequent to designating
a home state, the individual shall only change their home state through application for
licensure in the new state or through the process outlined in article IV.
new text end

new text begin ARTICLE VI
new text end

new text begin COMPACT PRIVILEGE TO PRACTICE TELEHEALTH
new text end

new text begin (a) Member states shall recognize the right of a licensed professional counselor, licensed
by a home state in accordance with article II and under rules promulgated by the commission,
to practice professional counseling in any member state via telehealth under a privilege to
practice as provided in the compact and rules promulgated by the commission.
new text end

new text begin (b) A licensee providing professional counseling services in a remote state under the
privilege to practice shall adhere to the laws and regulations of the remote state.
new text end

new text begin ARTICLE VII
new text end

new text begin ADVERSE ACTIONS
new text end

new text begin (a) In addition to the other powers conferred by state law, a remote state shall have the
authority, in accordance with existing state due process law, to:
new text end

new text begin (1) take adverse action against a licensed professional counselor's privilege to practice
within that member state; and
new text end

new text begin (2) issue subpoenas for both hearings and investigations that require the attendance and
testimony of witnesses as well as the production of evidence. Subpoenas issued by a licensing
board in a member state for the attendance and testimony of witnesses or the production of
evidence from another member state shall be enforced in the latter state by any court of
competent jurisdiction according to the practice and procedure of that court applicable to
subpoenas issued in proceedings pending before it. The issuing authority shall pay any
witness fees, travel expenses, mileage, and other fees required by the service statutes of the
state in which the witnesses or evidence are located.
new text end

new text begin (b) Only the home state shall have the power to take adverse action against a licensed
professional counselor's license issued by the home state.
new text end

new text begin (c) For purposes of taking adverse action, the home state shall give the same priority
and effect to reported conduct received from a member state as it would if the conduct had
occurred within the home state. In so doing, the home state shall apply its own state laws
to determine appropriate action.
new text end

new text begin (d) The home state shall complete any pending investigations of a licensed professional
counselor who changes primary state of residence during the course of the investigations.
The home state shall also have the authority to take appropriate action and shall promptly
report the conclusions of the investigations to the administrator of the data system. The
administrator of the coordinated licensure information system shall promptly notify the new
home state of any adverse actions.
new text end

new text begin (e) A member state, if otherwise permitted by state law, may recover from the affected
licensed professional counselor the costs of investigations and dispositions of cases resulting
from any adverse action taken against that licensed professional counselor.
new text end

new text begin (f) A member state may take adverse action based on the factual findings of the remote
state, provided that the member state follows its own procedures for taking the adverse
action.
new text end

new text begin (g) Joint investigations:
new text end

new text begin (1) in addition to the authority granted to a member state by its respective professional
counseling practice act or other applicable state law, any member state may participate with
other member states in joint investigations of licensees; and
new text end

new text begin (2) member states shall share any investigative, litigation, or compliance materials in
furtherance of any joint or individual investigation initiated under the compact.
new text end

new text begin (h) If adverse action is taken by the home state against the license of a licensed
professional counselor, the licensed professional counselor's privilege to practice in all other
member states shall be deactivated until all encumbrances have been removed from the
state license. All home state disciplinary orders that impose adverse action against the license
of a licensed professional counselor shall include a statement that the licensed professional
counselor's privilege to practice is deactivated in all member states during the pendency of
the order.
new text end

new text begin (i) If a member state takes adverse action, it shall promptly notify the administrator of
the data system. The administrator of the data system shall promptly notify the home state
of any adverse actions by remote states.
new text end

new text begin (j) Nothing in this compact shall override a member state's decision that participation
in an alternative program may be used in lieu of adverse action.
new text end

new text begin ARTICLE VIII
new text end

new text begin ESTABLISHMENT OF COUNSELING COMPACT COMMISSION
new text end

new text begin (a) The compact member states hereby create and establish a joint public agency known
as the counseling compact commission:
new text end

new text begin (1) the commission is an instrumentality of the compact states;
new text end

new text begin (2) venue is proper and judicial proceedings by or against the commission shall be
brought solely and exclusively in a court of competent jurisdiction where the principal office
of the commission is located. The commission may waive venue and jurisdictional defenses
to the extent it adopts or consents to participate in alternative dispute resolution proceedings;
and
new text end

new text begin (3) nothing in this compact shall be construed to be a waiver of sovereign immunity.
new text end

new text begin (b) Membership, voting, and meetings:
new text end

new text begin (1) each member state shall have and be limited to one delegate selected by that member
state's licensing board;
new text end

new text begin (2) the delegate shall be either:
new text end

new text begin (i) a current member of the licensing board at the time of appointment who is a licensed
professional counselor or public member; or
new text end

new text begin (ii) an administrator of the licensing board;
new text end

new text begin (3) any delegate may be removed or suspended from office as provided by the law of
the state from which the delegate is appointed;
new text end

new text begin (4) the member state licensing board shall fill any vacancy occurring on the commission
within 60 days;
new text end

new text begin (5) each delegate shall be entitled to one vote with regard to the promulgation of rules
and creation of bylaws and shall otherwise have an opportunity to participate in the business
and affairs of the commission;
new text end

new text begin (6) a delegate shall vote in person or by such other means as provided in the bylaws.
The bylaws may provide for delegates' participation in meetings by telephone or other means
of communication;
new text end

new text begin (7) the commission shall meet at least once during each calendar year. Additional
meetings shall be held as set forth in the bylaws; and
new text end

new text begin (8) the commission shall by rule establish a term of office for delegates and may by rule
establish term limits.
new text end

new text begin (c) The commission shall have the following powers and duties:
new text end

new text begin (1) establish the fiscal year of the commission;
new text end

new text begin (2) establish bylaws;
new text end

new text begin (3) maintain its financial records in accordance with the bylaws;
new text end

new text begin (4) meet and take such actions as are consistent with the provisions of this compact and
the bylaws;
new text end

new text begin (5) promulgate rules which shall be binding to the extent and in the manner provided
for in the compact;
new text end

new text begin (6) bring and prosecute legal proceedings or actions in the name of the commission,
provided that the standing of any state licensing board to sue or be sued under applicable
law shall not be affected;
new text end

new text begin (7) purchase and maintain insurance and bonds;
new text end

new text begin (8) borrow, accept, or contract for services of personnel, including but not limited to
employees of a member state;
new text end

new text begin (9) hire employees, elect or appoint officers, fix compensation, define duties, grant such
individuals appropriate authority to carry out the purposes of the compact, and establish the
commission's personnel policies and programs relating to conflicts of interest, qualifications
of personnel, and other related personnel matters;
new text end

new text begin (10) accept any and all appropriate donations and grants of money, equipment, supplies,
materials, and services and to receive, utilize, and dispose of the same; provided that at all
times the commission shall avoid any appearance of impropriety and conflict of interest;
new text end

new text begin (11) lease, purchase, accept appropriate gifts or donations of, or otherwise to own, hold,
improve, or use any property, real, personal, or mixed; provided that at all times the
commission shall avoid any appearance of impropriety;
new text end

new text begin (12) sell convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of
any property real, personal, or mixed;
new text end

new text begin (13) establish a budget and make expenditures;
new text end

new text begin (14) borrow money;
new text end

new text begin (15) appoint committees, including standing committees composed of members, state
regulators, state legislators or their representatives, and consumer representatives, and such
other interested persons as may be designated in this compact and the bylaws;
new text end

new text begin (16) provide and receive information from, and cooperate with, law enforcement agencies;
new text end

new text begin (17) establish and elect an executive committee; and
new text end

new text begin (18) perform such other functions as may be necessary or appropriate to achieve the
purposes of this compact consistent with the state regulation of professional counseling
licensure and practice.
new text end

new text begin (d) The executive committee:
new text end

new text begin (1) The executive committee shall have the power to act on behalf of the commission
according to the terms of this compact;
new text end

new text begin (2) The executive committee shall be composed of up to eleven members:
new text end

new text begin (i) seven voting members who are elected by the commission from the current
membership of the commission;
new text end

new text begin (ii) up to four ex-officio, nonvoting members from four recognized national professional
counselor organizations; and
new text end

new text begin (iii) the ex-officio members will be selected by their respective organizations;
new text end

new text begin (3) The commission may remove any member of the executive committee as provided
in bylaws;
new text end

new text begin (4) The executive committee shall meet at least annually; and
new text end

new text begin (5) The executive committee shall have the following duties and responsibilities:
new text end

new text begin (i) recommend to the entire commission changes to the rules or bylaws, changes to this
compact legislation, fees paid by compact member states such as annual dues, and any
commission compact fee charged to licensees for the privilege to practice;
new text end

new text begin (ii) ensure compact administration services are appropriately provided, contractual or
otherwise;
new text end

new text begin (iii) prepare and recommend the budget;
new text end

new text begin (iv) maintain financial records on behalf of the commission;
new text end

new text begin (v) monitor compact compliance of member states and provide compliance reports to
the commission;
new text end

new text begin (vi) establish additional committees as necessary; and
new text end

new text begin (vii) other duties as provided in rules or bylaws.
new text end

new text begin (e) Meetings of the commission:
new text end

new text begin (1) all meetings shall be open to the public, and public notice of meetings shall be given
in the same manner as required under the rulemaking provisions in article X;
new text end

new text begin (2) the commission or the executive committee or other committees of the commission
may convene in a closed, non-public meeting if the commission or executive committee or
other committees of the commission must discuss:
new text end

new text begin (i) non-compliance of a member state with its obligations under the compact;
new text end

new text begin (ii) the employment, compensation, discipline, or other matters, practices, or procedures
related to specific employees or other matters related to the commission's internal personnel
practices and procedures;
new text end

new text begin (iii) current, threatened, or reasonably anticipated litigation;
new text end

new text begin (iv) negotiation of contracts for the purchase, lease, or sale of goods, services, or real
estate;
new text end

new text begin (v) accusing any person of a crime or formally censuring any person;
new text end

new text begin (vi) disclosure of trade secrets or commercial or financial information that is privileged
or confidential;
new text end

new text begin (vii) disclosure of information of a personal nature where disclosure would constitute a
clearly unwarranted invasion of personal privacy;
new text end

new text begin (viii) disclosure of investigative records compiled for law enforcement purposes;
new text end

new text begin (ix) disclosure of information related to any investigative reports prepared by or on
behalf of or for use of the commission or other committee charged with responsibility of
investigation or determination of compliance issues pursuant to the compact; or
new text end

new text begin (x) matters specifically exempted from disclosure by federal or member state statute;
new text end

new text begin (3) if a meeting, or portion of a meeting, is closed pursuant to this provision, the
commission's legal counsel or designee shall certify that the meeting may be closed and
shall reference each relevant exempting provision; and
new text end

new text begin (4) the commission shall keep minutes that fully and clearly describe all matters discussed
in a meeting and shall provide a full and accurate summary of actions taken and the reasons
therefore, including a description of the views expressed. All documents considered in
connection with an action shall be identified in such minutes. All minutes and documents
of a closed meeting shall remain under seal, subject to release by a majority vote of the
commission or order of a court of competent jurisdiction.
new text end

new text begin (f) Financing of the commission:
new text end

new text begin (i) the commission shall pay, or provide for the payment of, the reasonable expenses of
its establishment, organization, and ongoing activities;
new text end

new text begin (ii) the commission may accept any and all appropriate revenue sources, donations, and
grants of money, equipment, supplies, materials, and services;
new text end

new text begin (iii) the commission may levy on and collect an annual assessment from each member
state or impose fees on other parties to cover the cost of the operations and activities of the
commission and its staff, which must be in a total amount sufficient to cover its annual
budget as approved each year for which revenue is not provided by other sources. The
aggregate annual assessment amount shall be allocated based upon a formula to be determined
by the commission, which shall promulgate a rule binding upon all member states;
new text end

new text begin (iv) the commission shall not incur obligations of any kind prior to securing the funds
adequate to meet the same; nor shall the commission pledge the credit of any of the member
states, except by and with the authority of the member state; and
new text end

new text begin (v) the commission shall keep accurate accounts of all receipts and disbursements. The
receipts and disbursements of the commission shall be subject to the audit and accounting
procedures established under its bylaws. However, all receipts and disbursements of funds
handled by the commission shall be audited yearly by a certified or licensed public
accountant, and the report of the audit shall be included in and become part of the annual
report of the commission.
new text end

new text begin (g) Qualified immunity, defense, and indemnification:
new text end

new text begin (1) the members, officers, executive director, employees, and representatives of the
commission shall be immune from suit and liability, either personally or in their official
capacity, for any claim for damage to or loss of property or personal injury or other civil
liability caused by or arising out of any actual or alleged act, error, or omission that occurred,
or that the person against whom the claim is made had a reasonable basis for believing
occurred within the scope of commission employment, duties or responsibilities; provided
that nothing in this paragraph shall be construed to protect any such person from suit or
liability for any damage, loss, injury, or liability caused by the intentional or willful or
wanton misconduct of that person;
new text end

new text begin (2) the commission shall defend any member, officer, executive director, employee or
representative of the commission in any civil action seeking to impose liability arising out
of any actual or alleged act, error, or omission that occurred within the scope of commission
employment, duties, or responsibilities, or that the person against whom the claim is made
had a reasonable basis for believing occurred within the scope of commission employment,
duties, or responsibilities; provided that nothing herein shall be construed to prohibit that
person from retaining his or her own counsel; and provided further, that the actual or alleged
act, error, or omission did not result from that person's intentional or willful or wanton
misconduct; and
new text end

new text begin (3) the commission shall indemnify and hold harmless any member, officer, executive
director, employee, or representative of the commission for the amount of any settlement
or judgment obtained against that person arising out of any actual or alleged act, error, or
omission that occurred within the scope of commission employment, duties, or
responsibilities, or that such person had a reasonable basis for believing occurred within
the scope of commission employment, duties, or responsibilities, provided that the actual
or alleged act, error, or omission did not result from the intentional or willful or wanton
misconduct of that person.
new text end

new text begin ARTICLE IX
new text end

new text begin DATA SYSTEM
new text end

new text begin (a) The commission shall provide for the development, maintenance, operation, and
utilization of a coordinated database and reporting system containing licensure, adverse
action, and investigative information on all licensed individuals in member states.
new text end

new text begin (b) Notwithstanding any other provision of state law to the contrary, a member state
shall submit a uniform data set to the data system on all individuals to whom this compact
is applicable as required by the rules of the commission, including:
new text end

new text begin (1) identifying information;
new text end

new text begin (2) licensure data;
new text end

new text begin (3) adverse actions against a license or privilege to practice;
new text end

new text begin (4) nonconfidential information related to alternative program participation;
new text end

new text begin (5) any denial of application for licensure and the reason for such denial;
new text end

new text begin (6) current significant investigative information; and
new text end

new text begin (7) other information that may facilitate the administration of this compact, as determined
by the rules of the commission.
new text end

new text begin (c) Investigative information pertaining to a licensee in any member state will only be
available to other member states.
new text end

new text begin (d) The commission shall promptly notify all member states of any adverse action taken
against a licensee or an individual applying for a license. Adverse action information
pertaining to a licensee in any member state will be available to any other member state.
new text end

new text begin (e) Member states contributing information to the data system may designate information
that may not be shared with the public without the express permission of the contributing
state.
new text end

new text begin (f) Any information submitted to the data system that is subsequently required to be
expunged by the laws of the member state contributing the information shall be removed
from the data system.
new text end

new text begin ARTICLE X
new text end

new text begin RULEMAKING
new text end

new text begin (a) The commission shall promulgate reasonable rules in order to effectively and
efficiently achieve the purpose of the compact. Notwithstanding the foregoing, in the event
the commission exercises its rulemaking authority in a manner that is beyond the scope of
the purposes of the compact, or the powers granted hereunder, then such an action by the
commission shall be invalid and have no force or effect.
new text end

new text begin (b) The commission shall exercise its rulemaking powers pursuant to the criteria set
forth in this article and the rules adopted thereunder. Rules and amendments shall become
binding as of the date specified in each rule or amendment.
new text end

new text begin (c) If a majority of the legislatures of the member states rejects a rule, by enactment of
a statute or resolution in the same manner used to adopt the compact within four years of
the date of adoption of the rule, then such rule shall have no further force and effect in any
member state.
new text end

new text begin (d) Rules or amendments to the rules shall be adopted at a regular or special meeting of
the commission.
new text end

new text begin (e) Prior to promulgation and adoption of a final rule or rules by the commission, and
at least thirty days in advance of the meeting at which the rule will be considered and voted
upon, the commission shall file a notice of proposed rulemaking:
new text end

new text begin (1) on the website of the commission or other publicly accessible platform; and
new text end

new text begin (2) on the website of each member state professional counseling licensing board or other
publicly accessible platform or the publication in which each state would otherwise publish
proposed rules.
new text end

new text begin (f) The notice of proposed rulemaking shall include:
new text end

new text begin (1) the proposed time, date, and location of the meeting in which the rule will be
considered and voted upon;
new text end

new text begin (2) the text of the proposed rule or amendment and the reason for the proposed rule;
new text end

new text begin (3) a request for comments on the proposed rule from any interested person; and
new text end

new text begin (4) the manner in which interested persons may submit notice to the commission of their
intention to attend the public hearing and any written comments.
new text end

new text begin (g) Prior to adoption of a proposed rule, the commission shall allow persons to submit
written data, facts, opinions, and arguments, which shall be made available to the public.
new text end

new text begin (h) The commission shall grant an opportunity for a public hearing before it adopts a
rule or amendment if a hearing is requested by:
new text end

new text begin (1) at least 25 persons;
new text end

new text begin (2) a state or federal governmental subdivision or agency; or
new text end

new text begin (3) an association having at least 25 members.
new text end

new text begin (i) If a hearing is held on the proposed rule or amendment, the commission shall publish
the place, time, and date of the scheduled public hearing. If the hearing is held via electronic
means, the commission shall publish the mechanism for access to the electronic hearing:
new text end

new text begin (1) all persons wishing to be heard at the hearing shall notify the executive director of
the commission or other designated member in writing of their desire to appear and testify
at the hearing not less than five business days before the scheduled date of the hearing;
new text end

new text begin (2) hearings shall be conducted in a manner providing each person who wishes to
comment a fair and reasonable opportunity to comment orally or in writing;
new text end

new text begin (3) all hearings will be recorded. A copy of the recording will be made available on
request; and
new text end

new text begin (4) nothing in this article shall be construed as requiring a separate hearing on each rule.
Rules may be grouped for the convenience of the commission at hearings required by this
article.
new text end

new text begin (j) Following the scheduled hearing date, or by the close of business on the scheduled
hearing date if the hearing was not held, the commission shall consider all written and oral
comments received.
new text end

new text begin (k) If no written notice of intent to attend the public hearing by interested parties is
received, the commission may proceed with promulgation of the proposed rule without a
public hearing.
new text end

new text begin (l) The commission shall, by majority vote of all members, take final action on the
proposed rule and shall determine the effective date of the rule, if any, based on the
rulemaking record and the full text of the rule.
new text end

new text begin (m) Upon determination that an emergency exists, the commission may consider and
adopt an emergency rule without prior notice, opportunity for comment, or hearing, provided
that the usual rulemaking procedures provided in the compact and in this article shall be
retroactively applied to the rule as soon as reasonably possible, in no event later than 90
days after the effective date of the rule. For the purposes of this provision, an emergency
rule is one that must be adopted immediately in order to:
new text end

new text begin (1) meet an imminent threat to public health, safety, or welfare;
new text end

new text begin (2) prevent a loss of commission or member state funds;
new text end

new text begin (3) meet a deadline for the promulgation of an administrative rule that is established by
federal law or rule; or
new text end

new text begin (4) protect public health and safety.
new text end

new text begin (n) The commission or an authorized committee of the commission may direct revisions
to a previously adopted rule or amendment for purposes of correcting typographical errors,
errors in format, errors in consistency, or grammatical errors. Public notice of any revisions
shall be posted on the website of the commission. The revision shall be subject to challenge
by any person for a period of thirty days after posting. The revision may be challenged only
on grounds that the revision results in a material change to a rule. A challenge shall be made
in writing and delivered to the chair of the commission prior to the end of the notice period.
If no challenge is made, the revision will take effect without further action. If the revision
is challenged, the revision may not take effect without the approval of the commission.
new text end

new text begin ARTICLE XI
new text end

new text begin OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT
new text end

new text begin (a) Oversight:
new text end

new text begin (1) the executive, legislative, and judicial branches of state government in each member
state shall enforce this compact and take all actions necessary and appropriate to effectuate
the compact's purposes and intent. The provisions of this compact and the rules promulgated
hereunder shall have standing as statutory law;
new text end

new text begin (2) all courts shall take judicial notice of the compact and the rules in any judicial or
administrative proceeding in a member state pertaining to the subject matter of this compact
which may affect the powers, responsibilities, or actions of the commission; and
new text end

new text begin (3) the commission shall be entitled to receive service of process in any such proceeding
and shall have standing to intervene in such a proceeding for all purposes. Failure to provide
service of process to the commission shall render a judgment or order void as to the
commission, this compact, or promulgated rules.
new text end

new text begin (b) Default, technical assistance, and termination:
new text end

new text begin (1) if the commission determines that a member state has defaulted in the performance
of its obligations or responsibilities under this compact or the promulgated rules, the
commission shall:
new text end

new text begin (i) provide written notice to the defaulting state and other member states of the nature
of the default, the proposed means of curing the default, or any other action to be taken by
the commission; and
new text end

new text begin (ii) provide remedial training and specific technical assistance regarding the default.
new text end

new text begin (c) If a state in default fails to cure the default, the defaulting state may be terminated
from the compact upon an affirmative vote of a majority of the member states, and all rights,
privileges, and benefits conferred by this compact may be terminated on the effective date
of termination. A cure of the default does not relieve the offending state of obligations or
liabilities incurred during the period of default.
new text end

new text begin (d) Termination of membership in the compact shall be imposed only after all other
means of securing compliance have been exhausted. Notice of intent to suspend or terminate
shall be given by the commission to the governor, the majority and minority leaders of the
defaulting state's legislature, and each of the member states.
new text end

new text begin (e) A state that has been terminated is responsible for all assessments, obligations, and
liabilities incurred through the effective date of termination, including obligations that
extend beyond the effective date of termination.
new text end

new text begin (f) The commission shall not bear any costs related to a state that is found to be in default
or that has been terminated from the compact, unless agreed upon in writing between the
commission and the defaulting state.
new text end

new text begin (g) The defaulting state may appeal the action of the commission by petitioning the
United States District Court for the District of Columbia or the federal district where the
commission has its principal offices. The prevailing member shall be awarded all costs of
such litigation, including reasonable attorney's fees.
new text end

new text begin (h) Dispute resolution:
new text end

new text begin (1) Upon request by a member state, the commission shall attempt to resolve disputes
related to the compact that arise among member states and between member and nonmember
states; and
new text end

new text begin (2) the commission shall promulgate a rule providing for both mediation and binding
dispute resolution for such disputes as appropriate.
new text end

new text begin (i) Enforcement:
new text end

new text begin (1) The commission, in the reasonable exercise of its discretion, shall enforce the
provisions and rules of this compact;
new text end

new text begin (2) by majority vote, the commission may initiate legal action in the United States District
Court for the District of Columbia or the federal district where the commission has its
principal offices against a member state in default to enforce compliance with the provisions
of the compact and its promulgated rules and bylaws. The relief sought may include both
injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing
member shall be awarded all costs of such litigation, including reasonable attorney's fees;
and
new text end

new text begin (3) the remedies herein shall not be the exclusive remedies of the commission. The
commission may pursue any other remedies available under federal or state law.
new text end

new text begin ARTICLE XII
new text end

new text begin DATE OF IMPLEMENTATION OF THE COUNSELING COMPACT COMMISSION
AND ASSOCIATED RULES, WITHDRAWAL, AND AMENDMENT
new text end

new text begin (a) The compact shall come into effect on the date on which the compact statute is
enacted into law in the tenth member state. The provisions, which become effective at that
time, shall be limited to the powers granted to the commission relating to assembly and the
promulgation of rules. Thereafter, the commission shall meet and exercise rulemaking
powers necessary to the implementation and administration of the compact.
new text end

new text begin (b) Any state that joins the compact subsequent to the commission's initial adoption of
the rules shall be subject to the rules as they exist on the date on which the compact becomes
law in that state. Any rule that has been previously adopted by the commission shall have
the full force and effect of law on the day the compact becomes law in that state.
new text end

new text begin (c) Any member state may withdraw from this compact by enacting a statute repealing
the same.
new text end

new text begin (1) a member state's withdrawal shall not take effect until six months after enactment
of the repealing statute; and
new text end

new text begin (2) withdrawal shall not affect the continuing requirement of the withdrawing state's
professional counseling licensing board to comply with the investigative and adverse action
reporting requirements of this act prior to the effective date of withdrawal.
new text end

new text begin (d) Nothing contained in this compact shall be construed to invalidate or prevent any
professional counseling licensure agreement or other cooperative arrangement between a
member state and a nonmember state that does not conflict with the provisions of this
compact.
new text end

new text begin (e) This compact may be amended by the member states. No amendment to this compact
shall become effective and binding upon any member state until it is enacted into the laws
of all member states.
new text end

new text begin ARTICLE XIII
new text end

new text begin CONSTRUCTION AND SEVERABILITY
new text end

new text begin This compact shall be liberally construed so as to effectuate the purposes thereof. The
provisions of this compact shall be severable and if any phrase, clause, sentence, or provision
of this compact is declared to be contrary to the constitution of any member state or of the
United States or the applicability thereof to any government, agency, person, or circumstance
is held invalid, the validity of the remainder of this compact and the applicability thereof
to any government, agency, person, or circumstance shall not be affected thereby. If this
compact shall be held contrary to the constitution of any member state, the compact shall
remain in full force and effect as to the remaining member states and in full force and effect
as to the member state affected as to all severable matters.
new text end

new text begin ARTICLE XIV
new text end

new text begin BINDING EFFECT OF COMPACT AND OTHER LAWS
new text end

new text begin (a) A licensee providing professional counseling services in a remote state under the
privilege to practice shall adhere to the laws and regulations, including scope of practice,
of the remote state.
new text end

new text begin (b) Nothing herein prevents the enforcement of any other law of a member state that is
not inconsistent with the compact.
new text end

new text begin (c) Any laws in a member state in conflict with the compact are superseded to the extent
of the conflict.
new text end

new text begin (d) Any lawful actions of the commission, including all rules and bylaws properly
promulgated by the commission, are binding upon the member states.
new text end

new text begin (e) All permissible agreements between the commission and the member states are
binding in accordance with their terms.
new text end

new text begin (f) In the event any provision of the compact exceeds the constitutional limits imposed
on the legislature of any member state, the provision shall be ineffective to the extent of the
conflict with the constitutional provision in question in that member state.
new text end

Sec. 19.

Minnesota Statutes 2020, section 148F.11, is amended by adding a subdivision
to read:


new text begin Subd. 2a. new text end

new text begin Former students. new text end

new text begin (a) A former student may practice alcohol and drug
counseling without a license for 90 days after the former student's degree conferral date
from an accredited school or educational program or after the last date the former student
received credit for an alcohol and drug counseling course from an accredited school or
educational program. The former student's practice under this subdivision must be supervised
by an alcohol and drug counselor as defined under section 245G.11, subdivision 5, an alcohol
and drug counselor supervisor as defined under section 245G.11, subdivision 4, or a treatment
director as defined under section 245G.11, subdivision 3.
new text end

new text begin (b) The former student's right to practice under this subdivision expires after 90 days
from the former student's degree conferral date or date of last course credit for an alcohol
and drug counseling course, whichever occurs last.
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. 20.

Minnesota Statutes 2020, section 150A.10, subdivision 1a, is amended to read:


Subd. 1a.

Collaborative practice authorization for dental hygienists in community
settings.

(a) Notwithstanding subdivision 1, a dental hygienist licensed under this chapter
may be employed or retained by a health care facility, program, deleted text beginordeleted text end nonprofit organizationnew text begin,
or licensed dentist
new text end to perform the dental hygiene services listed in Minnesota Rules, part
3100.8700, subpart 1, without the patient first being examined by a licensed dentist if the
dental hygienist:

(1) has entered into a collaborative agreement with a licensed dentist that designates
authorization for the services provided by the dental hygienist; and

(2) has documented completion of a course on medical emergencies within each
continuing education cycle.

(b) A collaborating dentist must be licensed under this chapter and may enter into a
collaborative agreement with no more than four dental hygienists unless otherwise authorized
by the board. The board shall develop parameters and a process for obtaining authorization
to collaborate with more than four dental hygienists. The collaborative agreement must
include:

(1) consideration for medically compromised patients and medical conditions for which
a dental evaluation and treatment plan must occur prior to the provision of dental hygiene
services;

(2) age- and procedure-specific standard collaborative practice protocols, including
recommended intervals for the performance of dental hygiene services and a period of time
in which an examination by a dentist should occur;

(3) copies of consent to treatment form provided to the patient by the dental hygienist;

(4) specific protocols for the placement of pit and fissure sealants and requirements for
follow-up care to deleted text beginassure thedeleted text endnew text begin ensurenew text end efficacy deleted text beginof the sealants after applicationdeleted text end; and

(5) the procedure for creating and maintaining dental records for patients who are treated
by the dental hygienist under Minnesota Rules, part 3100.9600, including specifying where
records will be located.

deleted text begin The collaborative agreement must be signed and maintained by the dentist, the dental
hygienist, and the facility, program, or organization; must be reviewed annually by the
collaborating dentist and dental hygienist and must be made available to the board upon
request.
deleted text end

new text begin (c) The collaborative agreement must be:
new text end

new text begin (1) signed and maintained by the dentist; the dental hygienist; and the facility, program,
or organization;
new text end

new text begin (2) reviewed annually by the collaborating dentist and the dental hygienist; and
new text end

new text begin (3) made available to the board upon request.
new text end

deleted text begin (c)deleted text endnew text begin (d)new text end Before performing any services authorized under this subdivision, a dental
hygienist must provide the patient with a consent to treatment form which must include a
statement advising the patient that the dental hygiene services provided are not a substitute
for a dental examination by a licensed dentist. When the patient requires a referral for
additional dental services, the dental hygienist shall complete a referral form and provide
a copy to the patient, the facility, if applicable, the dentist to whom the patient is being
referred, and the collaborating dentist, if specified in the collaborative agreement. A copy
of the referral form shall be maintained in the patient's health care record. The patient does
not become a new patient of record of the dentist to whom the patient was referred until the
dentist accepts the patient for follow-up services after referral from the dental hygienist.

deleted text begin (d)deleted text endnew text begin (e)new text end For the purposes of this subdivision, a "health care facility, program, or nonprofit
organization" includes a hospital; nursing home; home health agency; group home serving
the elderly, disabled, or juveniles; state-operated facility licensed by the commissioner of
human services or the commissioner of corrections; new text begina state agency administered public
health program or event;
new text endand federal, state, or local public health facility, community clinic,
tribal clinic, school authority, Head Start program, or nonprofit organization that serves
individuals who are uninsured or who are Minnesota health care public program recipients.

deleted text begin (e)deleted text endnew text begin (f)new text end For purposes of this subdivision, a "collaborative agreement" means a written
agreement with a licensed dentist who authorizes and accepts responsibility for the services
performed by the dental hygienist.

new text begin (g) A collaborative practice dental hygienist must be reimbursed for all services performed
through a health care facility, program, nonprofit organization, or licensed dentist.
new text end

new text begin (h) The commissioner of human services shall report annually, beginning February 15,
2023, and each February 15 thereafter, to the Board of Dentistry on the services provided
by collaborative practice dental hygienists to medical assistance and MinnesotaCare enrollees
during the previous calendar year. The information reported must include, at a minimum,
the geographic location and type of setting at which care was delivered, the number of
medical assistance and MinnesotaCare patients served, and the characteristics of the patient
population.
new text end

Sec. 21.

Minnesota Statutes 2020, section 150A.105, subdivision 8, is amended to read:


Subd. 8.

Definitions.

(a) For the purposes of this section, the following definitions apply.

(b) "Practice settings that serve the low-income and underserved" mean:

(1) critical access dental provider settings as designated by the commissioner of human
services under section 256B.76, subdivision 4;

(2) dental hygiene collaborative practice settings identified in section 150A.10,
subdivision 1a, paragraph deleted text begin(d)deleted text endnew text begin (e)new text end, and including medical facilities, assisted living facilities,
federally qualified health centers, and organizations eligible to receive a community clinic
grant under section 145.9268, subdivision 1;

(3) military and veterans administration hospitals, clinics, and care settings;

(4) a patient's residence or home when the patient is home-bound or receiving or eligible
to receive home care services or home and community-based waivered services, regardless
of the patient's income;

(5) oral health educational institutions; or

(6) any other clinic or practice setting, including mobile dental units, in which at least
50 percent of the total patient base of the dental therapist or advanced dental therapist
consists of patients who:

(i) are enrolled in a Minnesota health care program;

(ii) have a medical disability or chronic condition that creates a significant barrier to
receiving dental care;

(iii) do not have dental health coverage, either through a public health care program or
private insurance, and have an annual gross family income equal to or less than 200 percent
of the federal poverty guidelines; or

(iv) do not have dental health coverage, either through a state public health care program
or private insurance, and whose family gross income is equal to or less than 200 percent of
the federal poverty guidelines.

(c) "Dental health professional shortage area" means an area that meets the criteria
established by the secretary of the United States Department of Health and Human Services
and is designated as such under United States Code, title 42, section 254e.

Sec. 22.

Minnesota Statutes 2020, section 151.01, subdivision 27, is amended to read:


Subd. 27.

Practice of pharmacy.

"Practice of pharmacy" means:

(1) interpretation and evaluation of prescription drug orders;

(2) compounding, labeling, and dispensing drugs and devices (except labeling by a
manufacturer or packager of nonprescription drugs or commercially packaged legend drugs
and devices);

(3) participation in clinical interpretations and monitoring of drug therapy for assurance
of safe and effective use of drugs, including deleted text beginthe performance ofdeleted text endnew text begin ordering and performingnew text end
laboratory tests that are waived under the federal Clinical Laboratory Improvement Act of
1988, United States Code, title 42, section 263a et seq.deleted text begin, provided that a pharmacist may
interpret the results of laboratory tests but may modify
deleted text endnew text begin A pharmacist may collect specimens,
interpret results, notify the patient of results, and refer patients to other health care providers
for follow-up care and may initiate, modify, or discontinue
new text end drug therapy deleted text beginonlydeleted text end pursuant to
a protocol or collaborative practice agreementnew text begin. A pharmacy technician or pharmacist intern
may perform tests authorized under this clause if the technician or intern is working under
the direct supervision of a pharmacist
new text end;

(4) participation in drug and therapeutic device selection; drug administration for first
dosage and medical emergencies; intramuscular and subcutaneous administration used for
the treatment of alcohol or opioid dependence; drug regimen reviews; and drug or
drug-related research;

(5) drug administration, through intramuscular and subcutaneous administration used
to treat mental illnesses as permitted under the following conditions:

(i) upon the order of a prescriber and the prescriber is notified after administration is
complete; or

(ii) pursuant to a protocol or collaborative practice agreement as defined by section
151.01, subdivisions 27b and 27c, and participation in the initiation, management,
modification, administration, and discontinuation of drug therapy is according to the protocol
or collaborative practice agreement between the pharmacist and a dentist, optometrist,
physician, podiatrist, or veterinarian, or an advanced practice registered nurse authorized
to prescribe, dispense, and administer under section 148.235. Any changes in drug therapy
or medication administration made pursuant to a protocol or collaborative practice agreement
must be documented by the pharmacist in the patient's medical record or reported by the
pharmacist to a practitioner responsible for the patient's care;

(6) participation in administration of influenza vaccines and vaccines approved by the
United States Food and Drug Administration related to COVID-19 or SARS-CoV-2 to all
eligible individuals six years of age and older and all other vaccines to patients 13 years of
age and older by written protocol with a physician licensed under chapter 147, a physician
assistant authorized to prescribe drugs under chapter 147A, or an advanced practice registered
nurse authorized to prescribe drugs under section 148.235, provided that new text beginthe protocol includes
a procedure for handling an adverse reaction, and
new text endnew text begin the pharmacistnew text end:

deleted text begin (i) the protocol includes, at a minimum:
deleted text end

deleted text begin (A) the name, dose, and route of each vaccine that may be given;
deleted text end

deleted text begin (B) the patient population for whom the vaccine may be given;
deleted text end

deleted text begin (C) contraindications and precautions to the vaccine;
deleted text end

deleted text begin (D) the procedure for handling an adverse reaction;
deleted text end

deleted text begin (E) the name, signature, and address of the physician, physician assistant, or advanced
practice registered nurse;
deleted text end

deleted text begin (F) a telephone number at which the physician, physician assistant, or advanced practice
registered nurse can be contacted; and
deleted text end

deleted text begin (G) the date and time period for which the protocol is valid;
deleted text end

deleted text begin (ii) the pharmacistdeleted text endnew text begin (i)new text end has successfully completed a program approved by the Accreditation
Council for Pharmacy Education specifically for the administration of immunizations or a
program approved by the board;

deleted text begin (iii) the pharmacistdeleted text endnew text begin (ii)new text end utilizes the Minnesota Immunization Information Connection to
assess the immunization status of individuals prior to the administration of vaccines, except
when administering influenza vaccines to individuals age nine and older;

deleted text begin (iv) the pharmacistdeleted text endnew text begin (iii)new text end reports the administration of the immunization to the Minnesota
Immunization Information Connection; deleted text beginand
deleted text end

deleted text begin (v) the pharmacistdeleted text endnew text begin (iv)new text end complies with guidelines for vaccines and immunizations
established by the federal Advisory Committee on Immunization Practices, except that a
pharmacist does not need to comply with those portions of the guidelines that establish
immunization schedules deleted text beginwhendeleted text endnew text begin if the pharmacist isnew text end administering a vaccine pursuant to a
valid, patient-specific order issued by a physician licensed under chapter 147, a physician
assistant authorized to prescribe drugs under chapter 147A, or an advanced practice registered
nurse authorized to prescribe drugs under section 148.235, provided that the order is
consistent with the United States Food and Drug Administration approved labeling of the
vaccine;

new text begin (v) informs the patient of any contraindications and precautions to the vaccine before
administering the vaccine; and
new text end

new text begin (vi) if the patient is 18 years of age or younger, informs the patient and any adult caregiver
accompanying the patient of the importance of a well-child visit with a pediatrician or other
licensed primary care provider;
new text end

(7) participation in the initiation, management, modification, and discontinuation of
drug therapy according to a written protocol or collaborative practice agreement between:
(i) one or more pharmacists and one or more dentists, optometrists, physicians, podiatrists,
or veterinarians; or (ii) one or more pharmacists and one or more physician assistants
authorized to prescribe, dispense, and administer under chapter 147A, or advanced practice
registered nurses authorized to prescribe, dispense, and administer under section 148.235.
Any changes in drug therapy made pursuant to a protocol or collaborative practice agreement
must be documented by the pharmacist in the patient's medical record or reported by the
pharmacist to a practitioner responsible for the patient's care;

(8) participation in the storage of drugs and the maintenance of records;

(9) patient counseling on therapeutic values, content, hazards, and uses of drugs and
devices;

(10) offering or performing those acts, services, operations, or transactions necessary
in the conduct, operation, management, and control of a pharmacy;

(11) participation in the initiation, management, modification, and discontinuation of
therapy with opiate antagonists, as defined in section 604A.04, subdivision 1, pursuant to:

(i) a written protocol as allowed under clause (7); or

(ii) a written protocol with a community health board medical consultant or a practitioner
designated by the commissioner of health, as allowed under section 151.37, subdivision 13;
and

(12) prescribing self-administered hormonal contraceptives; nicotine replacement
medications; and opiate antagonists for the treatment of an acute opiate overdose pursuant
to section 151.37, subdivision 14, 15, or 16.

Sec. 23.

Minnesota Statutes 2020, section 151.065, subdivision 1, is amended to read:


Subdivision 1.

Application fees.

Application fees for licensure and registration are as
follows:

(1) pharmacist licensed by examination, $175;

(2) pharmacist licensed by reciprocity, $275;

(3) pharmacy intern, $50;

(4) pharmacy technician, $50;

(5) pharmacy, $260;

(6) drug wholesaler, legend drugs only, $5,260;

(7) drug wholesaler, legend and nonlegend drugs, $5,260;

(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $5,260;

(9) drug wholesaler, medical gases, deleted text begin$5,260 for the first facility anddeleted text end $260 deleted text beginfor each
additional facility
deleted text end;

(10) third-party logistics provider, $260;

(11) drug manufacturer, nonopiate legend drugs only, $5,260;

(12) drug manufacturer, nonopiate legend and nonlegend drugs, $5,260;

(13) drug manufacturer, nonlegend or veterinary legend drugs, $5,260;

(14) drug manufacturer, medical gases, deleted text begin$5,260 for the first facility anddeleted text end $260 deleted text beginfor each
additional facility
deleted text end;

(15) drug manufacturer, also licensed as a pharmacy in Minnesota, $5,260;

(16) drug manufacturer of opiate-containing controlled substances listed in section
152.02, subdivisions 3 to 5, $55,260;

(17) medical gas dispenser, $260;

(18) controlled substance researcher, $75; and

(19) pharmacy professional corporation, $150.

Sec. 24.

Minnesota Statutes 2020, section 151.065, subdivision 3, is amended to read:


Subd. 3.

Annual renewal fees.

Annual licensure and registration renewal fees are as
follows:

(1) pharmacist, $175;

(2) pharmacy technician, $50;

(3) pharmacy, $260;

(4) drug wholesaler, legend drugs only, $5,260;

(5) drug wholesaler, legend and nonlegend drugs, $5,260;

(6) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $5,260;

(7) drug wholesaler, medical gases, deleted text begin$5,260 for the first facility anddeleted text end $260 deleted text beginfor each
additional facility
deleted text end;

(8) third-party logistics provider, $260;

(9) drug manufacturer, nonopiate legend drugs only, $5,260;

(10) drug manufacturer, nonopiate legend and nonlegend drugs, $5,260;

(11) drug manufacturer, nonlegend, veterinary legend drugs, or both, $5,260;

(12) drug manufacturer, medical gases, deleted text begin$5,260 for the first facility anddeleted text end $260 deleted text beginfor each
additional facility
deleted text end;

(13) drug manufacturer, also licensed as a pharmacy in Minnesota, $5,260;

(14) drug manufacturer of opiate-containing controlled substances listed in section
152.02, subdivisions 3 to 5, $55,260;

(15) medical gas dispenser, $260;

(16) controlled substance researcher, $75; and

(17) pharmacy professional corporation, $100.

Sec. 25.

Minnesota Statutes 2020, section 151.065, subdivision 7, is amended to read:


Subd. 7.

Deposit of fees.

(a) The license fees collected under this section, with the
exception of the fees identified in paragraphs (b) and (c), shall be deposited in the state
government special revenue fund.

(b) $5,000 of each fee collected under subdivision 1, clauses (6) to deleted text begin(9)deleted text endnew text begin (8)new text end, deleted text beginanddeleted text end (11) to
new text begin (13), and new text end(15), and subdivision 3, clauses (4) to deleted text begin(7)deleted text endnew text begin (6)new text end, deleted text beginanddeleted text end (9) to new text begin(11), and new text end(13), and $55,000
of each fee collected under subdivision 1, clause (16), and subdivision 3, clause (14), shall
be deposited in the opiate epidemic response fund established in section 256.043.

(c) If the fees collected under subdivision 1, clause (16), or subdivision 3, clause (14),
are reduced under section 256.043, $5,000 of the reduced fee shall be deposited in the opiate
epidemic response fund in section 256.043.

Sec. 26.

new text begin [151.103] DELEGATION OF VACCINE ADMINISTRATION.
new text end

new text begin (a) A pharmacy technician or pharmacist intern may administer vaccines under section
151.01, subdivision 27, clause (6), if the technician or intern:
new text end

new text begin (1) is under the direct supervision of a pharmacist while administering the vaccine;
new text end

new text begin (2) has successfully completed a program approved by the Accreditation Council for
Pharmacy Education (ACPE) specifically for the administration of immunizations or a
program approved by the board;
new text end

new text begin (3) has a current certificate in basic cardiopulmonary resuscitation; and
new text end

new text begin (4) if delegated to a pharmacy technician, the technician has completed:
new text end

new text begin (i) one of the training programs listed under Minnesota Rules, part 6800.3850, subpart
1h, item B; and
new text end

new text begin (ii) a minimum of two hours of ACPE-approved, immunization-related continuing
pharmacy education as part of the pharmacy technician's two-year continuing education
schedule.
new text end

new text begin (b) Direct supervision under this section must be in-person and must not be done through
telehealth as defined under section 62A.673, subdivision 2.
new text end

Sec. 27.

Minnesota Statutes 2020, section 152.125, is amended to read:


152.125 INTRACTABLE PAIN.

Subdivision 1.

deleted text beginDefinitiondeleted text endnew text begin Definitionsnew text end.

new text begin(a) new text endFor purposes of this section, new text beginthe terms in this
subdivision have the meanings given.
new text end

new text begin (b) "Drug diversion" means the unlawful transfer of prescription drugs from their licit
medical purpose to the illicit marketplace.
new text end

new text begin (c) new text end"Intractable pain" means a pain state in which the cause of the pain cannot be removed
or otherwise treated with the consent of the patient and in which, in the generally accepted
course of medical practice, no relief or cure of the cause of the pain is possible, or none has
been found after reasonable efforts. new text beginConditions associated with intractable pain include but
are not limited to cancer and the recovery period, sickle cell disease, noncancer pain, rare
diseases, orphan diseases, severe injuries, and health conditions requiring the provision of
palliative care or hospice care.
new text endReasonable efforts for relieving or curing the cause of the
pain may be determined on the basis of, but are not limited to, the following:

(1) when treating a nonterminally ill patient for intractable pain, new text beginan new text endevaluation new text beginconducted
new text end by the attending physiciannew text begin, advanced practice registered nurse, or physician assistantnew text end and
one or more physiciansnew text begin, advanced practice registered nurses, or physician assistantsnew text end
specializing in pain medicine or the treatment of the area, system, or organ of the body
new text begin confirmed or new text endperceived as the source of the new text beginintractable new text endpain; or

(2) when treating a terminally ill patient, new text beginan new text endevaluation new text beginconducted new text endby the attending
physiciannew text begin, advanced practice registered nurse, or physician assistantnew text end who does so in
accordance with new text beginthe standard of care and new text endthe level of care, skill, and treatment that would
be recognized by a reasonably prudent physiciannew text begin, advanced practice registered nurse, or
physician assistant
new text end under similar conditions and circumstances.

new text begin (d) "Palliative care" has the meaning provided in section 144A.75, subdivision 12.
new text end

new text begin (e) "Rare disease" means a disease, disorder, or condition that affects fewer than 200,000
individuals in the United States and is chronic, serious, life altering, or life threatening.
new text end

new text begin Subd. 1a. new text end

new text begin Criteria for the evaluation and treatment of intractable pain. new text end

new text begin The evaluation
and treatment of intractable pain when treating a nonterminally ill patient is governed by
the following criteria:
new text end

new text begin (1) a diagnosis of intractable pain by the treating physician, advanced practice registered
nurse, or physician assistant and either by a physician, advanced practice registered nurse,
or physician assistant specializing in pain medicine or a physician, advanced practice
registered nurse, or physician assistant treating the area, system, or organ of the body that
is the source of the pain is sufficient to meet the definition of intractable pain; and
new text end

new text begin (2) the cause of the diagnosis of intractable pain must not interfere with medically
necessary treatment including but not limited to prescribing or administering a controlled
substance in Schedules II to V of section 152.02.
new text end

Subd. 2.

Prescription and administration of controlled substances for intractable
pain.

new text begin(a) new text endNotwithstanding any other provision of this chapter, a physiciannew text begin, advanced practice
registered nurse, or physician assistant
new text end may prescribe or administer a controlled substance
in Schedules II to V of section 152.02 to deleted text beginan individualdeleted text endnew text begin a patientnew text end in the course of the
physician'snew text begin, advanced practice registered nurse's, or physician assistant'snew text end treatment of the
deleted text begin individualdeleted text endnew text begin patientnew text end for a diagnosed condition causing intractable pain. No physiciannew text begin, advanced
practice registered nurse, or physician assistant
new text end shall be subject to disciplinary action by
the Board of Medical Practice new text beginor Board of Nursing new text endfor appropriately prescribing or
administering a controlled substance in Schedules II to V of section 152.02 in the course
of treatment of deleted text beginan individualdeleted text endnew text begin a patientnew text end for intractable pain, provided the physiciannew text begin, advanced
practice registered nurse, or physician assistant:
new text end

new text begin (1) new text endkeeps accurate records of the purpose, use, prescription, and disposal of controlled
substances, writes accurate prescriptions, and prescribes medications in conformance with
chapter 147deleted text begin.deleted text endnew text begin or 148 or in accordance with the current standard of care; and
new text end

new text begin (2) enters into a patient-provider agreement that meets the criteria in subdivision 5.
new text end

new text begin (b) No physician, advanced practice registered nurse, or physician assistant, acting in
good faith and based on the needs of the patient, shall be subject to disenrollment or
termination by the commissioner of health or human services solely for prescribing a dosage
that equates to an upward deviation from morphine milligram equivalent dosage
recommendations or thresholds specified in state or federal opioid prescribing guidelines
or policies, including but not limited to the Guideline for Prescribing Opioids for Chronic
Pain issued by the Centers for Disease Control and Prevention, Minnesota opioid prescribing
guidelines, the Minnesota opioid prescribing improvement program, and the Minnesota
quality improvement program established under section 256B.0638.
new text end

new text begin (c) A physician, advanced practice registered nurse, or physician assistant treating
intractable pain by prescribing, dispensing, or administering a controlled substance in
Schedules II to V of section 152.02 that includes but is not limited to opioid analgesics must
not taper a patient's medication dosage solely to meet a predetermined morphine milligram
equivalent dosage recommendation or threshold if the patient is stable and compliant with
the treatment plan, is experiencing no serious harm from the level of medication currently
being prescribed or previously prescribed, and is in compliance with the patient-provider
agreement as described in subdivision 5.
new text end

new text begin (d) A physician's, advanced practice registered nurse's, or physician assistant's decision
to taper a patient's medication dosage must be based on factors other than a morphine
milligram equivalent recommendation or threshold.
new text end

new text begin (e) No pharmacist, health plan company, or pharmacy benefit manager shall refuse to
fill a prescription for an opiate issued by a licensed practitioner with the authority to prescribe
opiates solely based on the prescription exceeding a predetermined morphine milligram
equivalent dosage recommendation or threshold.
new text end

Subd. 3.

Limits on applicability.

This section does not apply to:

(1) a physician'snew text begin, advanced practice registered nurse's, or physician assistant'snew text end treatment
of deleted text beginan individualdeleted text endnew text begin a patientnew text end for chemical dependency resulting from the use of controlled
substances in Schedules II to V of section 152.02;

(2) the prescription or administration of controlled substances in Schedules II to V of
section 152.02 to deleted text beginan individualdeleted text endnew text begin a patientnew text end whom the physiciannew text begin, advanced practice registered
nurse, or physician assistant
new text end knows to be using the controlled substances for nontherapeutic
new text begin or drug diversion new text endpurposes;

(3) the prescription or administration of controlled substances in Schedules II to V of
section 152.02 for the purpose of terminating the life of deleted text beginan individualdeleted text endnew text begin a patientnew text end having
intractable pain; or

(4) the prescription or administration of a controlled substance in Schedules II to V of
section 152.02 that is not a controlled substance approved by the United States Food and
Drug Administration for pain relief.

Subd. 4.

Notice of risks.

Prior to treating deleted text beginan individualdeleted text endnew text begin a patientnew text end for intractable pain in
accordance with subdivision 2, a physiciannew text begin, advanced practice registered nurse, or physician
assistant
new text end shall discuss with the deleted text beginindividualdeleted text endnew text begin patient or the patient's legal guardian, if applicable,new text end
the risks associated with the controlled substances in Schedules II to V of section 152.02
to be prescribed or administered in the course of the physician'snew text begin, advanced practice registered
nurse's, or physician assistant's
new text end treatment of deleted text beginan individualdeleted text endnew text begin a patientnew text end, and document the
discussion in the deleted text beginindividual'sdeleted text endnew text begin patient'snew text end recordnew text begin as required in the patient-provider agreement
described in subdivision 5
new text end.

new text begin Subd. 5. new text end

new text begin Patient-provider agreement. new text end

new text begin (a) Before treating a patient for intractable pain,
a physician, advanced practice registered nurse, or physician assistant and the patient or the
patient's legal guardian, if applicable, must mutually agree to the treatment and enter into
a provider-patient agreement. The agreement must include a description of the prescriber's
and the patient's expectations, responsibilities, and rights according to best practices and
current standards of care.
new text end

new text begin (b) The agreement must be signed by the patient or the patient's legal guardian, if
applicable, and the physician, advanced practice registered nurse, or physician assistant and
included in the patient's medical records. A copy of the signed agreement must be provided
to the patient.
new text end

new text begin (c) The agreement must be reviewed by the patient and the physician, advanced practice
registered nurse, or physician assistant annually. If there is a change in the patient's treatment
plan, the agreement must be updated and a revised agreement must be signed by the patient
or the patient's legal guardian. A copy of the revised agreement must be included in the
patient's medical record and a copy must be provided to the patient.
new text end

new text begin (d) A patient-provider agreement is not required in an emergency or inpatient hospital
setting.
new text end

Sec. 28. new text beginTEMPORARY REQUIREMENTS GOVERNING AMBULANCE SERVICE
OPERATIONS AND THE PROVISION OF EMERGENCY MEDICAL SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Application. new text end

new text begin Notwithstanding any law to the contrary in Minnesota
Statutes, chapter 144E, an ambulance service may operate according to this section, and
emergency medical technicians, advanced emergency medical technicians, and paramedics
may provide emergency medical services according to this section.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) The terms defined in this subdivision apply to this section.
new text end

new text begin (b) "Advanced emergency medical technician" has the meaning given in Minnesota
Statutes, section 144E.001, subdivision 5d.
new text end

new text begin (c) "Advanced life support" has the meaning given in Minnesota Statutes, section
144E.001, subdivision 1b.
new text end

new text begin (d) "Ambulance" has the meaning given in Minnesota Statutes, section 144E.001,
subdivision 2.
new text end

new text begin (e) "Ambulance service personnel" has the meaning given in Minnesota Statutes, section
144E.001, subdivision 3a.
new text end

new text begin (f) "Basic life support" has the meaning given in Minnesota Statutes, section 144E.001,
subdivision 4b.
new text end

new text begin (g) "Board" means the Emergency Medical Services Regulatory Board.
new text end

new text begin (h) "Emergency medical technician" has the meaning given in Minnesota Statutes, section
144E.001, subdivision 5c.
new text end

new text begin (i) "Paramedic" has the meaning given in Minnesota Statutes, section 144E.001,
subdivision 5e.
new text end

new text begin (j) "Primary service area" means the area designated by the board according to Minnesota
Statutes, section 144E.06, to be served by an ambulance service.
new text end

new text begin Subd. 3. new text end

new text begin Staffing. new text end

new text begin (a) For emergency ambulance calls in an ambulance service's primary
service area, an ambulance service must staff an ambulance that provides basic life support
with at least:
new text end

new text begin (1) one emergency medical technician, who must be in the patient compartment when
a patient is being transported; and
new text end

new text begin (2) one individual to drive the ambulance. The driver must hold a valid driver's license
from any state, must have attended an emergency vehicle driving course approved by the
ambulance service, and must have completed a course on cardiopulmonary resuscitation
approved by the ambulance service.
new text end

new text begin (b) For emergency ambulance calls in an ambulance service's primary service area, an
ambulance service must staff an ambulance that provides advanced life support with at least:
new text end

new text begin (1) one paramedic; one registered nurse who meets the requirements in Minnesota
Statutes, section 144E.001, subdivision 3a, clause (2); or one physician assistant who meets
the requirements in Minnesota Statutes, section 144E.001, subdivision 3a, clause (3), and
who must be in the patient compartment when a patient is being transported; and
new text end

new text begin (2) one individual to drive the ambulance. The driver must hold a valid driver's license
from any state, must have attended an emergency vehicle driving course approved by the
ambulance service, and must have completed a course on cardiopulmonary resuscitation
approved by the ambulance service.
new text end

new text begin (c) The ambulance service director and medical director must approve the staffing of
an ambulance according to this subdivision.
new text end

new text begin (d) An ambulance service staffing an ambulance according to this subdivision must
immediately notify the board in writing and in a manner prescribed by the board. The notice
must specify how the ambulance service is staffing its basic life support or advanced life
support ambulances and the time period the ambulance service plans to staff the ambulances
according to this subdivision. If an ambulance service continues to staff an ambulance
according to this subdivision after the date provided to the board in its initial notice, the
ambulance service must provide a new notice to the board in a manner that complies with
this paragraph.
new text end

new text begin (e) If an individual serving as a driver under this subdivision commits an act listed in
Minnesota Statutes, section 144E.27, subdivision 5, paragraph (a), the board may temporarily
suspend or prohibit the individual from driving an ambulance or place conditions on the
individual's ability to drive an ambulance using the procedures and authority in Minnesota
Statutes, section 144E.27, subdivisions 5 and 6.
new text end

new text begin Subd. 4. new text end

new text begin Use of expired emergency medications and medical supplies. new text end

new text begin (a) If an
ambulance service experiences a shortage of an emergency medication or medical supply,
ambulance service personnel may use an emergency medication or medical supply for up
to six months after the emergency medication's or medical supply's specified expiration
date, provided:
new text end

new text begin (1) the ambulance service director and medical director approve the use of the expired
emergency medication or medical supply;
new text end

new text begin (2) ambulance service personnel use an expired emergency medication or medical supply
only after depleting the ambulance service's supply of that emergency medication or medical
supply that is unexpired;
new text end

new text begin (3) the ambulance service has stored and maintained the expired emergency medication
or medical supply according to the manufacturer's instructions;
new text end

new text begin (4) if possible, ambulance service personnel obtain consent from the patient to use the
expired emergency medication or medical supply prior to its use; and
new text end

new text begin (5) when the ambulance service obtains a supply of that emergency medication or medical
supply that is unexpired, ambulance service personnel cease use of the expired emergency
medication or medical supply and instead use the unexpired emergency medication or
medical supply.
new text end

new text begin (b) Before approving the use of an expired emergency medication, an ambulance service
director and medical director must consult with the Board of Pharmacy regarding the safety
and efficacy of using the expired emergency medication.
new text end

new text begin (c) An ambulance service must keep a record of all expired emergency medications and
all expired medical supplies used and must submit that record in writing to the board in a
time and manner specified by the board. The record must list the specific expired emergency
medications and medical supplies used and the time period during which ambulance service
personnel used the expired emergency medication or medical supply.
new text end

new text begin Subd. 5. new text end

new text begin Provision of emergency medical services after certification expires. new text end

new text begin (a) At
the request of an emergency medical technician, advanced emergency medical technician,
or paramedic, and with the approval of the ambulance service director, an ambulance service
medical director may authorize the emergency medical technician, advanced emergency
medical technician, or paramedic to provide emergency medical services for the ambulance
service for up to three months after the certification of the emergency medical technician,
advanced emergency medical technician, or paramedic expires.
new text end

new text begin (b) An ambulance service must immediately notify the board each time its medical
director issues an authorization under paragraph (a). The notice must be provided in writing
and in a manner prescribed by the board and must include information on the time period
each emergency medical technician, advanced emergency medical technician, or paramedic
will provide emergency medical services according to an authorization under this subdivision;
information on why the emergency medical technician, advanced emergency medical
technician, or paramedic needs the authorization; and an attestation from the medical director
that the authorization is necessary to help the ambulance service adequately staff its
ambulances.
new text end

new text begin Subd. 6. new text end

new text begin Reports. new text end

new text begin The board must provide quarterly reports to the chairs and ranking
minority members of the legislative committees with jurisdiction over the board regarding
actions taken by ambulance services according to subdivisions 3, 4, and 5. The board must
submit reports by June 30, September 30, and December 31 of 2022; and by March 31, June
30, September 30, and December 31 of 2023. Each report must include the following
information:
new text end

new text begin (1) for each ambulance service staffing basic life support or advanced life support
ambulances according to subdivision 3, the primary service area served by the ambulance
service, the number of ambulances staffed according to subdivision 3, and the time period
the ambulance service has staffed and plans to staff the ambulances according to subdivision
3;
new text end

new text begin (2) for each ambulance service that authorized the use of an expired emergency
medication or medical supply according to subdivision 4, the expired emergency medications
and medical supplies authorized for use and the time period the ambulance service used
each expired emergency medication or medical supply; and
new text end

new text begin (3) for each ambulance service that authorized the provision of emergency medical
services according to subdivision 5, the number of emergency medical technicians, advanced
emergency medical technicians, and paramedics providing emergency medical services
under an expired certification and the time period each emergency medical technician,
advanced emergency medical technician, or paramedic provided and will provide emergency
medical services under an expired certification.
new text end

new text begin Subd. 7. new text end

new text begin Expiration. new text end

new text begin This section expires January 1, 2024.
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. 29. new text beginEXPEDITED REREGISTRATION FOR LAPSED NURSING LICENSES.
new text end

new text begin (a) Notwithstanding Minnesota Statutes, section 148.231, a nurse who desires to resume
the practice of professional or practical nursing at a licensed nursing facility or licensed
assisted living facility but whose license to practice nursing has lapsed effective on or after
January 1, 2019, may submit an application to the Board of Nursing for reregistration. The
application must be submitted and received by the board between March 31, 2022, and
March 31, 2023, and must be accompanied with the reregistration fee specified in Minnesota
Statutes, section 148.243, subdivision 5. The applicant must include with the application
the name and location of the facility where the nurse is or will be employed.
new text end

new text begin (b) The board shall issue a current registration if upon a licensure history review, the
board determines that at the time the nurse's license lapsed:
new text end

new text begin (1) the nurse's license was in good standing; and
new text end

new text begin (2) the nurse was not the subject of any pending investigations or disciplinary actions
or was not disqualified to practice in any way.
new text end

new text begin The board shall waive any other requirements for reregistration including any continuing
education requirements.
new text end

new text begin (c) The registration issued under this section shall remain valid until the nurse's next
registration period. If the nurse desires to continue to practice after that date, the nurse must
meet the reregistration requirements under Minnesota Statutes, section 148.231, including
any penalty fees required.
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. 30. new text beginREPEALER.
new text end

new text begin Minnesota Statutes 2020, section 147.02, subdivision 2a, 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 15

MINNESOTA HEALTH AND EDUCATION FACILITIES AUTHORITY

Section 1.

Minnesota Statutes 2020, section 3.732, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

As used in this section and section 3.736 the terms defined
in this section have the meanings given them.

(1) "State" includes each of the departments, boards, agencies, commissions, courts, and
officers in the executive, legislative, and judicial branches of the state of Minnesota and
includes but is not limited to the Housing Finance Agency, the Minnesota Office of Higher
Education, the deleted text beginHigherdeleted text endnew text begin Health andnew text end Education Facilities Authority, the Health Technology
Advisory Committee, the Armory Building Commission, the Zoological Board, the
Department of Iron Range Resources and Rehabilitation, the Minnesota Historical Society,
the State Agricultural Society, the University of Minnesota, the Minnesota State Colleges
and Universities, state hospitals, and state penal institutions. It does not include a city, town,
county, school district, or other local governmental body corporate and politic.

(2) "Employee of the state" means all present or former officers, members, directors, or
employees of the state, members of the Minnesota National Guard, members of a bomb
disposal unit approved by the commissioner of public safety and employed by a municipality
defined in section 466.01 when engaged in the disposal or neutralization of bombs or other
similar hazardous explosives, as defined in section 299C.063, outside the jurisdiction of the
municipality but within the state, or persons acting on behalf of the state in an official
capacity, temporarily or permanently, with or without compensation. It does not include
either an independent contractor except, for purposes of this section and section 3.736 only,
a guardian ad litem acting under court appointment, or members of the Minnesota National
Guard while engaged in training or duty under United States Code, title 10, or title 32,
section 316, 502, 503, 504, or 505, as amended through December 31, 1983. Notwithstanding
sections 43A.02 and 611.263, for purposes of this section and section 3.736 only, "employee
of the state" includes a district public defender or assistant district public defender in the
Second or Fourth Judicial District, a member of the Health Technology Advisory Committee,
and any officer, agent, or employee of the state of Wisconsin performing work for the state
of Minnesota pursuant to a joint state initiative.

(3) "Scope of office or employment" means that the employee was acting on behalf of
the state in the performance of duties or tasks lawfully assigned by competent authority.

(4) "Judicial branch" has the meaning given in section 43A.02, subdivision 25.

Sec. 2.

Minnesota Statutes 2021 Supplement, section 10A.01, subdivision 35, is amended
to read:


Subd. 35.

Public official.

"Public official" means any:

(1) member of the legislature;

(2) individual employed by the legislature as secretary of the senate, legislative auditor,
director of the Legislative Budget Office, chief clerk of the house of representatives, revisor
of statutes, or researcher, legislative analyst, fiscal analyst, or attorney in the Office of
Senate Counsel, Research and Fiscal Analysis, House Research, or the House Fiscal Analysis
Department;

(3) constitutional officer in the executive branch and the officer's chief administrative
deputy;

(4) solicitor general or deputy, assistant, or special assistant attorney general;

(5) commissioner, deputy commissioner, or assistant commissioner of any state
department or agency as listed in section 15.01 or 15.06, or the state chief information
officer;

(6) member, chief administrative officer, or deputy chief administrative officer of a state
board or commission that has either the power to adopt, amend, or repeal rules under chapter
14, or the power to adjudicate contested cases or appeals under chapter 14;

(7) individual employed in the executive branch who is authorized to adopt, amend, or
repeal rules under chapter 14 or adjudicate contested cases under chapter 14;

(8) executive director of the State Board of Investment;

(9) deputy of any official listed in clauses (7) and (8);

(10) judge of the Workers' Compensation Court of Appeals;

(11) administrative law judge or compensation judge in the State Office of Administrative
Hearings or unemployment law judge in the Department of Employment and Economic
Development;

(12) member, regional administrator, division director, general counsel, or operations
manager of the Metropolitan Council;

(13) member or chief administrator of a metropolitan agency;

(14) director of the Division of Alcohol and Gambling Enforcement in the Department
of Public Safety;

(15) member or executive director of the deleted text beginHigherdeleted text endnew text begin Health andnew text end Education Facilities
Authority;

(16) member of the board of directors or president of Enterprise Minnesota, Inc.;

(17) member of the board of directors or executive director of the Minnesota State High
School League;

(18) member of the Minnesota Ballpark Authority established in section 473.755;

(19) citizen member of the Legislative-Citizen Commission on Minnesota Resources;

(20) manager of a watershed district, or member of a watershed management organization
as defined under section 103B.205, subdivision 13;

(21) supervisor of a soil and water conservation district;

(22) director of Explore Minnesota Tourism;

(23) citizen member of the Lessard-Sams Outdoor Heritage Council established in section
97A.056;

(24) citizen member of the Clean Water Council established in section 114D.30;

(25) member or chief executive of the Minnesota Sports Facilities Authority established
in section 473J.07;

(26) district court judge, appeals court judge, or supreme court justice;

(27) county commissioner;

(28) member of the Greater Minnesota Regional Parks and Trails Commission;

(29) member of the Destination Medical Center Corporation established in section
469.41; or

(30) chancellor or member of the Board of Trustees of the Minnesota State Colleges
and Universities.

Sec. 3.

Minnesota Statutes 2020, section 136A.25, is amended to read:


136A.25 CREATION.

A state agency known as the Minnesota deleted text beginHigherdeleted text end new text beginHealth and new text endEducation Facilities Authority
is hereby created.

Sec. 4.

Minnesota Statutes 2020, section 136A.26, is amended to read:


136A.26 MEMBERSHIPS; OFFICERS; COMPENSATION; REMOVAL.

Subdivision 1.

Membership.

The Minnesota deleted text beginHigherdeleted text endnew text begin Health andnew text end Education Facilities
Authority shall consist of deleted text begineightdeleted text endnew text begin ninenew text end members appointed by the governor with the advice
and consent of the senate, and a representative of the deleted text beginofficedeleted text endnew text begin Office of Higher Educationnew text end.

All members to be appointed by the governor shall be residents of the state. At least two
members must reside outside the metropolitan area as defined in section 473.121, subdivision
2
. At least one of the members shall be a person having a favorable reputation for skill,
knowledge, and experience in the field of state and municipal finance; deleted text beginanddeleted text end at least one shall
be a person having a favorable reputation for skill, knowledge, and experience in the building
construction field; deleted text beginanddeleted text end at least one of the members shall be a trustee, director, officer, or
employee of an institution of higher educationnew text begin; and at least one of the members shall be a
trustee, director, officer, or employee of a health care organization
new text end.

Subd. 1a.

Private College Council member.

The president of the Minnesota Private
College Council, or the president's designee, shall serve without compensation as an advisory,
nonvoting member of the authority.

new text begin Subd. 1b. new text end

new text begin Nonprofit health care association member. new text end

new text begin The chief executive officer of
a Minnesota nonprofit membership association whose members are primarily nonprofit
health care organizations, or the chief executive officer's designee, shall serve without
compensation as an advisory, nonvoting member of the authority. The identity of the
Minnesota nonprofit membership association shall be determined and may be changed from
time to time by the members of the authority in accordance with and as shall be provided
in the bylaws of the authority.
new text end

Subd. 2.

Term; compensation; removal.

The membership terms, compensation, removal
of members, and filling of vacancies for authority members other than the representative
of the office, deleted text beginanddeleted text end the president of the Private College Council,new text begin or the chief executive officer
of the Minnesota nonprofit membership association described in subdivision 1b
new text end shall be as
provided in section 15.0575.

Sec. 5.

Minnesota Statutes 2020, section 136A.27, is amended to read:


136A.27 POLICY.

It is hereby declared that for the benefit of the people of the state, the increase of their
commerce, welfare and prosperity and the improvement of their health and living conditions
it is essential that new text beginhealth care organizations within the state be provided with appropriate
additional means to establish, acquire, construct, improve, and expand health care facilities
in furtherance of their purposes; that
new text endthis and future generations of youth be given the fullest
opportunity to learn and to develop their intellectual and mental capacities; deleted text beginthat it is essentialdeleted text end
that institutions of higher education within the state be provided with appropriate additional
means to assist such youth in achieving the required levels of learning and development of
their intellectual and mental capacitiesnew text begin;new text end andnew text begin that health care organizations and institutions
of higher education
new text end be enabled to refinance outstanding indebtedness incurred to provide
existing facilities used for such purposes in order to preserve and enhance the utilization of
facilities for purposes of new text beginhealth care and new text endhigher education, to extend or adjust maturities in
relation to the resources available for their payment, and to save interest costs and thereby
reduce new text beginhealth care costs or higher education new text endtuition, feesnew text begin,new text end and chargesdeleted text begin; anddeleted text endnew text begin. It is hereby
further declared
new text end that it is the purpose of sections 136A.25 to 136A.42 to provide a measure
of assistance and an alternative method to enable new text beginhealth care organizations and new text endinstitutions
of higher education in the state to provide the facilities and structures which are sorely
needed to accomplish the purposes of sections 136A.25 to 136A.42, all to the public benefit
and good, to the extent and manner provided herein.

Sec. 6.

Minnesota Statutes 2020, section 136A.28, is amended to read:


136A.28 DEFINITIONS.

Subdivision 1.

Scope.

In sections 136A.25 to 136A.42, the following words and terms
shall, unless the context otherwise requires, have the meanings ascribed to them.

new text begin Subd. 1a. new text end

new text begin Affiliate. new text end

new text begin "Affiliate" means an entity that directly or indirectly controls, is
controlled by, or is under common control with, another entity. For the purposes of this
subdivision, "control" means either the power to elect a majority of the members of the
governing body of an entity or the power, whether by contract or otherwise, to direct the
management and policies of the entity. Affiliate also means an entity whose business or
substantially all of whose property is operated under a lease, management agreement, or
operating agreement by another entity, or an entity who operates the business or substantially
all of the property of another entity under a lease, management agreement, or operating
agreement.
new text end

Subd. 2.

Authority.

"Authority" means the deleted text beginHigherdeleted text end new text beginHealth and new text endEducation Facilities
Authority created by sections 136A.25 to 136A.42.

Subd. 3.

Project.

"Project" means deleted text begina structure or structures available for use as a dormitory
or other student housing facility, a dining hall, student union, administration building,
academic building, library, laboratory, research facility, classroom, athletic facility, health
care facility, child care facility, and maintenance, storage, or utility facility and other
structures or facilities related thereto or required or useful for the instruction of students or
the conducting of research or the operation of an institution of higher education, whether
proposed, under construction, or completed, including parking and other facilities or
structures essential or convenient for the orderly conduct of such institution for higher
education, and shall also include landscaping, site preparation, furniture, equipment and
machinery, and other similar items necessary or convenient for the operation of a particular
facility or structure in the manner for which its use is intended but shall not include such
items as books, fuel, supplies, or other items the costs of which are customarily deemed to
result in a current operating charge, and shall
deleted text end new text begina health care facility or an education facility
whether proposed, under construction, or completed, and includes land or interests in land,
appurtenances, site preparation, landscaping, buildings and structures, systems, fixtures,
furniture, machinery, equipment, and parking. Project also includes other structures, facilities,
improvements, machinery, equipment, and means of transport of a capital nature that are
necessary or convenient for the operation of the facility. Project does
new text endnot includenew text begin: (1)new text end any
facility used or to be used for sectarian instruction or as a place of religious worship deleted text beginnordeleted text endnew text begin;
(2)
new text end any facility which is used or to be used primarily in connection with any part of the
program of a school or department of divinity for any religious denominationnew text begin; nor (3) any
books, supplies, medicine, medical supplies, fuel, or other items, the cost of which are
customarily deemed to result in a current operating charge
new text end.

Subd. 4.

Cost.

"Cost," as applied to a project or any portion thereof financed under the
provisions of sections 136A.25 to 136A.42, means all or any part of the cost of construction,
acquisition, alteration, enlargement, reconstruction and remodeling of a project including
all lands, structures, real or personal property, rights, rights-of-way, franchises, easements
and interests acquired or used for or in connection with a project, the cost of demolishing
or removing any buildings or structures on land so acquired, including the cost of acquiring
any lands to which deleted text beginsuchdeleted text end buildings or structures may be moved, the cost of all machinery
and equipment, financing charges, interest prior to, during and for a period after completion
of such construction and acquisition, provisions for reserves for principal and interest and
for extensions, enlargements, additions and improvements, the cost of architectural,
engineering, financial and legal services, plans, specifications, studies, surveys, estimates
of cost and of revenues, administrative expenses, expenses necessary or incident to
determining the feasibility or practicability of constructing the project and such other
expenses as may be necessary or incident to the construction and acquisition of the project,
the financing of such construction and acquisition and the placing of the project in operation.

Subd. 5.

Bonds.

"Bonds," or "revenue bonds" means revenue bonds of the authority
issued under the provisions of sections 136A.25 to 136A.42, including revenue refunding
bonds, notwithstanding that the same may be secured by mortgage or the full faith and credit
of a participating institution deleted text beginfor higher educationdeleted text end or any other lawfully pledged security of
a participating institution deleted text beginfor higher educationdeleted text end.

Subd. 6.

Institution of higher education.

"Institution of higher education" means a
nonprofit educational institution within the state authorized to provide a program of education
beyond the high school level.

new text begin Subd. 6a. new text end

new text begin Health care organization. new text end

new text begin (a) "Health care organization" means a nonprofit
organization located within the state and authorized by law to operate a nonprofit health
care facility in the state. Health care organization also means a nonprofit affiliate of a health
care organization as defined under this paragraph, provided the affiliate is located within
the state or within a state that is geographically contiguous to Minnesota.
new text end

new text begin (b) Health care organization also means a nonprofit organization located within another
state that is geographically contiguous to Minnesota and authorized by law to operate a
nonprofit health care facility in that state, provided that the nonprofit organization located
within the contiguous state is an affiliate of a health care organization located within the
state.
new text end

new text begin Subd. 6b. new text end

new text begin Education facility. new text end

new text begin "Education facility" means a structure or structures
available for use as a dormitory or other student housing facility, dining hall, student union,
administration building, academic building, library, laboratory, research facility, classroom,
athletic facility, student health care facility, or child care facility, and includes other facilities
or structures related thereto essential or convenient for the orderly conduct of an institution
of higher education.
new text end

new text begin Subd. 6c. new text end

new text begin Health care facility. new text end

new text begin (a) "Health care facility" means a structure or structures
available for use within this state as a hospital, clinic, psychiatric residential treatment
facility, birth center, outpatient surgical center, comprehensive outpatient rehabilitation
facility, outpatient physical therapy or speech pathology facility, end-stage renal dialysis
facility, medical laboratory, pharmacy, radiation therapy facility, diagnostic imaging facility,
medical office building, residence for nurses or interns, nursing home, boarding care home,
assisted living facility, residential hospice, intermediate care facility for persons with
developmental disabilities, supervised living facility, housing with services establishment,
board and lodging establishment with special services, adult day care center, day services
facility, prescribed pediatric extended care facility, community residential setting, adult
foster home, or other facility related to medical or health care research, or the delivery or
administration of health care services, and includes other structures or facilities related
thereto essential or convenient for the orderly conduct of a health care organization.
new text end

new text begin (b) Health care facility also means a facility in a state that is geographically contiguous
to Minnesota operated by a health care organization that corresponds by purpose, function,
or use with a facility listed in paragraph (a).
new text end

Subd. 7.

Participating institution deleted text beginof higher educationdeleted text end.

"Participating institution deleted text beginof
higher education
deleted text end" meansnew text begin a health care organization ornew text end an institution of higher education
that, under the provisions of sections 136A.25 to 136A.42, undertakes the financing and
construction or acquisition of a project or undertakes the refunding or refinancing of
obligations or of a mortgage or of advances as provided in sections 136A.25 to 136A.42.
Community colleges and technical colleges may be considered participating institutions deleted text beginof
higher education
deleted text end for the purpose of financing and constructing child care facilities and
parking facilities.

Sec. 7.

Minnesota Statutes 2020, section 136A.29, subdivision 1, is amended to read:


Subdivision 1.

Purpose.

The purpose of the authority shall be to assist new text beginhealth care
organizations and
new text endinstitutions of higher education in the construction, financing, and
refinancing of projects. The exercise by the authority of the powers conferred by sections
136A.25 to 136A.42, shall be deemed and held to be the performance of an essential public
function. For the purpose of sections 136A.25 to 136A.42, the authority shall have the
powers and duties set forth in subdivisions 2 to 23.

Sec. 8.

Minnesota Statutes 2020, section 136A.29, subdivision 3, is amended to read:


Subd. 3.

Employees.

The authority is authorized and empowered to appoint and employ
employees as it may deem necessary to carry out its duties, determine the title of the
employees so employed, and fix the salary of deleted text beginsaiddeleted text endnew text begin itsnew text end employees. Employees of the authority
shall participate in retirement and other benefits in the same manner that employees in the
deleted text begin unclassified service of the officedeleted text endnew text begin managerial plan under section 43A.18, subdivision 3,new text end
participate.

Sec. 9.

Minnesota Statutes 2020, section 136A.29, subdivision 6, is amended to read:


Subd. 6.

Projects; generally.

new text begin(a) new text endThe authority is authorized and empowered to determine
the location and character of any project to be financed under the provisions of sections
136A.25 to 136A.42, and to construct, reconstruct, remodel, maintain, manage, enlarge,
alter, add to, repair, operate, lease, as lessee or lessor, and regulate the same, to enter into
contracts for any or all of such purposes, to enter into contracts for the management and
operation of a project, and to designate a participating institution deleted text beginof higher educationdeleted text end as its
agent to determine the location and character of a project undertaken by such participating
institution deleted text beginof higher educationdeleted text end under the provisions of sections 136A.25 to 136A.42 and as
the agent of the authority, to construct, reconstruct, remodel, maintain, manage, enlarge,
alter, add to, repair, operate, lease, as lessee or lessor, and regulate the same, and as the
agent of the authority, to enter into contracts for any or all of such purposes, including
contracts for the management and operation of such project.

new text begin (b) Notwithstanding paragraph (a), a project involving a health care facility within the
state financed under sections 136A.25 to 136A.42, must comply with all applicable
requirements in state law related to authorizing construction of or modifications to a health
care facility, including the requirements of sections 144.5509, 144.551, 144A.071, and
252.291.
new text end

new text begin (c) new text endContracts of the authority or of a participating institution deleted text beginof higher educationdeleted text end to
acquire or to construct, reconstruct, remodel, maintain, enlarge, alter, add to, or repair
projects shall not be subject to the provisions of chapter 16C or section 574.26, or any other
public contract or competitive bid law.

Sec. 10.

Minnesota Statutes 2020, section 136A.29, subdivision 9, is amended to read:


Subd. 9.

Revenue bonds; limit.

new text begin(a) new text endThe authority is authorized and empowered to issue
revenue bonds whose aggregate principal amount at any time shall not exceed deleted text begin$1,300,000,000deleted text endnew text begin
$4,000,000,000
new text end and to issue notes, bond anticipation notes, and revenue refunding bonds
of the authority under the provisions of sections 136A.25 to 136A.42, to provide funds for
acquiring, constructing, reconstructing, enlarging, remodeling, renovating, improving,
furnishing, or equipping one or more projects or parts thereof.

new text begin (b) Of the $4,000,000,000 limit in paragraph (a), the aggregate principal amount used
to fund education facilities may not exceed $1,750,000,000 at any time, and the aggregate
principal amount used to fund health care facilities may not exceed $2,250,000,000 at any
time.
new text end

Sec. 11.

Minnesota Statutes 2020, section 136A.29, subdivision 10, is amended to read:


Subd. 10.

Revenue bonds; issuance, purpose, conditions.

The authority is authorized
and empowered to issue revenue bonds to acquire projects from or to make loans to
participating institutions deleted text beginof higher educationdeleted text end and thereby refinance outstanding indebtedness
incurred by participating institutions deleted text beginof higher educationdeleted text end to provide funds for the acquisition,
construction or improvement of a facility before or after the enactment of sections 136A.25
to 136A.42, but otherwise eligible to be and being a project thereunder, whenever the
authority finds that such refinancing will enhance or preserve such participating institutions
and such facilities or utilization thereof for new text beginhealth care or new text endeducational purposes or extend
or adjust maturities to correspond to the resources available for their payment, or reduce
new text begin charges or fees imposed on patients or occupants, or new text endthe tuition, chargesnew text begin,new text end or fees imposed
on students for the use new text beginor occupancy new text endof the facilities of such participating institutions deleted text beginof
higher education
deleted text end or costs met by federal or state public funds, or enhance or preserve new text beginhealth
care or
new text endeducational programs and research or the acquisition or improvement of other
facilities eligible to be a project or part thereof by the participating institution deleted text beginof higher
education
deleted text end. The amount of revenue bonds to be issued to refinance outstanding indebtedness
of a participating institution deleted text beginof higher educationdeleted text end shall not exceed the lesser of (a) the fair
value of the project to be acquired by the authority from the institution or mortgaged to the
authority by the institution or (b) the amount of the outstanding indebtedness including any
premium thereon and any interest accrued or to accrue to the date of redemption and any
legal, fiscal and related costs in connection with such refinancing and reasonable reserves,
as determined by the authority. The provisions of this subdivision do not prohibit the authority
from issuing revenue bonds within and charged against the limitations provided in subdivision
9 to provide funds for improvements, alteration, renovation, or extension of the project
refinanced.

Sec. 12.

Minnesota Statutes 2020, section 136A.29, subdivision 14, is amended to read:


Subd. 14.

Rules for use of projects.

The authority is authorized and empowered to
establish rules for the use of a project or any portion thereof and to designate a participating
institution deleted text beginof higher educationdeleted text end as its agent to establish rules for the use of a project undertaken
for such participating institution deleted text beginof higher educationdeleted text end.

Sec. 13.

Minnesota Statutes 2020, section 136A.29, subdivision 19, is amended to read:


Subd. 19.

Surety.

Before the issuance of any revenue bonds under the provisions of
sections 136A.25 to 136A.42, any member or officer of the authority authorized by resolution
of the authority to handle funds or sign checks of the authority shall be covered under a
surety or fidelity bond in an amount to be determined by the authority. Each such bond shall
be conditioned upon the faithful performance of the duties of the office of the member or
officer, new text beginand new text endshall be executed by a surety company authorized to transact business in the
state of Minnesota as surety. The cost of each such bond shall be paid by the authority.

Sec. 14.

Minnesota Statutes 2020, section 136A.29, subdivision 20, is amended to read:


Subd. 20.

Sale, lease, and disposal of property.

The authority is authorized and
empowered to sell, lease, releasenew text begin,new text end or otherwise dispose of real and personal property or
interests therein, or a combination thereof, acquired by the authority under authority of
sections 136A.25 to 136A.42 and no longer needed for the purposes of deleted text beginsuchdeleted text endnew text begin thisnew text end chapter or
of the authority, and grant such easements and other rights in, over, under, or across a project
as will not interfere with its use of deleted text beginsuchdeleted text endnew text begin thenew text end property. deleted text beginSuchdeleted text endnew text begin Thenew text end sale, lease, release,
disposition, or grant may be made without competitive bidding and in deleted text beginsuchdeleted text endnew text begin thenew text end mannernew text begin andnew text end
for such consideration as the authority in its judgment deems appropriate.

Sec. 15.

Minnesota Statutes 2020, section 136A.29, subdivision 21, is amended to read:


Subd. 21.

Loans.

The authority is authorized and empowered to make loans to any
participating institution deleted text beginof higher educationdeleted text end for the cost of a project in accordance with an
agreement between the authority and the participating institution deleted text beginof higher educationdeleted text end;
provided that no deleted text beginsuchdeleted text end loan shall exceed the total cost of the project as determined by the
participating institution deleted text beginof higher educationdeleted text end and approved by the authority.

Sec. 16.

Minnesota Statutes 2020, section 136A.29, subdivision 22, is amended to read:


Subd. 22.

Costs, expenses, and other charges.

The authority is authorized and
empowered to charge to and apportion among participating institutions deleted text beginof higher educationdeleted text end
its administrative costs and expenses incurred in the exercise of the powers and duties
conferred by sections 136A.25 to 136A.42new text begin in the manner as the authority in its judgment
deems appropriate
new text end.

Sec. 17.

Minnesota Statutes 2020, section 136A.29, is amended by adding a subdivision
to read:


new text begin Subd. 24. new text end

new text begin Determination of affiliate status. new text end

new text begin The authority is authorized and empowered
to determine whether an entity is an affiliate as defined in section 136A.28, subdivision 1a.
A determination by the authority of affiliate status shall be deemed conclusive for the
purposes of sections 136A.25 to 136A.42.
new text end

Sec. 18.

Minnesota Statutes 2020, section 136A.32, subdivision 4, is amended to read:


Subd. 4.

Provisions of resolution authorizing bonds.

Any resolution or resolutions
authorizing any revenue bonds or any issue of revenue bonds may contain provisions, which
shall be a part of the contract with the holders of the revenue bonds to be authorized, as to:

(1) pledging all or any part of the revenues of a project or projects, any revenue producing
contract or contracts made by the authority with deleted text beginany individual partnership, corporation or
association or other body
deleted text endnew text begin one or more partnerships, corporations or associations, or other
bodies
new text end, public or private, to secure the payment of the revenue bonds or of any particular
issue of revenue bonds, subject to such agreements with bondholders as may then exist;

(2) the rentals, fees and other charges to be charged, and the amounts to be raised in
each year thereby, and the use and disposition of the revenues;

(3) the setting aside of reserves or sinking funds, and the regulation and disposition
thereof;

(4) limitations on the right of the authority or its agent to restrict and regulate the use of
the project;

(5) limitations on the purpose to which the proceeds of sale of any issue of revenue
bonds then or thereafter to be issued may be applied and pledging such proceeds to secure
the payment of the revenue bonds or any issue of the revenue bonds;

(6) limitations on the issuance of additional bonds, the terms upon which additional
bonds may be issued and secured and the refunding of outstanding bonds;

(7) the procedure, if any, by which the terms of any contract with bondholders may be
amended or abrogated, the amount of bonds the holders of which must consent thereto, and
the manner in which such consent may be given;

(8) limitations on the amount of moneys derived from the project to be expended for
operating, administrative or other expenses of the authority;

(9) defining the acts or omissions to act which shall constitute a default in the duties of
the authority to holders of its obligations and providing the rights and remedies of such
holders in the event of a default;new text begin or
new text end

(10) the mortgaging of a project and the site thereof for the purpose of securing the
bondholders.

Sec. 19.

Minnesota Statutes 2020, section 136A.33, is amended to read:


136A.33 TRUST AGREEMENT.

In the discretion of the authority any revenue bonds issued under the provisions of
sections 136A.25 to 136A.42, may be secured by a trust agreement by and between the
authority and a corporate trustee or trustees, which may be any trust company or bank having
the powers of a trust company within the state. deleted text beginSuchdeleted text endnew text begin Thenew text end trust agreement or the resolution
providing for the issuance of deleted text beginsuchdeleted text end revenue bonds may pledge or assign the revenues to be
received or proceeds of any contract or contracts pledged and may convey or mortgage the
project or any portion thereof. deleted text beginSuchdeleted text endnew text begin Thenew text end trust agreement or resolution providing for the
issuance of deleted text beginsuchdeleted text end revenue bonds may contain such provisions for protecting and enforcing
the rights and remedies of the bondholders as may be reasonable and proper and not in
violation of laws, including particularly such provisions as have hereinabove been specifically
authorized to be included in any resolution or resolutions of the authority authorizing revenue
bonds thereof. Any bank or trust company incorporated under the laws of the state deleted text beginwhichdeleted text endnew text begin
that
new text end may act as depository of the proceeds of bonds or of revenues or other moneys may
furnish deleted text beginsuchdeleted text end indemnifying bonds or deleted text beginpledges suchdeleted text end new text beginpledge new text endsecurities as may be required by
the authority. Any deleted text beginsuchdeleted text end trust agreement may set forth the rights and remedies of the
bondholders and of the trustee or trustees and may restrict the individual right of action by
bondholders. In addition to the foregoing, any deleted text beginsuchdeleted text end trust agreement or resolution may contain
deleted text begin suchdeleted text end other provisions as the authority may deem reasonable and proper for the security of
the bondholders. All expenses incurred in carrying out the provisions of deleted text beginsuchdeleted text endnew text begin thenew text end trust
agreement or resolution may be treated as a part of the cost of the operation of a project.

Sec. 20.

Minnesota Statutes 2020, section 136A.34, subdivision 3, is amended to read:


Subd. 3.

Investment.

Any deleted text beginsuchdeleted text end escrowed proceeds, pending such use, may be invested
and reinvested in direct obligations of the United States of America, or in certificates of
deposit or time deposits secured by direct obligations of the United States of America, new text beginor
in shares or units in any money market mutual fund whose investment portfolio consists
solely of direct obligations of the United States of America,
new text endmaturing at such time or times
as shall be appropriate to assure the prompt payment, as to principal, interest and redemption
premium, if any, of the outstanding revenue bonds to be so refunded. The interest, income
and profits, if any, earned or realized on any such investment may also be applied to the
payment of the outstanding revenue bonds to be so refunded. After the terms of the escrow
have been fully satisfied and carried out, any balance of such proceeds and interest, income
and profits, if any, earned or realized on the investments thereof may be returned to the
authority for use by it in any lawful manner.

Sec. 21.

Minnesota Statutes 2020, section 136A.34, subdivision 4, is amended to read:


Subd. 4.

Additional purpose; improvements.

The portion of the proceeds of any deleted text beginsuchdeleted text end
revenue bonds issued for the additional purpose of paying all or any part of the cost of
constructing and acquiring additions, improvements, extensions or enlargements of a project
may be invested or deposited deleted text beginin time depositsdeleted text end as provided in section 136A.32, subdivision
7
.

Sec. 22.

Minnesota Statutes 2020, section 136A.36, is amended to read:


136A.36 REVENUES.

The authority may fix, revise, charge and collect rates, rents, fees and charges for the
use of and for the services furnished or to be furnished by each project and deleted text begintodeleted text endnew text begin maynew text end contract
with any person, partnership, association or corporation, or other body, public or private,
in respect thereof. deleted text beginSuchdeleted text endnew text begin Thenew text end rates, rents, feesnew text begin,new text end and charges new text beginmay vary between projects
involving an education facility and projects involving a health care facility and
new text endshall be
fixed and adjusted in respect of the aggregate of rates, rents, feesnew text begin,new text end and charges from deleted text beginsuchdeleted text endnew text begin
the
new text end project so as to provide funds sufficient with other revenues, if any:

(1) to pay the cost of maintaining, repairing and operating the project and each and every
portion thereof, to the extent that the payment of such cost has not otherwise been adequately
provided for;

(2) to pay the principal of and the interest on outstanding revenue bonds of the authority
issued in respect of such project as the same shall become due and payable; and

(3) to create and maintain reserves required or provided for in any resolution authorizing,
or trust agreement securing, deleted text beginsuchdeleted text end revenue bonds of the authority. deleted text beginSuchdeleted text endnew text begin Thenew text end rates, rents, fees
and charges shall not be subject to supervision or regulation by any department, commission,
board, body, bureau or agency of this state other than the authority. A sufficient amount of
the revenues derived in respect of a project, except deleted text beginsuchdeleted text end part of deleted text beginsuchdeleted text endnew text begin thenew text end revenues as may
be necessary to pay the cost of maintenance, repair and operation and to provide reserves
and for renewals, replacements, extensions, enlargements and improvements as may be
provided for in the resolution authorizing the issuance of any revenue bonds of the authority
or in the trust agreement securing the same, shall be set aside at such regular intervals as
may be provided in deleted text beginsuchdeleted text endnew text begin thenew text end resolution or trust agreement in a sinking or other similar fund
deleted text begin whichdeleted text endnew text begin thatnew text end is hereby pledged to, and charged with, the payment of the principal of and the
interest on deleted text beginsuchdeleted text end revenue bonds as the same shall become due, and the redemption price or
the purchase price of bonds retired by call or purchase as therein provided. deleted text beginSuchdeleted text endnew text begin Thenew text end pledge
shall be valid and binding from the time when the pledge is made; the rates, rents, fees and
charges and other revenues or other moneys so pledged and thereafter received by the
authority shall immediately be subject to the lien of deleted text beginsuchdeleted text endnew text begin thenew text end pledge without physical delivery
thereof or further act, and the lien of any such pledge shall be valid and binding as against
all parties having claims of any kind against the authority, irrespective of whether such
parties have notice thereof. Neither the resolution nor any trust agreement by which a pledge
is created need be filed or recorded except in the records of the authority. The use and
disposition of moneys to the credit of such sinking or other similar fund shall be subject to
the provisions of the resolution authorizing the issuance of such bonds or of such trust
agreement. Except as may otherwise be provided in deleted text beginsuchdeleted text endnew text begin thenew text end resolution or deleted text beginsuchdeleted text end trust
agreement, deleted text beginsuchdeleted text endnew text begin thenew text end sinking or other similar fund shall be a fund for all deleted text beginsuchdeleted text end revenue bonds
issued to finance a project or projects at one or more participating institutions deleted text beginof higher
education
deleted text end without distinction or priority of one over another; provided the authority in any
such resolution or trust agreement may provide that such sinking or other similar fund shall
be the fund for a particular project at deleted text beginandeleted text endnew text begin a participatingnew text end institution deleted text beginof higher educationdeleted text end and
for the revenue bonds issued to finance a particular project and may, additionally, permit
and provide for the issuance of revenue bonds having a subordinate lien in respect of the
security herein authorized to other revenue bonds of the authority and, in such case, the
authority may create separate or other similar funds in respect of deleted text beginsuchdeleted text endnew text begin thenew text end subordinate lien
bonds.

Sec. 23.

Minnesota Statutes 2020, section 136A.38, is amended to read:


136A.38 BONDS ELIGIBLE FOR INVESTMENT.

Bonds issued bynew text begin thenew text end authority under the provisions of sections 136A.25 to 136A.42, are
hereby made securities in which all public officers and public bodies of the state and its
political subdivisions, all insurance companies, trust companies, banking associations,
investment companies, executors, administrators, trustees and other fiduciaries may properly
and legally invest funds, including capital in their control or belonging to them; it being the
purpose of this section to authorize the investment in such bonds of all sinking, insurance,
retirement, compensation, pension and trust funds, whether owned or controlled by private
or public persons or officers; provided, however, that nothing contained in this section may
be construed as relieving any person, firm, or corporation from any duty of exercising due
care in selecting securities for purchase or investment; and provide further, that in no event
shall assets of pension funds of public employees of the state of Minnesota or any of its
agencies, boards or subdivisions, whether publicly or privately administered, be invested
in bonds issued under the provisions of sections 136A.25 to 136A.42. Such bonds are hereby
constituted "authorized securities" within the meaning and for the purposes of Minnesota
Statutes 1969, section 50.14. deleted text beginSuchdeleted text endnew text begin Thenew text end bonds are hereby made securities deleted text beginwhichdeleted text endnew text begin thatnew text end may
properly and legally be deposited with and received by any state or municipal officer or any
agency or political subdivision of the state for any purpose for which the deposit of bonds
or obligations of the state now or may hereafter be authorized by law.

Sec. 24.

Minnesota Statutes 2020, section 136A.41, is amended to read:


136A.41 CONFLICT OF INTEREST.

Notwithstanding any other law to the contrary it shall not be or constitute a conflict of
interest for a trustee, director, officer or employee of any participating institution deleted text beginof higher
education
deleted text end, financial institution, investment banking firm, brokerage firm, commercial bank
or trust company, architecture firm, insurance company, construction company, or any other
firm, person or corporation to serve as a member of the authority, provided such trustee,
director, officer or employee shall abstain from deliberation, action and vote by the authority
in each instance where the business affiliation of any such trustee, director, officer or
employee is involved.

Sec. 25.

Minnesota Statutes 2020, section 136A.42, is amended to read:


136A.42 ANNUAL REPORT.

The authority shall keep an accurate account of all of its activities and all of its receipts
and expenditures deleted text beginand shall annually report to the officedeleted text end.new text begin Each year, the authority shall submit
to the Minnesota Historical Society and the Legislative Reference Library a report of the
authority's activities in the previous year, including all financial activities.
new text end

Sec. 26.

Minnesota Statutes 2020, section 136F.67, subdivision 1, is amended to read:


Subdivision 1.

Authorization.

A technical college or a community college must not
seek financing for child care facilities or parking facilities through the deleted text beginHigherdeleted text endnew text begin Health andnew text end
Education Facilities Authority, as provided in section 136A.28, subdivision 7, without the
explicit authorization of the board.

Sec. 27.

Minnesota Statutes 2020, section 354B.20, subdivision 7, is amended to read:


Subd. 7.

Employing unit.

"Employing unit," if the agency employs any persons covered
by the individual retirement account plan under section 354B.211, means:

(1) the board;

(2) the Minnesota Office of Higher Education; and

(3) the deleted text beginHigherdeleted text endnew text begin Health andnew text end Education Facilities Authority.

Sec. 28. new text beginREVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall renumber the law establishing and governing the Minnesota
Higher Education Facilities Authority, renamed the Minnesota Health and Education
Facilities Authority in this act, as Minnesota Statutes, chapter 16F, coded in Minnesota
Statutes 2020, sections 136A.25 to 136A.42, as amended or repealed in this act. The revisor
of statutes shall also duplicate any required definitions from Minnesota Statutes, chapter
136A, revise any statutory cross-references consistent with the recoding, and report the
history in Minnesota Statutes, chapter 16F.
new text end

Sec. 29. new text beginREPEALER.
new text end

new text begin Minnesota Statutes 2020, section 136A.29, subdivision 4, new text end new text begin is repealed.
new text end

ARTICLE 16

MANDATED REPORTS

Section 1.

Minnesota Statutes 2020, section 62J.692, subdivision 5, is amended to read:


Subd. 5.

Report.

(a) Sponsoring institutions receiving funds under this section must
sign and submit a medical education grant verification report (GVR) to verify that the correct
grant amount was forwarded to each eligible training site. If the sponsoring institution fails
to submit the GVR by the stated deadline, or to request and meet the deadline for an
extension, the sponsoring institution is required to return the full amount of funds received
to the commissioner within 30 days of receiving notice from the commissioner. The
commissioner shall distribute returned funds to the appropriate training sites in accordance
with the commissioner's approval letter.

(b) The reports must provide verification of the distribution of the funds and must include:

(1) the total number of eligible trainee FTEs in each clinical medical education program;

(2) the name of each funded program and, for each program, the dollar amount distributed
to each training site and a training site expenditure report;

(3) documentation of any discrepancies between the initial grant distribution notice
included in the commissioner's approval letter and the actual distribution;

(4) a statement by the sponsoring institution stating that the completed grant verification
report is valid and accurate; and

(5) other information the commissioner deems appropriate to evaluate the effectiveness
of the use of funds for medical education.

(c) Each year, the commissioner shall provide an annual summary report to the legislature
on the implementation of this section.new text begin This report is exempt from section 144.05, subdivision
7.
new text end

Sec. 2.

Minnesota Statutes 2020, section 62Q.37, subdivision 7, is amended to read:


Subd. 7.

Human services.

deleted text begin(a)deleted text end The commissioner of human services shall implement
this section in a manner that is consistent with applicable federal laws and regulations and
that avoids the duplication of review activities performed by a nationally recognized
independent organization.

deleted text begin (b) By December 31 of each year, the commissioner shall submit to the legislature a
written report identifying the number of audits performed by a nationally recognized
independent organization that were accepted, partially accepted, or rejected by the
commissioner under this section. The commissioner shall provide the rationale for partial
acceptance or rejection. If the rationale for the partial acceptance or rejection was based on
the commissioner's determination that the standards used in the audit were not equivalent
to state law, regulation, or contract requirement, the report must document the variances
deleted text end deleted text begin between the audit standards and the applicable state requirements.
deleted text end

Sec. 3.

Minnesota Statutes 2020, section 144.193, is amended to read:


144.193 INVENTORY OF BIOLOGICAL AND HEALTH DATA.

By February 1, 2014, and annually after that date, the commissioner shall prepare an
inventory of biological specimens, registries, and health data and databases collected or
maintained by the commissioner. In addition to the inventory, the commissioner shall provide
the schedules for storage of health data and biological specimens. The inventories must be
listed in reverse chronological order beginning with the year 2012. The commissioner shall
make the inventory and schedules available on the department's website deleted text beginand submit the
inventory and schedules to the chairs and ranking minority members of the committees of
the legislature with jurisdiction over health policy and data practices issues
deleted text end.

Sec. 4.

Minnesota Statutes 2020, section 144.4199, subdivision 8, is amended to read:


Subd. 8.

Report.

By January 15 of each year, the commissioner shall submit a report to
the chairs and ranking minority members of the house of representatives Ways and Means
Committee, the senate Finance Committee, and the house of representatives and senate
committees with jurisdiction over health and human services finance, detailing expenditures
made in the previous calendar year from the public health response contingency account.new text begin
This report is exempt from section 144.05, subdivision 7.
new text end

Sec. 5.

Minnesota Statutes 2020, section 144.497, is amended to read:


144.497 ST ELEVATION MYOCARDIAL INFARCTION.

The commissioner of health shall assess and report on the quality of care provided in
the state for ST elevation myocardial infarction response and treatment. The commissioner
shall:

(1) utilize and analyze data provided by ST elevation myocardial infarction receiving
centers to the ACTION Registry-Get with the guidelines or an equivalent data platform that
does not identify individuals or associate specific ST elevation myocardial infarction heart
attack events with an identifiable individual;

(2) quarterly post a summary report of the data in aggregate form on the Department of
Health website;new text begin and
new text end

deleted text begin (3) annually inform the legislative committees with jurisdiction over public health of
progress toward improving the quality of care and patient outcomes for ST elevation
myocardial infarctions; and
deleted text end

deleted text begin (4)deleted text endnew text begin (3)new text end coordinate to the extent possible with national voluntary health organizations
involved in ST elevation myocardial infarction heart attack quality improvement to encourage
ST elevation myocardial infarction receiving centers to report data consistent with nationally
recognized guidelines on the treatment of individuals with confirmed ST elevation myocardial
infarction heart attacks within the state and encourage sharing of information among health
care providers on ways to improve the quality of care of ST elevation myocardial infarction
patients in Minnesota.

Sec. 6.

Minnesota Statutes 2020, section 144A.10, subdivision 17, is amended to read:


Subd. 17.

Agency quality improvement program; annual report on survey
process.

(a) The commissioner shall establish a quality improvement program for the nursing
facility survey and complaint processes. The commissioner must regularly consult with
consumers, consumer advocates, and representatives of the nursing home industry and
representatives of nursing home employees in implementing the program. The commissioner,
through the quality improvement program, shall submit to the legislature an annual survey
and certification quality improvement report, beginning December 15, 2004, and each
December 15 thereafter.new text begin This report is exempt from section 144.05, subdivision 7.
new text end

(b) The report must include, but is not limited to, an analysis of:

(1) the number, scope, and severity of citations by region within the state;

(2) cross-referencing of citations by region within the state and between states within
the Centers for Medicare and Medicaid Services region in which Minnesota is located;

(3) the number and outcomes of independent dispute resolutions;

(4) the number and outcomes of appeals;

(5) compliance with timelines for survey revisits and complaint investigations;

(6) techniques of surveyors in investigations, communication, and documentation to
identify and support citations;

(7) compliance with timelines for providing facilities with completed statements of
deficiencies; and

(8) other survey statistics relevant to improving the survey process.

(c) The report must also identify and explain inconsistencies and patterns across regions
of the state; include analyses and recommendations for quality improvement areas identified
by the commissioner, consumers, consumer advocates, and representatives of the nursing
home industry and nursing home employees; and provide action plans to address problems
that are identified.

Sec. 7.

Minnesota Statutes 2020, section 144A.351, subdivision 1, is amended to read:


Subdivision 1.

Report requirements.

new text begin(a) new text endThe commissioners of health and human
services, with the cooperation of counties and in consultation with stakeholders, including
persons who need or are using long-term care services and supports, lead agencies, regional
entities, senior, disability, and mental health organization representatives, service providers,
and community members shall deleted text beginprepare a report to the legislature by August 15, 2013, and
biennially thereafter,
deleted text endnew text begin compile datanew text end regarding the status of the full range of long-term care
services and supports for the elderly and children and adults with disabilities and mental
illnesses in Minnesota. deleted text beginAny amounts appropriated for this report are available in either year
of the biennium.
deleted text end The deleted text beginreport shall addressdeleted text endnew text begin compiled data shall includenew text end:

(1) demographics and need for long-term care services and supports in Minnesota;

(2) summary of county and regional reports on long-term care gaps, surpluses, imbalances,
and corrective action plans;

(3) status of long-term care services and related mental health services, housing options,
and supports by county and region including:

(i) changes in availability of the range of long-term care services and housing options;

(ii) access problems, including access to the least restrictive and most integrated services
and settings, regarding long-term care services; and

(iii) comparative measures of long-term care services availability, including serving
people in their home areas near family, and changes over time; and

(4) recommendations regarding goals for the future of long-term care services and
supports, policy and fiscal changes, and resource development and transition needs.

new text begin (b) The commissioners of health and human services shall make the compiled data
available on at least one of the department's websites.
new text end

Sec. 8.

Minnesota Statutes 2020, section 144A.483, subdivision 1, is amended to read:


Subdivision 1.

Annual legislative report on home care licensing.

The commissioner
shall establish a quality improvement program for the home care survey and home care
complaint investigation processes. The commissioner shall submit to the legislature an
annual report, beginning October 1, 2015, and each October 1 thereafternew text begin, until October 1,
2027
new text end. Each report will review the previous state fiscal year of home care licensing and
regulatory activities. The report must include, but is not limited to, an analysis of:

(1) the number of FTEs in the Division of Compliance Monitoring, including the Office
of Health Facility Complaints units assigned to home care licensing, survey, investigation,
and enforcement process;

(2) numbers of and descriptive information about licenses issued, complaints received
and investigated, including allegations made and correction orders issued, surveys completed
and timelines, and correction order reconsiderations and results;

(3) descriptions of emerging trends in home care provision and areas of concern identified
by the department in its regulation of home care providers;

(4) information and data regarding performance improvement projects underway and
planned by the commissioner in the area of home care surveys; and

(5) work of the Department of Health Home Care Advisory Council.

Sec. 9.

Minnesota Statutes 2020, section 145.4134, is amended to read:


145.4134 COMMISSIONER'S PUBLIC REPORT.

(a) By July 1 of each year, except for 1998 and 1999 information, the commissioner
shall issue a public report providing statistics for the previous calendar year compiled from
the data submitted under sections 145.4131 to 145.4133 and sections 145.4241 to 145.4249.
For 1998 and 1999 information, the report shall be issued October 1, 2000. Each report
shall provide the statistics for all previous calendar years, adjusted to reflect any additional
information from late or corrected reports. The commissioner shall ensure that none of the
information included in the public reports can reasonably lead to identification of an
individual having performed or having had an abortion. All data included on the forms
under sections 145.4131 to 145.4133 and sections 145.4241 to 145.4249 must be included
in the public report, except that the commissioner shall maintain as confidential, data which
alone or in combination may constitute information from which an individual having
performed or having had an abortion may be identified using epidemiologic principles. deleted text beginThe
commissioner shall submit the report to the senate Health and Family Security Committee
and the house of representatives Health and Human Services Committee.
deleted text end

(b) The commissioner may, by rules adopted under chapter 14, alter the submission
dates established under sections 145.4131 to 145.4133 for administrative convenience, fiscal
savings, or other valid reason, provided that physicians or facilities and the commissioner
of human services submit the required information once each year and the commissioner
issues a report once each year.

Sec. 10.

Minnesota Statutes 2020, section 145.928, subdivision 13, is amended to read:


Subd. 13.

Reports.

(a) The commissioner shall submit a biennial report to the legislature
on the local community projects, tribal government, and community health board prevention
activities funded under this section. These reports must include information on grant
recipients, activities that were conducted using grant funds, evaluation data, and outcome
measures, if available. These reports are due by January 15 of every other year, beginning
in the year 2003.

(b) The commissioner shall release an annual report to the public deleted text beginand submit the annual
report to the chairs and ranking minority members of the house of representatives and senate
committees with jurisdiction over public health
deleted text end on grants made under subdivision 7 to
decrease racial and ethnic disparities in infant mortality rates. The report must provide
specific information on the amount of each grant awarded to each agency or organization,
an itemized list submitted to the commissioner by each agency or organization awarded a
grant specifying all uses of grant funds and the amount expended for each use, the population
served by each agency or organization, outcomes of the programs funded by each grant,
and the amount of the appropriation retained by the commissioner for administrative and
associated expenses. The commissioner shall issue a report each January 15 for the previous
fiscal year beginning January 15, 2016.

Sec. 11.

Minnesota Statutes 2020, section 245.4661, subdivision 10, is amended to read:


Subd. 10.

Commissioner duty to report on use of grant funds biennially.

new text begin(a) new text endBy
November 1, 2016, and biennially thereafter, the commissioner of human services shall
provide sufficient information to the members of the legislative committees having
jurisdiction over mental health funding and policy issues to evaluate the use of funds
appropriated under this section of law. The commissioner shall provide, at a minimum, the
following information:

(1) the amount of funding to mental health initiatives, what programs and services were
funded in the previous two years, gaps in services that each initiative brought to the attention
of the commissioner, and outcome data for the programs and services that were funded; and

(2) the amount of funding for other targeted services and the location of services.

new text begin (b) This subdivision expires January 1, 2032.
new text end

Sec. 12.

Minnesota Statutes 2020, section 245.4889, subdivision 3, is amended to read:


Subd. 3.

Commissioner duty to report on use of grant funds biennially.

new text begin(a) new text endBy
November 1, 2016, and biennially thereafter, the commissioner of human services shall
provide sufficient information to the members of the legislative committees having
jurisdiction over mental health funding and policy issues to evaluate the use of funds
appropriated under this section. The commissioner shall provide, at a minimum, the following
information:

(1) the amount of funding for children's mental health grants, what programs and services
were funded in the previous two years, and outcome data for the programs and services that
were funded; and

(2) the amount of funding for other targeted services and the location of services.

new text begin (b) This subdivision expires January 1, 2032.
new text end

Sec. 13.

Minnesota Statutes 2021 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 family child foster care home or family adult foster care home
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 where at least 80 percent of the residents are 55 years of age or
older;

(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;

(5) 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; or

(6) new foster care licenses or community residential setting licenses for people receiving
customized living or 24-hour customized living services under the brain injury or community
access for disability inclusion waiver plans under section 256B.49 and residing in the
customized living setting before July 1, 2022, for which a license is required. A customized
living service provider 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, 2023. This exception is available
when:

(i) the person's customized living services are provided in a customized living service
setting serving four or fewer people under the brain injury or community access for disability
inclusion waiver plans under section 256B.49 in a single-family home operational on or
before June 30, 2021. Operational is defined in section 256B.49, subdivision 28;

(ii) 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

(iii) 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 customized
living 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
deleted text begin reportsdeleted text endnew text begin datanew text end 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. deleted text beginAnnually, 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.
deleted text end

(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.

Sec. 14.

Minnesota Statutes 2020, section 256.01, subdivision 29, is amended to read:


Subd. 29.

State medical review team.

(a) To ensure the timely processing of
determinations of disability by the commissioner's state medical review team under sections
256B.055, subdivisions 7, paragraph (b), and 12, and 256B.057, subdivision 9, the
commissioner shall review all medical evidence and seek information from providers,
applicants, and enrollees to support the determination of disability where necessary. Disability
shall be determined according to the rules of title XVI and title XIX of the Social Security
Act and pertinent rules and policies of the Social Security Administration.

(b) Prior to a denial or withdrawal of a requested determination of disability due to
insufficient evidence, the commissioner shall (1) ensure that the missing evidence is necessary
and appropriate to a determination of disability, and (2) assist applicants and enrollees to
obtain the evidence, including, but not limited to, medical examinations and electronic
medical records.

deleted text begin (c) The commissioner shall provide the chairs of the legislative committees with
jurisdiction over health and human services finance and budget the following information
on the activities of the state medical review team by February 1 of each year:
deleted text end

deleted text begin (1) the number of applications to the state medical review team that were denied,
approved, or withdrawn;
deleted text end

deleted text begin (2) the average length of time from receipt of the application to a decision;
deleted text end

deleted text begin (3) the number of appeals, appeal results, and the length of time taken from the date the
person involved requested an appeal for a written decision to be made on each appeal;
deleted text end

deleted text begin (4) for applicants, their age, health coverage at the time of application, hospitalization
history within three months of application, and whether an application for Social Security
or Supplemental Security Income benefits is pending; and
deleted text end

deleted text begin (5) specific information on the medical certification, licensure, or other credentials of
the person or persons performing the medical review determinations and length of time in
that position.
deleted text end

deleted text begin (d)deleted text endnew text begin (c)new text end Any appeal made under section 256.045, subdivision 3, of a disability
determination made by the state medical review team must be decided according to the
timelines under section 256.0451, subdivision 22, paragraph (a). If a written decision is not
issued within the timelines under section 256.0451, subdivision 22, paragraph (a), the appeal
must be immediately reviewed by the chief human services judge.

Sec. 15.

Minnesota Statutes 2021 Supplement, section 256.01, subdivision 42, is amended
to read:


Subd. 42.

Expiration of report mandates.

(a) If the submission of a report by the
commissioner of human services to the legislature is mandated by statute and the enabling
legislation does not include a date for the submission of a final reportnew text begin or an expiration datenew text end,
the mandate to submit the report shall expire in accordance with this section.

(b) If the mandate requires the submission of an annualnew text begin or more frequentnew text end report and the
mandate was enacted before January 1, 2021, the mandate shall expire on January 1, 2023.
If the mandate requires the submission of a biennial or less frequent report and the mandate
was enacted before January 1, 2021, the mandate shall expire on January 1, 2024.

(c) Any reporting mandate enacted on or after January 1, 2021, shall expire three years
after the date of enactment if the mandate requires the submission of an annualnew text begin or more
frequent
new text end report and shall expire five years after the date of enactment if the mandate requires
the submission of a biennial or less frequent report unless the enacting legislation provides
for a different expiration date.

(d)new text begin By January 15 of each year,new text end the commissioner shall submit deleted text begina listdeleted text end to the chairs and
ranking minority members of the legislative committees with jurisdiction over human
services deleted text beginby February 15 of each year, beginning February 15, 2022,deleted text endnew text begin a listnew text end of all reports set
to expire during the following calendar year deleted text beginin accordance with this sectiondeleted text end.new text begin Notwithstanding
paragraph (c), this paragraph does not expire.
new text end

Sec. 16.

Minnesota Statutes 2020, section 256.021, subdivision 3, is amended to read:


Subd. 3.

Report.

new text begin(a) new text endBy January 15 of each year, the panel shall submit a report to the
committees of the legislature with jurisdiction over section 626.557 regarding the number
of requests for review it receives under this section, the number of cases where the panel
requires the lead investigative agency to reconsider its final disposition, and the number of
cases where the final disposition is changed, and any recommendations to improve the
review or investigative process.

new text begin (b) This subdivision expires January 1, 2024.
new text end

Sec. 17.

Minnesota Statutes 2021 Supplement, section 256.042, subdivision 4, is amended
to read:


Subd. 4.

Grants.

(a) The commissioner of human services shall submit a report of the
grants proposed by the advisory council to be awarded for the upcoming calendar year to
the chairs and ranking minority members of the legislative committees with jurisdiction
over health and human services policy and finance, by December 1 of each year, beginning
deleted text begin March 1, 2020deleted text endnew text begin December 1, 2022. This paragraph expires upon the expiration of the advisory
council
new text end.

(b) The grants shall be awarded to proposals selected by the advisory council that address
the priorities in subdivision 1, paragraph (a), clauses (1) to (4), unless otherwise appropriated
by the legislature. The advisory council shall determine grant awards and funding amounts
based on the funds appropriated to the commissioner under section 256.043, subdivision 3,
paragraph (e). The commissioner shall award the grants from the opiate epidemic response
fund and administer the grants in compliance with section 16B.97. No more than ten percent
of the grant amount may be used by a grantee for administration.

Sec. 18.

Minnesota Statutes 2020, section 256.042, subdivision 5, is amended to read:


Subd. 5.

Reports.

(a) The advisory council shall report annually to the chairs and ranking
minority members of the legislative committees with jurisdiction over health and human
services policy and finance by January 31 of each year, beginning January 31, 2021. The
report shall include information about the individual projects that receive grants and the
overall role of the project in addressing the opioid addiction and overdose epidemic in
Minnesota. The report must describe the grantees and the activities implemented, along
with measurable outcomes as determined by the council in consultation with the
commissioner of human services and the commissioner of management and budget. At a
minimum, the report must include information about the number of individuals who received
information or treatment, the outcomes the individuals achieved, and demographic
information about the individuals participating in the project; an assessment of the progress
toward achieving statewide access to qualified providers and comprehensive treatment and
recovery services; and an update on the evaluations implemented by the commissioner of
management and budget for the promising practices and theory-based projects that receive
funding.

(b) The commissioner of management and budget, in consultation with the Opiate
Epidemic Response Advisory Council, shall report to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance when an evaluation study described in subdivision 1, paragraph (c), is
complete on the promising practices or theory-based projects that are selected for evaluation
activities. The report shall include demographic information; outcome information for the
individuals in the program; the results for the program in promoting recovery, employment,
family reunification, and reducing involvement with the criminal justice system; and other
relevant outcomes determined by the commissioner of management and budget that are
specific to the projects that are evaluated. The report shall include information about the
ability of grant programs to be scaled to achieve the statewide results that the grant project
demonstrated.

(c) The advisory council, in its annual report to the legislature under paragraph (a) due
by January 31, 2024, shall include recommendations on whether the appropriations to the
specified entities under Laws 2019, chapter 63, should be continued, adjusted, or
discontinued; whether funding should be appropriated for other purposes related to opioid
abuse prevention, education, and treatment; and on the appropriate level of funding for
existing and new uses.

new text begin (d) This subdivision expires upon the expiration of the advisory council.
new text end

Sec. 19.

Minnesota Statutes 2020, section 256.9657, subdivision 8, is amended to read:


Subd. 8.

Commissioner's duties.

new text begin(a) Beginning October 1, 2023, new text endthe commissioner of
human services shallnew text begin annuallynew text end report to the deleted text beginlegislature quarterly on the first day of January,
April, July, and October
deleted text endnew text begin chairs and ranking minority members of the legislative committees
with jurisdiction over health care policy and finance
new text end regarding the provider surcharge
program. The report shall include information on total billings, total collections, and
administrative expendituresnew text begin for the previous fiscal yearnew text end. deleted text beginThe report on January 1, 1993,
shall include information on all surcharge billings, collections, federal matching payments
received, efforts to collect unpaid amounts, and administrative costs pertaining to the
surcharge program in effect from July 1, 1991, to September 30, 1992
deleted text endnew text begin This paragraph expires
January 1, 2032
new text end.

new text begin (b) new text endThe surcharge shall be adjusted by inflationary and caseload changes in future
bienniums to maintain reimbursement of health care providers in accordance with the
requirements of the state and federal laws governing the medical assistance program,
including the requirements of the Medicaid moratorium amendments of 1991 found in
Public Law No. 102-234.

new text begin (c) new text endThe commissioner shall request the Minnesota congressional delegation to support
a change in federal law that would prohibit federal disallowances for any state that makes
a good faith effort to comply with Public Law 102-234 by enacting conforming legislation
prior to the issuance of federal implementing regulations.

Sec. 20.

Minnesota Statutes 2020, section 256.975, subdivision 11, is amended to read:


Subd. 11.

Regional and local dementia grants.

(a) The Minnesota Board on Aging
shall award competitive grants to eligible applicants for regional and local projects and
initiatives targeted to a designated community, which may consist of a specific geographic
area or population, to increase awareness of Alzheimer's disease and other dementias,
increase the rate of cognitive testing in the population at risk for dementias, promote the
benefits of early diagnosis of dementias, or connect caregivers of persons with dementia to
education and resources.

(b) The project areas for grants include:

(1) local or community-based initiatives to promote the benefits of physician or advanced
practice registered nurse consultations for all individuals who suspect a memory or cognitive
problem;

(2) local or community-based initiatives to promote the benefits of early diagnosis of
Alzheimer's disease and other dementias; and

(3) local or community-based initiatives to provide informational materials and other
resources to caregivers of persons with dementia.

(c) Eligible applicants for local and regional grants may include, but are not limited to,
community health boards, school districts, colleges and universities, community clinics,
tribal communities, nonprofit organizations, and other health care organizations.

(d) Applicants must:

(1) describe the proposed initiative, including the targeted community and how the
initiative meets the requirements of this subdivision; and

(2) identify the proposed outcomes of the initiative and the evaluation process to be used
to measure these outcomes.

(e) In awarding the regional and local dementia grants, the Minnesota Board on Aging
must give priority to applicants who demonstrate that the proposed project:

(1) is supported by and appropriately targeted to the community the applicant serves;

(2) is designed to coordinate with other community activities related to other health
initiatives, particularly those initiatives targeted at the elderly;

(3) is conducted by an applicant able to demonstrate expertise in the project areas;

(4) utilizes and enhances existing activities and resources or involves innovative
approaches to achieve success in the project areas; and

(5) strengthens community relationships and partnerships in order to achieve the project
areas.

(f) The board shall divide the state into specific geographic regions and allocate a
percentage of the money available for the local and regional dementia grants to projects or
initiatives aimed at each geographic region.

(g) The board shall award any available grants by January 1, 2016, and each July 1
thereafter.

(h) Each grant recipient shall report to the board on the progress of the initiative at least
once during the grant period, and within two months of the end of the grant period shall
submit a final report to the board that includes the outcome results.

(i) The Minnesota Board on Aging shalldeleted text begin:
deleted text end

deleted text begin (1)deleted text end develop the criteria and procedures to allocate the grants under this subdivision,
evaluate all applicants on a competitive basis and award the grants, and select qualified
providers to offer technical assistance to grant applicants and grantees. The selected provider
shall provide applicants and grantees assistance with project design, evaluation methods,
materials, and trainingdeleted text begin; anddeleted text endnew text begin.
new text end

deleted text begin (2) submit by January 15, 2017, and on each January 15 thereafter, a progress report on
the dementia grants programs under this subdivision to the chairs and ranking minority
members of the senate and house of representatives committees and divisions with jurisdiction
over health finance and policy. The report shall include:
deleted text end

deleted text begin (i) information on each grant recipient;
deleted text end

deleted text begin (ii) a summary of all projects or initiatives undertaken with each grant;
deleted text end

deleted text begin (iii) the measurable outcomes established by each grantee, an explanation of the
evaluation process used to determine whether the outcomes were met, and the results of the
evaluation; and
deleted text end

deleted text begin (iv) an accounting of how the grant funds were spent.
deleted text end

Sec. 21.

Minnesota Statutes 2020, section 256.975, subdivision 12, is amended to read:


Subd. 12.

Self-directed caregiver grants.

The Minnesota Board on Aging shall, in
consultation with area agencies on aging and other community caregiver stakeholders,
administer self-directed caregiver grants to support at-risk family caregivers of older adults
or others eligible under the Older Americans Act of 1965, United States Code, title 42,
chapter 35, sections 3001 to 3058ff, to sustain family caregivers in the caregivers' roles so
older adults can remain at home longer. deleted text beginThe board shall submit by January 15, 2022, and
each January 15 thereafter, a progress report on the self-directed caregiver grants program
to the chairs and ranking minority members of the senate and house of representatives
committees and divisions with jurisdiction over human services. The progress report must
include metrics on the use of the grant program.
deleted text end

Sec. 22.

Minnesota Statutes 2020, section 256B.0561, subdivision 4, is amended to read:


Subd. 4.

Report.

new text begin(a) new text endBy September 1, 2019, and each September 1 thereafter, the
commissioner shall submit a report to the chairs and ranking minority members of the house
and senate committees with jurisdiction over human services finance that includes the
number of cases affected by periodic data matching under this section, the number of
recipients identified as possibly ineligible as a result of a periodic data match, and the number
of recipients whose eligibility was terminated as a result of a periodic data match. The report
must also specify, for recipients whose eligibility was terminated, how many cases were
closed due to failure to cooperate.

new text begin (b) This subdivision expires January 1, 2027.
new text end

Sec. 23.

Minnesota Statutes 2020, section 256B.0911, subdivision 5, is amended to read:


Subd. 5.

Administrative activity.

(a) The commissioner shall streamline the processes,
including timelines for when assessments need to be completed, required to provide the
services in this section and shall implement integrated solutions to automate the business
processes to the extent necessary for community support plan approval, reimbursement,
program planning, evaluation, and policy development.

(b) The commissioner of human services shall work with lead agencies responsible for
conducting long-term consultation services to modify the MnCHOICES application and
assessment policies to create efficiencies while ensuring federal compliance with medical
assistance and long-term services and supports eligibility criteria.

(c) The commissioner shall work with lead agencies responsible for conducting long-term
consultation services to develop a set of measurable benchmarks sufficient to demonstrate
quarterly improvement in the average time per assessment and other mutually agreed upon
measures of increasing efficiency. The commissioner shall collect data on these benchmarks
and provide to the lead agencies deleted text beginand the chairs and ranking minority members of the
legislative committees with jurisdiction over human services
deleted text end an annual trend analysis of
the data in order to demonstrate the commissioner's compliance with the requirements of
this subdivision.

Sec. 24.

Minnesota Statutes 2020, section 256B.0949, subdivision 17, is amended to read:


Subd. 17.

Provider shortage; authority for exceptions.

(a) In consultation with the
Early Intensive Developmental and Behavioral Intervention Advisory Council and
stakeholders, including agencies, professionals, parents of people with ASD or a related
condition, and advocacy organizations, the commissioner shall determine if a shortage of
EIDBI providers exists. For the purposes of this subdivision, "shortage of EIDBI providers"
means a lack of availability of providers who meet the EIDBI provider qualification
requirements under subdivision 15 that results in the delay of access to timely services under
this section, or that significantly impairs the ability of a provider agency to have sufficient
providers to meet the requirements of this section. The commissioner shall consider
geographic factors when determining the prevalence of a shortage. The commissioner may
determine that a shortage exists only in a specific region of the state, multiple regions of
the state, or statewide. The commissioner shall also consider the availability of various types
of treatment modalities covered under this section.

(b) The commissioner, in consultation with the Early Intensive Developmental and
Behavioral Intervention Advisory Council and stakeholders, must establish processes and
criteria for granting an exception under this paragraph. The commissioner may grant an
exception only if the exception would not compromise a person's safety and not diminish
the effectiveness of the treatment. The commissioner may establish an expiration date for
an exception granted under this paragraph. The commissioner may grant an exception for
the following:

(1) EIDBI provider qualifications under this section;

(2) medical assistance provider enrollment requirements under section 256B.04,
subdivision 21; or

(3) EIDBI provider or agency standards or requirements.

(c) If the commissioner, in consultation with the Early Intensive Developmental and
Behavioral Intervention Advisory Council and stakeholders, determines that a shortage no
longer exists, the commissioner must submit a notice that a shortage no longer exists to the
chairs and ranking minority members of the senate and the house of representatives
committees with jurisdiction over health and human services. The commissioner must post
the notice for public comment for 30 days. The commissioner shall consider public comments
before submitting to the legislature a request to end the shortage declaration. deleted text beginThe
commissioner shall annually provide an update on the status of the provider shortage and
exceptions granted to the chairs and ranking minority members of the senate and house of
representatives committees with jurisdiction over health and human services.
deleted text end The
commissioner shall not declare the shortage of EIDBI providers ended without direction
from the legislature to declare it ended.

Sec. 25.

Minnesota Statutes 2020, section 256B.493, subdivision 2, is amended to read:


Subd. 2.

Planned closure process needs determination.

A resource need determination
process, managed at the state level, using available deleted text beginreportsdeleted text endnew text begin datanew text end required by section 144A.351
and other data and information shall be used by the commissioner to align capacity where
needed.

Sec. 26.

Minnesota Statutes 2020, section 256B.69, subdivision 9d, is amended to read:


Subd. 9d.

Financial and quality assurance audits.

(a) The commissioner shall require,
in the request for bids and resulting contracts with managed care plans and county-based
purchasing plans under this section and section 256B.692, that each managed care plan and
county-based purchasing plan submit to and fully cooperate with the independent third-party
financial audits by the legislative auditor under subdivision 9e of the information required
under subdivision 9c, paragraph (b). Each contract with a managed care plan or county-based
purchasing plan under this section or section 256B.692 must provide the commissioner, the
legislative auditor, and vendors contracting with the legislative auditor, access to all data
required to complete audits under subdivision 9e.

(b) Each managed care plan and county-based purchasing plan providing services under
this section shall provide to the commissioner biweekly encounter data and claims data for
state public health care programs and shall participate in a quality assurance program that
verifies the timeliness, completeness, accuracy, and consistency of the data provided. The
commissioner shall develop written protocols for the quality assurance program and shall
make the protocols publicly available. The commissioner shall contract for an independent
third-party audit to evaluate the quality assurance protocols as to the capacity of the protocols
to ensure complete and accurate data and to evaluate the commissioner's implementation
of the protocols.

(c) Upon completion of the evaluation under paragraph (b), the commissioner shall
provide copies of the report to the legislative auditor deleted text beginand the chairs and ranking minority
members of the legislative committees with jurisdiction over health care policy and financing
deleted text end.

(d) Any actuary under contract with the commissioner to provide actuarial services must
meet the independence requirements under the professional code for fellows in the Society
of Actuaries and must not have provided actuarial services to a managed care plan or
county-based purchasing plan that is under contract with the commissioner pursuant to this
section and section 256B.692 during the period in which the actuarial services are being
provided. An actuary or actuarial firm meeting the requirements of this paragraph must
certify and attest to the rates paid to the managed care plans and county-based purchasing
plans under this section and section 256B.692, and the certification and attestation must be
auditable.

(e) The commissioner, to the extent of available funding, shall conduct ad hoc audits of
state public health care program administrative and medical expenses reported by managed
care plans and county-based purchasing plans. This includes: financial and encounter data
reported to the commissioner under subdivision 9c, including payments to providers and
subcontractors; supporting documentation for expenditures; categorization of administrative
and medical expenses; and allocation methods used to attribute administrative expenses to
state public health care programs. These audits also must monitor compliance with data and
financial report certification requirements established by the commissioner for the purposes
of managed care capitation payment rate-setting. The managed care plans and county-based
purchasing plans shall fully cooperate with the audits in this subdivision.

deleted text begin The commissioner shall report to the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services policy and finance
by February 1, 2016, and each February 1 thereafter, the number of ad hoc audits conducted
in the past calendar year and the results of these audits.
deleted text end

(f) Nothing in this subdivision shall allow the release of information that is nonpublic
data pursuant to section 13.02.

Sec. 27.

Minnesota Statutes 2020, section 256E.28, subdivision 6, is amended to read:


Subd. 6.

Evaluation.

(a) Using the outcomes established according to subdivision 3,
the commissioner shall conduct a biennial evaluation of the grant program funded under
this section. Grant recipients shall cooperate with the commissioner in the evaluation and
shall provide the commissioner with the information needed to conduct the evaluation.

(b) The commissioner shall consult with the legislative task force on child protection
during the evaluation process deleted text beginanddeleted text endnew text begin.
new text end

new text begin (c) The commissioner new text endshall submit a biennial evaluation report to the task force and to
the chairs and ranking minority members of the house of representatives and senate
committees with jurisdiction over child protection funding.new text begin This paragraph expires January
1, 2032.
new text end

Sec. 28.

Minnesota Statutes 2020, section 256R.18, is amended to read:


256R.18 REPORT BY COMMISSIONER OF HUMAN SERVICES.

new text begin (a) new text endBeginning January 1, 2019, the commissioner shall provide to the house of
representatives and senate committees with jurisdiction over nursing facility payment rates
a biennial report on the effectiveness of the reimbursement system in improving quality,
restraining costs, and any other features of the system as determined by the commissioner.

new text begin (b) This section expires January 1, 2026.
new text end

Sec. 29.

Minnesota Statutes 2020, section 257.0725, is amended to read:


257.0725 ANNUAL REPORT.

new text begin (a) new text endThe 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, school enrollments within seven days of
placement pursuant to section 120A.21, 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.

new text begin (b) This section expires January 1, 2032.
new text end

Sec. 30.

Minnesota Statutes 2020, section 260.775, is amended to read:


260.775 PLACEMENT RECORDS.

new text begin (a) new text endThe commissioner of human services shall publish annually an inventory of all Indian
children in residential facilities. The inventory shall include, by county and statewide,
information on legal status, living arrangement, age, sex, tribe in which the child is a member
or eligible for membership, accumulated length of time in foster care, and other demographic
information deemed appropriate concerning all Indian children in residential facilities. The
report must also state the extent to which authorized child-placing agencies comply with
the order of preference described in United States Code, title 25, section 1901, et seq.new text begin The
commissioner shall include the information required under this paragraph in the annual
report on child maltreatment and on children in out-of-home placement under section
257.0725.
new text end

new text begin (b) This section expires January 1, 2032.
new text end

Sec. 31.

Minnesota Statutes 2020, section 260E.24, subdivision 6, is amended to read:


Subd. 6.

Required referral to early intervention services.

new text begin(a) new text endA child under age three
who is involved in a substantiated case of maltreatment shall be referred for screening under
the Individuals with Disabilities Education Act, part C. Parents must be informed that the
evaluation and acceptance of services are voluntary. The commissioner of human services
shall monitor referral rates by county deleted text beginand annually report the information to the legislaturedeleted text end.
Refusal to have a child screened is not a basis for a child in need of protection or services
petition under chapter 260C.

new text begin (b) The commissioner of human services shall include the referral rates by county for
screening under the Individuals with Disabilities Education Act, part C in the annual report
on child maltreatment under section 257.0725. This paragraph expires January 1, 2032.
new text end

Sec. 32.

Minnesota Statutes 2020, section 260E.38, subdivision 3, is amended to read:


Subd. 3.

Report required.

new text begin(a) new text endThe commissioner shall produce an annual report of the
summary results of the reviews. The report must only contain aggregate data and may not
include any data that could be used to personally identify any subject whose data is included
in the report. The report is public information and must be provided to the chairs and ranking
minority members of the legislative committees having jurisdiction over child protection
issues.new text begin The commissioner shall include the information required under this paragraph in the
annual report on child maltreatment and on children in out-of-home placement under section
257.0725.
new text end

new text begin (b) This subdivision expires January 1, 2032.
new text end

Sec. 33.

Minnesota Statutes 2020, section 518A.77, is amended to read:


518A.77 GUIDELINES REVIEW.

new text begin (a) new text endNo later than 2006 and every four years after that, the Department of Human Services
must conduct a review of the child support guidelines.

new text begin (b) This section expires January 1, 2032.
new text end

Sec. 34.

Minnesota Statutes 2020, section 626.557, subdivision 12b, is amended to read:


Subd. 12b.

Data management.

(a) In performing any of the duties of this section as a
lead investigative agency, the county social service agency shall maintain appropriate
records. Data collected by the county social service agency under this section are welfare
data under section 13.46. Notwithstanding section 13.46, subdivision 1, paragraph (a), data
under this paragraph that are inactive investigative data on an individual who is a vendor
of services are private data on individuals, as defined in section 13.02. The identity of the
reporter may only be disclosed as provided in paragraph (c).

Data maintained by the common entry point are confidential data on individuals or
protected nonpublic data as defined in section 13.02. Notwithstanding section 138.163, the
common entry point shall maintain data for three calendar years after date of receipt and
then destroy the data unless otherwise directed by federal requirements.

(b) The commissioners of health and human services shall prepare an investigation
memorandum for each report alleging maltreatment investigated under this section. County
social service agencies must maintain private data on individuals but are not required to
prepare an investigation memorandum. During an investigation by the commissioner of
health or the commissioner of human services, data collected under this section are
confidential data on individuals or protected nonpublic data as defined in section 13.02.
Upon completion of the investigation, the data are classified as provided in clauses (1) to
(3) and paragraph (c).

(1) The investigation memorandum must contain the following data, which are public:

(i) the name of the facility investigated;

(ii) a statement of the nature of the alleged maltreatment;

(iii) pertinent information obtained from medical or other records reviewed;

(iv) the identity of the investigator;

(v) a summary of the investigation's findings;

(vi) statement of whether the report was found to be substantiated, inconclusive, false,
or that no determination will be made;

(vii) a statement of any action taken by the facility;

(viii) a statement of any action taken by the lead investigative agency; and

(ix) when a lead investigative agency's determination has substantiated maltreatment, a
statement of whether an individual, individuals, or a facility were responsible for the
substantiated maltreatment, if known.

The investigation memorandum must be written in a manner which protects the identity
of the reporter and of the vulnerable adult and may not contain the names or, to the extent
possible, data on individuals or private data listed in clause (2).

(2) Data on individuals collected and maintained in the investigation memorandum are
private data, including:

(i) the name of the vulnerable adult;

(ii) the identity of the individual alleged to be the perpetrator;

(iii) the identity of the individual substantiated as the perpetrator; and

(iv) the identity of all individuals interviewed as part of the investigation.

(3) Other data on individuals maintained as part of an investigation under this section
are private data on individuals upon completion of the investigation.

(c) After the assessment or investigation is completed, the name of the reporter must be
confidential. The subject of the report may compel disclosure of the name of the reporter
only with the consent of the reporter or upon a written finding by a court that the report was
false and there is evidence that the report was made in bad faith. This subdivision does not
alter disclosure responsibilities or obligations under the Rules of Criminal Procedure, except
that where the identity of the reporter is relevant to a criminal prosecution, the district court
shall do an in-camera review prior to determining whether to order disclosure of the identity
of the reporter.

(d) Notwithstanding section 138.163, data maintained under this section by the
commissioners of health and human services must be maintained under the following
schedule and then destroyed unless otherwise directed by federal requirements:

(1) data from reports determined to be false, maintained for three years after the finding
was made;

(2) data from reports determined to be inconclusive, maintained for four years after the
finding was made;

(3) data from reports determined to be substantiated, maintained for seven years after
the finding was made; and

(4) data from reports which were not investigated by a lead investigative agency and for
which there is no final disposition, maintained for three years from the date of the report.

(e) The commissioners of health and human services shall annually publish on their
websites the number and type of reports of alleged maltreatment involving licensed facilities
reported under this section, the number of those requiring investigation under this section,
and the resolution of those investigations.

deleted text begin On a biennial basis, the commissioners of health and human services shall jointly report
the following information to the legislature and the governor:
deleted text end

deleted text begin (1) the number and type of reports of alleged maltreatment involving licensed facilities
reported under this section, the number of those requiring investigations under this section,
the resolution of those investigations, and which of the two lead agencies was responsible;
deleted text end

deleted text begin (2) trends about types of substantiated maltreatment found in the reporting period;
deleted text end

deleted text begin (3) if there are upward trends for types of maltreatment substantiated, recommendations
for addressing and responding to them;
deleted text end

deleted text begin (4) efforts undertaken or recommended to improve the protection of vulnerable adults;
deleted text end

deleted text begin (5) whether and where backlogs of cases result in a failure to conform with statutory
time frames and recommendations for reducing backlogs if applicable;
deleted text end

deleted text begin (6) recommended changes to statutes affecting the protection of vulnerable adults; and
deleted text end

deleted text begin (7) any other information that is relevant to the report trends and findings.
deleted text end

(f) Each lead investigative agency must have a record retention policy.

(g) Lead investigative agencies, prosecuting authorities, and law enforcement agencies
may exchange not public data, as defined in section 13.02, if the agency or authority
requesting the data determines that the data are pertinent and necessary to the requesting
agency in initiating, furthering, or completing an investigation under this section. Data
collected under this section must be made available to prosecuting authorities and law
enforcement officials, local county agencies, and licensing agencies investigating the alleged
maltreatment under this section. The lead investigative agency shall exchange not public
data with the vulnerable adult maltreatment review panel established in section 256.021 if
the data are pertinent and necessary for a review requested under that section.
Notwithstanding section 138.17, upon completion of the review, not public data received
by the review panel must be destroyed.

(h) Each lead investigative agency shall keep records of the length of time it takes to
complete its investigations.

(i) A lead investigative agency may notify other affected parties and their authorized
representative if the lead investigative agency has reason to believe maltreatment has occurred
and determines the information will safeguard the well-being of the affected parties or dispel
widespread rumor or unrest in the affected facility.

(j) Under any notification provision of this section, where federal law specifically
prohibits the disclosure of patient identifying information, a lead investigative agency may
not provide any notice unless the vulnerable adult has consented to disclosure in a manner
which conforms to federal requirements.

Sec. 35.

Laws 2009, chapter 79, article 13, section 3, subdivision 10, as amended by Laws
2009, chapter 173, article 2, section 1, subdivision 10, is amended to read:


Subd. 10.

State-Operated Services

The amounts that may be spent from the
appropriation for each purpose are as follows:

Transfer Authority Related to
State-Operated Services.
Money
appropriated to finance state-operated services
may be transferred between the fiscal years of
the biennium with the approval of the
commissioner of finance.

County Past Due Receivables. The
commissioner is authorized to withhold county
federal administrative reimbursement when
the county of financial responsibility for
cost-of-care payments due the state under
Minnesota Statutes, section 246.54 or
253B.045, is 90 days past due. The
commissioner shall deposit the withheld
federal administrative earnings for the county
into the general fund to settle the claims with
the county of financial responsibility. The
process for withholding funds is governed by
Minnesota Statutes, section 256.017.

deleted text begin Forecast and Census Data. The
commissioner shall include census data and
fiscal projections for state-operated services
and Minnesota sex offender services with the
November and February budget forecasts.
Notwithstanding any contrary provision in this
article, this paragraph shall not expire
deleted text end.

(a) Adult Mental Health Services
106,702,000
107,201,000

Appropriation Limitation. No part of the
appropriation in this article to the
commissioner for mental health treatment
services provided by state-operated services
shall be used for the Minnesota sex offender
program.

Community Behavioral Health Hospitals.
Under Minnesota Statutes, section 246.51,
subdivision 1, a determination order for the
clients served in a community behavioral
health hospital operated by the commissioner
of human services is only required when a
client's third-party coverage has been
exhausted.

Base Adjustment. The general fund base is
decreased by $500,000 for fiscal year 2012
and by $500,000 for fiscal year 2013.

(b) Minnesota Sex Offender Services
Appropriations by Fund
General
38,348,000
67,503,000
Federal Fund
26,495,000
0

Use of Federal Stabilization Funds. Of this
appropriation, $26,495,000 in fiscal year 2010
is from the fiscal stabilization account in the
federal fund to the commissioner. This
appropriation must not be used for any activity
or service for which federal reimbursement is
claimed. This is a onetime appropriation.

(c) Minnesota Security Hospital and METO
Services
Appropriations by Fund
General
230,000
83,735,000
Federal Fund
83,505,000
0

Minnesota Security Hospital. For the
purposes of enhancing the safety of the public,
improving supervision, and enhancing
community-based mental health treatment,
state-operated services may establish
additional community capacity for providing
treatment and supervision of clients who have
been ordered into a less restrictive alternative
of care from the state-operated services
transitional services program consistent with
Minnesota Statutes, section 246.014.

Use of Federal Stabilization Funds.
$83,505,000 in fiscal year 2010 is appropriated
from the fiscal stabilization account in the
federal fund to the commissioner. This
appropriation must not be used for any activity
or service for which federal reimbursement is
claimed. This is a onetime appropriation.

Sec. 36. new text beginREPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2020, sections 62U.10, subdivision 3; 144.1911, subdivision 10;
144.564, subdivision 3; 144A.483, subdivision 2; 245.981; 246.131; 246B.03, subdivision
2; 246B.035; 256.01, subdivision 31; and 256B.0638, subdivision 7,
new text end new text begin are repealed.
new text end

new text begin (b) new text end new text begin Laws 1998, chapter 382, article 1, section 23, new text end new text begin is repealed.
new text end

ARTICLE 17

HUMAN SERVICES FORECAST ADJUSTMENTS AND CARRY FORWARD
AUTHORITY

Section 1. new text beginHUMAN SERVICES APPROPRIATION.
new text end

new text begin The dollar amounts shown in the columns marked "Appropriations" are added to or, if
shown in parentheses, are subtracted from the appropriations in Laws 2021, First Special
Session chapter 7, article 16, from the general fund or any fund named to the Department
of Human Services for the purposes specified in this article, to be available for the fiscal
year indicated for each purpose. The figures "2022" and "2023" used in this article mean
that the appropriations listed under them are available for the fiscal years ending June 30,
2022, or June 30, 2023, respectively. "The first year" is fiscal year 2022. "The second year"
is fiscal year 2023. "The biennium" is fiscal years 2022 and 2023.
new text end

new text begin APPROPRIATIONS
new text end
new text begin Available for the Year
new text end
new text begin Ending June 30
new text end
new text begin 2022
new text end
new text begin 2023
new text end

Sec. 2. new text beginCOMMISSIONER OF HUMAN
SERVICES
new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation
new text end

new text begin $
new text end
new text begin (585,901,000)
new text end
new text begin $
new text end
new text begin 182,791,000
new text end
new text begin Appropriations by Fund
new text end
new text begin General Fund
new text end
new text begin (406,629,000)
new text end
new text begin 185,395,000
new text end
new text begin Health Care Access
Fund
new text end
new text begin (86,146,000)
new text end
new text begin (11,799,000)
new text end
new text begin Federal TANF
new text end
new text begin (93,126,000)
new text end
new text begin 9,195,000
new text end

new text begin Subd. 2. new text end

new text begin Forecasted Programs
new text end

new text begin (a) MFIP/DWP
new text end
new text begin Appropriations by Fund
new text end
new text begin General Fund
new text end
new text begin 72,106,000
new text end
new text begin (14,397,000)
new text end
new text begin Federal TANF
new text end
new text begin (93,126,000)
new text end
new text begin 9,195,000
new text end
new text begin (b) MFIP Child Care Assistance
new text end
new text begin (103,347,000)
new text end
new text begin (73,738,000)
new text end
new text begin (c) General Assistance
new text end
new text begin (4,175,000)
new text end
new text begin (1,488,000)
new text end
new text begin (d) Minnesota Supplemental Aid
new text end
new text begin 318,000
new text end
new text begin 1,613,000
new text end
new text begin (e) Housing Support
new text end
new text begin (1,994,000)
new text end
new text begin 9,257,000
new text end
new text begin (f) Northstar Care for Children
new text end
new text begin (9,613,000)
new text end
new text begin (4,865,000)
new text end
new text begin (g) MinnesotaCare
new text end
new text begin (86,146,000)
new text end
new text begin (11,799,000)
new text end

new text begin These appropriations are from the health care
access fund.
new text end

new text begin (h) Medical Assistance
new text end
new text begin Appropriations by Fund
new text end
new text begin General Fund
new text end
new text begin (348,364,000)
new text end
new text begin 292,880,000
new text end
new text begin Health Care Access
Fund
new text end
new text begin 0
new text end
new text begin 0
new text end
new text begin (i) Alternative Care Program
new text end
new text begin 0
new text end
new text begin 0
new text end
new text begin (j) Behavioral Health Fund
new text end
new text begin (11,560,000)
new text end
new text begin (23,867,000)
new text end

new text begin Subd. 3. new text end

new text begin Technical Activities
new text end

new text begin 0
new text end
new text begin 0
new text end

new text begin These appropriations are from the federal
TANF fund.
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. 3.

Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 29,
is amended to read:


Subd. 29.

Grant Programs; Disabilities Grants

31,398,000
31,010,000

(a) Training Stipends for Direct Support
Services Providers.
$1,000,000 in fiscal year
2022 is from the general fund for stipends for
individual providers of direct support services
as defined in Minnesota Statutes, section
256B.0711, subdivision 1. deleted text beginThesedeleted text end new text beginThe new text endstipends
are available to individual providers who have
completed designated voluntary trainings
made available through the State-Provider
Cooperation Committee formed by the State
of Minnesota and the Service Employees
International Union Healthcare Minnesota.
Any unspent appropriation in fiscal year 2022
is available in fiscal year 2023. This is a
onetime appropriation. This appropriation is
available only if the labor agreement between
the state of Minnesota and the Service
Employees International Union Healthcare
Minnesota under Minnesota Statutes, section
179A.54, is approved under Minnesota
Statutes, section 3.855.

(b) Parent-to-Parent Peer Support. $125,000
in fiscal year 2022 and $125,000 in fiscal year
2023 are from the general fund for a grant to
an alliance member of Parent to Parent USA
to support the alliance member's
parent-to-parent peer support program for
families of children with a disability or special
health care need.

(c) Self-Advocacy Grants. (1) $143,000 in
fiscal year 2022 and $143,000 in fiscal year
2023 are from the general fund for a grant
under Minnesota Statutes, section 256.477,
subdivision 1
.

(2) $105,000 in fiscal year 2022 and $105,000
in fiscal year 2023 are from the general fund
for subgrants under Minnesota Statutes,
section 256.477, subdivision 2.

(d) Minnesota Inclusion Initiative Grants.
$150,000 in fiscal year 2022 and $150,000 in
fiscal year 2023 are from the general fund for
grants under Minnesota Statutes, section
256.4772.

(e) Grants to Expand Access to Child Care
for Children with Disabilities.
$250,000 in
fiscal year 2022 and $250,000 in fiscal year
2023 are from the general fund for grants to
expand access to child care for children with
disabilities.new text begin Any unexpended amount in fiscal
year 2022 is available through June 30, 2023.
new text end
This is a onetime appropriation.

(f) Parenting with a Disability Pilot Project.
The general fund base includes $1,000,000 in
fiscal year 2024 and $0 in fiscal year 2025 to
implement the parenting with a disability pilot
project.

(g) Base Level Adjustment. The general fund
base is $29,260,000 in fiscal year 2024 and
$22,260,000 in fiscal year 2025.

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.

Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 31,
is amended to read:


Subd. 31.

Grant Programs; Adult Mental Health
Grants

Appropriations by Fund
General
98,772,000
98,703,000
Opiate Epidemic
Response
2,000,000
2,000,000

(a) Culturally and Linguistically
Appropriate Services Implementation
Grants.
$2,275,000 in fiscal year 2022 and
$2,206,000 in fiscal year 2023 are from the
general fund for grants to disability services,
mental health, and substance use disorder
treatment providers to implement culturally
and linguistically appropriate services
standards, according to the implementation
and transition plan developed by the
commissioner.new text begin Any unexpended amount in
fiscal year 2022 is available through June 30,
2023.
new text end The general fund base for this
appropriation is $1,655,000 in fiscal year 2024
and $0 in fiscal year 2025.

(b) Base Level Adjustment. The general fund
base is $93,295,000 in fiscal year 2024 and
$83,324,000 in fiscal year 2025. The opiate
epidemic response fund base is $2,000,000 in
fiscal year 2024 and $0 in fiscal year 2025.

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.

Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 33,
is amended to read:


Subd. 33.

Grant Programs; Chemical
Dependency Treatment Support Grants

Appropriations by Fund
General
4,273,000
4,274,000
Lottery Prize
1,733,000
1,733,000
Opiate Epidemic
Response
500,000
500,000

(a) Problem Gambling. $225,000 in fiscal
year 2022 and $225,000 in fiscal year 2023
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,
training for individuals and organizations
providing effective treatment services to
problem gamblers and their families, and
research related to problem gambling.

(b) Recovery Community Organization
Grants.
$2,000,000 in fiscal year 2022 and
$2,000,000 in fiscal year 2023 are from the
general fund for grants to recovery community
organizations, as defined in Minnesota
Statutes, section 254B.01, subdivision 8, to
provide for costs and community-based peer
recovery support services that are not
otherwise eligible for reimbursement under
Minnesota Statutes, section 254B.05, as part
of the continuum of care for substance use
disorders.new text begin Any unexpended amount in fiscal
year 2022 is available through June 30, 2023.
new text end
The general fund base for this appropriation
is $2,000,000 in fiscal year 2024 and $0 in
fiscal year 2025

(c) Base Level Adjustment. The general fund
base is $4,636,000 in fiscal year 2024 and
$2,636,000 in fiscal year 2025. The opiate
epidemic response fund base is $500,000 in
fiscal year 2024 and $0 in fiscal year 2025.

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.

Laws 2021, First Special Session chapter 7, article 17, section 3, is amended to
read:


Sec. 3. GRANTS FOR TECHNOLOGY FOR HCBS RECIPIENTS.

(a) This act includes $500,000 in fiscal year 2022 and $2,000,000 in fiscal year 2023
for the commissioner of human services to issue competitive grants to home and
community-based service providers. Grants must be used to provide technology assistance,
including but not limited to Internet services, to older adults and people with disabilities
who do not have access to technology resources necessary to use remote service delivery
and telehealth.new text begin Any unexpended amount in fiscal year 2022 is available through June 30,
2023.
new text end The general fund base included in this act for this purpose is $1,500,000 in fiscal year
2024 and $0 in fiscal year 2025.

(b) All grant activities must be completed by March 31, 2024.

(c) This section expires June 30, 2024.

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.

Laws 2021, First Special Session chapter 7, article 17, section 6, is amended to
read:


Sec. 6. TRANSITION TO COMMUNITY INITIATIVE.

(a) This act includes $5,500,000 in fiscal year 2022 and $5,500,000 in fiscal year 2023
for additional funding for grants awarded under the transition to community initiative
described in Minnesota Statutes, section 256.478.new text begin Any unexpended amount in fiscal year
2022 is available through June 30, 2023.
new text end The general fund base in this act for this purpose
is $4,125,000 in fiscal year 2024 and $0 in fiscal year 2025.

(b) All grant activities must be completed by March 31, 2024.

(c) This section expires June 30, 2024.

new text begin EFFECTIVE DATE. new text end

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

Sec. 8.

Laws 2021, First Special Session chapter 7, article 17, section 10, is amended to
read:


Sec. 10. PROVIDER CAPACITY GRANTS FOR RURAL AND UNDERSERVED
COMMUNITIES.

(a) This act includes $6,000,000 in fiscal year 2022 and $8,000,000 in fiscal year 2023
for the commissioner to establish a grant program for small provider organizations that
provide services to rural or underserved communities with limited home and
community-based services provider capacity. The grants are available to build organizational
capacity to provide home and community-based services in Minnesota and to build new or
expanded infrastructure to access medical assistance reimbursement.new text begin Any unexpended
amount in fiscal year 2022 is available through June 30, 2023.
new text end The general fund base in this
act for this purpose is $8,000,000 in fiscal year 2024 and $0 in fiscal year 2025.

(b) The commissioner shall conduct community engagement, provide technical assistance,
and establish a collaborative learning community related to the grants available under this
section and work with the commissioner of management and budget and the commissioner
of the Department of Administration to mitigate barriers in accessing grant funds. Funding
awarded for the community engagement activities described in this paragraph is exempt
from state solicitation requirements under Minnesota Statutes, section 16B.97, for activities
that occur in fiscal year 2022.

(c) All grant activities must be completed by March 31, 2024.

(d) This section expires June 30, 2024.

new text begin EFFECTIVE DATE. new text end

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

Sec. 9.

Laws 2021, First Special Session chapter 7, article 17, section 11, is amended to
read:


Sec. 11. EXPAND MOBILE CRISIS.

(a) This act includes $8,000,000 in fiscal year 2022 and $8,000,000 in fiscal year 2023
for additional funding for grants for adult mobile crisis services under Minnesota Statutes,
section 245.4661, subdivision 9, paragraph (b), clause (15).new text begin Any unexpended amounts in
fiscal year 2022 and fiscal year 2023 are available through June 30, 2024.
new text end The general fund
base in this act for this purpose is $4,000,000 in fiscal year 2024 and $0 in fiscal year 2025.

(b) Beginning April 1, 2024, counties may fund and continue conducting activities
funded under this section.

(c) All grant activities must be completed by March 31, 2024.

(d) This section expires June 30, 2024.

new text begin EFFECTIVE DATE. new text end

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

Sec. 10.

Laws 2021, First Special Session chapter 7, article 17, section 12, is amended to
read:


Sec. 12. PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY AND CHILD
AND ADOLESCENT MOBILE TRANSITION UNIT.

(a) This act includes $2,500,000 in fiscal year 2022 and $2,500,000 in fiscal year 2023
for the commissioner of human services to create children's mental health transition and
support teams to facilitate transition back to the community of children from psychiatric
residential treatment facilities, and child and adolescent behavioral health hospitals.new text begin Any
unexpended amount in fiscal year 2022 is available through June 30, 2023.
new text end The general
fund base included in this act for this purpose is $1,875,000 in fiscal year 2024 and $0 in
fiscal year 2025.

(b) Beginning April 1, 2024, counties may fund and continue conducting activities
funded under this section.

(c) This section expires March 31, 2024.

new text begin EFFECTIVE DATE. new text end

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

Sec. 11.

Laws 2021, First Special Session chapter 7, article 17, section 17, subdivision 3,
is amended to read:


Subd. 3.

Respite services for older adults grants.

(a) This act includes $2,000,000 in
fiscal year 2022 and $2,000,000 in fiscal year 2023 for the commissioner of human services
to establish a grant program for respite services for older adults. The commissioner must
award grants on a competitive basis to respite service providers.new text begin Any unexpended amount
in fiscal year 2022 is available through June 30, 2023.
new text end The general fund base included in
this act for this purpose is $2,000,000 in fiscal year 2024 and $0 in fiscal year 2025.

(b) All grant activities must be completed by March 31, 2024.

(c) This subdivision expires June 30, 2024.

new text begin EFFECTIVE DATE. new text end

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

Sec. 12.

Laws 2021, First Special Session chapter 7, article 17, section 19, is amended to
read:


Sec. 19. CENTERS FOR INDEPENDENT LIVING HCBS ACCESS GRANT.

(a) This act includes $1,200,000 in fiscal year 2022 and $1,200,000 in fiscal year 2023
for grants to expand services to support people with disabilities from underserved
communities who are ineligible for medical assistance to live in their own homes and
communities by providing accessibility modifications, independent living services, and
public health program facilitation. The commissioner of human services must award the
grants in equal amounts to deleted text beginthe eight organizationsdeleted text endnew text begin grantees. To be eligible, grantees must
be an organization
new text end defined in Minnesota Statutes, section 268A.01, subdivision 8.new text begin Any
unexpended amount in fiscal year 2022 is available through June 30, 2023.
new text end The general
fund base included in this act for this purpose is $0 in fiscal year 2024 and $0 in fiscal year
2025.

(b) All grant activities must be completed by March 31, 2024.

(c) This section expires June 30, 2024.

new text begin EFFECTIVE DATE. new text end

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

ARTICLE 18

APPROPRIATIONS

Section 1. new text beginHEALTH AND HUMAN SERVICES APPROPRIATIONS.
new text end

new text begin The sums shown in the columns marked "Appropriations" are added to or, if shown in
parentheses, subtracted from the appropriations in Laws 2021, First Special Session chapter
7, article 16, to the agencies and for the purposes specified in this article. The appropriations
are from the general fund or other named fund and are available for the fiscal years indicated
for each purpose. The figures "2022" and "2023" used in this article mean that the addition
to or subtraction from the appropriation listed under them is available for the fiscal year
ending June 30, 2022, or June 30, 2023, respectively. Base adjustments mean the addition
to or subtraction from the base level adjustment set in Laws 2021, First Special Session
chapter 7, article 16. Supplemental appropriations and reductions to appropriations for the
fiscal year ending June 30, 2022, are effective the day following final enactment unless a
different effective date is explicit.
new text end

new text begin APPROPRIATIONS
new text end
new text begin Available for the Year
new text end
new text begin Ending June 30
new text end
new text begin 2022
new text end
new text begin 2023
new text end

Sec. 2. new text beginCOMMISSIONER OF HUMAN
SERVICES
new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation
new text end

new text begin $
new text end
new text begin -0-
new text end
new text begin $
new text end
new text begin 161,848,000
new text end
new text begin Appropriations by Fund
new text end
new text begin 2022
new text end
new text begin 2023
new text end
new text begin General
new text end
new text begin -0-
new text end
new text begin 156,951,000
new text end
new text begin Federal TANF
new text end
new text begin -0-
new text end
new text begin 4,897,000
new text end

new text begin Subd. 2. new text end

new text begin Central Office; Operations
new text end

new text begin -0-
new text end
new text begin 1,986,000
new text end

new text begin (a) Supplemental Nutrition Assistance
Program.
The general fund appropriation for
operations in Laws 2021, First Special Session
chapter 7, article 16, section 2, subdivision 3,
is reduced by $8,000 in fiscal year 2022, and
reduced by $2,000 in fiscal year 2023. $8,000
in fiscal year 2022 and $2,000 in fiscal year
2023 are appropriated to implement the
supplemental nutrition assistance gross income
limit increase to 200 percent of the federal
poverty guidelines.
new text end

new text begin (b) Duplicative Background Study
Elimination.
$522,000 is to implement
provisions to eliminate duplicative background
studies. The general fund base for this
appropriation is $334,000 in fiscal year 2024,
$574,000 in fiscal year 2025, $170,000 in
fiscal year 2026, and $170,000 in fiscal year
2027. This paragraph expires July 1, 2027.
new text end

new text begin (c) Base Level Adjustment. The general fund
base is increased by $853,000 in fiscal year
2024 and increased by $1,228,000 in fiscal
year 2025.
new text end

new text begin Subd. 3. new text end

new text begin Central Office; Health Care
new text end

new text begin -0-
new text end
new text begin 80,000
new text end

new text begin Base Level Adjustment. The general fund
base is increased by $89,000 in fiscal year
2024 and increased by $89,000 in fiscal year
2025.
new text end

new text begin Subd. 4. new text end

new text begin Central Office; Continuing Care for
Older Adults
new text end

new text begin -0-
new text end
new text begin 4,498,000
new text end

new text begin (a) Life-Sharing Service Development.
$92,000 in fiscal year 2023 is for engaging
stakeholders and developing recommendations
regarding establishing a life-sharing service
under the state's medical assistance elderly
waiver. This is a onetime appropriation.
new text end

new text begin (b) new text beginBase Level Adjustment.new text end The general fund
base is increased by $326,000 in fiscal year
2024 and increased by $326,000 in fiscal year
2025.
new text end

new text begin Subd. 5. new text end

new text begin Central Office; Community Supports
new text end

new text begin -0-
new text end
new text begin 442,000
new text end

new text begin (a) Life-Sharing Service Development.
$92,000 in fiscal year 2023 is for engaging
stakeholders and developing recommendations
regarding establishing a life-sharing service
under the state's medical assistance disability
waivers. This is a onetime appropriation.
new text end

new text begin (b) Base Level Adjustment. The general fund
base is increased by $119,000 in fiscal year
2024 and increased by $119,000 in fiscal year
2025.
new text end

new text begin Subd. 6. new text end

new text begin Forecasted Programs; MFIP/DWP
new text end

new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin -0-
new text end
new text begin (825,000)
new text end
new text begin Federal TANF
new text end
new text begin -0-
new text end
new text begin 4,689,000
new text end

new text begin MFIP Earned Income Disregard TANF
Allocation.
In fiscal year 2023 the
commissioner shall reduce general fund
expenditures that are TANF eligible
expenditures by $2,216,000 and allocate
$2,216,000 of additional eligible general
expenditures to the federal TANF fund.
new text end

new text begin In fiscal year 2024 the commissioner shall
reduce general fund expenditures that are
TANF eligible expenditures by $2,942,000
and allocate $2,942,000 of additional eligible
general expenditures to the federal TANF
fund. This paragraph expires on July 1, 2025.
new text end

new text begin In fiscal year 2025 the commissioner shall
reduce general fund expenditures that are
TANF eligible expenditures by $2,945,000
and allocate $2,945,000 of additional eligible
general expenditures to the federal TANF
fund. This paragraph expires on July 1, 2025.
new text end

new text begin Subd. 7. new text end

new text begin Forecasted Programs; MFIP Child Care
Assistance
new text end

new text begin -0-
new text end
new text begin 208,000
new text end

new text begin This appropriation is from the federal TANF
fund.
new text end

new text begin Subd. 8. new text end

new text begin Forecasted Programs; General
Assistance
new text end

new text begin -0-
new text end
new text begin 35,000
new text end

new text begin Subd. 9. new text end

new text begin Forecasted Programs; Housing Support
new text end

new text begin -0-
new text end
new text begin 896,000
new text end

new text begin Subd. 10. new text end

new text begin Forecasted Programs; Medical
Assistance
new text end

new text begin -0-
new text end
new text begin 143,214,000
new text end

new text begin new text begin Base Level Adjustment.new text end The health care
access fund base is increased by $147,103,000
in fiscal year 2024 only.
new text end

new text begin Subd. 11. new text end

new text begin Forecasted Programs; Alternative
Care
new text end

new text begin -0-
new text end
new text begin 492,000
new text end

new text begin Subd. 12. new text end

new text begin Grant Programs; Children and
Economic Support Grants
new text end

new text begin -0-
new text end
new text begin 525,000
new text end

new text begin (a) Community Organizations Grants.
$100,000 in fiscal year 2023 is for community
organizations grants under Minnesota Statutes,
section 256.4791.
new text end

new text begin (b) Quality Parenting Initiative. $100,000
in fiscal year 2023 is for a grant to Quality
Parenting Initiative Minnesota.
new text end

new text begin (c) Minnesota Association for Volunteer
Administration.
$100,000 in fiscal year 2023
is for a grant to the Minnesota Association for
Volunteer Administration to award subgrants
to needs-based volunteerism subgrants
targeting under-resourced nonprofit
organizations in greater Minnesota to support
selected organizations' ongoing efforts to
address and minimize disparities in access to
human services through increased
volunteerism. Successful subgrant applicants
must demonstrate that the populations to be
served by the subgrantee are underserved or
are homeless or are at risk of homelessness,
hunger, poverty, or lack of access to health
care. The Minnesota Association for Volunteer
Administration shall give priority to
organizations that serve the needs of
vulnerable populations. By December 15 of
each year the Minnesota Association for
Volunteer Administration shall report data on
outcomes from the subgrants and
recommendations for improving and
sustaining volunteer efforts statewide to the
chairs and ranking minority members of the
legislative committees with jurisdiction over
human services.
new text end

new text begin Subd. 13. new text end

new text begin Grant Programs; Other Long-Term
Care Grants
new text end

new text begin -0-
new text end
new text begin 6,166,000
new text end

new text begin Residential Setting Closure Prevention
Grants.
$6,166,000 is for residential setting
closure prevention grants under Minnesota
Statutes, section 256.4795. The general fund
base for this appropriation is $6,671,000 in
fiscal year 2024 and $6,671,000 in fiscal year
2025.
new text end

new text begin Subd. 14. new text end

new text begin Grant Programs; Disabilities Grants
new text end

new text begin -0-
new text end
new text begin (811,000)
new text end

new text begin Subd. 15. new text end

new text begin Grant Programs; Chemical
Dependency Treatment Support Grants
new text end

new text begin -0-
new text end
new text begin 253,000
new text end

new text begin (a) Olmsted County Recovery Community
Organization.
$100,000 in fiscal year 2023
is for a grant to a recovery community
organization in Olmsted County, located in
the city of Rochester, that provides services
in an 11-county region.
new text end

new text begin (b) Rochester Nonprofit Recovery
Community Organization.
$53,000 in fiscal
year 2023 is for a grant to a nonprofit recovery
community organization located in Rochester,
Minnesota, that provides pretreatment housing,
post-treatment recovery housing, treatment
coordination, and peer recovery support to
individuals pursuing a life of recovery from
substance use disorders, and that also offers a
recovery coaching academy to individuals
interested in becoming peer recovery
specialists. The general fund base for this
appropriation is $55,000 in fiscal year 2024
and $55,000 in fiscal year 2025.
new text end

new text begin (c) Wellness in the Woods. $100,000 in fiscal
year 2023 is for a grant to Wellness in the
Woods.
new text end

new text begin (d) new text beginBase Level Adjustment.new text end The general fund
base is decreased by $495,000 in fiscal year
2024 and decreased by $495,000 in fiscal year
2025.
new text end

Sec. 3. new text beginCOMMISSIONER OF HEALTH
new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation
new text end

new text begin $
new text end
new text begin -0-
new text end
new text begin $
new text end
new text begin 412,000
new text end
new text begin Appropriations by Fund
new text end
new text begin 2022
new text end
new text begin 2023
new text end
new text begin General
new text end
new text begin -0-
new text end
new text begin 309,000
new text end
new text begin State Government
Special Revenue
new text end
new text begin -0-
new text end
new text begin 103,000
new text end

new text begin Subd. 2. new text end

new text begin Health Improvement
new text end

new text begin -0-
new text end
new text begin -0-
new text end

new text begin Base Level Adjustment; Fetal Alcohol
Spectrum Disorders Prevention Grants.

The general fund base for fetal alcohol
spectrum disorders prevention grants under
Minnesota Statutes, section 145.267, is
increased by $750,000 in fiscal year 2024 and
increased by $750,000 in fiscal year 2025.
new text end

new text begin Subd. 3. new text end

new text begin Health Protection
new text end

new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin -0-
new text end
new text begin 309,000
new text end
new text begin State Government
Special Revenue
new text end
new text begin -0-
new text end
new text begin 103,000
new text end

new text begin (a) Submerged Closed Loop Heat
Exchanger Regulation.
$103,000 in fiscal
year 2023 is from the state government special
revenue fund to implement submerged closed
loop heat exchanger requirements under
Minnesota Statutes, section 103I.631. The
state government special revenue fund base
for this appropriation is $86,000 in fiscal year
2024 and $86,000 in fiscal year 2025.
new text end

new text begin (b) Audiology and Speech-Language
Pathology Interstate Compact.
$309,000 in
fiscal year 2023 is from the general fund to
implement the audiology and speech-language
pathology interstate compact under Minnesota
Statutes, section 148.5185. The general fund
base for this appropriation is $63,000 in fiscal
year 2024 and $63,000 in fiscal year 2025.
new text end

new text begin (c) Base Level Adjustments. The general
fund base is increased by $63,000 in fiscal
year 2024 and increased by $63,000 in fiscal
year 2025. The state government special
revenue fund base is increased by $86,000 in
fiscal year 2024 and increased by $86,000 in
fiscal year 2025.
new text end

Sec. 4. new text beginHEALTH-RELATED BOARDS
new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation
new text end

new text begin $
new text end
new text begin -0-
new text end
new text begin $
new text end
new text begin 200,000
new text end

new text begin This appropriation is from the state
government special revenue fund. The
amounts that may be spent for each purpose
are specified in the following subdivisions.
new text end

new text begin Subd. 2. new text end

new text begin Board of Nursing
new text end

new text begin -0-
new text end
new text begin 157,000
new text end

new text begin Nurse Licensure Compact Implementation.
$157,000 in fiscal year 2023 is to implement
the nurse licensure compact under Minnesota
Statutes, section 148.2855. The base for this
appropriation is $6,000 in fiscal year 2024 and
$6,000 in fiscal year 2025.
new text end

new text begin Subd. 3. new text end

new text begin Board of Behavioral Health and
Therapy
new text end

new text begin -0-
new text end
new text begin 43,000
new text end

new text begin $43,000 in fiscal year 2023 is to implement
the interstate compact for professional
counselors. The state government special
revenue fund base for this appropriation is
$23,000 in fiscal year 2024 and $23,000 in
fiscal year 2025.
new text end

Sec. 5. new text beginPROFESSIONAL EDUCATOR
LICENSING STANDARDS BOARD
new text end

new text begin $
new text end
new text begin -0-
new text end
new text begin $
new text end
new text begin 82,000
new text end

new text begin Audiology and Speech-Language Pathology
Interstate Compact.
$82,000 in fiscal year
2023 is to implement the audiology and
speech-language pathology interstate compact
under Minnesota Statutes, section 148.5185.
The general fund base for this appropriation
is $57,000 in fiscal year 2024 and $57,000 in
fiscal year 2025.
new text end

Sec. 6.

Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 1, is
amended to read:


Subdivision 1.

Total Appropriation

$
8,356,760,000
$
deleted text begin 9,803,181,000 deleted text end new text begin
9,802,370,000
new text end
Appropriations by Fund
2022
2023
General
7,295,463,000
deleted text begin 8,951,733,000 deleted text end new text begin
8,950,922,000
new text end
State Government
Special Revenue
4,299,000
4,299,000
Health Care Access
769,889,000
564,448,000
Federal TANF
282,653,000
278,245,000
Lottery Prize
1,896,000
1,896,000
Opiate Epidemic
Response
2,560,000
2,560,000

The amounts that may be spent for each
purpose are specified in the following
subdivisions.

Sec. 7.

Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 24,
is amended to read:


Subd. 24.

Grant Programs; Children and
Economic Support Grants

29,740,000
29,740,000

new text begin (a) new text endMinnesota Food Assistance Program.
Unexpended funds for the Minnesota food
assistance program for fiscal year 2022 do not
cancel but are available in fiscal year 2023.

new text begin (b) Provider Repair or Improvement
Grants.
$1,000,000 in fiscal year 2022 and
$1,000,000 in fiscal year 2023 are for provider
repair or improvement grants under Minnesota
Statutes, section 256K.45, subdivision 8. The
amounts in this paragraph are available until
June 30, 2025. This paragraph expires July 1,
2025.
new text end

Sec. 8.

Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 29,
is amended to read:


Subd. 29.

Grant Programs; Disabilities Grants

31,398,000
deleted text begin 31,010,000 deleted text end new text begin
30,199,000
new text end

(a) Training Stipends for Direct Support
Services Providers.
$1,000,000 in fiscal year
2022 is from the general fund for stipends for
individual providers of direct support services
as defined in Minnesota Statutes, section
256B.0711, subdivision 1. These stipends are
available to individual providers who have
completed designated voluntary trainings
made available through the State-Provider
Cooperation Committee formed by the State
of Minnesota and the Service Employees
International Union Healthcare Minnesota.
Any unspent appropriation in fiscal year 2022
is available in fiscal year 2023. This is a
onetime appropriation. This appropriation is
available only if the labor agreement between
the state of Minnesota and the Service
Employees International Union Healthcare
Minnesota under Minnesota Statutes, section
179A.54, is approved under Minnesota
Statutes, section 3.855.

(b) Parent-to-Parent Peer Support. $125,000
in fiscal year 2022 and $125,000 in fiscal year
2023 are from the general fund for a grant to
an alliance member of Parent to Parent USA
to support the alliance member's
parent-to-parent peer support program for
families of children with a disability or special
health care need.

(c) Self-Advocacy Grants. (1) $143,000 in
fiscal year 2022 and $143,000 in fiscal year
2023 are from the general fund for a grant
under Minnesota Statutes, section 256.477,
subdivision 1
.

(2) $105,000 in fiscal year 2022 and $105,000
in fiscal year 2023 are from the general fund
for subgrants under Minnesota Statutes,
section 256.477, subdivision 2.

(d) Minnesota Inclusion Initiative Grants.
$150,000 in fiscal year 2022 and $150,000 in
fiscal year 2023 are from the general fund for
grants under Minnesota Statutes, section
256.4772.

(e) Grants to Expand Access to Child Care
for Children with Disabilities.
$250,000 in
fiscal year 2022 and $250,000 in fiscal year
2023 are from the general fund for grants to
expand access to child care for children with
disabilities. This is a onetime appropriation.

(f) Parenting with a Disability Pilot Project.
The general fund base includes $1,000,000 in
fiscal year 2024 and $0 in fiscal year 2025 to
implement the parenting with a disability pilot
project.

(g) Base Level Adjustment. The general fund
base is deleted text begin$29,260,000deleted text endnew text begin $28,449,000new text end in fiscal year
2024 and deleted text begin$22,260,000deleted text endnew text begin $21,449,000new text end in fiscal
year 2025.

Sec. 9.

Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 33,
is amended to read:


Subd. 33.

Grant Programs; Chemical
Dependency Treatment Support Grants

Appropriations by Fund
General
4,273,000
4,274,000
Lottery Prize
1,733,000
1,733,000
Opiate Epidemic
Response
500,000
500,000

(a) Problem Gambling. $225,000 in fiscal
year 2022 and $225,000 in fiscal year 2023
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,
training for individuals and organizations
providing effective treatment services to
problem gamblers and their families, and
research related to problem gambling.

(b) Recovery Community Organization
Grants.
$2,000,000 in fiscal year 2022 and
$2,000,000 in fiscal year 2023 are from the
general fund for grants to recovery community
organizations, as defined in Minnesota
Statutes, section 254B.01, subdivision 8, to
provide for costs and community-based peer
recovery support services that are not
otherwise eligible for reimbursement under
Minnesota Statutes, section 254B.05, as part
of the continuum of care for substance use
disorders. The general fund base for this
appropriation is $2,000,000 in fiscal year 2024
and $0 in fiscal year 2025

(c) new text beginGrant to Anoka County for Enhanced
Treatment Program.
new text end
new text begin $125,000 in fiscal year
2023 is from the general fund for a grant to
Anoka County for an enhanced treatment
program for substance use disorder. This
paragraph does not expire.
new text end

new text begin (d) new text endBase Level Adjustment. The general fund
base is $4,636,000 in fiscal year 2024 and
$2,636,000 in fiscal year 2025. The opiate
epidemic response fund base is $500,000 in
fiscal year 2024 and $0 in fiscal year 2025.

Sec. 10.

Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 33,
is amended to read:


Subd. 33.

Grant Programs; Chemical
Dependency Treatment Support Grants

Appropriations by Fund
General
4,273,000
4,274,000
Lottery Prize
1,733,000
1,733,000
Opiate Epidemic
Response
500,000
500,000

(a) Problem Gambling. $225,000 in fiscal
year 2022 and $225,000 in fiscal year 2023
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,
training for individuals and organizations
providing effective treatment services to
problem gamblers and their families, and
research related to problem gambling.

(b) Recovery Community Organization
Grants.
$2,000,000 in fiscal year 2022 and
$2,000,000 in fiscal year 2023 are from the
general fund for grants to recovery community
organizations, as defined in Minnesota
Statutes, section 254B.01, subdivision 8, to
provide for costs and community-based peer
recovery support services that are not
otherwise eligible for reimbursement under
Minnesota Statutes, section 254B.05, as part
of the continuum of care for substance use
disorders. The general fund base for this
appropriation is $2,000,000 in fiscal year 2024
and $0 in fiscal year 2025

(c) Base Level Adjustment. The general fund
base is deleted text begin$4,636,000deleted text endnew text begin $3,886,000new text end in fiscal year
2024 and deleted text begin$2,636,000deleted text endnew text begin $1,886,000new text end in fiscal year
2025. The opiate epidemic response fund base
is $500,000 in fiscal year 2024 and $0 in fiscal
year 2025.

Sec. 11.

Laws 2021, First Special Session chapter 7, article 16, section 5, is amended to
read:


Sec. 5. EMERGENCY MEDICAL SERVICES
REGULATORY BOARD

$
4,780,000
$
4,576,000

(a) Cooper/Sams Volunteer Ambulance
Program.
$950,000 in fiscal year 2022 and
$950,000 in fiscal year 2023 are for the
Cooper/Sams volunteer ambulance program
under Minnesota Statutes, section 144E.40.

(1) Of this amount, $861,000 in fiscal year
2022 and $861,000 in fiscal year 2023 are for
the ambulance service personnel longevity
award and incentive program under Minnesota
Statutes, section 144E.40.

(2) Of this amount, $89,000 in fiscal year 2022
and $89,000 in fiscal year 2023 are for the
operations of the ambulance service personnel
longevity award and incentive program under
Minnesota Statutes, section 144E.40.

(b) EMSRB Operations. $1,880,000 in fiscal
year 2022 and $1,880,000 in fiscal year 2023
are for board operations.

deleted text begin (c) Regional Grants for Continuing
Education.
$585,000 in fiscal year 2022 and
$585,000 in fiscal year 2023 are for regional
emergency medical services programs, to be
distributed equally to the eight emergency
medical service regions under Minnesota
Statutes, section 144E.52.
deleted text end

deleted text begin (d) deleted text enddeleted text beginRegional Grants for Local and Regional
Emergency Medical Services
deleted text endnew text begin (c) Emergency
Medical Services Fund
new text end.
deleted text begin$800,000deleted text endnew text begin $1,385,000new text end
in fiscal year 2022 and deleted text begin$800,000deleted text endnew text begin $1,385,000new text end
in fiscal year 2023 are for distribution tonew text begin
regional
new text end emergency medical services deleted text beginregionsdeleted text endnew text begin
systems
new text end for deleted text beginregional emergency medical
services programs
deleted text endnew text begin the purposesnew text end specified in
Minnesota Statutes, section 144E.50.
Notwithstanding Minnesota Statutes, section
144E.50, subdivision 5, in each year the board
shall distribute the appropriation equally
among the eight emergency medical services
deleted text begin regionsdeleted text endnew text begin systems designated by the boardnew text end. deleted text beginThis
is a onetime appropriation
deleted text endnew text begin The general fund
base for this appropriation is $585,000 in fiscal
year 2024 and $585,000 in fiscal year 2025
new text end.

deleted text begin (e)deleted text endnew text begin (d)new text end Ambulance Training Grants.
$565,000 in fiscal year 2022 and $361,000 in
fiscal year 2023 are for training grants under
Minnesota Statutes, section 144E.35.

deleted text begin (f)deleted text endnew text begin (e)new text end Base Level Adjustment. The general
fund base is $3,776,000 in fiscal year 2024
and $3,776,000 in fiscal year 2025.

new text begin EFFECTIVE DATE. new text end

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

Sec. 12.

Laws 2022, chapter 40, section 7, is amended to read:


Sec. 7. APPROPRIATION; TEMPORARY STAFFING POOL.

deleted text begin $1,029,000deleted text endnew text begin $5,145,000new text end in fiscal year 2022 is appropriated from the general fund to the
commissioner of human services for the temporary staffing pool described in this act. This
is a onetime appropriation and is available until June 30, deleted text begin2022deleted text endnew text begin 2023new text end.

APPENDIX

Repealed Minnesota Statutes: S4410-3

62U.10 HEALTH CARE TRANSFER, SAVINGS, AND REPAYMENT.

Subd. 3.

Actual spending and savings determination.

By June 1, 2010, and each June 1 thereafter until June 1, 2020, the commissioner of health shall determine the actual total private and public health care spending for residents of this state for the calendar year two years before the current calendar year, based on data collected under chapter 62J, and shall determine the difference between the projected spending, as determined under subdivision 2, and the actual spending for that year. The actual spending must be certified by an independent actuarial consultant. If the actual spending is less than the projected spending, the commissioner shall determine, based on the proportion of spending for state-administered health care programs to total private and public health care spending for the calendar year two years before the current calendar year, the percentage of the calculated aggregate savings amount accruing to state-administered health care programs.

136A.29 POWERS; DUTIES.

Subd. 4.

Mutual agreement; staff, equipment, office space.

By mutual agreement between the authority and the office, authority staff employees may also be members of the office staff. By mutual agreement, authority employees may be provided office space in the office of the Office of Higher Education, and said employees may make use of equipment, supplies, and office space, provided that the authority fully reimburses the office for salaries and for space, equipment, supplies, and materials used. In the absence of such mutual agreement between the authority and the office, the authority may maintain an office at such place or places as it may designate.

144.1911 INTERNATIONAL MEDICAL GRADUATES ASSISTANCE PROGRAM.

Subd. 10.

Report.

The commissioner shall submit an annual report to the chairs and ranking minority members of the legislative committees with jurisdiction over health care and higher education on the progress of the integration of international medical graduates into the Minnesota health care delivery system. The report shall include recommendations on actions needed for continued progress integrating international medical graduates. The report shall be submitted by January 15 each year, beginning January 15, 2016.

144.564 MONITORING OF SUBACUTE OR TRANSITIONAL CARE SERVICES.

Subd. 3.

Annual report.

The commissioner shall monitor the provision of services described in this section and shall report annually to the legislature concerning these services, including recommendations on the need for legislation.

144A.483 AGENCY QUALITY IMPROVEMENT PROGRAM.

Subd. 2.

Study of correction order appeal process.

Starting July 1, 2015, the commissioner shall study whether to add a correction order appeal process conducted by an independent reviewer such as an administrative law judge or other office and submit a report to the legislature by February 1, 2016. The commissioner shall review home care regulatory systems in other states as part of that study. The commissioner shall consult with the home care providers and representatives.

147.02 EXAMINATION; LICENSING.

Subd. 2a.

Temporary permit.

The board may issue a temporary permit to practice medicine to a physician eligible for licensure under this section only if the application for licensure is complete, all requirements in subdivision 1 have been met, and a nonrefundable fee set by the board has been paid. The permit remains valid only until the meeting of the board at which a decision is made on the physician's application for licensure.

169A.70 ALCOHOL SAFETY PROGRAMS; CHEMICAL USE ASSESSMENTS.

Subd. 6.

Method of assessment.

(a) As used in this subdivision, "collateral contact" means an oral or written communication initiated by an assessor for the purpose of gathering information from an individual or agency, other than the offender, to verify or supplement information provided by the offender during an assessment under this section. The term includes contacts with family members and criminal justice agencies.

(b) An assessment conducted under this section must include at least one personal interview with the offender designed to make a determination about the extent of the offender's past and present chemical and alcohol use or abuse. It must also include collateral contacts and a review of relevant records or reports regarding the offender including, but not limited to, police reports, arrest reports, driving records, chemical testing records, and test refusal records. If the offender has a probation officer, the officer must be the subject of a collateral contact under this subdivision. If an assessor is unable to make collateral contacts, the assessor shall specify why collateral contacts were not made.

245.981 COMPULSIVE GAMBLING ANNUAL REPORT.

(a) Each year by February 15, 2014, and thereafter, the commissioner of human services shall report to the chairs and ranking minority members of the legislative committees having jurisdiction over compulsive gambling on the percentage of gambling revenues that come from gamblers identified as problem gamblers, or a similarly defined term, as defined by the National Council on Problem Gambling. The report must disaggregate the revenue by the various types of gambling, including, but not limited to: lottery; electronic and paper pull-tabs; bingo; linked bingo; and pari-mutuel betting.

(b) By February 15, 2013, the commissioner shall provide a preliminary update for the report required under paragraph (a) to the chairs and ranking minority members of the legislative committees having jurisdiction over compulsive gambling and the estimated cost of the full report.

245G.22 OPIOID TREATMENT PROGRAMS.

Subd. 19.

Placing authorities.

A program must provide certain notification and client-specific updates to placing authorities for a client who is enrolled in Minnesota health care programs. At the request of the placing authority, the program must provide client-specific updates, including but not limited to informing the placing authority of positive drug testings and changes in medications used for the treatment of opioid use disorder ordered for the client.

246.0136 ESTABLISHING ENTERPRISE ACTIVITIES IN STATE-OPERATED SERVICES.

Subdivision 1.

Planning for enterprise activities.

The commissioner of human services is directed to study and make recommendations to the legislature on establishing enterprise activities within state-operated services. Before implementing an enterprise activity, the commissioner must obtain statutory authorization for its implementation, except that the commissioner has authority to implement enterprise activities for adult mental health, adolescent services, and to establish a public group practice without statutory authorization. Enterprise activities are defined as the range of services, which are delivered by state employees, needed by people with disabilities and are fully funded by public or private third-party health insurance or other revenue sources available to clients that provide reimbursement for the services provided. Enterprise activities within state-operated services shall specialize in caring for vulnerable people for whom no other providers are available or for whom state-operated services may be the provider selected by the payer. In subsequent biennia after an enterprise activity is established within a state-operated service, the base state appropriation for that state-operated service shall be reduced proportionate to the size of the enterprise activity.

Subd. 2.

Required components of any proposal; considerations.

In any proposal for an enterprise activity brought to the legislature by the commissioner, the commissioner must demonstrate that there is public or private third-party health insurance or other revenue available to the people served, that the anticipated revenues to be collected will fully fund the services, that there will be sufficient funds for cash flow purposes, and that access to services by vulnerable populations served by state-operated services will not be limited by implementation of an enterprise activity. In studying the feasibility of establishing an enterprise activity, the commissioner must consider:

(1) creating public or private partnerships to facilitate client access to needed services;

(2) administrative simplification and efficiencies throughout the state-operated services system;

(3) converting or disposing of buildings not utilized and surplus lands; and

(4) exploring the efficiencies and benefits of establishing state-operated services as an independent state agency.

246.131 REPORT ON ANOKA-METRO REGIONAL TREATMENT CENTER (AMRTC), MINNESOTA SECURITY HOSPITAL (MSH), AND COMMUNITY BEHAVIORAL HEALTH HOSPITALS (CBHH).

The commissioner of human services shall issue a public quarterly report to the chairs and ranking minority leaders of the senate and house of representatives committees having jurisdiction over health and human services issues on the AMRTC, MSH, and CBHH. The report shall contain information on the number of licensed beds, budgeted capacity, occupancy rate, number of Occupational Safety and Health Administration (OSHA) recordable injuries and the number of OSHA recordable injuries due to patient aggression or restraint, number of clinical positions budgeted, the percentage of those positions that are filled, the number of direct care positions budgeted, and the percentage of those positions that are filled.

246B.03 LICENSURE, EVALUATION, AND GRIEVANCE RESOLUTION.

Subd. 2.

Minnesota Sex Offender Program evaluation.

(a) The commissioner shall contract with national sex offender experts to evaluate the sex offender treatment program. The consultant group shall consist of four national experts, including:

(1) three experts who are licensed psychologists, psychiatrists, clinical therapists, or other mental health treatment providers with established and recognized training and experience in the assessment and treatment of sexual offenders; and

(2) one nontreatment professional with relevant training and experience regarding the oversight or licensing of sex offender treatment programs or other relevant mental health treatment programs.

(b) These experts shall, in consultation with the executive clinical director of the sex offender treatment program:

(1) review and identify relevant information and evidence-based best practices and methodologies for effectively assessing, diagnosing, and treating civilly committed sex offenders;

(2) on at least an annual basis, complete a site visit and comprehensive program evaluation that may include a review of program policies and procedures to determine the program's level of compliance, address specific areas of concern brought to the panel's attention by the executive clinical director or executive director, offer recommendations, and complete a written report of its findings to the executive director and clinical director; and

(3) in addition to the annual site visit and review, provide advice, input, and assistance as requested by the executive clinical director or executive director.

(c) The commissioner or commissioner's designee shall enter into contracts as necessary to fulfill the responsibilities under this subdivision.

246B.035 ANNUAL PERFORMANCE REPORT REQUIRED.

The executive director of the Minnesota Sex Offender Program shall submit electronically a performance report to the chairs and ranking minority members of the legislative committees and divisions with jurisdiction over funding for the program by February 15 of each year beginning in 2017. The report must include the following:

(1) a description of the program, including the strategic mission, goals, objectives, and outcomes;

(2) the programwide per diem reported in a standard calculated method as outlined in the program policies and procedures;

(3) program annual statistics as outlined in the departmental policies and procedures; and

(4) the sex offender program evaluation report required under section 246B.03. The executive director shall submit a printed copy upon request.

252.025 STATE HOSPITALS FOR PERSONS WITH DEVELOPMENTAL DISABILITIES.

Subd. 7.

Minnesota extended treatment options.

The commissioner shall develop by July 1, 1997, the Minnesota extended treatment options to serve Minnesotans who have developmental disabilities and exhibit severe behaviors which present a risk to public safety. This program is statewide and must provide specialized residential services in Cambridge and an array of community-based services with sufficient levels of care and a sufficient number of specialists to ensure that individuals referred to the program receive the appropriate care. The individuals working in the community-based services under this section are state employees supervised by the commissioner of human services. No layoffs shall occur as a result of restructuring under this section.

252.035 REGIONAL TREATMENT CENTER CATCHMENT AREAS.

The commissioner may administratively designate catchment areas for regional treatment centers and state nursing homes. Catchment areas may vary by client group served. Catchment areas in effect on January 1, 1989, may not be modified until the commissioner has consulted with the regional planning committees of the affected regional treatment centers.

254A.02 DEFINITIONS.

Subd. 8a.

Placing authority.

"Placing authority" means a county, prepaid health plan, or tribal governing board governed by Minnesota Rules, parts 9530.6600 to 9530.6655.

254A.04 CITIZENS ADVISORY COUNCIL.

There is hereby created an Alcohol and Other Drug Abuse Advisory Council to advise the Department of Human Services concerning the problems of substance misuse and substance use disorder, composed of ten members. Five members shall be individuals whose interests or training are in the field of alcohol-specific substance use disorder and alcohol misuse; and five members whose interests or training are in the field of substance use disorder and misuse of substances other than alcohol. The terms, compensation and removal of members shall be as provided in section 15.059. The council expires June 30, 2018. The commissioner of human services shall appoint members whose terms end in even-numbered years. The commissioner of health shall appoint members whose terms end in odd-numbered years.

254A.16 RESPONSIBILITIES OF THE COMMISSIONER.

Subd. 6.

Monitoring.

The commissioner shall gather and placing authorities shall provide information to measure compliance with Minnesota Rules, parts 9530.6600 to 9530.6655. The commissioner shall specify the format for data collection to facilitate tracking, aggregating, and using the information.

254A.19 CHEMICAL USE ASSESSMENTS.

Subd. 1a.

Emergency room patients.

A county may enter into a contract with a hospital to provide chemical use assessments under Minnesota Rules, parts 9530.6600 to 9530.6655, for patients admitted to an emergency room or inpatient hospital when:

(1) an assessor is not available; and

(2) detoxification services in the county are at full capacity.

Subd. 2.

Probation officer as contact.

When a chemical use assessment is required under Minnesota Rules, parts 9530.6600 to 9530.6655, for a person who is on probation or under other correctional supervision, the assessor, either orally or in writing, shall contact the person's probation officer to verify or supplement the information provided by the person.

Subd. 5.

Assessment via telehealth.

Notwithstanding Minnesota Rules, part 9530.6615, subpart 3, item A, a chemical use assessment may be conducted via telehealth as defined in section 256B.0625, subdivision 3b.

254A.21 FETAL ALCOHOL SPECTRUM DISORDERS PREVENTION GRANTS.

(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).

(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.

(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.

(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.

254B.04 ELIGIBILITY FOR BEHAVIORAL HEALTH FUND SERVICES.

Subd. 2b.

Eligibility for placement in opioid treatment programs.

Prior to placement of an individual who is determined by the assessor to require treatment for opioid addiction, the assessor must provide educational information concerning treatment options for opioid addiction, including the use of a medication for the use of opioid addiction. The commissioner shall develop educational materials supported by research and updated periodically that must be used by assessors to comply with this requirement.

Subd. 2c.

Eligibility to receive peer recovery support and treatment service coordination.

Notwithstanding Minnesota Rules, part 9530.6620, subpart 6, a placing authority may authorize peer recovery support and treatment service coordination for a person who scores a severity of one or more in dimension 4, 5, or 6, under Minnesota Rules, part 9530.6622. Authorization for peer recovery support and treatment service coordination under this subdivision does not need to be provided in conjunction with treatment services under Minnesota Rules, part 9530.6622, subpart 4, 5, or 6.

254B.041 CHEMICAL DEPENDENCY RULES.

Subd. 2.

Vendor collections; rule amendment.

The commissioner may amend Minnesota Rules, parts 9530.7000 to 9530.7025, to require a vendor of chemical dependency transitional and extended care rehabilitation services to collect the cost of care received under a program from an eligible person who has been determined to be partially responsible for treatment costs, and to remit the collections to the commissioner. The commissioner shall pay to a vendor, for the collections, an amount equal to five percent of the collections remitted to the commissioner by the vendor.

254B.14 CONTINUUM OF CARE PILOT PROJECTS; CHEMICAL HEALTH CARE.

Subdivision 1.

Authorization for continuum of care pilot projects.

The commissioner shall establish chemical dependency continuum of care pilot projects to begin implementing the measures developed with stakeholder input and identified in the report completed pursuant to Laws 2012, chapter 247, article 5, section 8. The pilot projects are intended to improve the effectiveness and efficiency of the service continuum for chemically dependent individuals in Minnesota while reducing duplication of efforts and promoting scientifically supported practices.

Subd. 2.

Program implementation.

(a) The commissioner, in coordination with representatives of the Minnesota Association of County Social Service Administrators and the Minnesota Inter-County Association, shall develop a process for identifying and selecting interested counties and providers for participation in the continuum of care pilot projects. There shall be three pilot projects: one representing the northern region, one for the metro region, and one for the southern region. The selection process of counties and providers must include consideration of population size, geographic distribution, cultural and racial demographics, and provider accessibility. The commissioner shall identify counties and providers that are selected for participation in the continuum of care pilot projects no later than September 30, 2013.

(b) The commissioner and entities participating in the continuum of care pilot projects shall enter into agreements governing the operation of the continuum of care pilot projects. The agreements shall identify pilot project outcomes and include timelines for implementation and beginning operation of the pilot projects.

(c) Entities that are currently participating in the navigator pilot project are eligible to participate in the continuum of care pilot project subsequent to or instead of participating in the navigator pilot project.

(d) The commissioner may waive administrative rule requirements that are incompatible with implementation of the continuum of care pilot projects.

(e) Notwithstanding section 254A.19, the commissioner may designate noncounty entities to complete chemical use assessments and placement authorizations required under section 254A.19 and Minnesota Rules, parts 9530.6600 to 9530.6655. Section 254A.19, subdivision 3, is applicable to the continuum of care pilot projects at the discretion of the commissioner.

Subd. 3.

Program design.

(a) The operation of the pilot projects shall include:

(1) new services that are responsive to the chronic nature of substance use disorder;

(2) telehealth services, when appropriate to address barriers to services;

(3) services that assure integration with the mental health delivery system when appropriate;

(4) services that address the needs of diverse populations; and

(5) an assessment and access process that permits clients to present directly to a service provider for a substance use disorder assessment and authorization of services.

(b) Prior to implementation of the continuum of care pilot projects, a utilization review process must be developed and agreed to by the commissioner, participating counties, and providers. The utilization review process shall be described in the agreements governing operation of the continuum of care pilot projects.

Subd. 4.

Notice of project discontinuation.

Each entity's participation in the continuum of care pilot project may be discontinued for any reason by the county or the commissioner after 30 days' written notice to the entity.

Subd. 5.

Duties of commissioner.

(a) Notwithstanding any other provisions in this chapter, the commissioner may authorize the behavioral health fund to pay for nontreatment services arranged by continuum of care pilot projects. Individuals who are currently accessing Rule 31 treatment services are eligible for concurrent participation in the continuum of care pilot projects.

(b) County expenditures for continuum of care pilot project services shall not be greater than their expected share of forecasted expenditures in the absence of the continuum of care pilot projects.

Subd. 6.

Managed care.

An individual who is eligible for the continuum of care pilot project is excluded from mandatory enrollment in managed care unless these services are included in the health plan's benefit set.

256.01 COMMISSIONER OF HUMAN SERVICES; POWERS, DUTIES.

Subd. 31.

Consumer satisfaction; human services.

(a) The commissioner of human services shall submit a memorandum each year to the governor and the chairs of the house of representatives and senate standing committees with jurisdiction over the department's programs that provides the following information:

(1) the number of calls made to each of the department's help lines by consumers and citizens regarding the services provided by the department;

(2) the program area related to the call;

(3) the number of calls resolved at the department;

(4) the number of calls that were referred to a county agency for resolution;

(5) the number of calls that were referred elsewhere for resolution;

(6) the number of calls that remain open; and

(7) the number of calls that were without merit.

(b) The initial memorandum shall be submitted no later than February 15, 2012, with subsequent memoranda submitted no later than February 15 each following year.

(c) The commissioner shall publish the annual memorandum on the department's website each year no later than March 1.

256B.0638 OPIOID PRESCRIBING IMPROVEMENT PROGRAM.

Subd. 7.

Annual report to legislature.

By September 15, 2016, and annually thereafter, the commissioner of human services shall report to the legislature on the implementation of the opioid prescribing improvement program in the Minnesota health care programs. The report must include data on the utilization of opioids within the Minnesota health care programs.

Repealed Minnesota Session Laws: S4410-3

Laws 1998, chapter 382, article 1, section 23

Sec. 23.

Laws 1995, chapter 257, article 1, section 34, is amended to read:


Sec. 34. new text beginREPORT.new text end

new text begin(a) new text endThe commissioner new text beginof human services new text endshall evaluate all child support programs and enforcement mechanismsdeleted text begin. The evaluation must include a cost-benefit analysis of each program or enforcement mechanism, and information related to which programs produce the highest revenue, reduce arrears, avoid litigation, and result in the best outcome for children and their parents.deleted text end

deleted text begin The reports related to the provisions in this chapter are due two years after the implementation date. All other reports on existing programs and enforcement mechanisms are due January 15, 1997 deleted text end new text begin to determine the following: new text end

new text begin (1) Minnesota's performance on the child support and incentive measures submitted by the federal Office of Child Support to the United States Congress; new text end

new text begin (2) Minnesota's performance relative to other states; new text end

new text begin (3) individual county performance; and new text end

new text begin (4) recommendations for further improvement. new text end

new text begin (b) The commissioner shall evaluate in separate categories the federal, state, and local government costs of child support enforcement in this state. The evaluation must also include a representative sample of private business costs relating to child support enforcement based on a survey of at least 50 Minnesota businesses and nonprofit organizations. new text end

new text begin (c) The commissioner shall also report on the amount of child support arrearages in this state with separate categories for the amount of child support in arrears for 90 days, six months, one year, and two or more years. The report must establish a process for determining when an arrearage is considered uncollectible based on the age of the arrearage and likelihood of collection of the amount owed. The amounts determined to be uncollectible must be deducted from the total amount of outstanding arrearages for purposes of determining arrearages that are considered collectible. new text end

new text begin(d) The first report on these topics shall be submitted to the legislature by January 1, 1999, and subsequent reports shall be submitted biennially before January 15 of each odd-numbered yearnew text end.

Laws 2022, chapter 33, section 1, subdivision 9

Section 1.

Minnesota Statutes 2020, section 256B.4914, as amended by Laws 2021, First Special Session chapter 7, article 13, sections 42 and 43, is amended to read:


256B.4914 HOME AND COMMUNITY-BASED SERVICES WAIVERS; RATE SETTING.

Subd. 9.

deleted text beginPayments fordeleted text end Unit-based services without programmingnew text begin; component values and calculation of payment ratesnew text end.

deleted text beginPayments fordeleted text end new text begin(a) For the purposes of this section, new text endunit-based services without programmingdeleted text begin, includingdeleted text endnew text begin includenew text end individualized home supportsdeleted text begin,deleted text endnew text begin without training andnew text end night supervisiondeleted text begin, personal support, respite, and companion caredeleted text end provided to an individual outside of anynew text begin service plan for anew text end daynew text begin programnew text end or residentialnew text begin supportnew text end service deleted text beginplandeleted text endnew text begin. Unit-based services without programming do not include respite.new text end

new text begin (b) Component values for unit-based services without programming are: new text end

new text begin (1) competitive workforce factor: 4.7 percent; new text end

new text begin (2) supervisory span of control ratio: 11 percent; new text end

new text begin (3) employee vacation, sick, and training allowance ratio: 8.71 percent; new text end

new text begin (4) employee-related cost ratio: 23.6 percent; new text end

new text begin (5) program plan support ratio: 7.0 percent; new text end

new text begin (6) client programming and support ratio: 2.3 percent, updated as specified in subdivision 5b; new text end

new text begin (7) general administrative support ratio: 13.25 percent; new text end

new text begin (8) program-related expense ratio: 2.9 percent; and new text end

new text begin (9) absence and utilization factor ratio: 3.9 percent. new text end

new text begin (c) A unit of service for unit-based services without programming is 15 minutes. new text end

new text begin(d) Payments for unit-based services without programming new text endmust be calculated as follows unless the services are deleted text beginauthorizeddeleted text endnew text begin reimbursednew text end separately deleted text beginunder subdivision 6 or 7deleted text endnew text begin as part of a residential support services or day program payment ratenew text end:

(1) deleted text beginfor all services except respite,deleted text end determine the number of units of service to meet a recipient's needs;

(2) deleted text beginpersonneldeleted text endnew text begin determine the appropriatenew text end hourlynew text begin staffnew text end wage deleted text beginrates must be based on the 2009 Bureau of Labor Statistics Minnesota-specific rate ordeleted text end rates derived by the commissioner as provided in deleted text beginsubdivision 5deleted text endnew text begin subdivisions 5 to 5anew text end;

(3) except for subdivision deleted text begin5, paragraph (a), clauses (4) and (21) to (23)deleted text endnew text begin 5a, clauses (1) to (4)new text end, multiply the result of clause (2) by the product of one plus the competitive workforce factor deleted text beginin subdivision 5, paragraph (g), clause (1)deleted text end;

(4) for a recipient requiring customization for deaf and hard-of-hearing language accessibility under subdivision 12, add the customization rate provided in subdivision 12 to the result of clause (3);

(5) multiply the number of direct deleted text beginstaffdeleted text endnew text begin staffingnew text end hours by the appropriate staff wage;

(6) multiply the number of direct deleted text beginstaffdeleted text endnew text begin staffingnew text end hours by the product of the deleted text beginsupervisiondeleted text endnew text begin supervisorynew text end span of control ratio deleted text beginin subdivision 5, paragraph (g), clause (2),deleted text end and the appropriate deleted text beginsupervisiondeleted text endnew text begin supervisory staffnew text end wage in subdivision deleted text begin5, paragraph (a), clause (21)deleted text endnew text begin 5a, clause (1)new text end;

(7) combine the results of clauses (5) and (6), and multiply the result by one plus the employee vacation, sick, and training allowance ratio deleted text beginin subdivision 5, paragraph (g), clause (3)deleted text end. This is defined as the direct staffing rate;

(8) for program plan support, multiply the result of clause (7) by one plus the program plan support ratio deleted text beginin subdivision 5, paragraph (g), clause (5)deleted text end;

(9) for employee-related expenses, multiply the result of clause (8) by one plus the employee-related cost ratio deleted text beginin subdivision 5, paragraph (g), clause (4)deleted text end;

(10) for client programming and supports, multiply the result of clause (9) by one plus the client programming and support ratio deleted text beginin subdivision 5, paragraph (g), clause (6)deleted text end;

(11) this is the subtotal rate;

(12) sum the standard general deleted text beginanddeleted text end administrative deleted text beginratedeleted text endnew text begin support rationew text end, the program-related expense ratio, and the absence and utilization factor ratio;

(13) divide the result of clause (11) by one minus the result of clause (12). This is the total payment amount;

new text begin (14) for individualized home supports without training provided in a shared manner, divide the total payment amount in clause (13) by the number of service recipients, not to exceed two; and new text end

new text begin (15) adjust the result of clause (14) by a factor to be determined by the commissioner to adjust for regional differences in the cost of providing services. new text end

Repealed Minnesota Rule: S4410-3

9530.7000 DEFINITIONS.

Subpart 1.

Scope.

For the purposes of parts 9530.7000 to 9530.7030, the following terms have the meanings given them.

Subp. 2.

Chemical.

"Chemical" means alcohol, solvents, and other mood altering substances, including controlled substances as defined in Minnesota Statutes, chapter 152.

Subp. 5.

Chemical dependency treatment services.

"Chemical dependency treatment services" means services provided by chemical dependency treatment programs licensed according to Minnesota Statutes, chapter 245G, or certified according to parts 2960.0450 to 2960.0490.

Subp. 6.

Client.

"Client" means an individual who has requested chemical abuse or dependency services, or for whom chemical abuse or dependency services have been requested, from a local agency.

Subp. 7.

Commissioner.

"Commissioner" means the commissioner of the Minnesota Department of Human Services or the commissioner's designated representative.

Subp. 8.

Behavioral health fund.

"Behavioral health fund" means money appropriated for payment of chemical dependency treatment services under Minnesota Statutes, chapter 254B.

Subp. 9.

Copayment.

"Copayment" means the amount an insured person is obligated to pay before the person's third-party payment source is obligated to make a payment, or the amount an insured person is obligated to pay in addition to the amount the person's third-party payment source is obligated to pay.

Subp. 10.

Drug and Alcohol Abuse Normative Evaluation System or DAANES.

"Drug and Alcohol Abuse Normative Evaluation System" or "DAANES" means the client information system operated by the department's Chemical Dependency Program Division.

Subp. 11.

Department.

"Department" means the Minnesota Department of Human Services.

Subp. 13.

Income.

"Income" means the total amount of cash received by an individual from the following sources:

A.

cash payments for wages or salaries;

B.

cash receipts from nonfarm or farm self-employment, minus deductions allowed by the federal Internal Revenue Service for business or farm expenses;

C.

regular cash payments from social security, railroad retirement, unemployment compensation, workers' union funds, veterans' benefits, the Minnesota family investment program, Supplemental Security Income, General Assistance, training stipends, alimony, child support, and military family allotments;

D.

cash payments from private pensions, government employee pensions, and regular insurance or annuity payments;

E.

cash payments for dividends, interest, rents, or royalties; and

F.

periodic cash receipts from estates or trusts.

Income does not include capital gains; any cash assets drawn down as withdrawals from a bank, the sale of property, a house, or a car; tax refunds, gifts, lump sum inheritances, one time insurance payments, or compensation for injury; court-ordered child support or health insurance premium payments made by the client or responsible relative; and noncash benefits such as health insurance, food or rent received in lieu of wages, and noncash benefits from programs such as Medicare, Medical Assistance, the Supplemental Nutrition Assistance Program, school lunches, and housing assistance. Annual income is the amount reported and verified by an individual as current income calculated prospectively to cover one year.

Subp. 14.

Local agency.

"Local agency" means the county or multicounty agency authorized under Minnesota Statutes, sections 254B.01, subdivision 5, and 254B.03, subdivision 1, to make placements under the behavioral health fund.

Subp. 15.

Minor child.

"Minor child" means an individual under the age of 18 years.

Subp. 17a.

Policyholder.

"Policyholder" means a person who has a third-party payment policy under which a third-party payment source has an obligation to pay all or part of a client's treatment costs.

Subp. 19.

Responsible relative.

"Responsible relative" means a person who is a member of the client's household and is a client's spouse or the parent of a minor child who is a client.

Subp. 20.

Third-party payment source.

"Third-party payment source" means a person, entity, or public or private agency other than medical assistance or general assistance medical care that has a probable obligation to pay all or part of the costs of a client's chemical dependency treatment.

Subp. 21.

Vendor.

"Vendor" means a licensed provider of chemical dependency treatment services that meets the criteria established in Minnesota Statutes, section 254B.05, and that has applied according to part 9505.0195 to participate as a provider in the medical assistance program.

9530.7005 SCOPE AND APPLICABILITY.

Parts 9530.7000 to 9530.7030 govern the administration of the behavioral health fund, establish the criteria to be applied by local agencies to determine a client's eligibility under the behavioral health fund, and establish a client's obligation to pay for chemical dependency treatment services.

These parts must be read in conjunction with Minnesota Statutes, chapter 254B, and parts 9530.6600 to 9530.6655.

9530.7010 COUNTY RESPONSIBILITY TO PROVIDE SERVICES.

The local agency shall provide chemical dependency treatment services to eligible clients who have been assessed and placed by the county according to parts 9530.6600 to 9530.6655 and Minnesota Statutes, chapter 256G.

9530.7012 VENDOR AGREEMENTS.

When a local agency enters into an agreement with a vendor of chemical dependency treatment services, the agreement must distinguish client per unit room and board costs from per unit chemical dependency treatment services costs.

For purposes of this part, "chemical dependency treatment services costs" are costs, including related administrative costs, of services that meet the criteria in items A to C:

A.

The services are provided within a program licensed according to Minnesota Statutes, chapter 245G, or certified according to parts 2960.0430 to 2960.0490.

B.

The services meet the definition of chemical dependency services in Minnesota Statutes, section 254B.01, subdivision 3.

C.

The services meet the applicable service standards for licensed chemical dependency treatment programs in item A, but are not under the jurisdiction of the commissioner.

This part also applies to vendors of room and board services that are provided concurrently with chemical dependency treatment services according to Minnesota Statutes, sections 254B.03, subdivision 2, and 254B.05, subdivision 1.

This part does not apply when a county contracts for chemical dependency services in an acute care inpatient hospital licensed by the Department of Health under chapter 4640.

9530.7015 CLIENT ELIGIBILITY; BEHAVIORAL HEALTH FUND.

Subpart 1.

Client eligibility to have treatment totally paid under the behavioral health fund.

A client who meets the criteria established in item A, B, C, or D shall be eligible to have chemical dependency treatment paid for totally with funds from the behavioral health fund.

A.

The client is eligible for MFIP as determined under Minnesota Statutes, chapter 256J.

B.

The client is eligible for medical assistance as determined under parts 9505.0010 to 9505.0140.

C.

The client is eligible for general assistance, general assistance medical care, or work readiness as determined under parts 9500.1200 to 9500.1272.

D.

The client's income is within current household size and income guidelines for entitled persons, as defined in Minnesota Statutes, section 254B.04, subdivision 1, and as determined by the local agency under part 9530.7020, subpart 1.

Subp. 2a.

Third-party payment source and client eligibility for the behavioral health fund.

Clients who meet the financial eligibility requirement in subpart 1 and who have a third-party payment source are eligible for the behavioral health fund if the third party payment source pays less than 100 percent of the treatment services determined according to parts 9530.6600 to 9530.6655.

Subp. 4.

Client ineligible to have treatment paid for from the behavioral health fund.

A client who meets the criteria in item A or B shall be ineligible to have chemical dependency treatment services paid for with behavioral health funds.

A.

The client has an income that exceeds current household size and income guidelines for entitled persons as defined in Minnesota Statutes, section 254B.04, subdivision 1, and as determined by the local agency under part 9530.7020, subpart 1.

B.

The client has an available third-party payment source that will pay the total cost of the client's treatment.

Subp. 5.

Eligibility of clients disenrolled from prepaid health plans.

A client who is disenrolled from a state prepaid health plan during a treatment episode is eligible for continued treatment service that is paid for by the behavioral health fund, until the treatment episode is completed or the client is re-enrolled in a state prepaid health plan if the client meets the criteria in item A or B. The client must:

A.

continue to be enrolled in MinnesotaCare, medical assistance, or general assistance medical care; or

B.

be eligible according to subparts 1 and 2a and be determined eligible by a local agency under part 9530.7020.

Subp. 6.

County responsibility.

When a county commits a client under Minnesota Statutes, chapter 253B, to a regional treatment center for chemical dependency treatment services and the client is ineligible for the behavioral health fund, the county is responsible for the payment to the regional treatment center according to Minnesota Statutes, section 254B.05, subdivision 4.

9530.7020 LOCAL AGENCY TO DETERMINE CLIENT ELIGIBILITY.

Subpart 1.

Local agency duty to determine client eligibility.

The local agency shall determine a client's eligibility for the behavioral health fund at the time the client is assessed under parts 9530.6600 to 9530.6655. Client eligibility must be determined using forms prescribed by the department. To determine a client's eligibility, the local agency must determine the client's income, the size of the client's household, the availability of a third-party payment source, and a responsible relative's ability to pay for the client's chemical dependency treatment, as specified in items A to C.

A.

The local agency must determine the client's income. A client who is a minor child shall not be deemed to have income available to pay for chemical dependency treatment, unless the minor child is responsible for payment under Minnesota Statutes, section 144.347, for chemical dependency treatment services sought under Minnesota Statutes, section 144.343, subdivision 1.

B.

The local agency must determine the client's household size according to subitems (1), (2), and (3).

(1)

If the client is a minor child, the household size includes the following persons living in the same dwelling unit:

(a)

the client;

(b)

the client's birth or adoptive parents; and

(c)

the client's siblings who are minors.

(2)

If the client is an adult, the household size includes the following persons living in the same dwelling unit:

(a)

the client;

(b)

the client's spouse;

(c)

the client's minor children; and

(d)

the client's spouse's minor children.

(3)

For purposes of this item, household size includes a person listed in subitems (1) and (2) who is in out-of-home placement if a person listed in subitem (1) or (2) is contributing to the cost of care of the person in out-of-home placement.

C.

The local agency must determine the client's current prepaid health plan enrollment, the availability of a third-party payment source, including the availability of total payment, partial payment, and amount of copayment.

D.

The local agency must provide the required eligibility information to the department in the manner specified by the department.

E.

The local agency shall require the client and policyholder to conditionally assign to the department the client and policyholder's rights and the rights of minor children to benefits or services provided to the client if the department is required to collect from a third-party pay source.

Subp. 1a.

Redetermination of client eligibility.

The local agency shall redetermine a client's eligibility for CCDTF every six months after the initial eligibility determination, if the client has continued to receive uninterrupted chemical dependency treatment services for that six months. For purposes of this subpart, placement of a client into more than one chemical dependency treatment program in less than ten working days, or placement of a client into a residential chemical dependency treatment program followed by nonresidential chemical dependency treatment services shall be treated as a single placement.

Subp. 2.

Client, responsible relative, and policyholder obligation to cooperate.

A client, responsible relative, and policyholder shall provide income or wage verification, household size verification, and shall make an assignment of third-party payment rights under subpart 1, item C. If a client, responsible relative, or policyholder does not comply with the provisions of this subpart, the client shall be deemed to be ineligible to have the behavioral health fund pay for his or her chemical dependency treatment, and the client and responsible relative shall be obligated to pay for the full cost of chemical dependency treatment services provided to the client.

9530.7021 PAYMENT AGREEMENTS.

When the local agency, the client, and the vendor agree that the vendor will accept payment from a third-party payment source for an eligible client's treatment, the local agency, the client, and the vendor shall enter into a third-party payment agreement. The agreement must stipulate that the vendor will accept, as payment in full for services provided to the client, the amount the third-party payor is obligated to pay for services provided to the client. The agreement must be executed in a form prescribed by the commissioner and is not effective unless an authorized representative of each of the three parties has signed it. The local agency shall maintain a record of third-party payment agreements into which the local agency has entered.

The vendor shall notify the local agency as soon as possible and not less than one business day before discharging a client whose treatment is covered by a payment agreement under this part if the discharge is caused by disruption of the third-party payment.

9530.7022 CLIENT FEES.

Subpart 1.

Income and household size criteria.

A client whose household income is within current household size and income guidelines for entitled persons as defined in Minnesota Statutes, section 254B.04, subdivision 1, shall pay no fee.

9530.7025 DENIAL OF PAYMENT.

Subpart 1.

Denial of payment when required assessment not completed.

The department shall deny payments from the behavioral health fund to vendors for chemical dependency treatment services provided to clients who have not been assessed and placed by the county in accordance with parts 9530.6600 to 9530.6655.

Subp. 2.

Denial of state participation in behavioral health fund payments when client found not eligible.

The department shall pay vendors from the behavioral health fund for chemical dependency treatment services provided to clients and shall bill the county for 100 percent of the costs of chemical dependency treatment services as follows:

A.

The department shall bill the county for 100 percent of the costs of a client's chemical dependency treatment services when the department determines that the client was not placed in accordance with parts 9530.6600 to 9530.6655.

B.

When a county's allocation under Minnesota Statutes, section 254B.02, subdivisions 1 and 2, has been exhausted, and the county's maintenance of effort has been met as required under Minnesota Statutes, section 254B.02, subdivision 3, and the local agency has been notified by the department that the only clients who are eligible to have their treatment paid for from the behavioral health fund are clients who are eligible under part 9530.7015, subpart 1, the department shall bill the county for 100 percent of the costs of a client's chemical dependency treatment services when the department determines that the client was not eligible under part 9530.7015, subpart 1.

9530.7030 VENDOR MUST PARTICIPATE IN DAANES SYSTEM.

Subpart 1.

Participation a condition of eligibility.

To be eligible for payment under the behavioral health fund, a vendor must participate in the Drug and Alcohol Normative Evaluation System (DAANES) or submit to the commissioner the information required in DAANES in the format specified by the commissioner.