HF 33

2nd Engrossment - 92nd Legislature, 2021 1st Special Session (2021 - 2021) Posted on 06/29/2021 02:53pm

A bill for an act
relating to state government; establishing a biennial budget for health and human
services; modifying various provisions governing Department of Human Services
health programs, the Department of Health, health-related licensing boards,
prescription drugs, telehealth, economic supports, child care assistance, child
protection, behavioral health, direct care and treatment, disability services, and
home and community-based services; continuing Minnesota premium security
plan to a certain date; making technical changes; modifying fees; establishing civil
and criminal penalties; establishing task forces; requiring reports; appropriating
money; amending Minnesota Statutes 2020, sections 16A.151, subdivision 2;
62J.495, subdivisions 1, 2, 4; 62J.497, subdivisions 1, 3; 62J.63, subdivisions 1,
2; 62U.04, subdivisions 4, 5; 62V.05, by adding a subdivision; 103H.201,
subdivision 1; 119B.03, subdivision 6, by adding a subdivision; 119B.09,
subdivision 4; 119B.11, subdivision 2a; 119B.125, subdivision 1; 119B.13,
subdivisions 1, 1a, 6, 7; 119B.25; 122A.18, subdivision 8; 124D.142; 136A.128,
subdivisions 2, 4; 144.0724, subdivisions 1, 2, 3a, 4, 5, 7, 8, 9, 12; 144.125,
subdivision 1; 144.1501, subdivisions 1, 2, 3; 144.212, by adding a subdivision;
144.225, subdivision 2; 144.226, by adding subdivisions; 144.551, subdivision 1;
144.555; 144.9501, subdivision 17; 144.9502, subdivision 3; 144.9504, subdivisions
2, 5; 144A.073, subdivision 2, by adding a subdivision; 145.32, subdivision 1;
145.901, subdivisions 2, 4, by adding a subdivision; 147.033; 148.90, subdivision
2; 148.911; 148.995, subdivision 2; 148.996, subdivisions 2, 4, by adding a
subdivision; 148B.30, subdivision 1; 148B.31; 148B.51; 148B.54, subdivision 2;
148E.010, by adding a subdivision; 148E.130, subdivision 1, by adding a
subdivision; 151.066, subdivision 3; 151.37, subdivision 2; 171.07, by adding a
subdivision; 245.462, subdivision 17; 245.4876, by adding a subdivision; 245.4882,
subdivisions 1, 3; 245.4885, subdivision 1, as amended; 245.4889, subdivision 1;
245.4901; 245A.02, by adding a subdivision; 245A.03, subdivision 7; 245A.05;
245A.07, subdivision 1; 245A.10, subdivision 4, as amended; 245A.14, subdivision
4; 245A.16, by adding a subdivision; 245A.50, subdivisions 7, 9; 245C.02,
subdivisions 4a, 5, by adding subdivisions; 245C.03; 245C.05, subdivisions 1, 2,
2a, 2b, 2c, 2d, 4, 5; 245C.08, subdivision 3, by adding a subdivision; 245C.10,
subdivisions 2, 3, 4, 5, 6, 8, 9, 9a, 10, 11, 12, 13, 15, 16, by adding subdivisions;
245C.13, subdivision 2; 245C.14, subdivision 1, by adding a subdivision; 245C.15,
by adding a subdivision; 245C.16, subdivisions 1, 2; 245C.17, subdivision 1, by
adding a subdivision; 245C.18; 245C.24, subdivisions 2, 3, 4, by adding a
subdivision; 245C.30, by adding a subdivision; 245C.32, subdivisions 1a, 2;
245E.07, subdivision 1; 245G.01, subdivisions 13, 26; 245G.06, subdivision 1;
246.54, subdivision 1b; 254A.19, subdivision 5; 254B.01, subdivision 4a, by
adding a subdivision; 254B.05, subdivision 5; 254B.12, by adding a subdivision;
256.01, subdivision 28; 256.041; 256.042, subdivision 4; 256.043, subdivisions
3, 4; 256.476, subdivision 11; 256.477; 256.478; 256.479; 256B.04, subdivision
14; 256B.055, subdivision 6; 256B.056, subdivision 10; 256B.06, subdivision 4;
256B.0621, subdivision 10; 256B.0622, subdivision 7a, as amended; 256B.0624,
as amended; 256B.0625, subdivisions 3b, as amended, 9, 13, 13c, 13d, 13e, 13g,
13h, 18, 20, 20b, 31, 46, 52, 58, by adding subdivisions; 256B.0631, subdivision
1; 256B.0653, by adding a subdivision; 256B.0654, by adding a subdivision;
256B.0659, subdivisions 11, 17a; 256B.0759, subdivisions 2, 4, by adding
subdivisions; 256B.0911, subdivisions 1a, 3a, as amended, 3f; 256B.092,
subdivisions 4, 5, 12, by adding a subdivision; 256B.0924, subdivision 6; 256B.094,
subdivision 6; 256B.0943, subdivision 1, as amended; 256B.0946, subdivisions
1, as amended, 4, as amended; 256B.0947, subdivisions 2, as amended, 3, as
amended, 5, as amended; 256B.0949, subdivision 13, by adding a subdivision;
256B.097, by adding subdivisions; 256B.439, by adding subdivisions; 256B.49,
subdivisions 11, 11a, 14, 17, by adding subdivisions; 256B.4905, by adding
subdivisions; 256B.4914, subdivisions 5, 6; 256B.5012, by adding a subdivision;
256B.5013, subdivisions 1, 6; 256B.5015, subdivision 2; 256B.69, subdivision
5a, as amended, by adding subdivisions; 256B.75; 256B.76, subdivisions 2, 4;
256B.79, subdivisions 1, 3; 256B.85, subdivisions 2, as amended, 7a, 11, as
amended, 14, 16, by adding a subdivision; 256D.051, by adding subdivisions;
256E.30, subdivision 2; 256I.05, subdivision 1c, by adding a subdivision; 256I.06,
subdivision 8; 256J.08, subdivisions 15, 53; 256J.10; 256J.21, subdivisions 3, 5;
256J.24, subdivision 5; 256J.33, subdivisions 1, 4; 256J.37, subdivisions 1, 1b;
256J.95, subdivision 9; 256L.07, subdivision 2; 256L.11, subdivisions 6a, 7;
256L.15, subdivision 2; 256N.25, subdivisions 2, 3; 256N.26, subdivisions 11,
13; 256P.01, subdivision 3; 256P.02, subdivisions 1a, 2; 256P.04, subdivisions 4,
8; 256P.05; 256P.06, subdivisions 2, 3; 256S.05, subdivision 2; 256S.18,
subdivision 7; 256S.20, subdivision 1; 256S.203; 256S.21; 256S.2101; 257.0755,
subdivision 1; 257.076, subdivisions 3, 5; 257.0768, subdivisions 1, 6; 257.0769;
260C.163, subdivision 3; 260C.215, subdivision 4; Laws 2017, chapter 13, article
1, section 15, as amended; Laws 2019, First Special Session chapter 9, article 14,
section 3, as amended; Laws 2020, First Special Session chapter 7, section 1,
subdivisions 1, 2, as amended, 3, 5, as amended; Laws 2021, chapter 30, article
12, section 5; proposing coding for new law in Minnesota Statutes, chapters 3;
62A; 119B; 144; 148; 151; 245; 245C; 245G; 254B; 256; 256B; 256S; 260E; 325F;
repealing Minnesota Statutes 2020, sections 16A.724, subdivision 2; 62A.67;
62A.671; 62A.672; 62J.63, subdivision 3; 119B.125, subdivision 5; 144.0721,
subdivision 1; 144.0722; 144.0724, subdivision 10; 144.693; 245.4871, subdivision
32a; 256B.0596; 256B.0916, subdivisions 2, 3, 4, 5, 8, 11, 12; 256B.0924,
subdivision 4a; 256B.097, subdivisions 1, 2, 3, 4, 5, 6; 256B.49, subdivisions 26,
27; 256B.4905, subdivisions 1, 2, 3, 4, 5, 6; 256D.051, subdivisions 1, 1a, 2, 2a,
3, 3a, 3b, 6b, 6c, 7, 8, 9, 18; 256D.052, subdivision 3; 256J.21, subdivisions 1, 2;
256S.20, subdivision 2; 259A.70; Laws 2019, First Special Session chapter 9,
article 5, section 90; Laws 2020, First Special Session chapter 7, section 1,
subdivision 2, as amended; Laws 2021, chapter 30, article 17, section 71; Minnesota
Rules, parts 9505.0275; 9505.1693; 9505.1696, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9,
11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22; 9505.1699; 9505.1701; 9505.1703;
9505.1706; 9505.1712; 9505.1715; 9505.1718; 9505.1724; 9505.1727; 9505.1730;
9505.1733; 9505.1736; 9505.1739; 9505.1742; 9505.1745; 9505.1748.

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

ARTICLE 1

DEPARTMENT OF HUMAN SERVICES HEALTH CARE PROGRAMS

Section 1.

Minnesota Statutes 2020, section 256.01, subdivision 28, is amended to read:

Subd. 28.

Statewide health information exchange.

(a) The commissioner has the
authority to join and participate as a member in a legal entity developing and operating a
statewide health information exchange new text begin or to develop and operate an encounter alerting
service new text end that shall meet the following criteria:

(1) the legal entity must meet all constitutional and statutory requirements to allow the
commissioner to participate; and

(2) the commissioner or the commissioner's designated representative must have the
right to participate in the governance of the legal entity under the same terms and conditions
and subject to the same requirements as any other member in the legal entity and in that
role shall act to advance state interests and lessen the burdens of government.

(b) Notwithstanding chapter 16C, the commissioner may pay the state's prorated share
of development-related expenses of the legal entity retroactively from October 29, 2007,
regardless of the date the commissioner joins the legal entity as a member.

Sec. 2.

new text begin [256B.0371] PERFORMANCE BENCHMARKS FOR DENTAL ACCESS;
CONTINGENT DENTAL ADMINISTRATOR.
new text end

new text begin Subdivision 1. new text end

new text begin Benchmark for dental access. new text end

new text begin For coverage years 2022 to 2024, the
commissioner shall establish a performance benchmark under which at least 55 percent of
children and adults who were continuously enrolled for at least 11 months in either medical
assistance or MinnesotaCare through a managed care or county-based purchasing plan
received at least one dental visit during the coverage year.
new text end

new text begin Subd. 2. new text end

new text begin Corrective action plan. new text end

new text begin For coverage years 2022 to 2024, if a managed care
or county-based purchasing plan under contract with the commissioner to provide dental
services under this chapter or chapter 256L has a rate of dental utilization that is ten percent
or more below the performance benchmark specified in subdivision 1, the commissioner
shall require the managed care or county-based purchasing plan to submit a corrective action
plan to the commissioner describing how the entity intends to increase dental utilization to
meet the performance benchmark. The managed care or county-based purchasing plan must:
new text end

new text begin (1) provide a written corrective action plan to the commissioner for approval;
new text end

new text begin (2) implement the plan; and
new text end

new text begin (3) provide the commissioner with documentation of each corrective action taken.
new text end

new text begin Subd. 3. new text end

new text begin Contingent contract with dental administrator. new text end

new text begin (a) The commissioner shall
determine the extent to which managed care and county-based purchasing plans in the
aggregate meet the performance benchmark specified in subdivision 1 for coverage year
2024. If managed care and county-based purchasing plans in the aggregate fail to meet the
performance benchmark, the commissioner, after issuing a request for information followed
by a request for proposals, shall contract with a dental administrator to administer dental
services beginning January 1, 2026, for all recipients of medical assistance and
MinnesotaCare, including persons served under fee-for-service and persons receiving
services through managed care and county-based purchasing plans.
new text end

new text begin (b) The dental administrator must provide administrative services, including but not
limited to:
new text end

new text begin (1) provider recruitment, contracting, and assistance;
new text end

new text begin (2) recipient outreach and assistance;
new text end

new text begin (3) utilization management and reviews of medical necessity for dental services;
new text end

new text begin (4) dental claims processing;
new text end

new text begin (5) coordination of dental care with other services;
new text end

new text begin (6) management of fraud and abuse;
new text end

new text begin (7) monitoring access to dental services;
new text end

new text begin (8) performance measurement;
new text end

new text begin (9) quality improvement and evaluation; and
new text end

new text begin (10) management of third-party liability requirements.
new text end

new text begin (c) Dental administrator payments to contracted dental providers must be at the rates
established under sections 256B.76 and 256L.11.
new text end

new text begin (d) Recipients must be given a choice of dental provider, including any provider who
agrees to provider participation requirements and payment rates established by the
commissioner and dental administrator. The dental administrator must comply with the
network adequacy and geographic access requirements that apply to managed care and
county-based purchasing plans for dental services under section 62K.14.
new text end

new text begin (e) The contract with the dental administrator must include a provision that states that
if the dental administrator fails to meet, by calendar year 2029, a performance benchmark
under which at least 55 percent of children and adults who were continuously enrolled for
at least 11 months in either medical assistance or MinnesotaCare received at least one dental
visit during the calendar year, the contract must be terminated and the commissioner must
enter into a contract with a new dental administrator as soon as practicable.
new text end

new text begin (f) The commissioner shall implement this subdivision in consultation with representatives
of providers who provide dental services to patients enrolled in medical assistance or
MinnesotaCare, including but not limited to providers serving primarily low-income and
socioeconomically complex populations, and with representatives of managed care plans
and county-based purchasing plans.
new text end

new text begin Subd. 4. new text end

new text begin Dental utilization report. new text end

new text begin (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:
new text end

new text begin (1) statewide utilization for both fee-for-service and for the prepaid medical assistance
program;
new text end

new text begin (2) utilization by county;
new text end

new text begin (3) utilization by children receiving dental services through fee-for-service and through
a managed care plan or county-based purchasing plan;
new text end

new text begin (4) utilization by adults receiving dental services through fee-for-service and through a
managed care plan or county-based purchasing plan.
new text end

new text begin (b) The report must also include a description of any corrective action plans required to
be submitted under subdivision 2.
new text end

new text begin (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 end

Sec. 3.

Minnesota Statutes 2020, section 256B.04, subdivision 14, is amended to read:

Subd. 14.

Competitive bidding.

(a) When determined to be effective, economical, and
feasible, the commissioner may utilize volume purchase through competitive bidding and
negotiation under the provisions of chapter 16C, to provide items under the medical assistance
program including but not limited to the following:

(1) eyeglasses;

(2) oxygen. The commissioner shall provide for oxygen needed in an emergency situation
on a short-term basis, until the vendor can obtain the necessary supply from the contract
dealer;

(3) hearing aids and supplies; deleted text begin and
deleted text end

(4) durable medical equipment, including but not limited to:

(i) hospital beds;

(ii) commodes;

(iii) glide-about chairs;

(iv) patient lift apparatus;

(v) wheelchairs and accessories;

(vi) oxygen administration equipment;

(vii) respiratory therapy equipment;

(viii) electronic diagnostic, therapeutic and life-support systems; new text begin and
new text end

new text begin (ix) allergen-reducing products as described in section 256B.0625, subdivision 67,
paragraph (c) or (d);
new text end

(5) nonemergency medical transportation level of need determinations, disbursement of
public transportation passes and tokens, and volunteer and recipient mileage and parking
reimbursements; and

(6) drugs.

(b) Rate changes and recipient cost-sharing under this chapter and chapter 256L do not
affect contract payments under this subdivision unless specifically identified.

(c) The commissioner may not utilize volume purchase through competitive bidding
and negotiation under the provisions of chapter 16C for special transportation services or
incontinence products and related supplies.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later.
new text end

Sec. 4.

Minnesota Statutes 2020, section 256B.055, subdivision 6, is amended to read:

Subd. 6.

Pregnant women; needy unborn child.

Medical assistance may be paid for
a pregnant woman who meets the other eligibility criteria of this section and whose unborn
child would be eligible as a needy child under subdivision 10 if born and living with the
woman. In accordance with Code of Federal Regulations, title 42, section 435.956, the
commissioner must accept self-attestation of pregnancy unless the agency has information
that is not reasonably compatible with such attestation. For purposes of this subdivision, a
woman is considered pregnant for deleted text begin 60 days deleted text end new text begin 12 months new text end postpartum.

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 shall notify the revisor of statutes when federal
approval has been obtained.
new text end

Sec. 5.

Minnesota Statutes 2020, section 256B.056, subdivision 10, is amended to read:

Subd. 10.

Eligibility verification.

(a) The commissioner shall require women who are
applying for the continuation of medical assistance coverage following the end of the deleted text begin 60-day deleted text end new text begin
12-month new text end postpartum period to update their income and asset information and to submit
any required income or asset verification.

(b) The commissioner shall determine the eligibility of private-sector health care coverage
for infants less than one year of age eligible under section 256B.055, subdivision 10, or
256B.057, subdivision 1, paragraph (c), and shall pay for private-sector coverage if this is
determined to be cost-effective.

(c) The commissioner shall verify assets and income for all applicants, and for all
recipients upon renewal.

(d) The commissioner shall utilize information obtained through the electronic service
established by the secretary of the United States Department of Health and Human Services
and other available electronic data sources in Code of Federal Regulations, title 42, sections
435.940 to 435.956, to verify eligibility requirements. The commissioner shall establish
standards to define when information obtained electronically is reasonably compatible with
information provided by applicants and enrollees, including use of self-attestation, to
accomplish real-time eligibility determinations and maintain program integrity.

(e) Each person applying for or receiving medical assistance under section 256B.055,
subdivision 7, and any other person whose resources are required by law to be disclosed to
determine the applicant's or recipient's eligibility must authorize the commissioner to obtain
information from financial institutions to identify unreported accounts as required in section
256.01, subdivision 18f. If a person refuses or revokes the authorization, the commissioner
may determine that the applicant or recipient is ineligible for medical assistance. For purposes
of this paragraph, an authorization to identify unreported accounts meets the requirements
of the Right to Financial Privacy Act, United States Code, title 12, chapter 35, and need not
be furnished to the financial institution.

(f) County and tribal agencies shall comply with the standards established by the
commissioner for appropriate use of the asset verification system specified in section 256.01,
subdivision 18f.

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 shall notify the revisor of statutes when federal
approval has been obtained.
new text end

Sec. 6.

Minnesota Statutes 2020, section 256B.06, subdivision 4, is amended to read:

Subd. 4.

Citizenship requirements.

(a) Eligibility for medical assistance is limited to
citizens of the United States, qualified noncitizens as defined in this subdivision, and other
persons residing lawfully in the United States. Citizens or nationals of the United States
must cooperate in obtaining satisfactory documentary evidence of citizenship or nationality
according to the requirements of the federal Deficit Reduction Act of 2005, Public Law
109-171.

(b) "Qualified noncitizen" means a person who meets one of the following immigration
criteria:

(1) admitted for lawful permanent residence according to United States Code, title 8;

(2) admitted to the United States as a refugee according to United States Code, title 8,
section 1157;

(3) granted asylum according to United States Code, title 8, section 1158;

(4) granted withholding of deportation according to United States Code, title 8, section
1253(h);

(5) paroled for a period of at least one year according to United States Code, title 8,
section 1182(d)(5);

(6) granted conditional entrant status according to United States Code, title 8, section
1153(a)(7);

(7) determined to be a battered noncitizen by the United States Attorney General
according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;

(8) is a child of a noncitizen determined to be a battered noncitizen by the United States
Attorney General according to the Illegal Immigration Reform and Immigrant Responsibility
Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
or

(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
Law 96-422, the Refugee Education Assistance Act of 1980.

(c) All qualified noncitizens who were residing in the United States before August 22,
1996, who otherwise meet the eligibility requirements of this chapter, are eligible for medical
assistance with federal financial participation.

(d) Beginning December 1, 1996, qualified noncitizens who entered the United States
on or after August 22, 1996, and who otherwise meet the eligibility requirements of this
chapter are eligible for medical assistance with federal participation for five years if they
meet one of the following criteria:

(1) refugees admitted to the United States according to United States Code, title 8, section
1157;

(2) persons granted asylum according to United States Code, title 8, section 1158;

(3) persons granted withholding of deportation according to United States Code, title 8,
section 1253(h);

(4) veterans of the United States armed forces with an honorable discharge for a reason
other than noncitizen status, their spouses and unmarried minor dependent children; or

(5) persons on active duty in the United States armed forces, other than for training,
their spouses and unmarried minor dependent children.

Beginning July 1, 2010, children and pregnant women who are noncitizens described
in paragraph (b) or who are lawfully present in the United States as defined in Code of
Federal Regulations, title 8, section 103.12, and who otherwise meet eligibility requirements
of this chapter, are eligible for medical assistance with federal financial participation as
provided by the federal Children's Health Insurance Program Reauthorization Act of 2009,
Public Law 111-3.

(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter are
eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this subdivision,
a "nonimmigrant" is a person in one of the classes listed in United States Code, title 8,
section 1101(a)(15).

(f) Payment shall also be made for care and services that are furnished to noncitizens,
regardless of immigration status, who otherwise meet the eligibility requirements of this
chapter, if such care and services are necessary for the treatment of an emergency medical
condition.

(g) For purposes of this subdivision, the term "emergency medical condition" means a
medical condition that meets the requirements of United States Code, title 42, section
1396b(v).

(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment of
an emergency medical condition are limited to the following:

(i) services delivered in an emergency room or by an ambulance service licensed under
chapter 144E that are directly related to the treatment of an emergency medical condition;

(ii) services delivered in an inpatient hospital setting following admission from an
emergency room or clinic for an acute emergency condition; and

(iii) follow-up services that are directly related to the original service provided to treat
the emergency medical condition and are covered by the global payment made to the
provider.

(2) Services for the treatment of emergency medical conditions do not include:

(i) services delivered in an emergency room or inpatient setting to treat a nonemergency
condition;

(ii) organ transplants, stem cell transplants, and related care;

(iii) services for routine prenatal care;

(iv) continuing care, including long-term care, nursing facility services, home health
care, adult day care, day training, or supportive living services;

(v) elective surgery;

(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as part
of an emergency room visit;

(vii) preventative health care and family planning services;

(viii) rehabilitation services;

(ix) physical, occupational, or speech therapy;

(x) transportation services;

(xi) case management;

(xii) prosthetics, orthotics, durable medical equipment, or medical supplies;

(xiii) dental services;

(xiv) hospice care;

(xv) audiology services and hearing aids;

(xvi) podiatry services;

(xvii) chiropractic services;

(xviii) immunizations;

(xix) vision services and eyeglasses;

(xx) waiver services;

(xxi) individualized education programs; or

(xxii) chemical dependency treatment.

(i) Pregnant noncitizens who are ineligible for federally funded medical assistance
because of immigration status, are not covered by a group health plan or health insurance
coverage according to Code of Federal Regulations, title 42, section 457.310, and who
otherwise meet the eligibility requirements of this chapter, are eligible for medical assistance
through the period of pregnancy, including labor and delivery, and deleted text begin 60 days deleted text end new text begin 12 months new text end
postpartum deleted text begin , to the extent federal funds are available under title XXI of the Social Security
Act, and the state children's health insurance program deleted text end .

(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation services
from a nonprofit center established to serve victims of torture and are otherwise ineligible
for medical assistance under this chapter are eligible for medical assistance without federal
financial participation. These individuals are eligible only for the period during which they
are receiving services from the center. Individuals eligible under this paragraph shall not
be required to participate in prepaid medical assistance. The nonprofit center referenced
under this paragraph may establish itself as a provider of mental health targeted case
management services through a county contract under section 256.0112, subdivision 6. If
the nonprofit center is unable to secure a contract with a lead county in its service area, then,
notwithstanding the requirements of section 256B.0625, subdivision 20, the commissioner
may negotiate a contract with the nonprofit center for provision of mental health targeted
case management services. When serving clients who are not the financial responsibility
of their contracted lead county, the nonprofit center must gain the concurrence of the county
of financial responsibility prior to providing mental health targeted case management services
for those clients.

(k) Notwithstanding paragraph (h), clause (2), the following services are covered as
emergency medical conditions under paragraph (f) except where coverage is prohibited
under federal law for services under clauses (1) and (2):

(1) dialysis services provided in a hospital or freestanding dialysis facility;

(2) surgery and the administration of chemotherapy, radiation, and related services
necessary to treat cancer if the recipient has a cancer diagnosis that is not in remission and
requires surgery, chemotherapy, or radiation treatment; and

(3) kidney transplant if the person has been diagnosed with end stage renal disease, is
currently receiving dialysis services, and is a potential candidate for a kidney transplant.

(l) Effective July 1, 2013, recipients of emergency medical assistance under this
subdivision are eligible for coverage of the elderly waiver services provided under chapter
256S, and coverage of rehabilitative services provided in a nursing facility. The age limit
for elderly waiver services does not apply. In order to qualify for coverage, a recipient of
emergency medical assistance is subject to the assessment and reassessment requirements
of section 256B.0911. Initial and continued enrollment under this paragraph is subject to
the limits of available funding.

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. If federal approval is not obtained, this section is effective on the effective
date of the amendment to Minnesota Statutes, section 256B.055, subdivision 6, and shall
be funded using only state funds. The commissioner shall notify the revisor of statutes when
federal approval has been obtained.
new text end

Sec. 7.

Minnesota Statutes 2020, section 256B.0625, subdivision 9, is amended to read:

Subd. 9.

Dental services.

(a) Medical assistance covers dental services.

(b) Medical assistance dental coverage for nonpregnant adults is limited to the following
services:

(1) comprehensive exams, limited to once every five years;

(2) periodic exams, limited to one per year;

(3) limited exams;

(4) bitewing x-rays, limited to one per year;

(5) periapical x-rays;

(6) panoramic x-rays, limited to one every five years except (1) when medically necessary
for the diagnosis and follow-up of oral and maxillofacial pathology and trauma or (2) once
every two years for patients who cannot cooperate for intraoral film due to a developmental
disability or medical condition that does not allow for intraoral film placement;

(7) prophylaxis, limited to one per year;

(8) application of fluoride varnish, limited to one per year;

(9) posterior fillings, all at the amalgam rate;

(10) anterior fillings;

(11) endodontics, limited to root canals on the anterior and premolars only;

(12) removable prostheses, each dental arch limited to one every six years;

(13) oral surgery, limited to extractions, biopsies, and incision and drainage of abscesses;

(14) palliative treatment and sedative fillings for relief of pain; deleted text begin and
deleted text end

(15) full-mouth debridement, limited to one every five years deleted text begin . deleted text end new text begin ; and
new text end

new text begin (16) nonsurgical treatment for periodontal disease, including scaling and root planing
once every two years for each quadrant, and routine periodontal maintenance procedures.
new text end

(c) In addition to the services specified in paragraph (b), medical assistance covers the
following services for adults, if provided in an outpatient hospital setting or freestanding
ambulatory surgical center as part of outpatient dental surgery:

(1) periodontics, limited to periodontal scaling and root planing once every two years;

(2) general anesthesia; and

(3) full-mouth survey once every five years.

(d) Medical assistance covers medically necessary dental services for children and
pregnant women. The following guidelines apply:

(1) posterior fillings are paid at the amalgam rate;

(2) application of sealants are covered once every five years per permanent molar for
children only;

(3) application of fluoride varnish is covered once every six months; and

(4) orthodontia is eligible for coverage for children only.

(e) In addition to the services specified in paragraphs (b) and (c), medical assistance
covers the following services for adults:

(1) house calls or extended care facility calls for on-site delivery of covered services;

(2) behavioral management when additional staff time is required to accommodate
behavioral challenges and sedation is not used;

(3) oral or IV sedation, if the covered dental service cannot be performed safely without
it or would otherwise require the service to be performed under general anesthesia in a
hospital or surgical center; and

(4) prophylaxis, in accordance with an appropriate individualized treatment plan, but
no more than four times per year.

(f) The commissioner shall not require prior authorization for the services included in
paragraph (e), clauses (1) to (3), and shall prohibit managed care and county-based purchasing
plans from requiring prior authorization for the services included in paragraph (e), clauses
(1) to (3), when provided under sections 256B.69, 256B.692, and 256L.12.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, or upon federal approval,
whichever is later.
new text end

Sec. 8.

Minnesota Statutes 2020, section 256B.0625, subdivision 13, is amended to read:

Subd. 13.

Drugs.

(a) Medical assistance covers drugs, except for fertility drugs when
specifically used to enhance fertility, if prescribed by a licensed practitioner and dispensed
by a licensed pharmacist, by a physician enrolled in the medical assistance program as a
dispensing physician, or by a physician, a physician assistant, or an advanced practice
registered nurse employed by or under contract with a community health board as defined
in section 145A.02, subdivision 5, for the purposes of communicable disease control.

(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply,
unless authorized by the commissioner deleted text begin . deleted text end new text begin or the drug appears on the 90-day supply list
published by the commissioner. The 90-day supply list shall be published by the
commissioner on the department's website. The commissioner may add to, delete from, and
otherwise modify the 90-day supply list after providing public notice and the opportunity
for a 15-day public comment period. The 90-day supply list may include cost-effective
generic drugs and shall not include controlled substances.
new text end

(c) For the purpose of this subdivision and subdivision 13d, an "active pharmaceutical
ingredient" is defined as a substance that is represented for use in a drug and when used in
the manufacturing, processing, or packaging of a drug becomes an active ingredient of the
drug product. An "excipient" is defined as an inert substance used as a diluent or vehicle
for a drug. The commissioner shall establish a list of active pharmaceutical ingredients and
excipients which are included in the medical assistance formulary. Medical assistance covers
selected active pharmaceutical ingredients and excipients used in compounded prescriptions
when the compounded combination is specifically approved by the commissioner or when
a commercially available product:

(1) is not a therapeutic option for the patient;

(2) does not exist in the same combination of active ingredients in the same strengths
as the compounded prescription; and

(3) cannot be used in place of the active pharmaceutical ingredient in the compounded
prescription.

(d) Medical assistance covers the following over-the-counter drugs when prescribed by
a licensed practitioner or by a licensed pharmacist who meets standards established by the
commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, family
planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults
with documented vitamin deficiencies, vitamins for children under the age of seven and
pregnant or nursing women, and any other over-the-counter drug identified by the
commissioner, in consultation with the Formulary Committee, as necessary, appropriate,
and cost-effective for the treatment of certain specified chronic diseases, conditions, or
disorders, and this determination shall not be subject to the requirements of chapter 14. A
pharmacist may prescribe over-the-counter medications as provided under this paragraph
for purposes of receiving reimbursement under Medicaid. When prescribing over-the-counter
drugs under this paragraph, licensed pharmacists must consult with the recipient to determine
necessity, provide drug counseling, review drug therapy for potential adverse interactions,
and make referrals as needed to other health care professionals.

(e) Effective January 1, 2006, medical assistance shall not cover drugs that are coverable
under Medicare Part D as defined in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), for individuals eligible
for drug coverage as defined in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section 1860D-1(a)(3)(A). For these
individuals, medical assistance may cover drugs from the drug classes listed in United States
Code, title 42, section 1396r-8(d)(2), subject to this subdivision and subdivisions 13a to
13g, except that drugs listed in United States Code, title 42, section 1396r-8(d)(2)(E), shall
not be covered.

(f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing
Program and dispensed by 340B covered entities and ambulatory pharmacies under common
ownership of the 340B covered entity. Medical assistance does not cover drugs acquired
through the federal 340B Drug Pricing Program and dispensed by 340B contract pharmacies.

(g) Notwithstanding paragraph (a), medical assistance covers self-administered hormonal
contraceptives prescribed and dispensed by a licensed pharmacist in accordance with section
151.37, subdivision 14; nicotine replacement medications prescribed and dispensed by a
licensed pharmacist in accordance with section 151.37, subdivision 15; and opiate antagonists
used for the treatment of an acute opiate overdose prescribed and dispensed by a licensed
pharmacist in accordance with section 151.37, subdivision 16.

new text begin EFFECTIVE DATE. new text end

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

Sec. 9.

Minnesota Statutes 2020, section 256B.0625, subdivision 13c, is amended to read:

Subd. 13c.

Formulary Committee.

The commissioner, after receiving recommendations
from professional medical associations and professional pharmacy associations, and consumer
groups shall designate a Formulary Committee to carry out duties as described in subdivisions
13 to 13g. The Formulary Committee shall be comprised of four licensed physicians actively
engaged in the practice of medicine in Minnesota new text begin , new text end one of whom must be actively engaged
in the treatment of persons with mental illness; at least three licensed pharmacists actively
engaged in the practice of pharmacy in Minnesota; and one consumer representative; the
remainder to be made up of health care professionals who are licensed in their field and
have recognized knowledge in the clinically appropriate prescribing, dispensing, and
monitoring of covered outpatient drugs. Members of the Formulary Committee shall not
be employed by the Department of Human Services, but the committee shall be staffed by
an employee of the department who shall serve as an ex officio, nonvoting member of the
committee. The department's medical director shall also serve as an ex officio, nonvoting
member for the committee. Committee members shall serve three-year terms and may be
reappointed by the commissioner. The Formulary Committee shall meet at least twice per
year. The commissioner may require more frequent Formulary Committee meetings as
needed. An honorarium of $100 per meeting and reimbursement for mileage shall be paid
to each committee member in attendance. The Formulary Committee expires June 30, deleted text begin 2022 deleted text end new text begin
2023 new text end .

Sec. 10.

Minnesota Statutes 2020, section 256B.0625, subdivision 13d, is amended to
read:

Subd. 13d.

Drug formulary.

(a) The commissioner shall establish a drug formulary. Its
establishment and publication shall not be subject to the requirements of the Administrative
Procedure Act, but the Formulary Committee shall review and comment on the formulary
contents.

(b) The formulary shall not include:

(1) drugs, active pharmaceutical ingredients, or products for which there is no federal
funding;

(2) over-the-counter drugs, except as provided in subdivision 13;

deleted text begin (3) drugs or active pharmaceutical ingredients used for weight loss, except that medically
necessary lipase inhibitors may be covered for a recipient with type II diabetes;
deleted text end

deleted text begin (4) deleted text end new text begin (3) new text end drugs or active pharmaceutical ingredients when used for the treatment of
impotence or erectile dysfunction;

deleted text begin (5) deleted text end new text begin (4) new text end drugs or active pharmaceutical ingredients for which medical value has not been
established;

deleted text begin (6) deleted text end new text begin (5) new text end drugs from manufacturers who have not signed a rebate agreement with the
Department of Health and Human Services pursuant to section 1927 of title XIX of the
Social Security Act; and

deleted text begin (7) deleted text end new text begin (6) new text end medical cannabis as defined in section 152.22, subdivision 6.

(c) If a single-source drug used by at least two percent of the fee-for-service medical
assistance recipients is removed from the formulary due to the failure of the manufacturer
to sign a rebate agreement with the Department of Health and Human Services, the
commissioner shall notify prescribing practitioners within 30 days of receiving notification
from the Centers for Medicare and Medicaid Services (CMS) that a rebate agreement was
not signed.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, or upon federal approval,
whichever is later. The commissioner shall notify the revisor of statutes when federal
approval is obtained.
new text end

Sec. 11.

Minnesota Statutes 2020, section 256B.0625, subdivision 13e, is amended to
read:

Subd. 13e.

Payment rates.

(a) The basis for determining the amount of payment shall
be the lower of the ingredient costs of the drugs plus the professional dispensing fee; or the
usual and customary price charged to the public. The usual and customary price means the
lowest price charged by the provider to a patient who pays for the prescription by cash,
check, or charge account and includes prices the pharmacy charges to a patient enrolled in
a prescription savings club or prescription discount club administered by the pharmacy or
pharmacy chain. The amount of payment basis must be reduced to reflect all discount
amounts applied to the charge by any third-party provider/insurer agreement or contract for
submitted charges to medical assistance programs. The net submitted charge may not be
greater than the patient liability for the service. The professional dispensing fee shall be
deleted text begin $10.48 deleted text end new text begin $10.77 new text end for prescriptions filled with legend drugs meeting the definition of "covered
outpatient drugs" according to United States Code, title 42, section 1396r-8(k)(2). The
dispensing fee for intravenous solutions that must be compounded by the pharmacist shall
be deleted text begin $10.48 deleted text end new text begin $10.77 new text end per deleted text begin bag deleted text end new text begin claim new text end . The professional dispensing fee for prescriptions filled
with over-the-counter drugs meeting the definition of covered outpatient drugs shall be
deleted text begin $10.48 deleted text end new text begin $10.77 new text end for dispensed quantities equal to or greater than the number of units contained
in the manufacturer's original package. The professional dispensing fee shall be prorated
based on the percentage of the package dispensed when the pharmacy dispenses a quantity
less than the number of units contained in the manufacturer's original package. The pharmacy
dispensing fee for prescribed over-the-counter drugs not meeting the definition of covered
outpatient drugs shall be $3.65 for quantities equal to or greater than the number of units
contained in the manufacturer's original package and shall be prorated based on the
percentage of the package dispensed when the pharmacy dispenses a quantity less than the
number of units contained in the manufacturer's original package. The National Average
Drug Acquisition Cost (NADAC) shall be used to determine the ingredient cost of a drug.
For drugs for which a NADAC is not reported, the commissioner shall estimate the ingredient
cost at the wholesale acquisition cost minus two percent. The ingredient cost of a drug for
a provider participating in the federal 340B Drug Pricing Program shall be either the 340B
Drug Pricing Program ceiling price established by the Health Resources and Services
Administration or NADAC, whichever is lower. Wholesale acquisition cost is defined as
the manufacturer's list price for a drug or biological to wholesalers or direct purchasers in
the United States, not including prompt pay or other discounts, rebates, or reductions in
price, for the most recent month for which information is available, as reported in wholesale
price guides or other publications of drug or biological pricing data. The maximum allowable
cost of a multisource drug may be set by the commissioner and it shall be comparable to
the actual acquisition cost of the drug product and no higher than the NADAC of the generic
product. Establishment of the amount of payment for drugs shall not be subject to the
requirements of the Administrative Procedure Act.

(b) Pharmacies dispensing prescriptions to residents of long-term care facilities using
an automated drug distribution system meeting the requirements of section 151.58, or a
packaging system meeting the packaging standards set forth in Minnesota Rules, part
6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ
retrospective billing for prescription drugs dispensed to long-term care facility residents. A
retrospectively billing pharmacy must submit a claim only for the quantity of medication
used by the enrolled recipient during the defined billing period. A retrospectively billing
pharmacy must use a billing period not less than one calendar month or 30 days.

(c) A pharmacy provider using packaging that meets the standards set forth in Minnesota
Rules, part 6800.2700, is required to credit the department for the actual acquisition cost
of all unused drugs that are eligible for reuse, unless the pharmacy is using retrospective
billing. The commissioner may permit the drug clozapine to be dispensed in a quantity that
is less than a 30-day supply.

(d) If a pharmacy dispenses a multisource drug, the ingredient cost shall be the NADAC
of the generic product or the maximum allowable cost established by the commissioner
unless prior authorization for the brand name product has been granted according to the
criteria established by the Drug Formulary Committee as required by subdivision 13f,
paragraph (a), and the prescriber has indicated "dispense as written" on the prescription in
a manner consistent with section 151.21, subdivision 2.

(e) The basis for determining the amount of payment for drugs administered in an
outpatient setting shall be the lower of the usual and customary cost submitted by the
provider, 106 percent of the average sales price as determined by the United States
Department of Health and Human Services pursuant to title XVIII, section 1847a of the
federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost
set by the commissioner. If average sales price is unavailable, the amount of payment must
be lower of the usual and customary cost submitted by the provider, the wholesale acquisition
cost, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner.
The commissioner shall discount the payment rate for drugs obtained through the federal
340B Drug Pricing Program by 28.6 percent. The payment for drugs administered in an
outpatient setting shall be made to the administering facility or practitioner. A retail or
specialty pharmacy dispensing a drug for administration in an outpatient setting is not
eligible for direct reimbursement.

(f) The commissioner may establish maximum allowable cost rates for specialty pharmacy
products that are lower than the ingredient cost formulas specified in paragraph (a). The
commissioner may require individuals enrolled in the health care programs administered
by the department to obtain specialty pharmacy products from providers with whom the
commissioner has negotiated lower reimbursement rates. Specialty pharmacy products are
defined as those used by a small number of recipients or recipients with complex and chronic
diseases that require expensive and challenging drug regimens. Examples of these conditions
include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C,
growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms of
cancer. Specialty pharmaceutical products include injectable and infusion therapies,
biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies that
require complex care. The commissioner shall consult with the Formulary Committee to
develop a list of specialty pharmacy products subject to maximum allowable cost
reimbursement. In consulting with the Formulary Committee in developing this list, the
commissioner shall take into consideration the population served by specialty pharmacy
products, the current delivery system and standard of care in the state, and access to care
issues. The commissioner shall have the discretion to adjust the maximum allowable cost
to prevent access to care issues.

(g) Home infusion therapy services provided by home infusion therapy pharmacies must
be paid at rates according to subdivision 8d.

(h) The commissioner shall contract with a vendor to conduct a cost of dispensing survey
for all pharmacies that are physically located in the state of Minnesota that dispense outpatient
drugs under medical assistance. The commissioner shall ensure that the vendor has prior
experience in conducting cost of dispensing surveys. Each pharmacy enrolled with the
department to dispense outpatient prescription drugs to fee-for-service members must
respond to the cost of dispensing survey. The commissioner may sanction a pharmacy under
section 256B.064 for failure to respond. The commissioner shall require the vendor to
measure a single statewide cost of dispensing for new text begin specialty prescription drugs and a single
statewide cost of dispensing for nonspecialty prescription drugs for new text end all responding pharmacies
to measure the mean, mean weighted by total prescription volume, mean weighted by
medical assistance prescription volume, median, median weighted by total prescription
volume, and median weighted by total medical assistance prescription volume. The
commissioner shall post a copy of the final cost of dispensing survey report on the
department's website. The initial survey must be completed no later than January 1, 2021,
and repeated every three years. The commissioner shall provide a summary of the results
of each cost of dispensing survey and provide recommendations for any changes to the
dispensing fee to the chairs and ranking members of the legislative committees with
jurisdiction over medical assistance pharmacy reimbursement.

(i) The commissioner shall increase the ingredient cost reimbursement calculated in
paragraphs (a) and (f) by 1.8 percent for prescription and nonprescription drugs subject to
the wholesale drug distributor tax under section 295.52.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, except the amendment
to paragraph (h) is effective the day following final enactment.
new text end

Sec. 12.

Minnesota Statutes 2020, section 256B.0625, subdivision 13g, is amended to
read:

Subd. 13g.

Preferred drug list.

(a) The commissioner shall adopt and implement a
preferred drug list by January 1, 2004. The commissioner may enter into a contract with a
vendor for the purpose of participating in a preferred drug list and supplemental rebate
program. The commissioner shall ensure that any contract meets all federal requirements
and maximizes federal financial participation. The commissioner shall publish the preferred
drug list annually in the State Register and shall maintain an accurate and up-to-date list on
the agency website.

(b) The commissioner may add to, delete from, and otherwise modify the preferred drug
list, after consulting with the Formulary Committee and appropriate medical specialists and
providing public notice and the opportunity for public comment.

(c) The commissioner shall adopt and administer the preferred drug list as part of the
administration of the supplemental drug rebate program. Reimbursement for prescription
drugs not on the preferred drug list may be subject to prior authorization.

(d) For purposes of this subdivision, "preferred drug list" means a list of prescription
drugs within designated therapeutic classes selected by the commissioner, for which prior
authorization based on the identity of the drug or class is not required.

(e) The commissioner shall seek any federal waivers or approvals necessary to implement
this subdivision.

new text begin (f) Notwithstanding paragraph (b), before the commissioner may delete a drug from the
preferred drug list or modify the inclusion of a drug on the preferred drug list, the
commissioner shall consider any implications that the deletion or modification may have
on state public health policies or initiatives and any impact that the deletion or modification
may have on increasing health disparities in the state. Prior to deleting a drug or modifying
the inclusion of a drug, the commissioner shall also conduct a public hearing. The
commissioner shall provide adequate notice to the public and the commissioner of health
prior to the hearing that specifies the drug that the commissioner is proposing to delete or
modify, any public medical or clinical analysis that the commissioner has relied on in
proposing the deletion or modification, and evidence that the commissioner has evaluated
the impact of the proposed deletion or modification on public health and health disparities.
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. 13.

Minnesota Statutes 2020, section 256B.0625, subdivision 18, is amended to read:

Subd. 18.

deleted text begin Bus deleted text end new text begin Public transit new text end or taxicab transportation.

new text begin (a) new text end To the extent authorized
by rule of the state agency, medical assistance covers the most appropriate and cost-effective
form of transportation incurred by any ambulatory eligible person for obtaining
nonemergency medical care.

new text begin (b) The commissioner may provide a monthly public transit pass to recipients who are
well-served by public transit for the recipient's nonemergency medical transportation needs.
Any recipient who is eligible for one public transit trip for a medically necessary covered
service may select to receive a transit pass for that month. Recipients who do not have any
transportation needs for a medically necessary service in any given month or who have
received a transit pass for that month through another program administered by a county or
Tribe are not eligible for a transit pass that month. The commissioner shall not require
recipients to select a monthly transit pass if the recipient's transportation needs cannot be
served by public transit systems. Recipients who receive a monthly transit pass are not
eligible for other modes of transportation, unless an unexpected need arises that cannot be
accessed through public transit.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021.
new text end

Sec. 14.

Minnesota Statutes 2020, section 256B.0625, subdivision 31, is amended to read:

Subd. 31.

Medical supplies and equipment.

(a) Medical assistance covers medical
supplies and equipment. Separate payment outside of the facility's payment rate shall be
made for wheelchairs and wheelchair accessories for recipients who are residents of
intermediate care facilities for the developmentally disabled. Reimbursement for wheelchairs
and wheelchair accessories for ICF/DD recipients shall be subject to the same conditions
and limitations as coverage for recipients who do not reside in institutions. A wheelchair
purchased outside of the facility's payment rate is the property of the recipient.

(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
must enroll as a Medicare provider.

(c) When necessary to ensure access to durable medical equipment, prosthetics, orthotics,
or medical supplies, the commissioner may exempt a vendor from the Medicare enrollment
requirement if:

(1) the vendor supplies only one type of durable medical equipment, prosthetic, orthotic,
or medical supply;

(2) the vendor serves ten or fewer medical assistance recipients per year;

(3) the commissioner finds that other vendors are not available to provide same or similar
durable medical equipment, prosthetics, orthotics, or medical supplies; and

(4) the vendor complies with all screening requirements in this chapter and Code of
Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
and Medicaid Services approved national accreditation organization as complying with the
Medicare program's supplier and quality standards and the vendor serves primarily pediatric
patients.

(d) Durable medical equipment means a device or equipment that:

(1) can withstand repeated use;

(2) is generally not useful in the absence of an illness, injury, or disability; and

(3) is provided to correct or accommodate a physiological disorder or physical condition
or is generally used primarily for a medical purpose.

(e) Electronic tablets may be considered durable medical equipment if the electronic
tablet will be used as an augmentative and alternative communication system as defined
under subdivision 31a, paragraph (a). To be covered by medical assistance, the device must
be locked in order to prevent use not related to communication.

(f) Notwithstanding the requirement in paragraph (e) that an electronic tablet must be
locked to prevent use not as an augmentative communication device, a recipient of waiver
services may use an electronic tablet for a use not related to communication when the
recipient has been authorized under the waiver to receive one or more additional applications
that can be loaded onto the electronic tablet, such that allowing the additional use prevents
the purchase of a separate electronic tablet with waiver funds.

(g) An order or prescription for medical supplies, equipment, or appliances must meet
the requirements in Code of Federal Regulations, title 42, part 440.70.

new text begin (h) Allergen-reducing products provided according to subdivision 67, paragraph (c) or
(d), shall be considered durable medical equipment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 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. 15.

Minnesota Statutes 2020, section 256B.0625, subdivision 58, is amended to read:

Subd. 58.

Early and periodic screening, diagnosis, and treatment services.

new text begin (a) new text end Medical
assistance covers early and periodic screening, diagnosis, and treatment services (EPSDT).
new text begin In administering the EPSDT program, the commissioner shall, at a minimum:
new text end

new text begin (1) provide information to children and families, using the most effective mode identified,
regarding:
new text end

new text begin (i) the benefits of preventative health care visits;
new text end

new text begin (ii) the services available as part of the EPSDT program; and
new text end

new text begin (iii) assistance finding a provider, transportation, or interpreter services;
new text end

new text begin (2) maintain an up-to-date periodicity schedule published in the department policy
manual, taking into consideration the most up-to-date community standard of care; and
new text end

new text begin (3) maintain up-to-date policies for providers on the delivery of EPSDT services that
are in the provider manual on the department website.
new text end

new text begin (b) The commissioner may contract for the administration of the outreach services as
required within the EPSDT program.
new text end

new text begin (c) The commissioner may contract for the required EPSDT outreach services, including
but not limited to children enrolled or attributed to an integrated health partnership
demonstration project described in section 256B.0755. Integrated health partnerships that
choose to include the EPSDT outreach services within the integrated health partnership's
contracted responsibilities must receive compensation from the commissioner on a
per-member per-month basis for each included child. Integrated health partnerships must
accept responsibility for the effectiveness of outreach services it delivers. For children who
are not a part of the demonstration project, the commissioner may contract for the
administration of the outreach services.
new text end

new text begin (d) new text end The payment amount for a complete EPSDT screening shall not include charges for
health care services and products that are available at no cost to the provider and shall not
exceed the rate established per Minnesota Rules, part 9505.0445, item M, effective October
1, 2010.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, except that paragraph (c)
is effective January 1, 2022.
new text end

Sec. 16.

Minnesota Statutes 2020, section 256B.0625, is amended by adding a subdivision
to read:

new text begin Subd. 67. new text end

new text begin Enhanced asthma care services. new text end

new text begin (a) Medical assistance covers enhanced
asthma care services and related products to be provided in the children's homes for children
with poorly controlled asthma. To be eligible for services and products under this subdivision,
a child must:
new text end

new text begin (1) have poorly controlled asthma defined by having received health care for the child's
asthma from a hospital emergency department at least one time in the past year or have
been hospitalized for the treatment of asthma at least one time in the past year; and
new text end

new text begin (2) receive a referral for services and products under this subdivision from a treating
health care provider.
new text end

new text begin (b) Covered services include home visits provided by a registered environmental health
specialist or lead risk assessor currently credentialed by the Department of Health or a
healthy homes specialist credentialed by the Building Performance Institute.
new text end

new text begin (c) Covered products include the following allergen-reducing products that are identified
as needed and recommended for the child by a registered environmental health specialist,
healthy homes specialist, lead risk assessor, certified asthma educator, public health nurse,
or other health care professional providing asthma care for the child, and proven to reduce
asthma triggers:
new text end

new text begin (1) allergen encasements for mattresses, box springs, and pillows;
new text end

new text begin (2) an allergen-rated vacuum cleaner, filters, and bags;
new text end

new text begin (3) a dehumidifier and filters;
new text end

new text begin (4) HEPA single-room air cleaners and filters;
new text end

new text begin (5) integrated pest management, including traps and starter packages of food storage
containers;
new text end

new text begin (6) a damp mopping system;
new text end

new text begin (7) if the child does not have access to a bed, a waterproof hospital-grade mattress; and
new text end

new text begin (8) for homeowners only, furnace filters.
new text end

new text begin (d) The commissioner shall determine additional products that may be covered as new
best practices for asthma care are identified.
new text end

new text begin (e) A home assessment is a home visit to identify asthma triggers in the home and to
provide education on trigger-reducing products. A child is limited to two home assessments
except that a child may receive an additional home assessment if the child moves to a new
home; if a new asthma trigger, including tobacco smoke, enters the home; or if the child's
health care provider identifies a new allergy for the child, including an allergy to mold,
pests, pets, or dust mites. The commissioner shall determine the frequency with which a
child may receive a product under paragraph (c) or (d) based on the reasonable expected
lifetime of the product.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 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. 17.

Minnesota Statutes 2020, section 256B.0631, subdivision 1, is amended to read:

Subdivision 1.

Cost-sharing.

(a) Except as provided in subdivision 2, the medical
assistance benefit plan shall include the following cost-sharing for all recipients, effective
for services provided on or after September 1, 2011:

(1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes of this
subdivision, a visit means an episode of service which is required because of a recipient's
symptoms, diagnosis, or established illness, and which is delivered in an ambulatory setting
by a physician or physician assistant, chiropractor, podiatrist, nurse midwife, advanced
practice nurse, audiologist, optician, or optometrist;

(2) $3.50 for nonemergency visits to a hospital-based emergency room, except that this
co-payment shall be increased to $20 upon federal approval;

(3) $3 per brand-name drug prescription deleted text begin and deleted text end new text begin , new text end $1 per generic drug prescription, new text begin and $1
per prescription for a brand-name multisource drug listed in preferred status on the preferred
drug list, new text end subject to a $12 per month maximum for prescription drug co-payments. No
co-payments shall apply to antipsychotic drugs when used for the treatment of mental illness;

(4) a family deductible equal to $2.75 per month per family and adjusted annually by
the percentage increase in the medical care component of the CPI-U for the period of
September to September of the preceding calendar year, rounded to the next higher five-cent
increment; and

(5) total monthly cost-sharing must not exceed five percent of family income. For
purposes of this paragraph, family income is the total earned and unearned income of the
individual and the individual's spouse, if the spouse is enrolled in medical assistance and
also subject to the five percent limit on cost-sharing. This paragraph does not apply to
premiums charged to individuals described under section 256B.057, subdivision 9.

(b) Recipients of medical assistance are responsible for all co-payments and deductibles
in this subdivision.

(c) Notwithstanding paragraph (b), the commissioner, through the contracting process
under sections 256B.69 and 256B.692, may allow managed care plans and county-based
purchasing plans to waive the family deductible under paragraph (a), clause (4). The value
of the family deductible shall not be included in the capitation payment to managed care
plans and county-based purchasing plans. Managed care plans and county-based purchasing
plans shall certify annually to the commissioner the dollar value of the family deductible.

(d) Notwithstanding paragraph (b), the commissioner may waive the collection of the
family deductible described under paragraph (a), clause (4), from individuals and allow
long-term care and waivered service providers to assume responsibility for payment.

(e) Notwithstanding paragraph (b), the commissioner, through the contracting process
under section 256B.0756 shall allow the pilot program in Hennepin County to waive
co-payments. The value of the co-payments shall not be included in the capitation payment
amount to the integrated health care delivery networks under the pilot program.

new text begin EFFECTIVE DATE. new text end

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

Sec. 18.

Minnesota Statutes 2020, section 256B.69, is amended by adding a subdivision
to read:

new text begin Subd. 6f. new text end

new text begin Dental fee schedules. new text end

new text begin (a) A managed care plan, county-based purchasing plan,
or dental benefits administrator must provide individual dental providers, upon request, the
applicable fee schedules for covered dental services provided under the contract between
the dental provider and the managed care plan, county-based purchasing plan, or dental
benefits administrator.
new text end

new text begin (b) A managed care plan, county-based purchasing plan, or dental benefits administrator
may fulfill this requirement by making the applicable fee schedules available through a
secure web portal for the contracted dental provider to access.
new text end

new text begin (c) For purposes of this subdivision, "dental benefits administrator" means an organization
licensed under chapter 62C or 62D that contracts with a managed care plan or county-based
purchasing plan to provide covered dental care services to enrollees of the plan.
new text end

Sec. 19.

Minnesota Statutes 2020, section 256B.69, is amended by adding a subdivision
to read:

new text begin Subd. 6g. new text end

new text begin Uniform dental credentialing process. new text end

new text begin (a) By January 1, 2022, the managed
care plans, county-based purchasing plans, and dental benefit administrators that contract
with the commissioner or subcontract with plans to provide dental services to medical
assistance or MinnesotaCare enrollees shall develop a uniform credentialing process for
dental providers.
new text end

new text begin (b) The process developed in this subdivision must include a uniform credentialing
application that must be available in electronic format and accessible on each plan or dental
benefit administrator's website. The process developed under this subdivision must include
an option to electronically submit a completed application. The uniform credentialing
application must be available for free to providers.
new text end

new text begin (c) If applicable, a managed care plan, county-based purchasing plan, dental benefit
administrator, contractor, or vendor that reviews and approves a credentialing application
must notify a provider regarding a deficiency on a submitted credentialing application form
no later than 30 business days after receiving the application form from the provider.
new text end

new text begin (d) For purposes of this subdivision, "dental benefits administrator" means an
organization, including an organization licensed under chapter 62C or 62D, that contracts
with a managed care plan or county-based purchasing plan to provide covered dental care
services to enrollees of the plan.
new text end

new text begin (e) This subdivision must be in compliance with the federal requirements for Medicaid
and Basic Health Program provider enrollment.
new text end

Sec. 20.

Minnesota Statutes 2020, section 256B.69, is amended by adding a subdivision
to read:

new text begin Subd. 9f. new text end

new text begin Annual report on provider reimbursement rates. new text end

new text begin (a) The commissioner,
by December 15 of each year, beginning December 15, 2021, 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.
new text end

new text begin (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:
new text end

new text begin (1) physician prenatal services;
new text end

new text begin (2) physician preventive services;
new text end

new text begin (3) physician services other than prenatal or preventive;
new text end

new text begin (4) dental services;
new text end

new text begin (5) inpatient hospital services;
new text end

new text begin (6) outpatient hospital services; and
new text end

new text begin (7) mental health services.
new text end

new text begin (c) The commissioner shall also include in the report:
new text end

new text begin (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
new text end

new text begin (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).
new text end

Sec. 21.

Minnesota Statutes 2020, section 256B.75, is amended to read:

256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.

(a) For outpatient hospital facility fee payments for services rendered on or after October
1, 1992, the commissioner of human services shall pay the lower of (1) submitted charge,
or (2) 32 percent above the rate in effect on June 30, 1992, except for those services for
which there is a federal maximum allowable payment. Effective for services rendered on
or after January 1, 2000, payment rates for nonsurgical outpatient hospital facility fees and
emergency room facility fees shall be increased by eight percent over the rates in effect on
December 31, 1999, except for those services for which there is a federal maximum allowable
payment. Services for which there is a federal maximum allowable payment shall be paid
at the lower of (1) submitted charge, or (2) the federal maximum allowable payment. Total
aggregate payment for outpatient hospital facility fee services shall not exceed the Medicare
upper limit. If it is determined that a provision of this section conflicts with existing or
future requirements of the United States government with respect to federal financial
participation in medical assistance, the federal requirements prevail. The commissioner
may, in the aggregate, prospectively reduce payment rates to avoid reduced federal financial
participation resulting from rates that are in excess of the Medicare upper limitations.

(b) Notwithstanding paragraph (a), payment for outpatient, emergency, and ambulatory
surgery hospital facility fee services for critical access hospitals designated under section
144.1483, clause (9), shall be paid on a cost-based payment system that is based on the
cost-finding methods and allowable costs of the Medicare program. Effective for services
provided on or after July 1, 2015, rates established for critical access hospitals under this
paragraph for the applicable payment year shall be the final payment and shall not be settled
to actual costs. Effective for services delivered on or after the first day of the hospital's fiscal
year ending in 2017, the rate for outpatient hospital services shall be computed using
information from each hospital's Medicare cost report as filed with Medicare for the year
that is two years before the year that the rate is being computed. Rates shall be computed
using information from Worksheet C series until the department finalizes the medical
assistance cost reporting process for critical access hospitals. After the cost reporting process
is finalized, rates shall be computed using information from Title XIX Worksheet D series.
The outpatient rate shall be equal to ancillary cost plus outpatient cost, excluding costs
related to rural health clinics and federally qualified health clinics, divided by ancillary
charges plus outpatient charges, excluding charges related to rural health clinics and federally
qualified health clinics.

(c) Effective for services provided on or after July 1, 2003, rates that are based on the
Medicare outpatient prospective payment system shall be replaced by a budget neutral
prospective payment system that is derived using medical assistance data. The commissioner
shall provide a proposal to the 2003 legislature to define and implement this provision. new text begin
When implementing prospective payment methodologies, the commissioner shall use general
methods and rate calculation parameters similar to the applicable Medicare prospective
payment systems for services delivered in outpatient hospital and ambulatory surgical center
settings unless other payment methodologies for these services are specified in this chapter.
new text end

(d) For fee-for-service services provided on or after July 1, 2002, the total payment,
before third-party liability and spenddown, made to hospitals for outpatient hospital facility
services is reduced by .5 percent from the current statutory rate.

(e) In addition to the reduction in paragraph (d), the total payment for fee-for-service
services provided on or after July 1, 2003, made to hospitals for outpatient hospital facility
services before third-party liability and spenddown, is reduced five percent from the current
statutory rates. Facilities defined under section 256.969, subdivision 16, are excluded from
this paragraph.

(f) In addition to the reductions in paragraphs (d) and (e), the total payment for
fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient
hospital facility services before third-party liability and spenddown, is reduced three percent
from the current statutory rates. Mental health services and facilities defined under section
256.969, subdivision 16, are excluded from this paragraph.

Sec. 22.

Minnesota Statutes 2020, section 256B.76, subdivision 2, is amended to read:

Subd. 2.

Dental reimbursement.

(a) Effective for services rendered on or after October
1, 1992, the commissioner shall make payments for dental services as follows:

(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 percent
above the rate in effect on June 30, 1992; and

(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th percentile
of 1989, less the percent in aggregate necessary to equal the above increases.

(b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.

(c) Effective for services rendered on or after January 1, 2000, payment rates for dental
services shall be increased by three percent over the rates in effect on December 31, 1999.

(d) Effective for services provided on or after January 1, 2002, payment for diagnostic
examinations and dental x-rays provided to children under age 21 shall be the lower of (1)
the submitted charge, or (2) 85 percent of median 1999 charges.

(e) The increases listed in paragraphs (b) and (c) shall be implemented January 1, 2000,
for managed care.

(f) Effective for dental services rendered on or after October 1, 2010, by a state-operated
dental clinic, payment shall be paid on a reasonable cost basis that is based on the Medicare
principles of reimbursement. This payment shall be effective for services rendered on or
after January 1, 2011, to recipients enrolled in managed care plans or county-based
purchasing plans.

(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics in
paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal year, a
supplemental state payment equal to the difference between the total payments in paragraph
(f) and $1,850,000 shall be paid from the general fund to state-operated services for the
operation of the dental clinics.

deleted text begin (h) If the cost-based payment system for state-operated dental clinics described in
paragraph (f) does not receive federal approval, then state-operated dental clinics shall be
designated as critical access dental providers under subdivision 4, paragraph (b), and shall
receive the critical access dental reimbursement rate as described under subdivision 4,
paragraph (a).
deleted text end

deleted text begin (i) Effective for services rendered on or after September 1, 2011, through June 30, 2013,
payment rates for dental services shall be reduced by three percent. This reduction does not
apply to state-operated dental clinics in paragraph (f).
deleted text end

deleted text begin (j) deleted text end new text begin (h) new text end Effective for services rendered on or after January 1, 2014 new text begin , through December
31, 2021 new text end , payment rates for dental services shall be increased by five percent from the rates
in effect on December 31, 2013. This increase does not apply to state-operated dental clinics
in paragraph (f), federally qualified health centers, rural health centers, and Indian health
services. Effective January 1, 2014, payments made to managed care plans and county-based
purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment
increase described in this paragraph.

deleted text begin (k) Effective for services rendered on or after July 1, 2015, through December 31, 2016,
the commissioner shall increase payment rates for services furnished by dental providers
located outside of the seven-county metropolitan area by the maximum percentage possible
above the rates in effect on June 30, 2015, while remaining within the limits of funding
appropriated for this purpose. This increase does not apply to state-operated dental clinics
in paragraph (f), federally qualified health centers, rural health centers, and Indian health
services. Effective January 1, 2016, through December 31, 2016, payments to managed care
plans and county-based purchasing plans under sections 256B.69 and 256B.692 shall reflect
the payment increase described in this paragraph. The commissioner shall require managed
care and county-based purchasing plans to pass on the full amount of the increase, in the
form of higher payment rates to dental providers located outside of the seven-county
metropolitan area.
deleted text end

deleted text begin (l) deleted text end new text begin (i) new text end Effective for services provided on or after January 1, 2017 new text begin , through December 31,
2021 new text end , the commissioner shall increase payment rates by 9.65 percent for dental services
provided outside of the seven-county metropolitan area. This increase does not apply to
state-operated dental clinics in paragraph (f), federally qualified health centers, rural health
centers, or Indian health services. Effective January 1, 2017, payments to managed care
plans and county-based purchasing plans under sections 256B.69 and 256B.692 shall reflect
the payment increase described in this paragraph.

deleted text begin (m) deleted text end new text begin (j) new text end Effective for services provided on or after July 1, 2017 new text begin , through December 31,
2022 new text end , the commissioner shall increase payment rates by 23.8 percent for dental services
provided to enrollees under the age of 21. This rate increase does not apply to state-operated
dental clinics in paragraph (f), federally qualified health centers, rural health centers, or
Indian health centers. This rate increase does not apply to managed care plans and
county-based purchasing plans.

new text begin (k) Effective for services provided on or after January 1, 2022, the commissioner shall
exclude from medical assistance and MinnesotaCare payments for dental services to public
health and community health clinics the 20 percent increase authorized under Laws 1989,
chapter 327, section 5, subdivision 2, paragraph (b).
new text end

new text begin (l) Effective for services provided on or after January 1, 2022, the commissioner shall
increase payment rates by 98 percent for all dental services. This rate increase does not
apply to state-operated dental clinics, federally qualified health centers, rural health centers,
or Indian health services.
new text end

new text begin (m) Managed care plans and county-based purchasing plans shall reimburse providers
at a level that is at least equal to the rate paid under fee-for-service for dental services. If,
for any coverage year, federal approval is not received for this paragraph, the commissioner
must adjust the capitation rates paid to managed care plans and county-based purchasing
plans for that contract year to reflect the removal of this provision. Contracts between
managed care plans and county-based purchasing plans and providers to whom this paragraph
applies must allow recovery of payments from those providers if capitation rates are adjusted
in accordance with this paragraph. Payment recoveries must not exceed an amount equal
to any increase in rates that results from this provision. If, for any coverage year, federal
approval is not received for this paragraph, the commissioner shall not implement this
paragraph for subsequent coverage years.
new text end

Sec. 23.

Minnesota Statutes 2020, section 256B.76, subdivision 4, is amended to read:

Subd. 4.

Critical access dental providers.

(a) The commissioner shall increase
reimbursements to dentists and dental clinics deemed by the commissioner to be critical
access dental providers. For dental services rendered on or after July 1, 2016 new text begin , through
December 31, 2021 new text end , the commissioner shall increase reimbursement by 37.5 percent above
the reimbursement rate that would otherwise be paid to the critical access dental provider,
except as specified under paragraph (b). The commissioner shall pay the managed care
plans and county-based purchasing plans in amounts sufficient to reflect increased
reimbursements to critical access dental providers as approved by the commissioner.

(b) For dental services rendered on or after July 1, 2016 new text begin , through December 31, 2021 new text end ,
by a dental clinic or dental group that meets the critical access dental provider designation
under paragraph deleted text begin (d) deleted text end new text begin (f) new text end , clause (4), and is owned and operated by a health maintenance
organization licensed under chapter 62D, the commissioner shall increase reimbursement
by 35 percent above the reimbursement rate that would otherwise be paid to the critical
access provider.

new text begin (c) The commissioner shall increase reimbursement to dentists and dental clinics deemed
by the commissioner to be critical access dental providers. For dental services provided on
or after January 1, 2022, by a dental provider deemed to be a critical access dental provider
under paragraph (f), the commissioner shall increase reimbursement by 20 percent above
the reimbursement rate that would otherwise be paid to the critical access dental provider.
This paragraph does not apply to federally qualified health centers, rural health centers,
state-operated dental clinics, or Indian health centers.
new text end

new text begin (d) Managed care plans and county-based purchasing plans shall increase reimbursement
to critical access dental providers by at least the amount specified in paragraph (c). If, for
any coverage year, federal approval is not received for this paragraph, the commissioner
must adjust the capitation rates paid to managed care plans and county-based purchasing
plans for that contract year to reflect the removal of this provision. Contracts between
managed care plans and county-based purchasing plans and providers to whom this paragraph
applies must allow recovery of payments from those providers if capitation rates are adjusted
in accordance with this paragraph. Payment recoveries must not exceed an amount equal
to any increase in rates that results from this provision. If, for any coverage year, federal
approval is not received for this paragraph, the commissioner shall not implement this
paragraph for subsequent coverage years.
new text end

deleted text begin (c) deleted text end new text begin (e) new text end Critical access dental payments made under deleted text begin paragraph (a) or (b) deleted text end new text begin this subdivision new text end
for dental services provided by a critical access dental provider to an enrollee of a managed
care plan or county-based purchasing plan must not reflect any capitated payments or
cost-based payments from the managed care plan or county-based purchasing plan. The
managed care plan or county-based purchasing plan must base the additional critical access
dental payment on the amount that would have been paid for that service had the dental
provider been paid according to the managed care plan or county-based purchasing plan's
fee schedule that applies to dental providers that are not paid under a capitated payment or
cost-based payment.

deleted text begin (d) deleted text end new text begin (f) new text end The commissioner shall designate the following dentists and dental clinics as
critical access dental providers:

(1) nonprofit community clinics that:

(i) have nonprofit status in accordance with chapter 317A;

(ii) have tax exempt status in accordance with the Internal Revenue Code, section
501(c)(3);

(iii) are established to provide oral health services to patients who are low income,
uninsured, have special needs, and are underserved;

(iv) have professional staff familiar with the cultural background of the clinic's patients;

(v) charge for services on a sliding fee scale designed to provide assistance to low-income
patients based on current poverty income guidelines and family size;

(vi) do not restrict access or services because of a patient's financial limitations or public
assistance status; and

(vii) have free care available as needed;

(2) federally qualified health centers, rural health clinics, and public health clinics;

(3) hospital-based dental clinics owned and operated by a city, county, or former state
hospital as defined in section 62Q.19, subdivision 1, paragraph (a), clause (4);

(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
accordance with chapter 317A with more than 10,000 patient encounters per year with
patients who are uninsured or covered by medical assistance or MinnesotaCare;

(5) a dental clinic owned and operated by the University of Minnesota or the Minnesota
State Colleges and Universities system; and

(6) private practicing dentists if:

(i) the dentist's office is located within the seven-county metropolitan area and more
than 50 percent of the dentist's patient encounters per year are with patients who are uninsured
or covered by medical assistance or MinnesotaCare; or

(ii) the dentist's office is located outside the seven-county metropolitan area and more
than 25 percent of the dentist's patient encounters per year are with patients who are uninsured
or covered by medical assistance or MinnesotaCare.

Sec. 24.

Minnesota Statutes 2020, section 256B.79, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

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

(b) "Adverse outcomes" means maternal opiate addiction, other reportable prenatal
substance abuse, low birth weight, or preterm birth.

(c) "Qualified integrated perinatal care collaborative" or "collaborative" means a
combination of (1) members of community-based organizations that represent communities
within the identified targeted populations, and (2) local or tribally based service entities,
including health care, public health, social services, mental health, chemical dependency
treatment, and community-based providers, determined by the commissioner to meet the
criteria for the provision of integrated care and enhanced services for enrollees within
targeted populations.

(d) "Targeted populations" means pregnant medical assistance enrollees residing in
deleted text begin geographic areas deleted text end new text begin communities new text end identified by the commissioner as being at above-average
risk for adverse outcomes.

Sec. 25.

Minnesota Statutes 2020, section 256B.79, subdivision 3, is amended to read:

Subd. 3.

Grant awards.

The commissioner shall award grants to qualifying applicants
to support interdisciplinary, integrated perinatal care. Grant funds must be distributed through
a request for proposals process to a designated lead agency within an entity that has been
determined to be a qualified integrated perinatal care collaborative or within an entity in
the process of meeting the qualifications to become a qualified integrated perinatal care
collaborative deleted text begin , and priority shall be given to qualified integrated perinatal care collaboratives
that received grants under this section prior to January 1, 2019 deleted text end . Grant awards must be used
to support interdisciplinary, team-based needs assessments, planning, and implementation
of integrated care and enhanced services for targeted populations. In determining grant
award amounts, the commissioner shall consider the identified health and social risks linked
to adverse outcomes and attributed to enrollees within the identified targeted population.

Sec. 26.

new text begin [256B.795] MATERNAL AND INFANT HEALTH REPORT.
new text end

new text begin (a) The commissioner of human services, in consultation with the commissioner of
health, shall submit a biennial report beginning April 15, 2022, to the chairs and ranking
minority members of the legislative committees with jurisdiction over health policy and
finance on the effectiveness of state maternal and infant health policies and programs
addressing health disparities in prenatal and postpartum health outcomes. For each reporting
period, the commissioner shall determine the number of women enrolled in the medical
assistance program who are pregnant or are in the 12-month postpartum period of eligibility
and the percentage of women in that group who, during each reporting period:
new text end

new text begin (1) received prenatal services;
new text end

new text begin (2) received doula services;
new text end

new text begin (3) gave birth by primary cesarean section;
new text end

new text begin (4) gave birth to an infant who received care in the neonatal intensive care unit;
new text end

new text begin (5) gave birth to an infant who was premature or who had a low birth weight;
new text end

new text begin (6) experienced postpartum hemorrhage;
new text end

new text begin (7) received postpartum care within six weeks of giving birth; and
new text end

new text begin (8) received a prenatal and postpartum follow-up home visit from a public health nurse.
new text end

new text begin (b) These measurements must be determined through an analysis of the utilization data
from claims submitted during each reporting period and by any other appropriate means.
The measurements for each metric must be determined in the aggregate stratified by race
and ethnicity.
new text end

new text begin (c) The commissioner shall establish a baseline for the metrics described in paragraph
(a) using calendar year 2017. The initial report due April 15, 2022, must contain the baseline
metrics and the metrics data for calendar years 2019 and 2020. The following reports due
biennially thereafter must contain the metrics for the preceding two calendar years.
new text end

Sec. 27.

Minnesota Statutes 2020, section 256L.07, subdivision 2, is amended to read:

Subd. 2.

Must not have access to employer-subsidized minimum essential
coverage.

(a) To be eligible, a family or individual must not have access to subsidized health
coverage that is affordable and provides minimum value as defined in Code of Federal
Regulations, title 26, section 1.36B-2.

(b) new text begin Notwithstanding paragraph (a), an individual who has access through a spouse's or
parent's employer to subsidized health coverage that is deemed minimum essential coverage
under Code of Federal Regulations, title 26, section 1.36B-2, is eligible for MinnesotaCare
if the employee's portion of the annual premium for employee and dependent coverage
exceeds the required contribution percentage, as defined for premium tax credit eligibility
under United States Code, title 26, section 36B(c)(2)(C)(i)(II), as indexed according to item
(iv) of that section, of the individual's household income for the coverage year.
new text end

new text begin (c) new text end This subdivision does not apply to a family or individual who no longer has
employer-subsidized coverage due to the employer terminating health care coverage as an
employee benefit.

new text begin EFFECTIVE DATE. new text end

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

Sec. 28.

Minnesota Statutes 2020, section 256L.11, subdivision 6a, is amended to read:

Subd. 6a.

Dental providers.

new text begin (a) new text end Effective for dental services provided to MinnesotaCare
enrollees on or after January 1, 2018 new text begin , to December 31, 2021 new text end , the commissioner shall increase
payment rates to dental providers by 54 percent.

new text begin (b) Effective for dental services provided on or after January 1, 2022, payment rates to
dental providers shall equal the payment rates described in section 256B.76, subdivision 2.
new text end

new text begin (c) new text end Payments made to prepaid health plans under section 256L.12 shall reflect the payment
deleted text begin increase deleted text end new text begin rates new text end described in this subdivision. The prepaid health plans under contract with
the commissioner shall provide payments to dental providers that are at least equal to a rate
that includes the payment rate specified in this subdivision, and if applicable to the provider,
the rates described under subdivision 7.

Sec. 29.

Minnesota Statutes 2020, section 256L.11, subdivision 7, is amended to read:

Subd. 7.

Critical access dental providers.

new text begin (a) new text end Effective for dental services provided to
MinnesotaCare enrollees on or after July 1, 2017, the commissioner shall increase payment
rates to dentists and dental clinics deemed by the commissioner to be critical access providers
under section 256B.76, subdivision 4, by 20 percent above the payment rate that would
otherwise be paid to the provider. The commissioner shall pay the prepaid health plans
under contract with the commissioner amounts sufficient to reflect this rate increase. deleted text begin The
prepaid health plan must pass this rate increase to providers who have been identified by
the commissioner as critical access dental providers under section 256B.76, subdivision 4.
deleted text end

new text begin (b) Managed care plans and county-based purchasing plans shall increase reimbursement
to critical access dental providers by at least the amount specified in paragraph (a). If, for
any coverage year, federal approval is not received for this paragraph, the commissioner
must adjust the capitation rates paid to managed care plans and county-based purchasing
plans for that contract year to reflect the removal of this provision. Contracts between
managed care plans and county-based purchasing plans and providers to whom this paragraph
applies must allow recovery of payments from those providers if capitation rates are adjusted
in accordance with this paragraph. Payment recoveries must not exceed an amount equal
to any increase in rates that results from this provision. If, for any coverage year, federal
approval is not received for this paragraph, the commissioner shall not implement this
paragraph for subsequent coverage years.
new text end

Sec. 30.

Minnesota Statutes 2020, section 256L.15, subdivision 2, is amended to read:

Subd. 2.

Sliding fee scale; monthly individual or family income.

(a) The commissioner
shall establish a sliding fee scale to determine the percentage of monthly individual or family
income that households at different income levels must pay to obtain coverage through the
MinnesotaCare program. The sliding fee scale must be based on the enrollee's monthly
individual or family income.

(b) Beginning January 1, 2014, MinnesotaCare enrollees shall pay premiums according
to the premium scale specified in paragraph (d).

(c) Paragraph (b) does not apply to:

(1) children 20 years of age or younger; and

(2) individuals with household incomes below 35 percent of the federal poverty
guidelines.

(d) The following premium scale is established for each individual in the household who
is 21 years of age or older and enrolled in MinnesotaCare:

Federal Poverty Guideline Greater than or Equal to	Less than	Individual Premium Amount
35%	55%	$4
55%	80%	$6
80%	90%	$8
90%	100%	$10
100%	110%	$12
110%	120%	$14
120%	130%	$15
130%	140%	$16
140%	150%	$25
150%	160%	$37
160%	170%	$44
170%	180%	$52
180%	190%	$61
190%	200%	$71
200%		$80

new text begin (e) Beginning January 1, 2021, the commissioner shall adjust the premium scale
established under paragraph (d) to ensure that premiums do not exceed the amount that an
individual would have been required to pay if the individual was enrolled in an applicable
benchmark plan in accordance with the Code of Federal Regulations, title 42, section
600.505(a)(1).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from January 1, 2021 and
applies to premiums due on or after that date.
new text end

Sec. 31. new text begin FEDERAL APPROVAL; EXTENSION OF POSTPARTUM COVERAGE.
new text end

new text begin The commissioner of human services shall seek all federal waivers and approvals
necessary to extend medical assistance postpartum coverage, as provided in Minnesota
Statutes, sections 256B.055, subdivision 6, and 256B.06, subdivision 4.
new text end

Sec. 32. new text begin COVID-19 TREATMENT, TESTING, AND VACCINATION.
new text end

new text begin Medical assistance covers treatment, testing, and vaccination for COVID-19 as required
under and for the time periods specified in section 9811 of the federal American Rescue
Plan Act, Public Law 117-2.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from March 11, 2021.
new text end

Sec. 33. new text begin DENTAL HOME DEMONSTRATION PROJECT.
new text end

new text begin (a) The Dental Services Advisory Committee, in collaboration with stakeholders, shall
design a dental home demonstration project and present recommendations by February 1,
2022, to the commissioner and the chairs and ranking minority members of the legislative
committees with jurisdiction over health finance and policy.
new text end

new text begin (b) The Dental Services Advisory Committee, at a minimum, shall engage with the
following stakeholders: the Minnesota Department of Health, the Minnesota Dental
Association, the Minnesota Dental Hygienists' Association, the University of Minnesota
School of Dentistry, dental programs operated by the Minnesota State Colleges and
Universities system, and representatives of each of the following dental provider types
serving medical assistance and MinnesotaCare enrollees:
new text end

new text begin (1) private practice dental clinics for which medical assistance and MinnesotaCare
enrollees comprise more than 25 percent of the clinic's patient load;
new text end

new text begin (2) private practice dental clinics for which medical assistance and MinnesotaCare
enrollees comprise 25 percent or less of the clinic's patient load;
new text end

new text begin (3) nonprofit dental clinics with a primary focus on serving Indigenous communities
and other communities of color;
new text end

new text begin (4) nonprofit dental clinics with a primary focus on providing eldercare;
new text end

new text begin (5) nonprofit dental clinics with a primary focus on serving children;
new text end

new text begin (6) nonprofit dental clinics providing services within the seven-county metropolitan
area;
new text end

new text begin (7) nonprofit dental clinics providing services outside of the seven-county metropolitan
area; and
new text end

new text begin (8) multispecialty hospital-based dental clinics.
new text end

new text begin (c) The dental home demonstration project shall give incentives for qualified providers
that provide high-quality, patient-centered, comprehensive, and coordinated oral health
services. The demonstration project shall seek to increase the number of new dental providers
serving medical assistance and MinnesotaCare enrollees and increase the capacity of existing
providers. The demonstration project must test payment methods that establish value-based
incentives to:
new text end

new text begin (1) increase the extent to which current dental providers serve medical assistance and
MinnesotaCare enrollees across their lifespan;
new text end

new text begin (2) develop service models that create equity and reduce disparities in access to dental
services for high-risk and medically and socially complex enrollees;
new text end

new text begin (3) advance alternative delivery models of care within community settings using
evidence-based approaches and innovative workforce teams; and
new text end

new text begin (4) improve the quality of dental care by meeting dental home goals.
new text end

Sec. 34. new text begin OVERPAYMENTS FOR DURABLE MEDICAL EQUIPMENT,
PROSTHETICS, ORTHOTICS, OR SUPPLIES.
new text end

new text begin (a) Notwithstanding any other law to the contrary, providers who received payment for
durable medical equipment, prosthetics, orthotics, or supplies between January 1, 2018, and
June 30, 2019, that were subject to the upper payment limits under United States Code, title
42, section 1396b(i)(27), shall not be required to repay any amount received in excess of
the allowable amount to either the state or the Centers for Medicare and Medicaid Services.
new text end

new text begin (b) The state shall repay with state funds any amount owed to the Centers for Medicare
and Medicaid Services for the federal financial participation amount received by the state
for payments identified in paragraph (a) in excess of the amount allowed effective January
1, 2018, and the state shall hold harmless the providers who received these payments from
recovery of both the state and federal share of the amount determined to have exceeded the
Medicare upper payment limit.
new text end

new text begin (c) Nothing in this section shall be construed to prohibit the commissioner from recouping
past overpayments due to false claims or for reasons other than exceeding the Medicare
upper payment limits or from recouping future overpayments including the recoupment of
payments that exceed the upper Medicare payment limits.
new text end

Sec. 35. new text begin PROPOSED FORMULARY COMMITTEE.
new text end

new text begin By March 1, 2022, the commissioner of human services, after soliciting recommendations
from professional medical associations, professional pharmacy associations, and consumer
groups, shall submit to the chairs and ranking minority members of the legislative committees
with jurisdiction over health and human services an overview of the Formulary Committee
under Minnesota Statutes, section 256B.0625, subdivision 13c, that includes:
new text end

new text begin (1) a review of the current composition of and any recommended revisions to the
membership of the committee. The review shall ensure the committee is composed of
adequate representation of consumers and health care professionals with expertise in clinical
prescribing; and
new text end

new text begin (2) a summary of the committee's policies and procedures for the operation of the
committee, opportunities for public input, providing public notice, and gathering public
comments on the committee's recommendations and proposed actions.
new text end

Sec. 36. new text begin RESPONSE TO COVID-19 PUBLIC HEALTH EMERGENCY.
new text end

new text begin (a) Notwithstanding Minnesota Statutes, section 256B.057, subdivision 9, 256L.06,
subdivision 3, or any other provision to the contrary, the commissioner shall not collect any
unpaid premium for a coverage month that occurred during the COVID-19 public health
emergency declared by the United States Secretary of Health and Human Services.
new text end

new text begin (b) Notwithstanding any provision to the contrary, periodic data matching under
Minnesota Statutes, section 256B.0561, subdivision 2, may be suspended for up to six
months following the last day of the COVID-19 public health emergency declared by the
United States Secretary of Health and Human Services.
new text end

new text begin (c) Notwithstanding any provision to the contrary, the requirement for the commissioner
of human services to issue an annual report on periodic data matching under Minnesota
Statutes, section 256B.0561, is suspended for one year following the last day of the
COVID-19 public health emergency declared by the United States Secretary of Health and
Human 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. 37. new text begin DENTAL PROGRAM DELIVERY STUDY.
new text end

new text begin (a) The commissioner of human services shall review the Medicaid dental program
delivery systems in states that have enacted and implemented a carve out dental delivery
system. At a minimum, the review must compare in those states program design, provider
rates, program costs, including administrative costs, and quality metrics for children one
through 20 years of age with at least one preventive dental service within a year.
new text end

new text begin (b) The commissioner, in consultation with interested stakeholders, shall also conduct
an analysis of dental provider hesitancy to participate in the medical assistance program as
an enrolled provider.
new text end

new text begin (c) By February 1, 2022, the commissioner shall submit to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance the results of the review and analysis described in this section. The
commissioner may combine the requirements in this section with the dental home
demonstration project report due on February 1, 2022.
new text end

Sec. 38. new text begin DENTAL RATE REBASING.
new text end

new text begin The commissioner of human services shall present recommendations on dental rate
rebasing to the chairs and ranking minority members of the legislative committees with
jurisdiction over health and human services finance and policy by February 1, 2022. The
recommendations must be consistent with the proposed design of the dental home
demonstration project and must address the frequency of rebasing, whether rebasing should
incorporate an inflation factor, and other factors relevant to ensuring patient access to dental
providers and the delivery of high quality dental care.
new text end

Sec. 39. new text begin CONTINGENT FUNDING RELATED TO DENTAL ADMINISTRATOR.
new text end

new text begin If managed care and county-based purchasing plans do not meet in the aggregate the
dental access performance benchmark under Minnesota Statutes, section 256B.0371,
subdivision 1, for coverage year 2024, the general fund base for the department of human
services for the 2026-2027 biennium shall include $107,000 in fiscal year 2026 and $122,000
in fiscal year 2027 for staffing necessary to contract with a dental administrator, and $5,000
in fiscal year 2026 and $1,000 in fiscal year 2027 for systems changes necessary to contract
with a dental administrator.
new text end

Sec. 40. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Rules, parts 9505.0275; 9505.1693; 9505.1696, subparts 1, 2, 3, 4, 5, 6,
7, 8, 9, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, and 22; 9505.1699; 9505.1701; 9505.1703;
9505.1706; 9505.1712; 9505.1715; 9505.1718; 9505.1724; 9505.1727; 9505.1730;
9505.1733; 9505.1736; 9505.1739; 9505.1742; 9505.1745; and 9505.1748, new text end new text begin are repealed.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2020, section 16A.724, subdivision 2, new text end new text begin is repealed effective July
1, 2025.
new text end

ARTICLE 2

DEPARTMENT OF HUMAN SERVICES
LICENSING AND BACKGROUND STUDIES

Section 1.

Minnesota Statutes 2020, section 62V.05, is amended by adding a subdivision
to read:

new text begin Subd. 4a. new text end

new text begin Background study required. new text end

new text begin (a) The board must initiate background studies
under section 245C.031 of:
new text end

new text begin (1) each navigator;
new text end

new text begin (2) each in-person assister; and
new text end

new text begin (3) each certified application counselor.
new text end

new text begin (b) The board may initiate the background studies required by paragraph (a) using the
online NETStudy 2.0 system operated by the commissioner of human services.
new text end

new text begin (c) The board shall not permit any individual to provide any service or function listed
in paragraph (a) until the board has received notification from the commissioner of human
services indicating that the individual:
new text end

new text begin (1) is not disqualified under chapter 245C; or
new text end

new text begin (2) is disqualified, but has received a set aside from the board of that disqualification
according to sections 245C.22 and 245C.23.
new text end

new text begin (d) The board or its delegate shall review a reconsideration request of an individual in
paragraph (a), including granting a set aside, according to the procedures and criteria in
chapter 245C. The board shall notify the individual and the Department of Human Services
of the board's decision.
new text end

Sec. 2.

Minnesota Statutes 2020, section 122A.18, subdivision 8, is amended to read:

Subd. 8.

Background deleted text begin checks deleted text end new text begin studies new text end .

(a) The Professional Educator Licensing and
Standards Board and the Board of School Administrators must deleted text begin obtain a deleted text end new text begin initiate new text end criminal
history background deleted text begin check on deleted text end new text begin studies of new text end all first-time deleted text begin teaching deleted text end applicants for new text begin educator new text end licenses
under their jurisdiction. Applicants must include with their licensure applications:

(1) an executed criminal history consent form, including fingerprints; and

(2) payment to conduct the background deleted text begin check deleted text end new text begin study new text end . The Professional Educator Licensing
and Standards Board must deposit payments received under this subdivision in an account
in the special revenue fund. Amounts in the account are annually appropriated to the
Professional Educator Licensing and Standards Board to pay for the costs of background
deleted text begin checks deleted text end new text begin studies new text end on applicants for licensure.

(b) The background deleted text begin check deleted text end new text begin study new text end for all first-time teaching applicants for licenses must
include a review of information from the Bureau of Criminal Apprehension, including
criminal history data as defined in section 13.87, and must also include a review of the
national criminal records repository. The superintendent of the Bureau of Criminal
Apprehension is authorized to exchange fingerprints with the Federal Bureau of Investigation
for purposes of the criminal history check. deleted text begin The superintendent shall recover the cost to the
bureau of a background check through the fee charged to the applicant under paragraph (a).
deleted text end

(c) The Professional Educator Licensing and Standards Board deleted text begin must contract with deleted text end new text begin may
initiate criminal history background studies through new text end the commissioner of human services
new text begin according to section 245C.031 new text end to deleted text begin conduct background checks and deleted text end obtain background deleted text begin check deleted text end
new text begin study new text end data required under this chapter.

Sec. 3.

new text begin [245.975] OMBUDSPERSON FOR FAMILY CHILD CARE PROVIDERS.
new text end

new text begin Subdivision 1. new text end

new text begin Appointment. new text end

new text begin The governor shall appoint an ombudsperson in the
unclassified service to assist family child care providers with licensing, compliance, and
other issues facing family child care providers. The ombudsperson must be selected without
regard to the person's political affiliation and must have been a licensed family child care
provider for at least three years. The ombudsperson shall serve a term of four years, which
may be renewed, and may be removed prior to the end of the term for just cause.
new text end

new text begin Subd. 2. new text end

new text begin Duties. new text end

new text begin (a) The ombudsperson's duties shall include:
new text end

new text begin (1) advocating on behalf of a family child care provider to address all areas of concern
related to the provision of child care services, including licensing monitoring activities,
licensing actions, and other interactions with state and county licensing staff;
new text end

new text begin (2) providing recommendations for family child care improvement or family child care
provider education;
new text end

new text begin (3) operating a telephone line to answer questions, receive complaints, and discuss
agency actions when a family child care provider believes that the provider's rights or
program may have been adversely affected; and
new text end

new text begin (4) assisting a family child care license applicant with navigating the application process.
new text end

new text begin (b) The ombudsperson must report annually by December 31 to the commissioner and
the chairs and ranking minority members of the legislative committees with jurisdiction
over child care on the services provided by the ombudsperson to child care providers,
including the number and locations of child care providers served and the activities of the
ombudsperson in carrying out the duties under this section. The commissioner shall determine
the form of the report and may specify additional reporting requirements.
new text end

new text begin Subd. 3. new text end

new text begin Staff. new text end

new text begin The ombudsperson may appoint and compensate out of available funds
a deputy, confidential secretary, and other employees in the unclassified service as authorized
by law. The ombudsperson and the full-time staff are members of the Minnesota State
Retirement Association. The ombudsperson may delegate to staff members any authority
or duties of the office, except the duty to provide reports to the governor, commissioner, or
the legislature.
new text end

new text begin Subd. 4. new text end

new text begin Access to records. new text end

new text begin (a) The ombudsperson or designee, excluding volunteers,
has access to any data of a state agency necessary for the discharge of the ombudsperson's
duties, including records classified as confidential data on individuals or private data on
individuals under chapter 13 or any other law. The ombudsperson's data request must relate
to a specific case and is subject to section 13.03, subdivision 4. If the data concerns an
individual, the ombudsperson or designee shall first obtain the individual's consent. If the
individual is unable to consent and has no parent or legal guardian, then the ombudsperson's
or designee's access to the data is authorized by this section.
new text end

new text begin (b) The ombudsperson and designees must adhere to the Minnesota Government Data
Practices Act and must not disseminate any private or confidential data on individuals unless
specifically authorized by state, local, or federal law or pursuant to a court order.
new text end

new text begin (c) The commissioner and any county agency must provide the ombudsperson copies
of all fix-it tickets, correction orders, and licensing actions issued to family child care
providers.
new text end

new text begin Subd. 5. new text end

new text begin Independence of action. new text end

new text begin In carrying out the duties under this section, the
ombudsperson may, independently of the department, provide testimony to the legislature,
make periodic reports to the legislature, and address areas of concern to family child care
providers.
new text end

new text begin Subd. 6. new text end

new text begin Civil actions. new text end

new text begin The ombudsperson or designee is not civilly liable for any action
taken under this section if the action was taken in good faith, was within the scope of the
ombudsperson's authority, and did not constitute willful or reckless misconduct.
new text end

new text begin Subd. 7. new text end

new text begin Qualifications. new text end

new text begin The ombudsperson must be a person who has knowledge and
experience concerning the provision of family child care. The ombudsperson must be
experienced in dealing with governmental entities, interpretation of laws and regulations,
investigations, record keeping, report writing, public speaking, and management. A person
is not eligible to serve as the ombudsperson while running for or holding public office or
while holding a family child care license.
new text end

new text begin Subd. 8. new text end

new text begin Office support. new text end

new text begin The commissioner shall provide the ombudsperson with the
necessary office space, supplies, equipment, and clerical support to effectively perform the
duties under this section.
new text end

new text begin Subd. 9. new text end

new text begin Posting. new text end

new text begin (a) The commissioner shall post on the department's website the
mailing address, e-mail address, and telephone number for the office of the ombudsperson.
The commissioner shall provide family child care providers with the mailing address, e-mail
address, and telephone number of the ombudsperson's office on the family child care licensing
website and upon request of a family child care applicant or provider. Counties must provide
family child care applicants and providers with the name, mailing address, e-mail address,
and telephone number of the ombudsperson's office upon request.
new text end

new text begin (b) The ombudsperson must approve all postings and notices required by the department
and counties under this subdivision.
new text end

Sec. 4.

Minnesota Statutes 2020, section 245A.05, is amended to read:

245A.05 DENIAL OF APPLICATION.

(a) The commissioner may deny a license if an applicant or controlling individual:

(1) fails to submit a substantially complete application after receiving notice from the
commissioner under section 245A.04, subdivision 1;

(2) fails to comply with applicable laws or rules;

(3) knowingly withholds relevant information from or gives false or misleading
information to the commissioner in connection with an application for a license or during
an investigation;

(4) has a disqualification that has not been set aside under section 245C.22 and no
variance has been granted;

(5) has an individual living in the household who received a background study under
section 245C.03, subdivision 1, paragraph (a), clause (2), who has a disqualification that
has not been set aside under section 245C.22, and no variance has been granted;

(6) is associated with an individual who received a background study under section
245C.03, subdivision 1, paragraph (a), clause (6), who may have unsupervised access to
children or vulnerable adults, and who has a disqualification that has not been set aside
under section 245C.22, and no variance has been granted;

(7) fails to comply with section 245A.04, subdivision 1, paragraph (f) or (g);

(8) fails to demonstrate competent knowledge as required by section 245A.04, subdivision
6;

(9) has a history of noncompliance as a license holder or controlling individual with
applicable laws or rules, including but not limited to this chapter and chapters 119B and
245C; deleted text begin or
deleted text end

(10) is prohibited from holding a license according to section 245.095 deleted text begin . deleted text end new text begin ; or
new text end

new text begin (11) for a family foster setting, has nondisqualifying background study information, as
described in section 245C.05, subdivision 4, that reflects on the individual's ability to safely
provide care to foster children.
new text end

(b) An applicant whose application has been denied by the commissioner must be given
notice of the denial, which must state the reasons for the denial in plain language. Notice
must be given by certified mail or personal service. The notice must state the reasons the
application was denied and must inform the applicant of the right to a contested case hearing
under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The applicant may
appeal the denial by notifying the commissioner in writing by certified mail or personal
service. If mailed, the appeal must be postmarked and sent to the commissioner within 20
calendar days after the applicant received the notice of denial. If an appeal request is made
by personal service, it must be received by the commissioner within 20 calendar days after
the applicant received the notice of denial. Section 245A.08 applies to hearings held to
appeal the commissioner's denial of an application.

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 245A.07, subdivision 1, is amended to read:

Subdivision 1.

Sanctions; appeals; license.

(a) In addition to making a license conditional
under section 245A.06, the commissioner may suspend or revoke the license, impose a fine,
or secure an injunction against the continuing operation of the program of a license holder
who does not comply with applicable law or rule new text begin , or who has nondisqualifying background
study information, as described in section 245C.05, subdivision 4, that reflects on the license
holder's ability to safely provide care to foster children new text end . When applying sanctions authorized
under this section, the commissioner shall consider the nature, chronicity, or severity of the
violation of law or rule and the effect of the violation on the health, safety, or rights of
persons served by the program.

(b) If a license holder appeals the suspension or revocation of a license and the license
holder continues to operate the program pending a final order on the appeal, the commissioner
shall issue the license holder a temporary provisional license. Unless otherwise specified
by the commissioner, variances in effect on the date of the license sanction under appeal
continue under the temporary provisional license. If a license holder fails to comply with
applicable law or rule while operating under a temporary provisional license, the
commissioner may impose additional sanctions under this section and section 245A.06, and
may terminate any prior variance. If a temporary provisional license is set to expire, a new
temporary provisional license shall be issued to the license holder upon payment of any fee
required under section 245A.10. The temporary provisional license shall expire on the date
the final order is issued. If the license holder prevails on the appeal, a new nonprovisional
license shall be issued for the remainder of the current license period.

(c) If a license holder is under investigation and the license issued under this chapter is
due to expire before completion of the investigation, the program shall be issued a new
license upon completion of the reapplication requirements and payment of any applicable
license fee. Upon completion of the investigation, a licensing sanction may be imposed
against the new license under this section, section 245A.06, or 245A.08.

(d) Failure to reapply or closure of a license issued under this chapter by the license
holder prior to the completion of any investigation shall not preclude the commissioner
from issuing a licensing sanction under this section or section 245A.06 at the conclusion
of the investigation.

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 245A.10, subdivision 4, as amended by Laws
2021, chapter 30, article 17, section 47, is amended to read:

Subd. 4.

License or certification fee for certain programs.

(a) Child care centers shall
pay an annual nonrefundable license fee based on the following schedule:

	Licensed Capacity	Child Care Center License Fee
	1 to 24 persons	$200
	25 to 49 persons	$300
	50 to 74 persons	$400
	75 to 99 persons	$500
	100 to 124 persons	$600
	125 to 149 persons	$700
	150 to 174 persons	$800
	175 to 199 persons	$900
	200 to 224 persons	$1,000
	225 or more persons	$1,100

(b)(1) A program licensed to provide one or more of the home and community-based
services and supports identified under chapter 245D to persons with disabilities or age 65
and older, shall pay an annual nonrefundable license fee based on revenues derived from
the provision of services that would require licensure under chapter 245D during the calendar
year immediately preceding the year in which the license fee is paid, according to the
following schedule:

License Holder Annual Revenue		License Fee
less than or equal to $10,000		$200
greater than $10,000 but less than or equal to $25,000		$300
greater than $25,000 but less than or equal to $50,000		$400
greater than $50,000 but less than or equal to $100,000		$500
greater than $100,000 but less than or equal to $150,000		$600
greater than $150,000 but less than or equal to $200,000		$800
greater than $200,000 but less than or equal to $250,000		$1,000
greater than $250,000 but less than or equal to $300,000		$1,200
greater than $300,000 but less than or equal to $350,000		$1,400
greater than $350,000 but less than or equal to $400,000		$1,600
greater than $400,000 but less than or equal to $450,000		$1,800
greater than $450,000 but less than or equal to $500,000		$2,000
greater than $500,000 but less than or equal to $600,000		$2,250
greater than $600,000 but less than or equal to $700,000		$2,500
greater than $700,000 but less than or equal to $800,000		$2,750
greater than $800,000 but less than or equal to $900,000		$3,000
greater than $900,000 but less than or equal to $1,000,000		$3,250
greater than $1,000,000 but less than or equal to $1,250,000		$3,500
greater than $1,250,000 but less than or equal to $1,500,000		$3,750
greater than $1,500,000 but less than or equal to $1,750,000		$4,000
greater than $1,750,000 but less than or equal to $2,000,000		$4,250
greater than $2,000,000 but less than or equal to $2,500,000		$4,500
greater than $2,500,000 but less than or equal to $3,000,000		$4,750
greater than $3,000,000 but less than or equal to $3,500,000		$5,000
greater than $3,500,000 but less than or equal to $4,000,000		$5,500
greater than $4,000,000 but less than or equal to $4,500,000		$6,000
greater than $4,500,000 but less than or equal to $5,000,000		$6,500
greater than $5,000,000 but less than or equal to $7,500,000		$7,000
greater than $7,500,000 but less than or equal to $10,000,000		$8,500
greater than $10,000,000 but less than or equal to $12,500,000		$10,000
greater than $12,500,000 but less than or equal to $15,000,000		$14,000
greater than $15,000,000		$18,000

(2) If requested, the license holder shall provide the commissioner information to verify
the license holder's annual revenues or other information as needed, including copies of
documents submitted to the Department of Revenue.

(3) At each annual renewal, a license holder may elect to pay the highest renewal fee,
and not provide annual revenue information to the commissioner.

(4) A license holder that knowingly provides the commissioner incorrect revenue amounts
for the purpose of paying a lower license fee shall be subject to a civil penalty in the amount
of double the fee the provider should have paid.

(5) Notwithstanding clause (1), a license holder providing services under one or more
licenses under chapter 245B that are in effect on May 15, 2013, shall pay an annual license
fee for calendar years 2014, 2015, and 2016, equal to the total license fees paid by the license
holder for all licenses held under chapter 245B for calendar year 2013. For calendar year
2017 and thereafter, the license holder shall pay an annual license fee according to clause
(1).

(c) A chemical dependency treatment program licensed under chapter 245G, to provide
chemical dependency treatment shall pay an annual nonrefundable license fee based on the
following schedule:

	Licensed Capacity	License Fee
	1 to 24 persons	$600
	25 to 49 persons	$800
	50 to 74 persons	$1,000
	75 to 99 persons	$1,200
	100 or more persons	$1,400

(d) A deleted text begin chemical dependency deleted text end new text begin detoxification new text end program licensed under Minnesota Rules,
parts 9530.6510 to 9530.6590, deleted text begin to provide detoxification services deleted text end new text begin or a withdrawal management
program licensed under chapter 245F new text end shall pay an annual nonrefundable license fee based
on the following schedule:

	Licensed Capacity	License Fee
	1 to 24 persons	$760
	25 to 49 persons	$960
	50 or more persons	$1,160

new text begin A detoxification program that also operates a withdrawal management program at the same
location shall only pay one fee based upon the licensed capacity of the program with the
higher overall capacity.
new text end

(e) Except for child foster care, a residential facility licensed under Minnesota Rules,
chapter 2960, to serve children shall pay an annual nonrefundable license fee based on the
following schedule:

	Licensed Capacity	License Fee
	1 to 24 persons	$1,000
	25 to 49 persons	$1,100
	50 to 74 persons	$1,200
	75 to 99 persons	$1,300
	100 or more persons	$1,400

(f) A residential facility licensed under section 245I.23 or Minnesota Rules, parts
9520.0500 to 9520.0670, to serve persons with mental illness shall pay an annual
nonrefundable license fee based on the following schedule:

	Licensed Capacity	License Fee
	1 to 24 persons	$2,525
	25 or more persons	$2,725

(g) A residential facility licensed under Minnesota Rules, parts 9570.2000 to 9570.3400,
to serve persons with physical disabilities shall pay an annual nonrefundable license fee
based on the following schedule:

	Licensed Capacity	License Fee
	1 to 24 persons	$450
	25 to 49 persons	$650
	50 to 74 persons	$850
	75 to 99 persons	$1,050
	100 or more persons	$1,250

(h) A program licensed to provide independent living assistance for youth under section
245A.22 shall pay an annual nonrefundable license fee of $1,500.

(i) A private agency licensed to provide foster care and adoption services under Minnesota
Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable license fee of $875.

(j) A program licensed as an adult day care center licensed under Minnesota Rules, parts
9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on the
following schedule:

	Licensed Capacity	License Fee
	1 to 24 persons	$500
	25 to 49 persons	$700
	50 to 74 persons	$900
	75 to 99 persons	$1,100
	100 or more persons	$1,300

(k) A program licensed to provide treatment services to persons with sexual psychopathic
personalities or sexually dangerous persons under Minnesota Rules, parts 9515.3000 to
9515.3110, shall pay an annual nonrefundable license fee of $20,000.

(l) A mental health clinic certified under section 245I.20 shall pay an annual
nonrefundable certification fee of $1,550. If the mental health clinic provides services at a
primary location with satellite facilities, the satellite facilities shall be certified with the
primary location without an additional charge.

Sec. 7.

Minnesota Statutes 2020, section 245A.14, subdivision 4, is amended to read:

Subd. 4.

Special family deleted text begin day deleted text end new text begin child new text end care homes.

Nonresidential child care programs
serving 14 or fewer children that are conducted at a location other than the license holder's
own residence shall be licensed under this section and the rules governing family deleted text begin day deleted text end new text begin child new text end
care or group family deleted text begin day deleted text end new text begin child new text end care if:

(a) the license holder is the primary provider of care and the nonresidential child care
program is conducted in a dwelling that is located on a residential lot;

(b) the license holder is an employer who may or may not be the primary provider of
care, and the purpose for the child care program is to provide child care services to children
of the license holder's employees;

(c) the license holder is a church or religious organization;

(d) the license holder is a community collaborative child care provider. For purposes of
this subdivision, a community collaborative child care provider is a provider participating
in a cooperative agreement with a community action agency as defined in section 256E.31;

(e) the license holder is a not-for-profit agency that provides child care in a dwelling
located on a residential lot and the license holder maintains two or more contracts with
community employers or other community organizations to provide child care services.
The county licensing agency may grant a capacity variance to a license holder licensed
under this paragraph to exceed the licensed capacity of 14 children by no more than five
children during transition periods related to the work schedules of parents, if the license
holder meets the following requirements:

(1) the program does not exceed a capacity of 14 children more than a cumulative total
of four hours per day;

(2) the program meets a one to seven staff-to-child ratio during the variance period;

(3) all employees receive at least an extra four hours of training per year than required
in the rules governing family child care each year;

(4) the facility has square footage required per child under Minnesota Rules, part
9502.0425;

(5) the program is in compliance with local zoning regulations;

(6) the program is in compliance with the applicable fire code as follows:

(i) if the program serves more than five children older than 2-1/2 years of age, but no
more than five children 2-1/2 years of age or less, the applicable fire code is educational
occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code 2015,
Section 202; or

(ii) if the program serves more than five children 2-1/2 years of age or less, the applicable
fire code is Group I-4 Occupancies, as provided in the Minnesota State Fire Code 2015,
Section 202, unless the rooms in which the children are cared for are located on a level of
exit discharge and each of these child care rooms has an exit door directly to the exterior,
then the applicable fire code is Group E occupancies, as provided in the Minnesota State
Fire Code 2015, Section 202; and

(7) any age and capacity limitations required by the fire code inspection and square
footage determinations shall be printed on the license; or

(f) the license holder is the primary provider of care and has located the licensed child
care program in a commercial space, if the license holder meets the following requirements:

(1) the program is in compliance with local zoning regulations;

(2) the program is in compliance with the applicable fire code as follows:

(i) if the program serves more than five children older than 2-1/2 years of age, but no
more than five children 2-1/2 years of age or less, the applicable fire code is educational
occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code 2015,
Section 202; or

(ii) if the program serves more than five children 2-1/2 years of age or less, the applicable
fire code is Group I-4 Occupancies, as provided under the Minnesota State Fire Code 2015,
Section 202;

(3) any age and capacity limitations required by the fire code inspection and square
footage determinations are printed on the license; and

(4) the license holder prominently displays the license issued by the commissioner which
contains the statement "This special family child care provider is not licensed as a child
care center."

(g) deleted text begin The commissioner may approve two or more licenses under paragraphs (a) to (f) to
be issued at the same location or under one contiguous roof, if each license holder is able
to demonstrate compliance with all applicable rules and laws. Each license holder must
operate the license holder's respective licensed program as a distinct program and within
the capacity, age, and ratio distributions of each license. deleted text end new text begin Notwithstanding Minnesota Rules,
part 9502.0335, subpart 12, the commissioner may issue up to four licenses to an organization
licensed under paragraphs (b), (c), or (e). Each license must have its own primary provider
of care as required under paragraph (i). Each license must operate as a distinct and separate
program in compliance with all applicable laws and regulations.
new text end

(h) deleted text begin The commissioner may grant variances to this section to allow a primary provider
of care, a not-for-profit organization, a church or religious organization, an employer, or a
community collaborative to be licensed to provide child care under paragraphs (e) and (f)
if the license holder meets the other requirements of the statute. deleted text end new text begin For licenses issued under
paragraphs (b), (c), (d), (e), or (f), the commissioner may approve up to four licenses at the
same location or under one contiguous roof if each license holder is able to demonstrate
compliance with all applicable rules and laws. Each licensed program must operate as a
distinct program and within the capacity, age, and ratio distributions of each license.
new text end

new text begin (i) For a license issued under paragraphs (b), (c), or (e), the license holder must designate
a person to be the primary provider of care at the licensed location on a form and in a manner
prescribed by the commissioner. The license holder shall notify the commissioner in writing
before there is a change of the person designated to be the primary provider of care. The
primary provider of care:
new text end

new text begin (1) must be the person who will be the provider of care at the program and present during
the hours of operation;
new text end

new text begin (2) must operate the program in compliance with applicable laws and regulations under
chapter 245A and Minnesota Rules, chapter 9502;
new text end

new text begin (3) is considered a child care background study subject as defined in section 245C.02,
subdivision 6a, and must comply with background study requirements in chapter 245C; and
new text end

new text begin (4) must complete the training that is required of license holders in section 245A.50.
new text end

new text begin (j) For any license issued under this subdivision, the license holder must ensure that any
other caregiver, substitute, or helper who assists in the care of children meets the training
requirements in section 245A.50 and background study requirements under chapter 245C.
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. 8.

Minnesota Statutes 2020, section 245A.16, is amended by adding a subdivision to
read:

new text begin Subd. 9. new text end

new text begin Licensed family foster settings. new text end

new text begin (a) Before recommending to grant a license,
deny a license under section 245A.05, or revoke a license under section 245A.07 for
nondisqualifying background study information received under section 245C.05, subdivision
4, paragraph (a), clause (3), for a licensed family foster setting, a county agency or private
agency that has been designated or licensed by the commissioner must review the following:
new text end

new text begin (1) the type of offenses;
new text end

new text begin (2) the number of offenses;
new text end

new text begin (3) the nature of the offenses;
new text end

new text begin (4) the age of the individual at the time of the offenses;
new text end

new text begin (5) the length of time that has elapsed since the last offense;
new text end

new text begin (6) the relationship of the offenses and the capacity to care for a child;
new text end

new text begin (7) evidence of rehabilitation;
new text end

new text begin (8) information or knowledge from community members regarding the individual's
capacity to provide foster care;
new text end

new text begin (9) any available information regarding child maltreatment reports or child in need of
protection or services petitions, or related cases, in which the individual has been involved
or implicated, and documentation that the individual has remedied issues or conditions
identified in child protection or court records that are relevant to safely caring for a child;
new text end

new text begin (10) a statement from the study subject;
new text end

new text begin (11) a statement from the license holder; and
new text end

new text begin (12) other aggravating and mitigating factors.
new text end

new text begin (b) For purposes of this section, "evidence of rehabilitation" includes but is not limited
to the following:
new text end

new text begin (1) maintaining a safe and stable residence;
new text end

new text begin (2) continuous, regular, or stable employment;
new text end

new text begin (3) successful participation in an education or job training program;
new text end

new text begin (4) positive involvement with the community or extended family;
new text end

new text begin (5) compliance with the terms and conditions of probation or parole following the
individual's most recent conviction;
new text end

new text begin (6) if the individual has had a substance use disorder, successful completion of a substance
use disorder assessment, substance use disorder treatment, and recommended continuing
care, if applicable, demonstrated abstinence from controlled substances, as defined in section
152.01, subdivision 4, or the establishment of a sober network;
new text end

new text begin (7) if the individual has had a mental illness or documented mental health issues,
demonstrated completion of a mental health evaluation, participation in therapy or other
recommended mental health treatment, or appropriate medication management, if applicable;
new text end

new text begin (8) if the individual's offense or conduct involved domestic violence, demonstrated
completion of a domestic violence or anger management program, and the absence of any
orders for protection or harassment restraining orders against the individual since the previous
offense or conduct;
new text end

new text begin (9) written letters of support from individuals of good repute, including but not limited
to employers, members of the clergy, probation or parole officers, volunteer supervisors,
or social services workers;
new text end

new text begin (10) demonstrated remorse for convictions or conduct, or demonstrated positive behavior
changes; and
new text end

new text begin (11) absence of convictions or arrests since the previous offense or conduct, including
any convictions that were expunged or pardoned.
new text end

new text begin (c) An applicant for a family foster setting license must sign all releases of information
requested by the county or private licensing agency.
new text end

new text begin (d) When licensing a relative for a family foster setting, the commissioner shall also
consider the importance of maintaining the child's relationship with relatives as an additional
significant factor in determining whether an application will be denied.
new text end

new text begin (e) When recommending that the commissioner deny or revoke a license, the county or
private licensing agency must send a summary of the review completed according to
paragraph (a), on a form developed by the commissioner, to the commissioner and include
any recommendation for licensing action.
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. 9.

Minnesota Statutes 2020, section 245A.50, subdivision 7, is amended to read:

Subd. 7.

Training requirements for family and group family child care.

new text begin (a) new text end For
purposes of family and group family child care, the license holder and each second adult
caregiver must complete 16 hours of ongoing training each year. Repeat of topical training
requirements in subdivisions 2 to 8 shall count toward the annual 16-hour training
requirement. Additional ongoing training subjects to meet the annual 16-hour training
requirement must be selected from the following areas:

(1) child development and learning training in understanding how a child develops
physically, cognitively, emotionally, and socially, and how a child learns as part of the
child's family, culture, and community;

(2) developmentally appropriate learning experiences, including training in creating
positive learning experiences, promoting cognitive development, promoting social and
emotional development, promoting physical development, promoting creative development;
and behavior guidance;

(3) relationships with families, including training in building a positive, respectful
relationship with the child's family;

(4) assessment, evaluation, and individualization, including training in observing,
recording, and assessing development; assessing and using information to plan; and assessing
and using information to enhance and maintain program quality;

(5) historical and contemporary development of early childhood education, including
training in past and current practices in early childhood education and how current events
and issues affect children, families, and programs;

(6) professionalism, including training in knowledge, skills, and abilities that promote
ongoing professional development; and

(7) health, safety, and nutrition, including training in establishing healthy practices;
ensuring safety; and providing healthy nutrition.

new text begin (b) A provider who is approved as a trainer through the Develop data system may count
up to two hours of training instruction toward the annual 16-hour training requirement in
paragraph (a). The provider may only count training instruction hours for the first instance
in which they deliver a particular content-specific training during each licensing year. Hours
counted as training instruction must be approved through the Develop data system with
attendance verified on the trainer's individual learning record and must be in Knowledge
and Competency Framework content area VII A (Establishing Healthy Practices) or B
(Ensuring Safety).
new text end

Sec. 10.

Minnesota Statutes 2020, section 245A.50, subdivision 9, is amended to read:

Subd. 9.

Supervising for safety; training requirement.

(a) Courses required by this
subdivision must include the following health and safety topics:

(1) preventing and controlling infectious diseases;

(2) administering medication;

(3) preventing and responding to allergies;

(4) ensuring building and physical premises safety;

(5) handling and storing biological contaminants;

(6) preventing and reporting child abuse and maltreatment; and

(7) emergency preparedness.

(b) Before initial licensure and before caring for a child, all family child care license
holders and each second adult caregiver shall complete and document the completion of
the six-hour Supervising for Safety for Family Child Care course developed by the
commissioner.

(c) The license holder must ensure and document that, before caring for a child, all
substitutes have completed the four-hour Basics of Licensed Family Child Care for
Substitutes course developed by the commissioner, which must include health and safety
topics as well as child development and learning.

(d) The family child care license holder and each second adult caregiver shall complete
and document:

(1) the annual completion of new text begin either:
new text end

new text begin (i) new text end a two-hour active supervision course developed by the commissioner; new text begin or
new text end

new text begin (ii) any courses in the ensuring safety competency area under the health, safety, and
nutrition standard of the Knowledge and Competency Framework that the commissioner
has identified as an active supervision training course; new text end and

(2) the completion at least once every five years of the two-hour courses Health and
Safety I and Health and Safety II. When the training is due for the first time or expires, it
must be taken no later than the day before the anniversary of the license holder's license
effective date. A license holder's or second adult caregiver's completion of either training
in a given year meets the annual active supervision training requirement in clause (1).

(e) At least once every three years, license holders must ensure and document that
substitutes have completed the four-hour Basics of Licensed Family Child Care for
Substitutes course. When the training expires, it must be retaken no later than the day before
the anniversary of the license holder's license effective date.

Sec. 11.

Minnesota Statutes 2020, section 245C.02, subdivision 4a, is amended to read:

Subd. 4a.

Authorized fingerprint collection vendor.

"Authorized fingerprint collection
vendor" means a qualified organization under a written contract with the commissioner to
provide services in accordance with section 245C.05, subdivision 5, paragraph (b). new text begin The
commissioner may retain the services of more than one authorized fingerprint collection
vendor.
new text end

Sec. 12.

Minnesota Statutes 2020, section 245C.02, subdivision 5, is amended to read:

Subd. 5.

Background study.

"Background study" means new text begin :
new text end

new text begin (1) the collection and processing of a background study subject's fingerprints, including
the process of obtaining a background study subject's classifiable fingerprints and photograph
as required by section 245C.05, subdivision 5, paragraph (b); and
new text end

new text begin (2) new text end the review of records conducted by the commissioner to determine whether a subject
is disqualified from direct contact with persons served by a program and, where specifically
provided in statutes, whether a subject is disqualified from having access to persons served
by a program and from working in a children's residential facility or foster residence setting.

Sec. 13.

Minnesota Statutes 2020, section 245C.02, is amended by adding a subdivision
to read:

new text begin Subd. 5b. new text end

new text begin Alternative background study. new text end

new text begin "Alternative background study" means:
new text end

new text begin (1) the collection and processing of a background study subject's fingerprints, including
the process of obtaining a background study subject's classifiable fingerprints and photograph
as required by section 245C.05, subdivision 5, paragraph (b); and
new text end

new text begin (2) a review of records conducted by the commissioner pursuant to section 245C.08 in
order to forward the background study investigating information to the entity that submitted
the alternative background study request under section 245C.031, subdivision 2. The
commissioner shall not make any eligibility determinations on background studies conducted
under section 245C.031.
new text end

Sec. 14.

Minnesota Statutes 2020, section 245C.02, is amended by adding a subdivision
to read:

new text begin Subd. 5c. new text end

new text begin Public law background study. new text end

new text begin "Public law background study" means a
background study conducted by the commissioner pursuant to section 245C.032.
new text end

Sec. 15.

Minnesota Statutes 2020, section 245C.02, is amended by adding a subdivision
to read:

new text begin Subd. 11c. new text end

new text begin Entity. new text end

new text begin "Entity" means any program, organization, or agency initiating a
background study.
new text end

Sec. 16.

Minnesota Statutes 2020, section 245C.02, is amended by adding a subdivision
to read:

new text begin Subd. 16a. new text end

new text begin Results. new text end

new text begin "Results" means a determination that a study subject is eligible,
disqualified, set aside, granted a variance, or that more time is needed to complete the
background study.
new text end

Sec. 17.

Minnesota Statutes 2020, section 245C.03, is amended to read:

245C.03 BACKGROUND STUDY; INDIVIDUALS TO BE STUDIED.

Subdivision 1.

Licensed programs.

(a) The commissioner shall conduct a background
study on:

(1) the person or persons applying for a license;

(2) an individual age 13 and over living in the household where the licensed program
will be provided who is not receiving licensed services from the program;

(3) current or prospective employees or contractors of the applicant who will have direct
contact with persons served by the facility, agency, or program;

(4) volunteers or student volunteers who will have direct contact with persons served
by the program to provide program services if the contact is not under the continuous, direct
supervision by an individual listed in clause (1) or (3);

(5) an individual age ten to 12 living in the household where the licensed services will
be provided when the commissioner has reasonable cause as defined in section 245C.02,
subdivision 15;

(6) an individual who, without providing direct contact services at a licensed program,
may have unsupervised access to children or vulnerable adults receiving services from a
program, when the commissioner has reasonable cause as defined in section 245C.02,
subdivision 15;

(7) all controlling individuals as defined in section 245A.02, subdivision 5a;

(8) notwithstanding the other requirements in this subdivision, child care background
study subjects as defined in section 245C.02, subdivision 6a; and

(9) notwithstanding clause (3), for children's residential facilities and foster residence
settings, any adult working in the facility, whether or not the individual will have direct
contact with persons served by the facility.

(b) For child foster care when the license holder resides in the home where foster care
services are provided, a short-term substitute caregiver providing direct contact services for
a child for less than 72 hours of continuous care is not required to receive a background
study under this chapter.

new text begin (c) This subdivision applies to the following programs that must be licensed under
chapter 245A:
new text end

new text begin (1) adult foster care;
new text end

new text begin (2) child foster care;
new text end

new text begin (3) children's residential facilities;
new text end

new text begin (4) family child care;
new text end

new text begin (5) licensed child care centers;
new text end

new text begin (6) licensed home and community-based services under chapter 245D;
new text end

new text begin (7) residential mental health programs for adults;
new text end

new text begin (8) substance use disorder treatment programs under chapter 245G;
new text end

new text begin (9) withdrawal management programs under chapter 245F;
new text end

new text begin (10) adult day care centers;
new text end

new text begin (11) family adult day services;
new text end

new text begin (12) independent living assistance for youth;
new text end

new text begin (13) detoxification programs;
new text end

new text begin (14) community residential settings; and
new text end

new text begin (15) intensive residential treatment services and residential crisis stabilization under
chapter 245I.
new text end

new text begin Subd. 1a. new text end

new text begin Procedure. new text end

new text begin (a) Individuals and organizations that are required under this
section to have or initiate background studies shall comply with the requirements of this
chapter.
new text end

new text begin (b) All studies conducted under this section shall be conducted according to sections
299C.60 to 299C.64. This requirement does not apply to subdivisions 1, paragraph (c),
clauses (2) to (5), and 6a.
new text end

Subd. 2.

Personal care provider organizations.

The commissioner shall conduct
background studies on any individual required under sections 256B.0651 to 256B.0654 and
256B.0659 to have a background study completed under this chapter.

Subd. 3.

Supplemental nursing services agencies.

The commissioner shall conduct all
background studies required under this chapter and initiated by supplemental nursing services
agencies registered under section 144A.71, subdivision 1.

new text begin Subd. 3a. new text end

new text begin Personal care assistance provider agency; background studies. new text end

new text begin Personal
care assistance provider agencies enrolled to provide personal care assistance services under
the medical assistance program must meet the following requirements:
new text end

new text begin (1) owners who have a five percent interest or more and all managing employees are
subject to a background study as provided in this chapter. This requirement applies to
currently enrolled personal care assistance provider agencies and agencies seeking enrollment
as a personal care assistance provider agency. "Managing employee" has the same meaning
as Code of Federal Regulations, title 42, section 455.101. An organization is barred from
enrollment if:
new text end

new text begin (i) the organization has not initiated background studies of owners and managing
employees; or
new text end

new text begin (ii) the organization has initiated background studies of owners and managing employees
and the commissioner has sent the organization a notice that an owner or managing employee
of the organization has been disqualified under section 245C.14, and the owner or managing
employee has not received a set aside of the disqualification under section 245C.22; and
new text end

new text begin (2) a background study must be initiated and completed for all qualified professionals.
new text end

new text begin Subd. 3b. new text end

new text begin Exception to personal care assistant; requirements. new text end

new text begin The personal care
assistant for a recipient may be allowed to enroll with a different personal care assistance
provider agency upon initiation of a new background study according to this chapter if:
new text end

new text begin (1) the commissioner determines that a change in enrollment or affiliation of the personal
care assistant is needed in order to ensure continuity of services and protect the health and
safety of the recipient;
new text end

new text begin (2) the chosen agency has been continuously enrolled as a personal care assistance
provider agency for at least two years;
new text end

new text begin (3) the recipient chooses to transfer to the personal care assistance provider agency;
new text end

new text begin (4) the personal care assistant has been continuously enrolled with the former personal
care assistance provider agency since the last background study was completed; and
new text end

new text begin (5) the personal care assistant continues to meet requirements of section 256B.0659,
subdivision 11, notwithstanding paragraph (a), clause (3).
new text end

Subd. 4.

Personnel agencies; educational programs; professional services
agencies.

The commissioner also may conduct studies on individuals specified in subdivision
1, paragraph (a), clauses (3) and (4), when the studies are initiated by:

(1) personnel pool agencies;

(2) temporary personnel agencies;

(3) educational programs that train individuals by providing direct contact services in
licensed programs; and

(4) professional services agencies that are not licensed and which contract with licensed
programs to provide direct contact services or individuals who provide direct contact services.

Subd. 5.

Other state agencies.

The commissioner shall conduct background studies on
applicants and license holders under the jurisdiction of other state agencies who are required
in other statutory sections to initiate background studies under this chapter, including the
applicant's or license holder's employees, contractors, and volunteers when required under
other statutory sections.

new text begin Subd. 5a. new text end

new text begin Facilities serving children or adults licensed or regulated by the
Department of Health. new text end

new text begin (a) The commissioner shall conduct background studies of:
new text end

new text begin (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;
new text end

new text begin (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;
new text end

new text begin (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;
new text end

new text begin (4) individuals employed by a supplemental nursing services agency, as defined under
section 144A.70, who are providing services in health care facilities; and
new text end

new text begin (5) controlling persons of a supplemental nursing services agency, as defined by section
144A.70.
new text end

new text begin (b) If 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.
new text end

new text begin (c) 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 end

new text begin Subd. 5b. new text end

new text begin Facilities serving children or youth licensed by the Department of
Corrections. new text end

new text begin (a) The commissioner shall conduct background studies of individuals working
in secure and nonsecure children's residential facilities, juvenile detention facilities, and
foster residence settings, whether or not the individual will have direct contact, as defined
under section 245C.02, subdivision 11, with persons served in the facilities or settings.
new text end

new text begin (b) A clerk or administrator of any court, the Bureau of Criminal Apprehension, a
prosecuting attorney, a county sheriff, or a chief of a local police department shall assist in
conducting background studies by providing the commissioner of human services or the
commissioner's representative all criminal conviction data available from local and state
criminal history record repositories related to applicants, operators, all persons living in a
household, and all staff of any facility subject to background studies under this subdivision.
new text end

new text begin (c) For the purpose of this subdivision, the term "secure and nonsecure residential facility
and detention facility" includes programs licensed or certified under section 241.021,
subdivision 2.
new text end

new text begin (d) If an individual is disqualified, the Department of Human Services shall notify the
disqualified individual and the facility in which the disqualified individual provides services
of the disqualification and shall inform the disqualified individual of the right to request a
reconsideration of the disqualification by submitting the request to the Department of
Corrections.
new text end

new text begin (e) The commissioner of corrections 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 corrections shall inform the requesting
individual and the Department of Human Services of the commissioner of corrections'
decision regarding the reconsideration. The commissioner of corrections' decision to grant
or deny a reconsideration of a disqualification is the final administrative agency action.
new text end

Subd. 6.

Unlicensed home and community-based waiver providers of service to
seniors and individuals with disabilities.

new text begin (a) new text end The commissioner shall conduct background
studies deleted text begin on deleted text end new text begin of new text end any individual deleted text begin required under section 256B.4912 to have a background study
completed under this chapter deleted text end new text begin who provides direct contact, as defined in section 245C.02,
subdivision 11, for services specified in the federally approved home and community-based
waiver plans under section 256B.4912. The individual studied must meet the requirements
of this chapter prior to providing waiver services and as part of ongoing enrollment.
new text end

new text begin (b) The requirements in paragraph (a) apply to consumer-directed community supports
under section 256B.4911 new text end .

Subd. 6a.

Legal nonlicensed and certified child care programs.

The commissioner
shall conduct background studies deleted text begin on an individual deleted text end new text begin for each child care background study
subject as defined in section 245C.02, subdivision 6a, as new text end required deleted text begin under deleted text end new text begin by new text end sections 119B.125
and 245H.10 deleted text begin to complete a background study under this chapter deleted text end .

Subd. 7.

Children's therapeutic services and supports providers.

The commissioner
shall conduct background studies deleted text begin according to this chapter when initiated by a children's
therapeutic services and supports provider deleted text end new text begin of all direct service providers and volunteers for
children's therapeutic services and supports providers new text end under section 256B.0943.

deleted text begin Subd. 8. deleted text end

deleted text begin Self-initiated background studies. deleted text end

deleted text begin Upon implementation of NETStudy 2.0,
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.
deleted text end

Subd. 9.

Community first services and supports new text begin and financial management services
new text end organizations.

deleted text begin The commissioner shall conduct background studies on any individual
required under section 256B.85 to have a background study completed under this chapter. deleted text end new text begin
Individuals affiliated with Community First Services and Supports (CFSS) agency-providers
and Financial Management Services (FMS) providers enrolled to provide CFSS services
under the medical assistance program must meet the following requirements:
new text end

new text begin (1) owners who have a five percent interest or more and all managing employees are
subject to a background study under this chapter. This requirement applies to currently
enrolled providers and agencies seeking enrollment. "Managing employee" has the meaning
given in Code of Federal Regulations, title 42, section 455.101. An organization is barred
from enrollment if:
new text end

new text begin (i) the organization has not initiated background studies of owners and managing
employees; or
new text end

new text begin (ii) the organization has initiated background studies of owners and managing employees
and the commissioner has sent the organization a notice that an owner or managing employee
of the organization has been disqualified under section 245C.14 and the owner or managing
employee has not received a set aside of the disqualification under section 245C.22;
new text end

new text begin (2) a background study must be initiated and completed for all staff who will have direct
contact with the participant to provide worker training and development; and
new text end

new text begin (3) a background study must be initiated and completed for all support workers.
new text end

new text begin Subd. 9a. new text end

new text begin Exception to support worker requirements for continuity of services. new text end

new text begin The
support worker for a participant may enroll with a different Community First Services and
Supports (CFSS) agency-provider or Financial Management Services (FMS) provider upon
initiation, rather than completion, of a new background study according to this chapter if:
new text end

new text begin (1) the commissioner determines that the support worker's change in enrollment or
affiliation is necessary to ensure continuity of services and to protect the health and safety
of the participant;
new text end

new text begin (2) the chosen agency-provider or FMS provider has been continuously enrolled as a
CFSS agency-provider or FMS provider for at least two years or since the inception of the
CFSS program, whichever is shorter;
new text end

new text begin (3) the participant served by the support worker chooses to transfer to the CFSS
agency-provider or the FMS provider to which the support worker is transferring;
new text end

new text begin (4) the support worker has been continuously enrolled with the former CFSS
agency-provider or FMS provider since the support worker's last background study was
completed; and
new text end

new text begin (5) the support worker continues to meet the requirements of section 256B.85, subdivision
16, notwithstanding paragraph (a), clause (1).
new text end

Subd. 10.

Providers of group residential housing or supplementary services.

new text begin (a) new text end The
commissioner shall conduct background studies deleted text begin on any individual required under section
256I.04 to have a background study completed under this chapter. deleted text end new text begin of the following individuals
who provide services under section 256I.04:
new text end

new text begin (1) controlling individuals as defined in section 245A.02;
new text end

new text begin (2) managerial officials as defined in section 245A.02; and
new text end

new text begin (3) all employees and volunteers of the establishment who have direct contact with
recipients or who have unsupervised access to recipients, recipients' personal property, or
recipients' private data.
new text end

new text begin (b) The provider of housing support must comply with all requirements for entities
initiating background studies under this chapter.
new text end

new text begin (c) A provider of housing support must demonstrate that all individuals who are required
to have a background study according to paragraph (a) have a notice stating that:
new text end

new text begin (1) the individual is not disqualified under section 245C.14; or
new text end

new text begin (2) the individual is disqualified and the individual has been issued a set aside of the
disqualification for the setting under section 245C.22.
new text end

deleted text begin Subd. 11. deleted text end

deleted text begin Child protection workers or social services staff having responsibility for
child protective duties. deleted text end

deleted text begin (a) The commissioner must complete background studies, according
to paragraph (b) and section 245C.04, subdivision 10, when initiated by a county social
services agency or by a local welfare agency according to section 626.559, subdivision 1b.
deleted text end

deleted text begin (b) For background studies completed by the commissioner under this subdivision, the
commissioner shall not make a disqualification decision, but shall provide the background
study information received to the county that initiated the study.
deleted text end

Subd. 12.

Providers of special transportation service.

new text begin (a) new text end The commissioner shall
conduct background studies deleted text begin on any individual required under section 174.30 to have a
background study completed under this chapter. deleted text end new text begin of the following individuals who provide
special transportation services under section 174.30:
new text end

new text begin (1) each person with a direct or indirect ownership interest of five percent or higher in
a transportation service provider;
new text end

new text begin (2) each controlling individual as defined under section 245A.02;
new text end

new text begin (3) a managerial official as defined in section 245A.02;
new text end

new text begin (4) each driver employed by the transportation service provider;
new text end

new text begin (5) each individual employed by the transportation service provider to assist a passenger
during transport; and
new text end

new text begin (6) each employee of the transportation service agency who provides administrative
support, including an employee who:
new text end

new text begin (i) may have face-to-face contact with or access to passengers, passengers' personal
property, or passengers' private data;
new text end

new text begin (ii) performs any scheduling or dispatching tasks; or
new text end

new text begin (iii) performs any billing activities.
new text end

new text begin (b) When a local or contracted agency is authorizing a ride under section 256B.0625,
subdivision 17, by a volunteer driver, and the agency authorizing the ride has a reason to
believe that the volunteer driver has a history that would disqualify the volunteer driver or
that may pose a risk to the health or safety of passengers, the agency may initiate a
background study that shall be completed according to this chapter using the commissioner
of human services' online NETStudy system, or by contacting the Department of Human
Services background study division for assistance. The agency that initiates the background
study under this paragraph shall be responsible for providing the volunteer driver with the
privacy notice required by section 245C.05, subdivision 2c, and with the payment for the
background study required by section 245C.10 before the background study is completed.
new text end

Subd. 13.

Providers of housing support services.

The commissioner shall conduct
background studies deleted text begin on deleted text end new text begin of new text end any deleted text begin individual deleted text end new text begin provider of housing support services new text end required deleted text begin under deleted text end new text begin
by new text end section 256B.051 to have a background study completed under this chapter.

new text begin Subd. 14. new text end

new text begin Tribal nursing facilities. new text end

new text begin For completed background studies to comply with
a Tribal organization's licensing requirements for individuals affiliated with a tribally licensed
nursing facility, the commissioner shall obtain state and national criminal history data.
new text end

new text begin Subd. 15. new text end

new text begin Early intensive developmental and behavioral intervention providers. new text end

new text begin The
commissioner shall conduct background studies according to this chapter when initiated by
an early intensive developmental and behavioral intervention provider under section
256B.0949.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, except subdivision 6,
paragraph (b), is effective upon federal approval and subdivision 15 is effective the day
following final enactment. The commissioner of human services shall notify the revisor of
statutes when federal approval is obtained.
new text end

Sec. 18.

new text begin [245C.031] BACKGROUND STUDY; ALTERNATIVE BACKGROUND
STUDIES.
new text end

new text begin Subdivision 1. new text end

new text begin Alternative background studies. new text end

new text begin (a) The commissioner shall conduct
an alternative background study of individuals listed in this section.
new text end

new text begin (b) Notwithstanding other sections of this chapter, all alternative background studies
except subdivision 12 shall be conducted according to this section and with section 299C.60
to 299C.64.
new text end

new text begin (c) All terms in this section shall have the definitions provided in section 245C.02.
new text end

new text begin (d) The entity that submits an alternative background study request under this section
shall submit the request to the commissioner according to section 245C.05.
new text end

new text begin (e) The commissioner shall comply with the destruction requirements in section 245C.051.
new text end

new text begin (f) Background studies conducted under this section are subject to the provisions of
section 245C.32.
new text end

new text begin (g) The commissioner shall forward all information that the commissioner receives under
section 245C.08 to the entity that submitted the alternative background study request under
subdivision 2. The commissioner shall not make any eligibility determinations regarding
background studies conducted under this section.
new text end

new text begin Subd. 2. new text end

new text begin Access to information. new text end

new text begin Each entity that submits an alternative background
study request shall enter into an agreement with the commissioner before submitting requests
for alternative background studies under this section. As a part of the agreement, the entity
must agree to comply with state and federal law.
new text end

new text begin Subd. 3. new text end

new text begin Child protection workers or social services staff having responsibility for
child protective duties. new text end

new text begin The commissioner shall conduct an alternative background study
of any person who has responsibility for child protection duties when the background study
is initiated by a county social services agency or by a local welfare agency according to
section 260E.36, subdivision 3.
new text end

new text begin Subd. 4. new text end

new text begin Applicants, licensees, and other occupations regulated by the commissioner
of health. new text end

new text begin The commissioner shall conduct an alternative background study, including a
check of state data, and a national criminal history records check of the following individuals.
For studies under this section, the following persons shall complete a consent form:
new text end

new text begin (1) an applicant for initial licensure, temporary licensure, or relicensure after a lapse in
licensure as an audiologist or speech-language pathologist or an applicant for initial
certification as a hearing instrument dispenser who must submit to a background study
under section 144.0572.
new text end

new text begin (2) an applicant for a renewal license or certificate as an audiologist, speech-language
pathologist, or hearing instrument dispenser who was licensed or obtained a certificate
before January 1, 2018.
new text end

new text begin Subd. 5. new text end

new text begin Guardians and conservators. new text end

new text begin (a) The commissioner shall conduct an alternative
background study of:
new text end

new text begin (1) every court-appointed guardian and conservator, unless a background study has been
completed of the person under this section within the previous five years. The alternative
background study shall be completed prior to the appointment of the guardian or conservator,
unless a court determines that it would be in the best interests of the ward or protected person
to appoint a guardian or conservator before the alternative background study can be
completed. If the court appoints the guardian or conservator while the alternative background
study is pending, the alternative background study must be completed as soon as reasonably
possible after the guardian or conservator's appointment and no later than 30 days after the
guardian or conservator's appointment; and
new text end

new text begin (2) a guardian and a conservator once every five years after the guardian or conservator's
appointment if the person continues to serve as a guardian or conservator.
new text end

new text begin (b) An alternative background study is not required if the guardian or conservator is:
new text end

new text begin (1) a state agency or county;
new text end

new text begin (2) a parent or guardian of a proposed ward or protected person who has a developmental
disability if the parent or guardian has raised the proposed ward or protected person in the
family home until the time that the petition is filed, unless counsel appointed for the proposed
ward or protected person under section 524.5-205, paragraph (d); 524.5-304, paragraph (b);
524.5-405, paragraph (a); or 524.5-406, paragraph (b), recommends a background study;
or
new text end

new text begin (3) a bank with trust powers, a bank and trust company, or a trust company, organized
under the laws of any state or of the United States and regulated by the commissioner of
commerce or a federal regulator.
new text end

new text begin Subd. 6. new text end

new text begin Guardians and conservators; required checks. new text end

new text begin (a) An alternative background
study for a guardian or conservator pursuant to subdivision 5 shall include:
new text end

new text begin (1) criminal history data from the Bureau of Criminal Apprehension and other criminal
history data obtained by the commissioner of human services;
new text end

new text begin (2) data regarding whether the person has been a perpetrator of substantiated maltreatment
of a vulnerable adult under section 626.557 or a minor under chapter 260E. If the subject
of the study has been the perpetrator of substantiated maltreatment of a vulnerable adult or
a minor, the commissioner must include a copy of the public portion of the investigation
memorandum under section 626.557, subdivision 12b, or the public portion of the
investigation memorandum under section 260E.30. The commissioner shall provide the
court with information from a review of information according to subdivision 7 if the study
subject provided information that the study subject has a current or prior affiliation with a
state licensing agency;
new text end

new text begin (3) criminal history data from a national criminal history record check as defined in
section 245C.02, subdivision 13c; and
new text end

new text begin (4) state licensing agency data if a search of the database or databases of the agencies
listed in subdivision 7 shows that the proposed guardian or conservator has held a
professional license directly related to the responsibilities of a professional fiduciary from
an agency listed in subdivision 7 that was conditioned, suspended, revoked, or canceled.
new text end

new text begin (b) If the guardian or conservator is not an individual, the background study must be
completed of all individuals who are currently employed by the proposed guardian or
conservator who are responsible for exercising powers and duties under the guardianship
or conservatorship.
new text end

new text begin Subd. 7. new text end

new text begin Guardians and conservators; state licensing data. new text end

new text begin (a) Within 25 working
days of receiving the request for an alternative background study of a guardian or conservator,
the commissioner shall provide the court with licensing agency data for licenses directly
related to the responsibilities of a guardian or conservator if the study subject has a current
or prior affiliation with the:
new text end

new text begin (1) Lawyers Responsibility Board;
new text end

new text begin (2) State Board of Accountancy;
new text end

new text begin (3) Board of Social Work;
new text end

new text begin (4) Board of Psychology;
new text end

new text begin (5) Board or Nursing;
new text end

new text begin (6) Board of Medical Practice;
new text end

new text begin (7) Department of Education;
new text end

new text begin (8) Department of Commerce;
new text end

new text begin (9) Board of Chiropractic Examiners;
new text end

new text begin (10) Board of Dentistry;
new text end

new text begin (11) Board of Marriage and Family Therapy;
new text end

new text begin (12) Department of Human Services;
new text end

new text begin (13) Peace Officer Standards and Training (POST) Board; and
new text end

new text begin (14) Professional Educator Licensing and Standards Board.
new text end

new text begin (b) The commissioner and each of the agencies listed above, except for the Department
of Human Services, shall enter into a written agreement to provide the commissioner with
electronic access to the relevant licensing data and to provide the commissioner with a
quarterly list of new sanctions issued by the agency.
new text end

new text begin (c) The commissioner shall provide to the court the electronically available data
maintained in the agency's database, including whether the proposed guardian or conservator
is or has been licensed by the agency and whether a disciplinary action or a sanction against
the individual's license, including a condition, suspension, revocation, or cancellation, is in
the licensing agency's database.
new text end

new text begin (d) If the proposed guardian or conservator has resided in a state other than Minnesota
during the previous ten years, licensing agency data under this section shall also include
licensing agency data from any other state where the proposed guardian or conservator
reported to have resided during the previous ten years if the study subject has a current or
prior affiliation to the licensing agency. If the proposed guardian or conservator has or has
had a professional license in another state that is directly related to the responsibilities of a
guardian or conservator from one of the agencies listed under paragraph (a), state licensing
agency data shall also include data from the relevant licensing agency of the other state.
new text end

new text begin (e) The commissioner is not required to repeat a search for Minnesota or out-of-state
licensing data on an individual if the commissioner has provided this information to the
court within the prior five years.
new text end

new text begin (f) The commissioner shall review the information in paragraph (c) at least once every
four months to determine whether an individual who has been studied within the previous
five years:
new text end

new text begin (1) has any new disciplinary action or sanction against the individual's license; or
new text end

new text begin (2) did not disclose a prior or current affiliation with a Minnesota licensing agency.
new text end

new text begin (g) If the commissioner's review in paragraph (f) identifies new information, the
commissioner shall provide any new information to the court.
new text end

new text begin Subd. 8. new text end

new text begin Guardians ad litem. new text end

new text begin The commissioner shall conduct an alternative background
study of:
new text end

new text begin (1) a guardian ad litem appointed under section 518.165 if a background study of the
guardian ad litem has not been completed within the past three years. The background study
of the guardian ad litem must be completed before the court appoints the guardian ad litem,
unless the court determines that it is in the best interests of the child to appoint the guardian
ad litem before a background study is completed by the commissioner.
new text end

new text begin (2) a guardian ad litem once every three years after the guardian has been appointed, as
long as the individual continues to serve as a guardian ad litem.
new text end

new text begin Subd. 9. new text end

new text begin Guardians ad litem; required checks. new text end

new text begin (a) An alternative background study
for a guardian ad litem under subdivision 8 must include:
new text end

new text begin (1) criminal history data from the Bureau of Criminal Apprehension and other criminal
history data obtained by the commissioner of human services; and
new text end

new text begin (2) data regarding whether the person has been a perpetrator of substantiated maltreatment
of a minor or a vulnerable adult. If the study subject has been determined by the Department
of Human Services or the Department of Health to be the perpetrator of substantiated
maltreatment of a minor or a vulnerable adult in a licensed facility, the response must include
a copy of the public portion of the investigation memorandum under section 260E.30 or the
public portion of the investigation memorandum under section 626.557, subdivision 12b.
When the background study shows that the subject has been determined by a county adult
protection or child protection agency to have been responsible for maltreatment, the court
shall be informed of the county, the date of the finding, and the nature of the maltreatment
that was substantiated.
new text end

new text begin (b) For checks of records under paragraph (a), clauses (1) and (2), the commissioner
shall provide the records within 15 working days of receiving the request. The information
obtained under sections 245C.05 and 245C.08 from a national criminal history records
check shall be provided within three working days of the commissioner's receipt of the data.
new text end

new text begin (c) Notwithstanding section 260E.30 or 626.557, subdivision 12b, if the commissioner
or county lead agency or lead investigative agency has information that a person of whom
a background study was previously completed under this section has been determined to
be a perpetrator of maltreatment of a minor or vulnerable adult, the commissioner or the
county may provide this information to the court that requested the background study.
new text end

new text begin Subd. 10. new text end

new text begin First-time applicants for educator licenses with the Professional Educator
Licensing and Standards Board. new text end

new text begin The Professional Educator Licensing and Standards
Board shall make all eligibility determinations for alternative background studies conducted
under this section for the Professional Educator Licensing and Standards Board. The
commissioner may conduct an alternative background study of all first-time applicants for
educator licenses pursuant to section 122A.18, subdivision 8. The alternative background
study for all first-time applicants for educator licenses must include a review of information
from the Bureau of Criminal Apprehension, including criminal history data as defined in
section 13.87, and must also include a review of the national criminal records repository.
new text end

new text begin Subd. 11. new text end

new text begin First-time applicants for administrator licenses with the Board of School
Administrators. new text end

new text begin The Board of School Administrators shall make all eligibility determinations
for alternative background studies conducted under this section for the Board of School
Administrators. The commissioner may conduct an alternative background study of all
first-time applicants for administrator licenses pursuant to section 122A.18, subdivision 8.
The alternative background study for all first-time applicants for administrator licenses must
include a review of information from the Bureau of Criminal Apprehension, including
criminal history data as defined in section 13.87, and must also include a review of the
national criminal records repository.
new text end

new text begin Subd. 12. new text end

new text begin Occupations regulated by MNsure. new text end

new text begin (a) The commissioner shall conduct a
background study of any individual required under section 62V.05 to have a background
study completed under this chapter. Notwithstanding subdivision 1, paragraph (g), the
commissioner shall conduct a background study only based on Minnesota criminal records
of:
new text end

new text begin (1) each navigator;
new text end

new text begin (2) each in-person assister; and
new text end

new text begin (3) each certified application counselor.
new text end

new text begin (b) The MNsure board of directors may initiate background studies required by paragraph
(a) using the online NETStudy 2.0 system operated by the commissioner.
new text end

new text begin (c) The commissioner shall review information that the commissioner receives to
determine if the study subject has potentially disqualifying offenses. The commissioner
shall send a letter to the subject indicating any of the subject's potential disqualifications as
well as any relevant records. The commissioner shall send a copy of the letter indicating
any of the subject's potential disqualifications to the MNsure board.
new text end

new text begin (d) The MNsure board or its delegate shall review a reconsideration request of an
individual in paragraph (a), including granting a set aside, according to the procedures and
criteria in chapter 245C. The board shall notify the individual and the Department of Human
Services of the board's decision.
new text end

Sec. 19.

new text begin [245C.032] PUBLIC LAW BACKGROUND STUDIES.
new text end

new text begin Subdivision 1. new text end

new text begin Public law background studies. new text end

new text begin (a) Notwithstanding all other sections
of chapter 245C, the commissioner shall conduct public law background studies exclusively
in accordance with this section. The commissioner shall conduct a public law background
study under this section for an individual having direct contact with persons served by a
licensed sex offender treatment program under chapters 246B and 253D.
new text end

new text begin (b) All terms in this section shall have the definitions provided in section 245C.02.
new text end

new text begin (c) The commissioner shall conduct public law background studies according to the
following:
new text end

new text begin (1) section 245C.04, subdivision 1, paragraphs (a), (b), (d), (g), (h), and (i), subdivision
4a, and subdivision 7;
new text end

new text begin (2) section 245C.05, subdivision 1, paragraphs (a) and (d), subdivisions 2, 2c, and 2d,
subdivision 4, paragraph (a), clauses (1) and (2), subdivision 5, paragraphs (b) to (f), and
subdivisions 6 and 7;
new text end

new text begin (3) section 245C.051;
new text end

new text begin (4) section 245C.07, paragraphs (a), (b), (d), and (f);
new text end

new text begin (5) section 245C.08, subdivision 1, paragraph (a), clauses (1) to (5), paragraphs (b), (c),
(d), and (e), subdivision 3, and subdivision 4, paragraphs (a), (c), (d), and (e);
new text end

new text begin (6) section 245C.09, subdivisions 1 and 2;
new text end

new text begin (7) section 245C.10, subdivision 9;
new text end

new text begin (8) section 245C.13, subdivision 1, and subdivision 2, paragraph (a), and paragraph (c),
clauses (1) to (3);
new text end

new text begin (9) section 245C.14, subdivisions 1 and 2;
new text end

new text begin (10) section 245C.15;
new text end

new text begin (11) section 245C.16, subdivision 1, paragraphs (a), (b), (c), and (f), and subdivision 2,
paragraphs (a) and (b);
new text end

new text begin (12) section 245C.17, subdivision 1, subdivision 2, paragraph (a), clauses (1) to (3),
clause (6), item (ii), subdivision 3, paragraphs (a) and (b), paragraph (c), clauses (1) and
(2), items (ii) and (iii), paragraph (d), clauses (1) and (2), item (ii), and paragraph (e);
new text end

new text begin (13) section 245C.18, paragraph (a);
new text end

new text begin (14) section 245C.19;
new text end

new text begin (15) section 245C.20;
new text end

new text begin (16) section 245C.21, subdivision 1, subdivision 1a, paragraph (c), and subdivisions 2,
3, and 4;
new text end

new text begin (17) section 245C.22, subdivisions 1, 2, and 3, subdivision 4, paragraphs (a) to (c),
subdivision 5, paragraphs (a), (b), and (d), and subdivision 6;
new text end

new text begin (18) section 245C.23, subdivision 1, paragraphs (a) and (b), and subdivision 2, paragraphs
(a) to (c);
new text end

new text begin (19) section 245C.24, subdivision 2, paragraph (a);
new text end

new text begin (20) section 245C.25;
new text end

new text begin (21) section 245C.27;
new text end

new text begin (22) section 245C.28;
new text end

new text begin (23) section 245C.29, subdivision 1, and subdivision 2, paragraphs (a) and (c);
new text end

new text begin (24) section 245C.30, subdivision 1, paragraphs (a) and (d), and subdivisions 3 to 5;
new text end

new text begin (25) section 245C.31; and
new text end

new text begin (26) section 245C.32.
new text end

new text begin Subd. 2. new text end

new text begin Classification of public law background study data; access to
information. new text end

new text begin All data obtained by the commissioner for a background study completed
under this section shall be classified as private data.
new text end

Sec. 20.

Minnesota Statutes 2020, section 245C.05, subdivision 1, is amended to read:

Subdivision 1.

Individual studied.

(a) The individual who is the subject of the
background study must provide the applicant, license holder, or other entity under section
245C.04 with sufficient information to ensure an accurate study, including:

(1) the individual's first, middle, and last name and all other names by which the
individual has been known;

(2) current home address, city, and state of residence;

(3) current zip code;

(4) sex;

(5) date of birth;

(6) driver's license number or state identification number; and

(7) upon implementation of NETStudy 2.0, the home address, city, county, and state of
residence for the past five years.

(b) Every subject of a background study conducted or initiated by counties or private
agencies under this chapter must also provide the home address, city, county, and state of
residence for the past five years.

(c) Every subject of a background study related to private agency adoptions or related
to child foster care licensed through a private agency, who is 18 years of age or older, shall
also provide the commissioner a signed consent for the release of any information received
from national crime information databases to the private agency that initiated the background
study.

(d) The subject of a background study shall provide fingerprints and a photograph as
required in subdivision 5.

new text begin (e) The subject of a background study shall submit a completed criminal and maltreatment
history records check consent form for applicable national and state level record checks.
new text end

Sec. 21.

Minnesota Statutes 2020, section 245C.05, subdivision 2, is amended to read:

Subd. 2.

Applicant, license holder, or other entity.

(a) The applicant, license holder,
or other deleted text begin entities deleted text end new text begin entity initiating the background study new text end as provided in this chapter shall verify
that the information collected under subdivision 1 about an individual who is the subject of
the background study is correct and must provide the information on forms or in a format
prescribed by the commissioner.

(b) The information collected under subdivision 1 about an individual who is the subject
of a completed background study may only be viewable by an entity that initiates a
subsequent background study on that individual under NETStudy 2.0 after the entity has
paid the applicable fee for the study and has provided the individual with the privacy notice
in subdivision 2c.

Sec. 22.

Minnesota Statutes 2020, section 245C.05, subdivision 2a, is amended to read:

Subd. 2a.

County or private agency.

For background studies related to child foster care
when the applicant or license holder resides in the home where child foster care services
are provided, county and private agencies new text begin initiating the background study new text end must collect the
information under subdivision 1 and forward it to the commissioner.

Sec. 23.

Minnesota Statutes 2020, section 245C.05, subdivision 2b, is amended to read:

Subd. 2b.

County agency to collect and forward information to commissioner.

(a)
For background studies related to all family adult day services and to adult foster care when
the adult foster care license holder resides in the adult foster care residence, the county
agency new text begin or private agency initiating the background study new text end must collect the information
required under subdivision 1 and forward it to the commissioner.

(b) Upon implementation of NETStudy 2.0, for background studies related to family
child care and legal nonlicensed child care authorized under chapter 119B, the county agency
new text begin initiating the background study new text end must collect the information required under subdivision 1
and provide the information to the commissioner.

Sec. 24.

Minnesota Statutes 2020, section 245C.05, subdivision 2c, is amended to read:

Subd. 2c.

Privacy notice to background study subject.

(a) Prior to initiating each
background study, the entity initiating the study must provide the commissioner's privacy
notice to the background study subject required under section 13.04, subdivision 2. The
notice must be available through the commissioner's electronic NETStudy and NETStudy
2.0 systems and shall include the information in paragraphs (b) and (c).

(b) The background study subject shall be informed that any previous background studies
that received a set-aside will be reviewed, and without further contact with the background
study subject, the commissioner may notify the agency that initiated the subsequent
background study:

(1) that the individual has a disqualification that has been set aside for the program or
agency that initiated the study;

(2) the reason for the disqualification; and

(3) that information about the decision to set aside the disqualification will be available
to the license holder upon request without the consent of the background study subject.

(c) The background study subject must also be informed that:

(1) the subject's fingerprints collected for purposes of completing the background study
under this chapter must not be retained by the Department of Public Safety, Bureau of
Criminal Apprehension, or by the commissioner. The Federal Bureau of Investigation will
deleted text begin only retain fingerprints of subjects with a criminal history deleted text end new text begin not retain background study
subjects' fingerprints new text end ;

(2) effective upon implementation of NETStudy 2.0, the subject's photographic image
will be retained by the commissioner, and if the subject has provided the subject's Social
Security number for purposes of the background study, the photographic image will be
available to prospective employers and agencies initiating background studies under this
chapter to verify the identity of the subject of the background study;

(3) the deleted text begin commissioner's deleted text end authorized fingerprint collection vendor new text begin or vendors new text end 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 new text begin or vendors new text end shall retain no more
than the subject's name and the date and time the subject's fingerprints were recorded and
sent, only as necessary for auditing and billing activities;

(4) the commissioner shall provide the subject notice, as required in section 245C.17,
subdivision 1, paragraph (a), when an entity initiates a background study on the individual;

(5) the subject may request in writing a report listing the entities that initiated a
background study on the individual as provided in section 245C.17, subdivision 1, paragraph
(b);

(6) the subject may request in writing that information used to complete the individual's
background study in NETStudy 2.0 be destroyed if the requirements of section 245C.051,
paragraph (a), are met; and

(7) notwithstanding clause (6), the commissioner shall destroy:

(i) the subject's photograph after a period of two years when the requirements of section
245C.051, paragraph (c), are met; and

(ii) any data collected on a subject under this chapter after a period of two years following
the individual's death as provided in section 245C.051, paragraph (d).

Sec. 25.

Minnesota Statutes 2020, section 245C.05, subdivision 2d, is amended to read:

Subd. 2d.

Fingerprint data notification.

The commissioner of human services shall
notify all background study subjects under this chapter that the Department of Human
Services, Department of Public Safety, and the Bureau of Criminal Apprehension do not
retain fingerprint data after a background study is completed, and that the Federal Bureau
of Investigation deleted text begin only retains the fingerprints of subjects who have a criminal history deleted text end new text begin does
not retain background study subjects' fingerprints new text end .

Sec. 26.

Minnesota Statutes 2020, section 245C.05, subdivision 4, is amended to read:

Subd. 4.

Electronic transmission.

(a) For background studies conducted by the
Department of Human Services, the commissioner shall implement a secure system for the
electronic transmission of:

(1) background study information to the commissioner;

(2) background study results to the license holder;

(3) background study deleted text begin results deleted text end new text begin information obtained under this section and section 245C.08 new text end
to counties new text begin and private agencies new text end for background studies conducted by the commissioner for
child foster care new text begin , including a summary of nondisqualifying results, except as prohibited by
law new text end ; and

(4) background study results to county agencies for background studies conducted by
the commissioner for adult foster care and family adult day services and, upon
implementation of NETStudy 2.0, family child care and legal nonlicensed child care
authorized under chapter 119B.

(b) Unless the commissioner has granted a hardship variance under paragraph (c), a
license holder or an applicant must use the electronic transmission system known as
NETStudy or NETStudy 2.0 to submit all requests for background studies to the
commissioner as required by this chapter.

(c) A license holder or applicant whose program is located in an area in which high-speed
Internet is inaccessible may request the commissioner to grant a variance to the electronic
transmission requirement.

(d) Section 245C.08, subdivision 3, paragraph (c), applies to results transmitted under
this subdivision.

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 245C.05, subdivision 5, is amended to read:

Subd. 5.

Fingerprints and photograph.

(a) Notwithstanding paragraph (b), for
background studies conducted by the commissioner for 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
deleted text begin commissioner's deleted text end authorized fingerprint collection vendor new text begin or vendors new text end 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 deleted text begin commissioner's deleted text end authorized fingerprint collection vendor new text begin or vendors new text end 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 new text begin or vendors new text end 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.

Sec. 28.

Minnesota Statutes 2020, section 245C.08, subdivision 3, is amended to read:

Subd. 3.

Arrest and investigative information.

(a) For any background study completed
under this section, if the commissioner has reasonable cause to believe the information is
pertinent to the disqualification of an individual, the commissioner also may review arrest
and investigative information from:

(1) the Bureau of Criminal Apprehension;

(2) the commissioners of health and human services;

(3) a county attorney;

(4) a county sheriff;

(5) a county agency;

(6) a local chief of police;

(7) other states;

(8) the courts;

(9) the Federal Bureau of Investigation;

(10) the National Criminal Records Repository; and

(11) criminal records from other states.

(b) Except when specifically required by law, the commissioner is not required to conduct
more than one review of a subject's records from the Federal Bureau of Investigation if a
review of the subject's criminal history with the Federal Bureau of Investigation has already
been completed by the commissioner and there has been no break in the subject's affiliation
with the entity that initiated the background study.

(c) If the commissioner conducts a national criminal history record check when required
by law and uses the information from the national criminal history record check to make a
disqualification determination, the data obtained is private data and cannot be shared with
deleted text begin county agencies, deleted text end private agencies deleted text begin , deleted text end or prospective employers of the background study subject.

(d) If the commissioner conducts a national criminal history record check when required
by law and uses the information from the national criminal history record check to make a
disqualification determination, the license holder or entity that submitted the study is not
required to obtain a copy of the background study subject's disqualification letter under
section 245C.17, subdivision 3.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021.
new text end

Sec. 29.

Minnesota Statutes 2020, section 245C.08, is amended by adding a subdivision
to read:

new text begin Subd. 5. new text end

new text begin Authorization. new text end

new text begin The commissioner of human services shall be authorized to
receive information under this chapter.
new text end

Sec. 30.

Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:

new text begin Subd. 1b. new text end

new text begin Background study fees. new text end

new text begin (a) The commissioner shall recover the cost of
background studies. Except as otherwise provided in subdivisions 1c and 1d, the fees
collected under this section shall be appropriated to the commissioner for the purpose of
conducting background studies under this chapter. Fees under this section are charges under
section 16A.1283, paragraph (b), clause (3).
new text end

new text begin (b) Background study fees may include:
new text end

new text begin (1) a fee to compensate the commissioner's authorized fingerprint collection vendor or
vendors for obtaining and processing a background study subject's classifiable fingerprints
and photograph pursuant to subdivision 1c; and
new text end

new text begin (2) a separate fee under subdivision 1c to complete a review of background-study-related
records as authorized under this chapter.
new text end

new text begin (c) Fees charged under paragraph (b) may be paid in whole or part when authorized by
law by a state agency or board; by state court administration; by a service provider, employer,
license holder, or other organization that initiates the background study; by the commissioner
or other organization with duly appropriated funds; by a background study subject; or by
some combination of these sources.
new text end

Sec. 31.

Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:

new text begin Subd. 1c. new text end

new text begin Fingerprint and photograph processing fees. new text end

new text begin The commissioner shall enter
into a contract with a qualified vendor or vendors to obtain and process a background study
subject's classifiable fingerprints and photograph as required by section 245C.05. The
commissioner may, at their discretion, directly collect fees and reimburse the commissioner's
authorized fingerprint collection vendor for the vendor's services or require the vendor to
collect the fees. The authorized vendor is responsible for reimbursing the vendor's
subcontractors at a rate specified in the contract with the commissioner.
new text end

Sec. 32.

Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:

new text begin Subd. 1d. new text end

new text begin National criminal history record check fees. new text end

new text begin The commissioner may increase
background study fees as necessary, commensurate with an increase in the national criminal
history record check fee. The commissioner shall report any fee increase under this
subdivision to the legislature during the legislative session following the fee increase, so
that the legislature may consider adoption of the fee increase into statute. By July 1 of every
year, background study fees shall be set at the amount adopted by the legislature under this
section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021.
new text end

Sec. 33.

Minnesota Statutes 2020, section 245C.10, subdivision 2, is amended to read:

Subd. 2.

Supplemental nursing services agencies.

The commissioner shall recover the
cost of the background studies initiated by supplemental nursing services agencies registered
under section 144A.71, subdivision 1, through a fee of no more than deleted text begin $20 deleted text end new text begin $42 new text end per study
charged to the agency. The fees collected under this subdivision are appropriated to the
commissioner for the purpose of conducting background studies.

Sec. 34.

Minnesota Statutes 2020, section 245C.10, subdivision 3, is amended to read:

Subd. 3.

Personal care provider organizations.

The commissioner shall recover the
cost of background studies initiated by a personal care provider organization under sections
256B.0651 to 256B.0654 and 256B.0659 through a fee of no more than deleted text begin $20 deleted text end new text begin $42 new text end per study
charged to the organization responsible for submitting the background study form. The fees
collected under this subdivision are appropriated to the commissioner for the purpose of
conducting background studies.

Sec. 35.

Minnesota Statutes 2020, section 245C.10, subdivision 4, is amended to read:

Subd. 4.

Temporary personnel agencies, educational programs, and professional
services agencies.

The commissioner shall recover the cost of the background studies
initiated by temporary personnel agencies, educational programs, and professional services
agencies that initiate background studies under section 245C.03, subdivision 4, through a
fee of no more than deleted text begin $20 deleted text end new text begin $42 new text end per study charged to the agency. The fees collected under this
subdivision are appropriated to the commissioner for the purpose of conducting background
studies.

Sec. 36.

Minnesota Statutes 2020, section 245C.10, subdivision 5, is amended to read:

Subd. 5.

Adult foster care and family adult day services.

The commissioner shall
recover the cost of background studies required under section 245C.03, subdivision 1, for
the purposes of adult foster care and family adult day services licensing, through a fee of
no more than deleted text begin $20 deleted text end new text begin $42 new text end per study charged to the license holder. The fees collected under this
subdivision are appropriated to the commissioner for the purpose of conducting background
studies.

Sec. 37.

Minnesota Statutes 2020, section 245C.10, subdivision 6, is amended to read:

Subd. 6.

Unlicensed home and community-based waiver providers of service to
seniors and individuals with disabilities.

The commissioner shall recover the cost of
background studies initiated by unlicensed home and community-based waiver providers
of service to seniors and individuals with disabilities under section 256B.4912 through a
fee of no more than deleted text begin $20 deleted text end new text begin $42 new text end per study.

Sec. 38.

Minnesota Statutes 2020, section 245C.10, subdivision 8, is amended to read:

Subd. 8.

Children's therapeutic services and supports providers.

The commissioner
shall recover the cost of background studies required under section 245C.03, subdivision
7, for the purposes of children's therapeutic services and supports under section 256B.0943,
through a fee of no more than deleted text begin $20 deleted text end new text begin $42 new text end per study charged to the license holder. The fees
collected under this subdivision are appropriated to the commissioner for the purpose of
conducting background studies.

Sec. 39.

Minnesota Statutes 2020, section 245C.10, subdivision 9, is amended to read:

Subd. 9.

Human services licensed programs.

The commissioner shall recover the cost
of background studies required under section 245C.03, subdivision 1, for all programs that
are licensed by the commissioner, except child foster care when the applicant or license
holder resides in the home where child foster care services are provided, family child care,
child care centers, certified license-exempt child care centers, and legal nonlicensed child
care authorized under chapter 119B, through a fee of no more than deleted text begin $20 deleted text end new text begin $42 new text end per study charged
to the license holder. The fees collected under this subdivision are appropriated to the
commissioner for the purpose of conducting background studies.

Sec. 40.

Minnesota Statutes 2020, section 245C.10, subdivision 9a, is amended to read:

Subd. 9a.

Child care programs.

The commissioner shall recover the cost of a background
study required for family child care, certified license-exempt child care centers, licensed
child care centers, and legal nonlicensed child care providers authorized under chapter 119B
through a fee of no more than $40 per study charged to the license holder. A fee of no more
than deleted text begin $20 deleted text end new text begin $42 new text end per study shall be charged for studies conducted under section 245C.05,
subdivision 5a, paragraph (a). The fees collected under this subdivision are appropriated to
the commissioner to conduct background studies.

Sec. 41.

Minnesota Statutes 2020, section 245C.10, subdivision 10, is amended to read:

Subd. 10.

Community first services and supports organizations.

The commissioner
shall recover the cost of background studies initiated by an agency-provider delivering
services under section 256B.85, subdivision 11, or a financial management services provider
providing service functions under section 256B.85, subdivision 13, through a fee of no more
than deleted text begin $20 deleted text end new text begin $42 new text end per study, charged to the organization responsible for submitting the background
study form. The fees collected under this subdivision are appropriated to the commissioner
for the purpose of conducting background studies.

Sec. 42.

Minnesota Statutes 2020, section 245C.10, subdivision 11, is amended to read:

Subd. 11.

Providers of housing support.

The commissioner shall recover the cost of
background studies initiated by providers of housing support under section 256I.04 through
a fee of no more than deleted text begin $20 deleted text end new text begin $42 new text end per study. The fees collected under this subdivision are
appropriated to the commissioner for the purpose of conducting background studies.

Sec. 43.

Minnesota Statutes 2020, section 245C.10, subdivision 12, is amended to read:

Subd. 12.

Child protection workers or social services staff having responsibility for
child protective duties.

The commissioner shall recover the cost of background studies
initiated by county social services agencies and local welfare agencies for individuals who
are required to have a background study under section deleted text begin 626.559, subdivision 1b deleted text end new text begin 260E.36,
subdivision 3 new text end , through a fee of no more than deleted text begin $20 deleted text end new text begin $42 new text end per study. The fees collected under
this subdivision are appropriated to the commissioner for the purpose of conducting
background studies.

Sec. 44.

Minnesota Statutes 2020, section 245C.10, subdivision 13, is amended to read:

Subd. 13.

Providers of special transportation service.

The commissioner shall recover
the cost of background studies initiated by providers of special transportation service under
section 174.30 through a fee of no more than deleted text begin $20 deleted text end new text begin $42 new text end per study. The fees collected under
this subdivision are appropriated to the commissioner for the purpose of conducting
background studies.

Sec. 45.

Minnesota Statutes 2020, section 245C.10, subdivision 15, is amended to read:

Subd. 15.

Guardians and conservators.

The commissioner shall recover the cost of
conducting background studies for guardians and conservators under section 524.5-118
through a fee of no more than $110 per study. The fees collected under this subdivision are
appropriated to the commissioner for the purpose of conducting background studies. new text begin The
fee for conducting an alternative background study for appointment of a professional guardian
or conservator must be paid by the guardian or conservator. In other cases, the fee must be
paid as follows:
new text end

new text begin (1) if the matter is proceeding in forma pauperis, the fee must be paid as an expense for
purposes of section 524.5-502, paragraph (a);
new text end

new text begin (2) if there is an estate of the ward or protected person, the fee must be paid from the
estate; or
new text end

new text begin (3) in the case of a guardianship or conservatorship of a person that is not proceeding
in forma pauperis, the fee must be paid by the guardian, conservator, or the court.
new text end

Sec. 46.

Minnesota Statutes 2020, section 245C.10, subdivision 16, is amended to read:

Subd. 16.

Providers of housing support services.

The commissioner shall recover the
cost of background studies initiated by providers of housing support services under section
256B.051 through a fee of no more than deleted text begin $20 deleted text end new text begin $42 new text end per study. The fees collected under this
subdivision are appropriated to the commissioner for the purpose of conducting background
studies.

Sec. 47.

Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:

new text begin Subd. 17. new text end

new text begin Early intensive developmental and behavioral intervention providers. new text end

new text begin The
commissioner shall recover the cost of background studies required under section 245C.03,
subdivision 15, for the purposes of early intensive developmental and behavioral intervention
under section 256B.0949, through a fee of no more than $42 per study charged to the enrolled
agency. The fees collected under this subdivision are appropriated to the commissioner for
the purpose of conducting background studies.
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. 48.

Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:

new text begin Subd. 18. new text end

new text begin Applicants, licensees, and other occupations regulated by commissioner
of health. new text end

new text begin The applicant or license holder is responsible for paying to the Department of
Human Services all fees associated with the preparation of the fingerprints, the criminal
records check consent form, and the criminal background check.
new text end

Sec. 49.

Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:

new text begin Subd. 19. new text end

new text begin Occupations regulated by MNsure. new text end

new text begin The commissioner shall set fees to
recover the cost of background studies and criminal background checks initiated by MNsure
under sections 62V.05 and 245C.031. The fee amount shall be established through
interagency agreement between the commissioner and the board of MNsure or its designee.
The fees collected under this subdivision shall be deposited in the special revenue fund and
are appropriated to the commissioner for the purpose of conducting background studies and
criminal background checks.
new text end

Sec. 50.

Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:

new text begin Subd. 20. new text end

new text begin Professional Educators Licensing Standards Board. new text end

new text begin The commissioner
shall recover the cost of background studies initiated by the Professional Educators Licensing
Standards Board through a fee of no more than $51 per study. Fees collected under this
subdivision are appropriated to the commissioner for purposes of conducting background
studies.
new text end

Sec. 51.

Minnesota Statutes 2020, section 245C.10, is amended by adding a subdivision
to read:

new text begin Subd. 21. new text end

new text begin Board of School Administrators. new text end

new text begin The commissioner shall recover the cost
of background studies initiated by the Board of School Administrators through a fee of no
more than $51 per study. Fees collected under this subdivision are appropriated to the
commissioner for purposes of conducting background studies.
new text end

Sec. 52.

Minnesota Statutes 2020, section 245C.13, subdivision 2, is amended to read:

Subd. 2.

Activities pending completion of background study.

The subject of a
background study may not perform any activity requiring a background study under
paragraph (c) until the commissioner has issued one of the notices under paragraph (a).

(a) Notices from the commissioner required prior to activity under paragraph (c) include:

(1) a notice of the study results under section 245C.17 stating that:

(i) the individual is not disqualified; or

(ii) more time is needed to complete the study but the individual is not required to be
removed from direct contact or access to people receiving services prior to completion of
the study as provided under section 245C.17, subdivision 1, paragraph (b) or (c). The notice
that more time is needed to complete the study must also indicate whether the individual is
required to be under continuous direct supervision prior to completion of the background
study. When more time is necessary to complete a background study of an individual
affiliated with a Title IV-E eligible children's residential facility or foster residence setting,
the individual may not work in the facility or setting regardless of whether or not the
individual is supervised;

(2) a notice that a disqualification has been set aside under section 245C.23; or

(3) a notice that a variance has been granted related to the individual under section
245C.30.

(b) For a background study affiliated with a licensed child care center or certified
license-exempt child care center, the notice sent under paragraph (a), clause (1), item (ii),
must require the individual to be under continuous direct supervision prior to completion
of the background study except as permitted in subdivision 3.

(c) Activities prohibited prior to receipt of notice under paragraph (a) include:

(1) being issued a license;

(2) living in the household where the licensed program will be provided;

(3) providing direct contact services to persons served by a program unless the subject
is under continuous direct supervision;

(4) having access to persons receiving services if the background study was completed
under section 144.057, subdivision 1, or 245C.03, subdivision 1, paragraph (a), clause (2),
(5), or (6), unless the subject is under continuous direct supervision;

(5) for licensed child care centers and certified license-exempt child care centers,
providing direct contact services to persons served by the program; deleted text begin or
deleted text end

(6) for children's residential facilities or foster residence settings, working in the facility
or setting deleted text begin . deleted text end new text begin ; or
new text end

new text begin (7) for background studies affiliated with a personal care provider organization, except
as provided in section 245C.03, subdivision 3b, before a personal care assistant provides
services, the personal care assistance provider agency must initiate a background study of
the personal care assistant under this chapter and the personal care assistance provider
agency must have received a notice from the commissioner that the personal care assistant
is:
new text end

new text begin (i) not disqualified under section 245C.14; or
new text end

new text begin (ii) disqualified, but the personal care assistant has received a set aside of the
disqualification under section 245C.22.
new text end

Sec. 53.

Minnesota Statutes 2020, section 245C.14, subdivision 1, is amended to read:

Subdivision 1.

Disqualification from direct contact.

(a) The commissioner shall
disqualify an individual who is the subject of a background study from any position allowing
direct contact with persons receiving services from the license holder or entity identified in
section 245C.03, upon receipt of information showing, or when a background study
completed under this chapter shows any of the following:

(1) a conviction of, admission to, or Alford plea to one or more crimes listed in section
245C.15, regardless of whether the conviction or admission is a felony, gross misdemeanor,
or misdemeanor level crime;

(2) a preponderance of the evidence indicates the individual has committed an act or
acts that meet the definition of any of the crimes listed in section 245C.15, regardless of
whether the preponderance of the evidence is for a felony, gross misdemeanor, or
misdemeanor level crime; or

(3) an investigation results in an administrative determination listed under section
245C.15, subdivision 4, paragraph (b).

(b) No individual who is disqualified following a background study under section
245C.03, subdivisions 1 and 2, may be retained in a position involving direct contact with
persons served by a program or entity identified in section 245C.03, unless the commissioner
has provided written notice under section 245C.17 stating that:

(1) the individual may remain in direct contact during the period in which the individual
may request reconsideration as provided in section 245C.21, subdivision 2;

(2) the commissioner has set aside the individual's disqualification for that program or
entity identified in section 245C.03, as provided in section 245C.22, subdivision 4; or

(3) the license holder has been granted a variance for the disqualified individual under
section 245C.30.

new text begin (c) Notwithstanding paragraph (a), for the purposes of a background study affiliated
with a licensed family foster setting, the commissioner shall disqualify an individual who
is the subject of a background study from any position allowing direct contact with persons
receiving services from the license holder or entity identified in section 245C.03, upon
receipt of information showing or when a background study completed under this chapter
shows reason for disqualification under section 245C.15, subdivision 4a.
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. 54.

Minnesota Statutes 2020, section 245C.14, is amended by adding a subdivision
to read:

new text begin Subd. 4. new text end

new text begin Disqualification from working in licensed child care centers or certified
license-exempt child care centers. new text end

new text begin (a) For a background study affiliated with a licensed
child care center or certified license-exempt child care center, if an individual is disqualified
from direct contact under subdivision 1, the commissioner must also disqualify the individual
from working in any position regardless of whether the individual would have direct contact
with or access to children served in the licensed child care center or certified license-exempt
child care center and from having access to a person receiving services from the center.
new text end

new text begin (b) Notwithstanding any other requirement of this chapter, for a background study
affiliated with a licensed child care center or a certified license-exempt child care center, if
an individual is disqualified, the individual may not work in the child care center until the
commissioner has issued a notice stating that:
new text end

new text begin (1) the individual is not disqualified;
new text end

new text begin (2) a disqualification has been set aside under section 245C.23; or
new text end

new text begin (3) a variance has been granted related to the individual under section 245C.30.
new text end

Sec. 55.

Minnesota Statutes 2020, section 245C.15, is amended by adding a subdivision
to read:

new text begin Subd. 4a. new text end

new text begin Licensed family foster setting disqualifications. new text end

new text begin (a) Notwithstanding
subdivisions 1 to 4, for a background study affiliated with a licensed family foster setting,
regardless of how much time has passed, an individual is disqualified under section 245C.14
if the individual committed an act that resulted in a felony-level conviction for sections:
609.185 (murder in the first degree); 609.19 (murder in the second degree); 609.195 (murder
in the third degree); 609.20 (manslaughter in the first degree); 609.205 (manslaughter in
the second degree); 609.2112 (criminal vehicular homicide); 609.221 (assault in the first
degree); 609.223, subdivision 2 (assault in the third degree, past pattern of child abuse);
609.223, subdivision 3 (assault in the third degree, victim under four); a felony offense
under sections 609.2242 and 609.2243 (domestic assault, spousal abuse, child abuse or
neglect, or a crime against children); 609.2247 (domestic assault by strangulation); 609.2325
(criminal abuse of a vulnerable adult resulting in the death of a vulnerable adult); 609.245
(aggravated robbery); 609.25 (kidnapping); 609.255 (false imprisonment); 609.2661 (murder
of an unborn child in the first degree); 609.2662 (murder of an unborn child in the second
degree); 609.2663 (murder of an unborn child in the third degree); 609.2664 (manslaughter
of an unborn child in the first degree); 609.2665 (manslaughter of an unborn child in the
second degree); 609.267 (assault of an unborn child in the first degree); 609.2671 (assault
of an unborn child in the second degree); 609.268 (injury or death of an unborn child in the
commission of a crime); 609.322, subdivision 1 (solicitation, inducement, and promotion
of prostitution; sex trafficking in the first degree); 609.324, subdivision 1 (other prohibited
acts; engaging in, hiring, or agreeing to hire minor to engage in prostitution); 609.342
(criminal sexual conduct in the first degree); 609.343 (criminal sexual conduct in the second
degree); 609.344 (criminal sexual conduct in the third degree); 609.345 (criminal sexual
conduct in the fourth degree); 609.3451 (criminal sexual conduct in the fifth degree);
609.3453 (criminal sexual predatory conduct); 609.352 (solicitation of children to engage
in sexual conduct); 609.377 (malicious punishment of a child); 609.378 (neglect or
endangerment of a child); 609.561 (arson in the first degree); 609.582, subdivision 1 (burglary
in the first degree); 609.746 (interference with privacy); 617.23 (indecent exposure); 617.246
(use of minors in sexual performance prohibited); or 617.247 (possession of pictorial
representations of minors).
new text end

new text begin (b) Notwithstanding subdivisions 1 to 4, for the purposes of a background study affiliated
with a licensed family foster setting, an individual is disqualified under section 245C.14,
regardless of how much time has passed, if the individual:
new text end

new text begin (1) committed an action under paragraph (e) that resulted in death or involved sexual
abuse, as defined in section 260E.03, subdivision 20;
new text end

new text begin (2) committed an act that resulted in a gross misdemeanor-level conviction for section
609.3451 (criminal sexual conduct in the fifth degree);
new text end

new text begin (3) committed an act against or involving a minor that resulted in a felony-level conviction
for: section 609.222 (assault in the second degree); 609.223, subdivision 1 (assault in the
third degree); 609.2231 (assault in the fourth degree); or 609.224 (assault in the fifth degree);
or
new text end

new text begin (4) committed an act that resulted in a misdemeanor or gross misdemeanor-level
conviction for section 617.293 (dissemination and display of harmful materials to minors).
new text end

new text begin (c) Notwithstanding subdivisions 1 to 4, for a background study affiliated with a licensed
family foster setting, an individual is disqualified under section 245C.14 if fewer than 20
years have passed since the termination of the individual's parental rights under section
260C.301, subdivision 1, paragraph (b), or if the individual consented to a termination of
parental rights under section 260C.301, subdivision 1, paragraph (a), to settle a petition to
involuntarily terminate parental rights. An individual is disqualified under section 245C.14
if fewer than 20 years have passed since the termination of the individual's parental rights
in any other state or country, where the conditions for the individual's termination of parental
rights are substantially similar to the conditions in section 260C.301, subdivision 1, paragraph
(b).
new text end

new text begin (d) Notwithstanding subdivisions 1 to 4, for a background study affiliated with a licensed
family foster setting, an individual is disqualified under section 245C.14 if fewer than five
years have passed since a felony-level violation for sections: 152.021 (controlled substance
crime in the first degree); 152.022 (controlled substance crime in the second degree); 152.023
(controlled substance crime in the third degree); 152.024 (controlled substance crime in the
fourth degree); 152.025 (controlled substance crime in the fifth degree); 152.0261 (importing
controlled substances across state borders); 152.0262, subdivision 1, paragraph (b)
(possession of substance with intent to manufacture methamphetamine); 152.027, subdivision
6, paragraph (c) (sale or possession of synthetic cannabinoids); 152.096 (conspiracies
prohibited); 152.097 (simulated controlled substances); 152.136 (anhydrous ammonia;
prohibited conduct; criminal penalties; civil liabilities); 152.137 (methamphetamine-related
crimes involving children or vulnerable adults); 169A.24 (felony first-degree driving while
impaired); 243.166 (violation of predatory offender registration requirements); 609.2113
(criminal vehicular operation; bodily harm); 609.2114 (criminal vehicular operation; unborn
child); 609.228 (great bodily harm caused by distribution of drugs); 609.2325 (criminal
abuse of a vulnerable adult not resulting in the death of a vulnerable adult); 609.233 (criminal
neglect); 609.235 (use of drugs to injure or facilitate a crime); 609.24 (simple robbery);
609.322, subdivision 1a (solicitation, inducement, and promotion of prostitution; sex
trafficking in the second degree); 609.498, subdivision 1 (tampering with a witness in the
first degree); 609.498, subdivision 1b (aggravated first-degree witness tampering); 609.562
(arson in the second degree); 609.563 (arson in the third degree); 609.582, subdivision 2
(burglary in the second degree); 609.66 (felony dangerous weapons); 609.687 (adulteration);
609.713 (terroristic threats); 609.749, subdivision 3, 4, or 5 (felony-level harassment or
stalking); 609.855, subdivision 5 (shooting at or in a public transit vehicle or facility); or
624.713 (certain people not to possess firearms).
new text end

new text begin (e) Notwithstanding subdivisions 1 to 4, except as provided in paragraph (a), for a
background study affiliated with a licensed family child foster care license, an individual
is disqualified under section 245C.14 if fewer than five years have passed since:
new text end

new text begin (1) a felony-level violation for an act not against or involving a minor that constitutes:
section 609.222 (assault in the second degree); 609.223, subdivision 1 (assault in the third
degree); 609.2231 (assault in the fourth degree); or 609.224, subdivision 4 (assault in the
fifth degree);
new text end

new text begin (2) a violation of an order for protection under section 518B.01, subdivision 14;
new text end

new text begin (3) a determination or disposition of the individual's failure to make required reports
under section 260E.06 or 626.557, subdivision 3, for incidents in which the final disposition
under chapter 260E or section 626.557 was substantiated maltreatment and the maltreatment
was recurring or serious;
new text end

new text begin (4) a determination or disposition of the individual's substantiated serious or recurring
maltreatment of a minor under chapter 260E, a vulnerable adult under section 626.557, or
serious or recurring maltreatment in any other state, the elements of which are substantially
similar to the elements of maltreatment under chapter 260E or section 626.557 and meet
the definition of serious maltreatment or recurring maltreatment;
new text end

new text begin (5) a gross misdemeanor-level violation for sections: 609.224, subdivision 2 (assault in
the fifth degree); 609.2242 and 609.2243 (domestic assault); 609.233 (criminal neglect);
609.377 (malicious punishment of a child); 609.378 (neglect or endangerment of a child);
609.746 (interference with privacy); 609.749 (stalking); or 617.23 (indecent exposure); or
new text end

new text begin (6) committing an act against or involving a minor that resulted in a misdemeanor-level
violation of section 609.224, subdivision 1 (assault in the fifth degree).
new text end

new text begin (f) For purposes of this subdivision, the disqualification begins from:
new text end

new text begin (1) the date of the alleged violation, if the individual was not convicted;
new text end

new text begin (2) the date of conviction, if the individual was convicted of the violation but not
committed to the custody of the commissioner of corrections; or
new text end

new text begin (3) the date of release from prison, if the individual was convicted of the violation and
committed to the custody of the commissioner of corrections.
new text end

new text begin Notwithstanding clause (3), if the individual is subsequently reincarcerated for a violation
of the individual's supervised release, the disqualification begins from the date of release
from the subsequent incarceration.
new text end

new text begin (g) An individual's aiding and abetting, attempt, or conspiracy to commit any of the
offenses listed in paragraphs (a) and (b), as each of these offenses is defined in Minnesota
Statutes, permanently disqualifies the individual under section 245C.14. An individual is
disqualified under section 245C.14 if fewer than five years have passed since the individual's
aiding and abetting, attempt, or conspiracy to commit any of the offenses listed in paragraphs
(d) and (e).
new text end

new text begin (h) An individual's offense in any other state or country, where the elements of the
offense are substantially similar to any of the offenses listed in paragraphs (a) and (b),
permanently disqualifies the individual under section 245C.14. An individual is disqualified
under section 245C.14 if fewer than five years have passed since an offense in any other
state or country, the elements of which are substantially similar to the elements of any
offense listed in paragraphs (d) and (e).
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. 56.

Minnesota Statutes 2020, section 245C.16, subdivision 1, is amended to read:

Subdivision 1.

Determining immediate risk of harm.

(a) If the commissioner determines
that the individual studied has a disqualifying characteristic, the commissioner shall review
the information immediately available and make a determination as to the subject's immediate
risk of harm to persons served by the program where the individual studied will have direct
contact with, or access to, people receiving services.

(b) The commissioner shall consider all relevant information available, including the
following factors in determining the immediate risk of harm:

(1) the recency of the disqualifying characteristic;

(2) the recency of discharge from probation for the crimes;

(3) the number of disqualifying characteristics;

(4) the intrusiveness or violence of the disqualifying characteristic;

(5) the vulnerability of the victim involved in the disqualifying characteristic;

(6) the similarity of the victim to the persons served by the program where the individual
studied will have direct contact;

(7) whether the individual has a disqualification from a previous background study that
has not been set aside; deleted text begin and
deleted text end

(8) if the individual has a disqualification which may not be set aside because it is a
permanent bar under section 245C.24, subdivision 1, or the individual is a child care
background study subject who has a felony-level conviction for a drug-related offense in
the last five years, the commissioner may order the immediate removal of the individual
from any position allowing direct contact with, or access to, persons receiving services from
the program and from working in a children's residential facility or foster residence setting deleted text begin . deleted text end new text begin ;
and
new text end

new text begin (9) if the individual has a disqualification which may not be set aside because it is a
permanent bar under section 245C.24, subdivision 2, or the individual is a child care
background study subject who has a felony-level conviction for a drug-related offense during
the last five years, the commissioner may order the immediate removal of the individual
from any position allowing direct contact with or access to persons receiving services from
the center and from working in a licensed child care center or certified license-exempt child
care center.
new text end

(c) This section does not apply when the subject of a background study is regulated by
a health-related licensing board as defined in chapter 214, and the subject is determined to
be responsible for substantiated maltreatment under section 626.557 or chapter 260E.

(d) This section does not apply to a background study related to an initial application
for a child foster family setting license.

(e) Except for paragraph (f), this section does not apply to a background study that is
also subject to the requirements under section 256B.0659, subdivisions 11 and 13, for a
personal care assistant or a qualified professional as defined in section 256B.0659,
subdivision 1.

(f) If the commissioner has reason to believe, based on arrest information or an active
maltreatment investigation, that an individual poses an imminent risk of harm to persons
receiving services, the commissioner may order that the person be continuously supervised
or immediately removed pending the conclusion of the maltreatment investigation or criminal
proceedings.

Sec. 57.

Minnesota Statutes 2020, section 245C.16, subdivision 2, is amended to read:

Subd. 2.

Findings.

(a) After evaluating the information immediately available under
subdivision 1, the commissioner may have reason to believe one of the following:

(1) the individual poses an imminent risk of harm to persons served by the program
where the individual studied will have direct contact or access to persons served by the
program or where the individual studied will work;

(2) the individual poses a risk of harm requiring continuous, direct supervision while
providing direct contact services during the period in which the subject may request a
reconsideration; or

(3) the individual does not pose an imminent risk of harm or a risk of harm requiring
continuous, direct supervision while providing direct contact services during the period in
which the subject may request a reconsideration.

(b) After determining an individual's risk of harm under this section, the commissioner
must notify the subject of the background study and the applicant or license holder as
required under section 245C.17.

(c) For Title IV-E eligible children's residential facilities and foster residence settings,
the commissioner is prohibited from making the findings in paragraph (a), clause (2) or (3).

new text begin (d) For licensed child care centers or certified license-exempt child care centers, the
commissioner is prohibited from making the findings in paragraph (a), clause (2) or (3).
new text end

Sec. 58.

Minnesota Statutes 2020, section 245C.17, subdivision 1, is amended to read:

Subdivision 1.

Time frame for notice of study results and auditing system access.

(a)
Within three working days after the commissioner's receipt of a request for a background
study submitted through the commissioner's NETStudy or NETStudy 2.0 system, the
commissioner shall notify the background study subject and the license holder or other
entity as provided in this chapter in writing or by electronic transmission of the results of
the study or that more time is needed to complete the study. The notice to the individual
shall include the identity of the entity that initiated the background study.

(b) Before being provided access to NETStudy 2.0, the license holder or other entity
under section 245C.04 shall sign an acknowledgment of responsibilities form developed
by the commissioner that includes identifying the sensitive background study information
person, who must be an employee of the license holder or entity. All queries to NETStudy
2.0 are electronically recorded and subject to audit by the commissioner. The electronic
record shall identify the specific user. A background study subject may request in writing
to the commissioner a report listing the entities that initiated a background study on the
individual.

(c) When the commissioner has completed a prior background study on an individual
that resulted in an order for immediate removal and more time is necessary to complete a
subsequent study, the notice that more time is needed that is issued under paragraph (a)
shall include an order for immediate removal of the individual from any position allowing
direct contact with or access to people receiving services and from working in a children's
residential facility deleted text begin or deleted text end new text begin , new text end foster residence setting new text begin , child care center, or certified license-exempt
child care center new text end pending completion of the background study.

Sec. 59.

Minnesota Statutes 2020, section 245C.17, is amended by adding a subdivision
to read:

new text begin Subd. 8. new text end

new text begin Disqualification notice to child care centers and certified license-exempt
child care centers. new text end

new text begin (a) For child care centers and certified license-exempt child care centers,
all notices under this section that order the license holder to immediately remove the
individual studied from any position allowing direct contact with, or access to a person
served by the center, must also order the license holder to immediately remove the individual
studied from working in any position regardless of whether the individual would have direct
contact with or access to children served in the center.
new text end

new text begin (b) For child care centers and certified license-exempt child care centers, notices under
this section must not allow an individual to work in the center.
new text end

Sec. 60.

Minnesota Statutes 2020, section 245C.18, is amended to read:

245C.18 OBLIGATION TO REMOVE DISQUALIFIED INDIVIDUAL FROM
DIRECT CONTACT AND FROM WORKING IN A PROGRAM, FACILITY, deleted text begin OR deleted text end
SETTING new text begin , OR CENTER new text end .

(a) Upon receipt of notice from the commissioner, the license holder must remove a
disqualified individual from direct contact with persons served by the licensed program if:

(1) the individual does not request reconsideration under section 245C.21 within the
prescribed time;

(2) the individual submits a timely request for reconsideration, the commissioner does
not set aside the disqualification under section 245C.22, subdivision 4, and the individual
does not submit a timely request for a hearing under sections 245C.27 and 256.045, or
245C.28 and chapter 14; or

(3) the individual submits a timely request for a hearing under sections 245C.27 and
256.045, or 245C.28 and chapter 14, and the commissioner does not set aside or rescind the
disqualification under section 245A.08, subdivision 5, or 256.045.

(b) For children's residential facility and foster residence setting license holders, upon
receipt of notice from the commissioner under paragraph (a), the license holder must also
remove the disqualified individual from working in the program, facility, or setting and
from access to persons served by the licensed program.

(c) For Title IV-E eligible children's residential facility and foster residence setting
license holders, upon receipt of notice from the commissioner under paragraph (a), the
license holder must also remove the disqualified individual from working in the program
and from access to persons served by the program and must not allow the individual to work
in the facility or setting until the commissioner has issued a notice stating that:

(1) the individual is not disqualified;

(2) a disqualification has been set aside under section 245C.23; or

(3) a variance has been granted related to the individual under section 245C.30.

new text begin (d) For licensed child care center and certified license-exempt child care center license
holders, upon receipt of notice from the commissioner under paragraph (a), the license
holder must remove the disqualified individual from working in any position regardless of
whether the individual would have direct contact with or access to children served in the
center and from having access to persons served by the center and must not allow the
individual to work in the center until the commissioner has issued a notice stating that:
new text end

new text begin (1) the individual is not disqualified;
new text end

new text begin (2) a disqualification has been set aside under section 245C.23; or
new text end

new text begin (3) a variance has been granted related to the individual under section 245C.30.
new text end

Sec. 61.

Minnesota Statutes 2020, section 245C.24, subdivision 2, is amended to read:

Subd. 2.

Permanent bar to set aside a disqualification.

(a) Except as provided in
paragraphs (b) to deleted text begin (e) deleted text end new text begin (f) new text end , the commissioner may not set aside the disqualification of any
individual disqualified pursuant to this chapter, regardless of how much time has passed,
if the individual was disqualified for a crime or conduct listed in section 245C.15, subdivision
1.

(b) For an individual in the chemical dependency or corrections field who was disqualified
for a crime or conduct listed under section 245C.15, subdivision 1, and whose disqualification
was set aside prior to July 1, 2005, the commissioner must consider granting a variance
pursuant to section 245C.30 for the license holder for a program dealing primarily with
adults. A request for reconsideration evaluated under this paragraph must include a letter
of recommendation from the license holder that was subject to the prior set-aside decision
addressing the individual's quality of care to children or vulnerable adults and the
circumstances of the individual's departure from that service.

(c) If an individual who requires a background study for nonemergency medical
transportation services under section 245C.03, subdivision 12, was disqualified for a crime
or conduct listed under section 245C.15, subdivision 1, and if more than 40 years have
passed since the discharge of the sentence imposed, the commissioner may consider granting
a set-aside pursuant to section 245C.22. A request for reconsideration evaluated under this
paragraph must include a letter of recommendation from the employer. This paragraph does
not apply to a person disqualified based on a violation of sections 243.166; 609.185 to
609.205; 609.25; 609.342 to 609.3453; 609.352; 617.23, subdivision 2, clause (1), or 3,
clause (1); 617.246; or 617.247.

(d) When a licensed foster care provider adopts an individual who had received foster
care services from the provider for over six months, and the adopted individual is required
to receive a background study under section 245C.03, subdivision 1, paragraph (a), clause
(2) or (6), the commissioner may grant a variance to the license holder under section 245C.30
to permit the adopted individual with a permanent disqualification to remain affiliated with
the license holder under the conditions of the variance when the variance is recommended
by the county of responsibility for each of the remaining individuals in placement in the
home and the licensing agency for the home.

new text begin (e) For an individual 18 years of age or older affiliated with a licensed family foster
setting, the commissioner must not set aside or grant a variance for the disqualification of
any individual disqualified pursuant to this chapter, regardless of how much time has passed,
if the individual was disqualified for a crime or conduct listed in section 245C.15, subdivision
4a, paragraphs (a) and (b).
new text end

new text begin (f) In connection with a family foster setting license, the commissioner may grant a
variance to the disqualification for an individual who is under 18 years of age at the time
the background study is submitted.
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. 62.

Minnesota Statutes 2020, section 245C.24, subdivision 3, is amended to read:

Subd. 3.

Ten-year bar to set aside disqualification.

(a) The commissioner may not set
aside the disqualification of an individual in connection with a license to provide family
child care for children deleted text begin , foster care for children in the provider's home, deleted text end or foster care or day
care services for adults in the provider's home if: (1) less than ten years has passed since
the discharge of the sentence imposed, if any, for the offense; or (2) when disqualified based
on a preponderance of evidence determination under section 245C.14, subdivision 1,
paragraph (a), clause (2), or an admission under section 245C.14, subdivision 1, paragraph
(a), clause (1), and less than ten years has passed since the individual committed the act or
admitted to committing the act, whichever is later; and (3) the individual has committed a
violation of any of the following offenses: sections 609.165 (felon ineligible to possess
firearm); criminal vehicular homicide or criminal vehicular operation causing death under
609.2112, 609.2113, or 609.2114 (criminal vehicular homicide or injury); 609.215 (aiding
suicide or aiding attempted suicide); felony violations under 609.223 or 609.2231 (assault
in the third or fourth degree); 609.229 (crimes committed for benefit of a gang); 609.713
(terroristic threats); 609.235 (use of drugs to injure or to facilitate crime); 609.24 (simple
robbery); 609.255 (false imprisonment); 609.562 (arson in the second degree); 609.71 (riot);
609.498, subdivision 1 or 1b (aggravated first-degree or first-degree tampering with a
witness); burglary in the first or second degree under 609.582 (burglary); 609.66 (dangerous
weapon); 609.665 (spring guns); 609.67 (machine guns and short-barreled shotguns);
609.749, subdivision 2 (gross misdemeanor harassment); 152.021 or 152.022 (controlled
substance crime in the first or second degree); 152.023, subdivision 1, clause (3) or (4) or
subdivision 2, clause (4) (controlled substance crime in the third degree); 152.024,
subdivision 1, clause (2), (3), or (4) (controlled substance crime in the fourth degree);
609.224, subdivision 2, paragraph (c) (fifth-degree assault by a caregiver against a vulnerable
adult); 609.23 (mistreatment of persons confined); 609.231 (mistreatment of residents or
patients); 609.2325 (criminal abuse of a vulnerable adult); 609.233 (criminal neglect of a
vulnerable adult); 609.2335 (financial exploitation of a vulnerable adult); 609.234 (failure
to report); 609.265 (abduction); 609.2664 to 609.2665 (manslaughter of an unborn child in
the first or second degree); 609.267 to 609.2672 (assault of an unborn child in the first,
second, or third degree); 609.268 (injury or death of an unborn child in the commission of
a crime); repeat offenses under 617.23 (indecent exposure); 617.293 (disseminating or
displaying harmful material to minors); a felony-level conviction involving alcohol or drug
use, a gross misdemeanor offense under 609.324, subdivision 1 (other prohibited acts); a
gross misdemeanor offense under 609.378 (neglect or endangerment of a child); a gross
misdemeanor offense under 609.377 (malicious punishment of a child); 609.72, subdivision
3 (disorderly conduct against a vulnerable adult); or 624.713 (certain persons not to possess
firearms); or Minnesota Statutes 2012, section 609.21.

(b) The commissioner may not set aside the disqualification of an individual if less than
ten years have passed since the individual's aiding and abetting, attempt, or conspiracy to
commit any of the offenses listed in paragraph (a) as each of these offenses is defined in
Minnesota Statutes.

(c) The commissioner may not set aside the disqualification of an individual if less than
ten years have passed since the discharge of the sentence imposed for an offense in any
other state or country, the elements of which are substantially similar to the elements of any
of the offenses listed in paragraph (a).

new text begin EFFECTIVE DATE. new text end

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

Sec. 63.

Minnesota Statutes 2020, section 245C.24, subdivision 4, is amended to read:

Subd. 4.

Seven-year bar to set aside disqualification.

The commissioner may not set
aside the disqualification of an individual in connection with a license to provide family
child care for children deleted text begin , foster care for children in the provider's home, deleted text end or foster care or day
care services for adults in the provider's home if within seven years preceding the study:

(1) the individual committed an act that constitutes maltreatment of a child under sections
260E.24, subdivisions 1, 2, and 3, and 260E.30, subdivisions 1, 2, and 4, and the maltreatment
resulted in substantial bodily harm as defined in section 609.02, subdivision 7a, or substantial
mental or emotional harm as supported by competent psychological or psychiatric evidence;
or

(2) the individual was determined under section 626.557 to be the perpetrator of a
substantiated incident of maltreatment of a vulnerable adult that resulted in substantial
bodily harm as defined in section 609.02, subdivision 7a, or substantial mental or emotional
harm as supported by competent psychological or psychiatric evidence.

new text begin EFFECTIVE DATE. new text end

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

Sec. 64.

Minnesota Statutes 2020, section 245C.24, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Five-year bar to set aside disqualification; family foster setting. new text end

new text begin (a) The
commissioner shall not set aside or grant a variance for the disqualification of an individual
18 years of age or older in connection with a foster family setting license if within five years
preceding the study the individual is convicted of a felony in section 245C.15, subdivision
4a, paragraph (d).
new text end

new text begin (b) In connection with a foster family setting license, the commissioner may set aside
or grant a variance to the disqualification for an individual who is under 18 years of age at
the time the background study is submitted.
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. 65.

Minnesota Statutes 2020, section 245C.30, is amended by adding a subdivision
to read:

new text begin Subd. 1a. new text end

new text begin Public law background study variances. new text end

new text begin For a variance related to a public
law background study conducted under section 245C.032, the variance shall state the services
that may be provided by the disqualified individual and state the conditions with which the
license holder or applicant must comply for the variance to remain in effect. The variance
shall not state the reason for the disqualification.
new text end

Sec. 66.

Minnesota Statutes 2020, section 245C.32, subdivision 1a, is amended to read:

Subd. 1a.

NETStudy 2.0 system.

(a) The commissioner shall design, develop, and test
the NETStudy 2.0 system and implement it no later than September 1, 2015.

(b) The NETStudy 2.0 system developed and implemented by the commissioner shall
incorporate and meet all applicable data security standards and policies required by the
Federal Bureau of Investigation (FBI), Department of Public Safety, Bureau of Criminal
Apprehension, and the Office of MN.IT Services. The system shall meet all required
standards for encryption of data at the database level as well as encryption of data that
travels electronically among agencies initiating background studies, the commissioner's
authorized fingerprint collection vendor new text begin or vendors new text end , the commissioner, the Bureau of Criminal
Apprehension, and in cases involving national criminal record checks, the FBI.

(c) The data system developed and implemented by the commissioner shall incorporate
a system of data security that allows the commissioner to control access to the data field
level by the commissioner's employees. The commissioner shall establish that employees
have access to the minimum amount of private data on any individual as is necessary to
perform their duties under this chapter.

(d) The commissioner shall oversee regular quality and compliance audits of the
authorized fingerprint collection vendor new text begin or vendors new text end .

Sec. 67.

Minnesota Statutes 2020, section 245C.32, subdivision 2, is amended to read:

Subd. 2.

Use.

(a) The commissioner may also use these systems and records to obtain
and provide criminal history data from the Bureau of Criminal Apprehension, criminal
history data held by the commissioner, and data about substantiated maltreatment under
section 626.557 or chapter 260E, for other purposes, provided that:

(1) the background study is specifically authorized in statute; or

(2) the request is made with the informed consent of the subject of the study as provided
in section 13.05, subdivision 4.

(b) An individual making a request under paragraph (a), clause (2), must agree in writing
not to disclose the data to any other individual without the consent of the subject of the data.

(c) The commissioner may recover the cost of obtaining and providing background study
data by charging the individual or entity requesting the study a fee of no more than deleted text begin $20 deleted text end new text begin $42 new text end
per study. The fees collected under this paragraph are appropriated to the commissioner for
the purpose of conducting background studies.

Sec. 68.

new text begin [245G.031] ALTERNATIVE LICENSING INSPECTIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Eligibility for an alternative licensing inspection. new text end

new text begin (a) A license holder
who holds a qualifying accreditation may request approval for an alternative licensing
inspection by the commissioner when the standards of the accrediting body are determined
by the commissioner to be the same as or similar to the standards set forth in this chapter.
Programs licensed according to section 245G.19 to serve clients with children and opioid
treatment programs licensed according to section 245G.22 are not eligible for an alternative
licensing inspection.
new text end

new text begin (b) A license holder may request an alternative licensing inspection after the license
holder has had at least one inspection by the commissioner that included a review of all
applicable requirements in this chapter after issuance of the initial license.
new text end

new text begin (c) To be eligible for an alternative licensing inspection, the license holder must be in
substantial and consistent compliance at the time of the request. For purposes of this section,
"substantial and consistent compliance" means:
new text end

new text begin (1) the license holder has not had a license made conditional, suspended, or revoked
within the last five years;
new text end

new text begin (2) there have been no substantiated allegations of maltreatment for which the facility
was determined responsible within the past five years; and
new text end

new text begin (3) the license holder has corrected all violations and submitted required documentation
as specified in the correction orders issued within the past two years.
new text end

new text begin Subd. 2. new text end

new text begin Qualifying accreditation; determination of same and similar standards. new text end

new text begin (a)
The commissioner must accept a qualifying accreditation from an accrediting body listed
in paragraph (c) after determining, in consultation with the accrediting body and license
holders, the accrediting body's standards that are the same as or similar to the licensing
requirements in this chapter. In determining whether standards of an accrediting body are
the same as or similar to licensing requirements under this chapter, the commissioner shall
give due consideration to the existence of a standard that aligns in whole or in part to a
licensing standard.
new text end

new text begin (b) Upon request by a license holder, the commissioner may allow the accrediting body
to monitor for compliance with licensing requirements under this chapter that are determined
to be neither the same as nor similar to those of the accrediting body.
new text end

new text begin (c) For purposes of this section, "accrediting body" means the joint commission.
new text end

new text begin (d) Qualifying accreditation only applies to the license holder's licensed programs that
are included in the accrediting body's survey during each survey period.
new text end

new text begin Subd. 3. new text end

new text begin Request for approval of an alternative licensing inspection status. new text end

new text begin (a) A
license holder may request an alternative licensing inspection on the forms and in the manner
prescribed by the commissioner. When submitting the request, the license holder must
submit all documentation issued by the accrediting body verifying that the license holder
has obtained and maintained the qualifying accreditation and has complied with
recommendations or requirements from the accrediting body during the period of
accreditation. Prior to approving an alternative licensing inspection under this section, the
commissioner must have reviewed and approved the license holder's policies and procedures
required to demonstrate compliance with all applicable requirements in this chapter.
new text end

new text begin (b) The commissioner must notify the license holder in writing within 90 days whether
the request for an alternative licensing inspection status has been approved.
new text end

new text begin Subd. 4. new text end

new text begin Programs approved for alternative licensing inspection; licensing
requirements. new text end

new text begin (a) A license holder approved for alternative licensing inspection under this
section is required to maintain compliance with all licensing standards according to this
chapter.
new text end

new text begin (b) After approval, the license holder must submit to the commissioner changes to
policies required as a result of legislative changes to this chapter.
new text end

new text begin (c) The commissioner may conduct licensing inspections of requirements that are not
already covered by the accrediting body, as determined under subdivision 2, paragraphs (a)
and (b), including applicable requirements in chapters 245A and 245C, and Minnesota
Rules, chapter 9544.
new text end

new text begin (d) The commissioner may conduct routine licensing inspections every five years of all
applicable requirements in this chapter, chapters 245A and 245C, and Minnesota Rules,
chapter 9544.
new text end

new text begin (e) Within ten days of final approval of a corrective action plan by the accrediting body,
if any, or if no corrections, upon receipt of the final report by the accrediting body, the
license holder must mail or e-mail to the commissioner the complete contents of all survey
results and corrective responses.
new text end

new text begin (f) If the accrediting body determines the scope of noncompliance of a standard with a
pattern or widespread moderate likelihood to harm a client or any high likelihood to harm
a client, the commissioner may conduct an inspection.
new text end

new text begin (g) If the accrediting body does not subject a licensed location to a survey by the
accrediting body, the license holder must inform the commissioner and the commissioner
may conduct an inspection of that location.
new text end

new text begin (h) Upon receipt of a complaint or report regarding the services of a license holder
approved for alternative licensing inspection under this section, the commissioner may
investigate the complaint or report and may take any action as provided under section
245A.06 or 245A.07.
new text end

new text begin (i) The license holder must notify the commissioner in a timely manner if the license
holder no longer holds a qualifying accreditation from an accrediting body.
new text end

new text begin Subd. 5. new text end

new text begin Investigations of alleged or suspected maltreatment. new text end

new text begin Nothing in this section
changes the commissioner's responsibilities to investigate alleged or suspected maltreatment
of a minor under chapter 260E or a vulnerable adult under section 626.557.
new text end

new text begin Subd. 6. new text end

new text begin Termination or denial of subsequent approval. new text end

new text begin The commissioner may
terminate the approval of an alternative licensing inspection if after approval:
new text end

new text begin (1) the commissioner determines that the license holder has not maintained the qualifying
accreditation;
new text end

new text begin (2) the license holder fails to provide the commissioner with documentation that
demonstrates the license holder has complied with accreditation standards;
new text end

new text begin (3) the commissioner substantiates maltreatment for which the license holder or facility
is determined to be responsible; or
new text end

new text begin (4) the license holder is issued an order for conditional license, fine, suspension, or
license revocation that has not been reversed upon appeal.
new text end

new text begin Subd. 7. new text end

new text begin Appeals. new text end

new text begin The commissioner's decision that the conditions for approval for an
alternative licensing inspection have not been met is final and not subject to appeal under
the provisions of chapter 14.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 69.

Minnesota Statutes 2020, section 256B.0949, is amended by adding a subdivision
to read:

new text begin Subd. 16a. new text end

new text begin Background studies. new text end

new text begin An early intensive developmental and behavioral
intervention services agency must fulfill any background studies requirements under this
section by initiating a background study through the commissioner's NETStudy system as
provided under sections 245C.03, subdivision 15, and 245C.10, subdivision 17.
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. 70.

Minnesota Statutes 2020, section 260C.215, subdivision 4, is amended to read:

Subd. 4.

Duties of commissioner.

The commissioner of human services shall:

(1) provide practice guidance to responsible social services agencies and licensed
child-placing agencies that reflect federal and state laws and policy direction on placement
of children;

(2) develop criteria for determining whether a prospective adoptive or foster family has
the ability to understand and validate the child's cultural background;

(3) provide a standardized training curriculum for adoption and foster care workers and
administrators who work with children. Training must address the following objectives:

(i) developing and maintaining sensitivity to all cultures;

(ii) assessing values and their cultural implications;

(iii) making individualized placement decisions that advance the best interests of a
particular child under section 260C.212, subdivision 2; and

(iv) issues related to cross-cultural placement;

(4) provide a training curriculum for all prospective adoptive and foster families that
prepares them to care for the needs of adoptive and foster children taking into consideration
the needs of children outlined in section 260C.212, subdivision 2, paragraph (b), and, as
necessary, preparation is continued after placement of the child and includes the knowledge
and skills related to reasonable and prudent parenting standards for the participation of the
child in age or developmentally appropriate activities, according to section 260C.212,
subdivision 14;

(5) develop and provide to responsible social services agencies and licensed child-placing
agencies a home study format to assess the capacities and needs of prospective adoptive
and foster families. The format must address problem-solving skills; parenting skills; evaluate
the degree to which the prospective family has the ability to understand and validate the
child's cultural background, and other issues needed to provide sufficient information for
agencies to make an individualized placement decision consistent with section 260C.212,
subdivision 2. For a study of a prospective foster parent, the format must also address the
capacity of the prospective foster parent to provide a safe, healthy, smoke-free home
environment. If a prospective adoptive parent has also been a foster parent, any update
necessary to a home study for the purpose of adoption may be completed by the licensing
authority responsible for the foster parent's license. If a prospective adoptive parent with
an approved adoptive home study also applies for a foster care license, the license application
may be made with the same agency which provided the adoptive home study; deleted text begin and
deleted text end

(6) consult with representatives reflecting diverse populations from the councils
established under sections 3.922 and 15.0145, and other state, local, and community
organizations deleted text begin . deleted text end new text begin ; and
new text end

new text begin (7) establish family foster setting licensing guidelines for county agencies and private
agencies designated or licensed by the commissioner to perform licensing functions and
activities under section 245A.04. Guidelines that the commissioner establishes under this
clause shall be considered directives of the commissioner under section 245A.16.
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. 71.

Laws 2020, First Special Session chapter 7, section 1, subdivision 1, 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 that are required to comply with federal law
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) new text begin CV15: allowing telephone or video visits for waiver programs;
new text end

new text begin (2) new text end CV17: preserving health care coverage for Medical Assistance and MinnesotaCare;

deleted text begin (2) deleted text end new text begin (3) new text end CV18: implementation of federal changes to the Supplemental Nutrition Assistance
Program;

deleted text begin (3) deleted text end new text begin (4) new text end CV20: eliminating cost-sharing for COVID-19 diagnosis and treatment;

deleted text begin (4) deleted text end new text begin (5) CV24: allowing telephone or video use for targeted case management visits;
new text end

new text begin (6) CV30: expanding telemedicine in health care, mental health, and substance use
disorder settings;
new text end

new text begin (7) new text end CV37: implementation of federal changes to the Supplemental Nutrition Assistance
Program;

deleted text begin (5) deleted text end new text begin (8) new text end CV39: implementation of federal changes to the Supplemental Nutrition Assistance
Program;

deleted text begin (6) deleted text end new text begin (9) CV42: implementation of federal changes to the Supplemental Nutrition Assistance
Program;
new text end

new text begin (10) CV43: expanding remote home and community-based waiver services;
new text end

new text begin (11) CV44: allowing remote delivery of adult day services;
new text end

new text begin (12) new text end CV59: modifying eligibility period for the federally funded Refugee Cash Assistance
Program; deleted text begin and
deleted text end

deleted text begin (7) deleted text end new text begin (13) new text end CV60: modifying eligibility period for the federally funded Refugee Social
Services Program deleted text begin . deleted text end new text begin ; and
new text end

new text begin (14) CV109: providing 15 percent increase for Minnesota Food Assistance Program and
Minnesota Family Investment Program maximum food benefits.
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. 72.

Laws 2020, First Special Session chapter 7, section 1, subdivision 3, is amended
to read:

Subd. 3.

Waivers and modifications; 60-day transition period.

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, all waivers or modifications issued by
the commissioner of human services in response to the COVID-19 outbreak that have not
been new text begin otherwise new text end extended as provided in deleted text begin subdivisions 1, 2, and 4 of deleted text end this section may remain
in effect for no more than 60 days, only for purposes of transitioning affected programs
back to operating without the waivers or modifications in place.

new text begin EFFECTIVE DATE. new text end

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

Sec. 73.

Laws 2020, First Special Session chapter 7, section 1, as amended by Laws 2020,
Third Special Session chapter 1, section 3, is amended by adding a subdivision to read:

new text begin Subd. 5. new text end

new text begin Waivers and modifications; extension for 365 days. new text end

new text begin 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, waiver CV23: modifying background
study requirements, issued by the commissioner of human services pursuant to Executive
Orders 20-11 and 20-12, including any amendments to the modification issued before the
peacetime emergency expires, shall remain in effect for 365 days after the peacetime
emergency ends.
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. 74. new text begin LEGISLATIVE TASK FORCE; HUMAN SERVICES BACKGROUND
STUDY ELIGIBILITY.
new text end

new text begin Subdivision 1. new text end

new text begin Creation; duties. new text end

new text begin A legislative task force is created to review the statutes
relating to human services background study eligibility and disqualifications, including but
not limited to Minnesota Statutes, sections 245C.14 and 245C.15, in order to:
new text end

new text begin (1) evaluate the existing statutes' effectiveness in protecting the individuals served by
programs for which background studies are conducted under Minnesota Statutes, chapter
245C, including by gathering and reviewing available background study disqualification
data;
new text end

new text begin (2) identify the existing statutes' weaknesses and inefficiencies, ways in which the
existing statutes may unnecessarily or unintentionally prevent qualified individuals from
providing services or securing employment, and any additional areas for improvement or
modernization; and
new text end

new text begin (3) develop legislative proposals that improve or modernize the human services
background study eligibility and disqualification statutes, or otherwise address the issues
identified in clauses (1) and (2).
new text end

new text begin Subd. 2. new text end

new text begin Membership. new text end

new text begin (a) The task force shall consist of 26 members, appointed as
follows:
new text end

new text begin (1) two members representing licensing boards whose licensed providers are subject to
the provisions in Minnesota Statutes, section 245C.03, one appointed by the speaker of the
house of representatives, and one appointed by the senate majority leader;
new text end

new text begin (2) the commissioner of human services or a designee;
new text end

new text begin (3) the commissioner of health or a designee;
new text end

new text begin (4) two members representing county attorneys and law enforcement, one appointed by
the speaker of the house of representatives, and one appointed by the senate majority leader;
new text end

new text begin (5) two members representing licensed service providers who are subject to the provisions
in Minnesota Statutes, section 245C.15, one appointed by the speaker of the house of
representatives, and one appointed by the senate majority leader;
new text end

new text begin (6) four members of the public, including two who have been subject to disqualification
based on the provisions of Minnesota Statutes, section 245C.15, and two who have been
subject to a set-aside based on the provisions of Minnesota Statutes, section 245C.15, with
one from each category appointed by the speaker of the house of representatives, and one
from each category appointed by the senate majority leader;
new text end

new text begin (7) one member appointed by the governor's Workforce Development Board;
new text end

new text begin (8) one member appointed by the One Minnesota Council on Diversity, Inclusion, and
Equity;
new text end

new text begin (9) two members representing the Minnesota courts, one appointed by the speaker of
the house of representatives, and one appointed by the senate majority leader;
new text end

new text begin (10) one member appointed jointly by Mid-Minnesota Legal Aid, Southern Minnesota
Legal Services, and the Legal Rights Center;
new text end

new text begin (11) one member representing Tribal organizations, appointed by the Minnesota Indian
Affairs Council;
new text end

new text begin (12) two members from the house of representatives, including one appointed by the
speaker of the house of representatives and one appointed by the minority leader in the
house of representatives;
new text end

new text begin (13) two members from the senate, including one appointed by the senate majority leader
and one appointed by the senate minority leader;
new text end

new text begin (14) two members representing county human services agencies appointed by the
Minnesota Association of County Social Service Administrators, including one appointed
to represent the metropolitan area as defined in Minnesota Statutes, section 473.121,
subdivision 2, and one appointed to represent the area outside of the metropolitan area; and
new text end

new text begin (15) two attorneys who have represented individuals that appealed a background study
disqualification determination based on Minnesota Statutes, sections 245C.14 and 245C.15,
one appointed by the speaker of the house of representatives, and one appointed by the
senate majority leader.
new text end

new text begin (b) Appointments to the task force must be made by August 18, 2021.
new text end

new text begin Subd. 3. new text end

new text begin Compensation. new text end

new text begin Public members of the task force may be compensated as
provided by Minnesota Statutes, section 15.059, subdivision 3.
new text end

new text begin Subd. 4. new text end

new text begin Officers; meetings. new text end

new text begin (a) The first meeting of the task force shall be cochaired
by the task force member from the majority party of the house of representatives and the
task force member from the majority party of the senate. The task force shall elect a chair
and vice chair at the first meeting who shall preside at the remainder of the task force
meetings. The task force may elect other officers as necessary.
new text end

new text begin (b) The task force shall meet at least monthly. The Legislative Coordinating Commission
shall convene the first meeting by September 1, 2021.
new text end

new text begin (c) Meetings of the task force are subject to the Minnesota Open Meeting Law under
Minnesota Statutes, chapter 13D.
new text end

new text begin Subd. 5. new text end

new text begin Reports required. new text end

new text begin The task force shall submit an interim written report by
March 1, 2022, and a final report by December 16, 2022, to the chairs and ranking minority
members of the committees in the house of representatives and the senate with jurisdiction
over human services licensing. The reports shall explain the task force's findings and
recommendations relating to each of the duties under subdivision 1, and include any draft
legislation necessary to implement the recommendations.
new text end

new text begin Subd. 6. new text end

new text begin Expiration. new text end

new text begin The task force expires upon submission of the final report in
subdivision 5 or December 20, 2022, whichever is later.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment and
expires December 31, 2022.
new text end

Sec. 75. new text begin CHILD CARE CENTER REGULATION MODERNIZATION.
new text end

new text begin (a) The commissioner of human services shall contract with an experienced and
independent organization or individual consultant to conduct the work outlined in this
section. If practicable, the commissioner must contract with the National Association for
Regulatory Administration.
new text end

new text begin (b) The consultant must develop a proposal for revised licensing standards that includes
a risk-based model for monitoring compliance with child care center licensing standards,
grounded in national regulatory best practices. Violations in the new model must be weighted
to reflect the potential risk that the violations pose to children's health and safety, and
licensing sanctions must be tied to the potential risk. The proposed new model must protect
the health and safety of children in child care centers and be child-centered, family-friendly,
and fair to providers.
new text end

new text begin (c) The consultant shall develop and implement a stakeholder engagement process that
solicits input from parents, licensed child care centers, staff of the Department of Human
Services, and experts in child development about appropriate licensing standards, appropriate
tiers for violations of the standards based on the potential risk of harm that each violation
poses, and appropriate licensing sanctions for each tier.
new text end

new text begin (d) The consultant shall solicit input from parents, licensed child care centers, and staff
of the Department of Human Services about which child care centers should be eligible for
abbreviated inspections that predict compliance with other licensing standards for licensed
child care centers using key indicators previously identified by an empirically based statistical
methodology developed by the National Association for Regulatory Administration and the
Research Institute for Key Indicators.
new text end

new text begin (e) No later than February 1, 2024, the commissioner shall submit a report and proposed
legislation required to implement the new licensing model to the chairs and ranking minority
members of the legislative committees with jurisdiction over child care regulation.
new text end

Sec. 76. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; CHILD
FOSTER CARE LICENSING GUIDELINES.
new text end

new text begin By July 1, 2023, the commissioner of human services shall, in consultation with
stakeholders with expertise in child protection and children's behavioral health, develop
family foster setting licensing guidelines for county agencies and private agencies that
perform licensing functions. Stakeholders include but are not limited to child advocates,
representatives from community organizations, representatives of the state ethnic councils,
the ombudsperson for families, family foster setting providers, youth who have experienced
family foster setting placements, county child protection staff, and representatives of county
and private licensing agencies.
new text end

Sec. 77. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; DHS
FAMILY CHILD CARE FREQUENTLY ASKED QUESTIONS WEBSITE
MODIFICATIONS.
new text end

new text begin By July 1, 2022, the commissioner of human services shall expand the "frequently asked
questions" website for family child care providers to include more answers to submitted
questions and a function to search for answers to specific question topics.
new text end

Sec. 78. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; FAMILY
CHILD CARE TASK FORCE RECOMMENDATIONS IMPLEMENTATION PLAN.
new text end

new text begin The commissioner of human services shall include individuals representing family child
care providers in stakeholder groups that participate in implementing the recommendations
of the Family Child Care Task Force.
new text end

Sec. 79. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; CHILD
CARE ONE-STOP ASSISTANCE NETWORK.
new text end

new text begin (a) By January 1, 2022, the commissioner of human services shall, in consultation with
county agencies, child care providers, and stakeholders, develop a plan to establish a one-stop
regional assistance network of individuals with: (1) experience or expertise starting a licensed
family child care or group family child care program, or a child care center; or (2) technical
expertise regarding state licensing statutes and procedures. The one-stop regional assistance
network will assist child care providers and individuals interested in becoming child care
providers with establishing and sustaining a licensed family child care or group family child
care program, or a child care center.
new text end

new text begin (b) The plan to establish a one-stop regional assistance network shall include:
new text end

new text begin (1) an estimated timeline for implementing the assistance network through the child care
resource and referral system in Minnesota Statutes, section 119B.19;
new text end

new text begin (2) an estimated budget for the assistance network;
new text end

new text begin (3) a strategy to raise awareness and distribute the network's contact information statewide
to licensed family child care providers and group family child care providers, and to child
care centers; and
new text end

new text begin (4) any necessary legislative proposals necessary to implement the assistance network.
new text end

new text begin (c) The child care resource and referral system in Minnesota Statutes, section 119B.19,
shall begin implementing the plan according to the established timeline.
new text end

Sec. 80. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
RECOMMENDED FAMILY CHILD CARE ORIENTATION TRAINING.
new text end

new text begin By July 1, 2022, the commissioner of human services shall work with licensed family
child care providers and county agencies to develop recommended orientation training
materials for family child care license applicants to ensure that all family child care license
applicants receive uniform materials with basic information about Minnesota Statutes,
chapters 245A, 245C, and 260E, and Minnesota Rules, chapter 9502.
new text end

Sec. 81. new text begin FAMILY CHILD CARE REGULATION MODERNIZATION.
new text end

new text begin (a) The commissioner of human services shall contract with an experienced and
independent organization or individual consultant to conduct the work outlined in this
section. If practicable, the commissioner must contract with the National Association for
Regulatory Administration.
new text end

new text begin (b) The consultant must develop a proposal for updated family child care licensing
standards and solicit input from stakeholders as described in paragraph (d).
new text end

new text begin (c) The consultant must develop a proposal for a risk-based model for monitoring
compliance with family child care licensing standards, grounded in national regulatory best
practices. Violations in the new model must be weighted to reflect the potential risk they
pose to children's health and safety, and licensing sanctions must be tied to the potential
risk. The proposed new model must protect the health and safety of children in family child
care programs and be child-centered, family-friendly, and fair to providers.
new text end

new text begin (d) The consultant shall develop and implement a stakeholder engagement process that
solicits input from parents, licensed family child care providers, county licensors, staff of
the Department of Human Services, and experts in child development about licensing
standards, tiers for violations of the standards based on the potential risk of harm that each
violation poses, and licensing sanctions for each tier.
new text end

new text begin (e) The consultant shall solicit input from parents, licensed family child care providers,
county licensors, and staff of the Department of Human Services about which family child
care providers should be eligible for abbreviated inspections that predict compliance with
other licensing standards for licensed family child care providers using key indicators
previously identified by an empirically based statistical methodology developed by the
National Association for Regulatory Administration and the Research Institute for Key
Indicators.
new text end

new text begin (f) No later than February 1, 2024, the commissioner shall submit a report and proposed
legislation required to implement the new licensing model and the new licensing standards
to the chairs and ranking minority members of the legislative committees with jurisdiction
over child care regulation.
new text end

Sec. 82. new text begin FAMILY CHILD CARE TRAINING ADVISORY COMMITTEE.
new text end

new text begin Subdivision 1. new text end

new text begin Formation; duties. new text end

new text begin (a) The Family Child Care Training Advisory
Committee shall advise the commissioner of human services on the training requirements
for licensed family and group family child care providers. Beginning January 1, 2022, the
advisory committee shall meet at least twice per year. The advisory committee shall annually
elect a chair from committee members who shall establish the agenda for each meeting.
The commissioner or commissioner's designee shall attend all advisory committee meetings.
new text end

new text begin (b) The Family Child Care Training Advisory Committee shall advise and make
recommendations to the commissioner of human services and contractors working on the
family child care licensing modernization project on:
new text end

new text begin (1) updates to the rules and statutes governing family child care training, including
technical updates to facilitate providers' understanding of training requirements;
new text end

new text begin (2) modernization of family child care training requirements, including substantive
changes to training subject areas;
new text end

new text begin (3) difficulties that family child care providers face in completing training requirements,
including proposed solutions to provider difficulties; and
new text end

new text begin (4) other ideas for improving access to and quality of training for family child care
providers.
new text end

new text begin (c) The Family Child Care Training Advisory Committee shall expire December 1, 2025.
new text end

new text begin Subd. 2. new text end

new text begin Advisory committee members. new text end

new text begin (a) The Family Child Care Training Advisory
Committee consists of:
new text end

new text begin (1) four members representing family child care providers from greater Minnesota,
including two appointed by the speaker of the house and two appointed by the senate majority
leader;
new text end

new text begin (2) two members representing family child care providers from the seven-county
metropolitan area as defined in Minnesota Statutes, section 473.121, subdivision 2, including
one appointed by the speaker of the house and one appointed by the senate majority leader;
new text end

new text begin (3) one member representing family child care providers appointed by the Minnesota
Association of Child Care Professionals;
new text end

new text begin (4) one member representing family child care providers appointed by the Minnesota
Child Care Provider Information Network;
new text end

new text begin (5) two members appointed by the Association of Minnesota Child Care Licensors,
including one from greater Minnesota and one from the seven-county metropolitan area, as
defined in Minnesota Statutes, section 473.121, subdivision 2; and
new text end

new text begin (6) five members with expertise in child development and either instructional design or
training delivery, including:
new text end

new text begin (i) two members appointed by the speaker of the house;
new text end

new text begin (ii) two members appointed by the senate majority leader; and
new text end

new text begin (iii) one member appointed by Achieve, the Minnesota Center for Professional
Development.
new text end

new text begin (b) Advisory committee members shall not be employed by the Department of Human
Services. Advisory committee members shall receive no compensation, except that public
members of the advisory committee may be compensated as provided by Minnesota Statutes,
section 15.059, subdivision 3.
new text end

new text begin (c) Advisory committee members must include representatives of diverse cultural
communities.
new text end

new text begin (d) Advisory committee members shall serve two-year terms. Initial appointments to
the advisory committee must be made by December 1, 2021. Subsequent appointments to
the advisory committee must be made by December 1 of the year in which the member's
term expires. Any vacancy on the advisory committee must be filled within 60 days and
must be filled in the same manner that the leaving member was appointed under paragraph
(a).
new text end

new text begin (e) The commissioner of human services must convene the first meeting of the advisory
committee by March 1, 2022.
new text end

new text begin Subd. 3. new text end

new text begin Commissioner report. new text end

new text begin The commissioner of human services shall report
annually by December 15 to the chairs and ranking minority members of the legislative
committees with jurisdiction over early care and education programs on any recommendations
from the Family Child Care Training Advisory Committee. The report may include draft
legislation necessary to implement recommendations from the advisory committee.
new text end

Sec. 83. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES;
ALTERNATIVE CHILD CARE LICENSING MODELS.
new text end

new text begin The commissioner of human services, in consultation with counties, child care providers,
and other relevant stakeholders, shall review child care models that are not currently allowed
under state statutes, including licensing standards related to age, group size, and capacity.
The commissioner must consider whether any models could address the state's child care
needs while protecting children's safety, health, and well-being and make recommendations
for implementing the models that meet these criteria. No later than January 1, 2023, the
commissioner of human services shall report the recommendations to the chairs and ranking
minority members of the legislative committees with jurisdiction over child care licensing.
new text end

Sec. 84. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; FEDERAL
FUND AND CHILD CARE AND DEVELOPMENT BLOCK GRANT
ALLOCATIONS.
new text end

new text begin (a) The commissioner of human services shall allocate $3,000,000 in fiscal year 2022
from the child care and development block grant for grants to organizations operating child
care resource and referral programs under Minnesota Statutes, section 119B.19, to offer a
child care one-stop regional assistance network.
new text end

new text begin (b) The commissioner of human services shall allocate $50,000 in fiscal year 2022 from
the child care and development block grant for modifications to the family child care provider
frequently asked questions website.
new text end

new text begin (c) The commissioner of human services shall allocate $4,500,000 in fiscal year 2022
from the child care and development block grant for costs to cover the fees related to
administering child care background studies.
new text end

new text begin (d) The commissioner of human services shall allocate $2,059,000 in fiscal year 2022
from the child care and development block grant for the child care center regulation
modernization project.
new text end

new text begin (e) The commissioner of human services shall allocate $1,719,000 in fiscal year 2022
from the child care and development block grant for the family child care regulation
modernization project.
new text end

new text begin (f) The commissioner of human services shall allocate $100,000 in fiscal year 2022 from
the federal fund for a working group to review alternative child care licensing models.
new text end

new text begin (g) The commissioner of human services shall allocate $59,000 in fiscal year 2022 from
the child care and development block grant for the family child care training advisory
committee.
new text end

new text begin (h) The commissioner of human services shall allocate $7,650,000 in fiscal year 2022
from the child care and development block grant for child care information technology and
system improvements.
new text end

new text begin (i) The allocations in this section are available until June 30, 2025.
new text end

Sec. 85. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall renumber Minnesota Statutes, section 245C.02, so that the
subdivisions are alphabetical. The revisor shall correct any cross-references that arise as a
result of the renumbering.
new text end

Sec. 86. new text begin REPEALER.
new text end

new text begin Laws 2020, First Special Session chapter 7, section 1, subdivision 2, as amended by
Laws 2020, Third Special Session chapter 1, section 3, new text end new text begin is repealed.
new text end

new text begin EFFECTIVE DATE. new text end

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

ARTICLE 3

HEALTH DEPARTMENT

Section 1.

Minnesota Statutes 2020, section 62J.495, subdivision 1, is amended to read:

Subdivision 1.

Implementation.

The commissioner of health, in consultation with the
e-Health Advisory Committee, shall develop uniform standards to be used for the
interoperable electronic health records system for sharing and synchronizing patient data
across systems. The standards must be compatible with federal efforts. The uniform standards
must be developed by January 1, 2009, and updated on an ongoing basis. deleted text begin The commissioner
shall include an update on standards development as part of an annual report to the legislature. deleted text end
Individual health care providers in private practice with no other providers and health care
providers that do not accept reimbursement from a group purchaser, as defined in section
62J.03, subdivision 6, are excluded from the requirements of this section.

Sec. 2.

Minnesota Statutes 2020, section 62J.495, subdivision 2, is amended to read:

Subd. 2.

E-Health Advisory Committee.

(a) The commissioner shall establish an
e-Health Advisory Committee governed by section 15.059 to advise the commissioner on
the following matters:

(1) assessment of the adoption and effective use of health information technology by
the state, licensed health care providers and facilities, and local public health agencies;

(2) recommendations for implementing a statewide interoperable health information
infrastructure, to include estimates of necessary resources, and for determining standards
for clinical data exchange, clinical support programs, patient privacy requirements, and
maintenance of the security and confidentiality of individual patient data;

(3) recommendations for encouraging use of innovative health care applications using
information technology and systems to improve patient care and reduce the cost of care,
including applications relating to disease management and personal health management
that enable remote monitoring of patients' conditions, especially those with chronic
conditions; and

(4) other related issues as requested by the commissioner.

(b) The members of the e-Health Advisory Committee shall include the commissioners,
or commissioners' designees, of health, human services, administration, and commerce and
additional members to be appointed by the commissioner to include persons representing
Minnesota's local public health agencies, licensed hospitals and other licensed facilities and
providers, private purchasers, the medical and nursing professions, health insurers and health
plans, the state quality improvement organization, academic and research institutions,
consumer advisory organizations with an interest and expertise in health information
technology, and other stakeholders as identified by the commissioner to fulfill the
requirements of section 3013, paragraph (g), of the HITECH Act.

(c) deleted text begin The commissioner shall prepare and issue an annual report not later than January 30
of each year outlining progress to date in implementing a statewide health information
infrastructure and recommending action on policy and necessary resources to continue the
promotion of adoption and effective use of health information technology.
deleted text end

deleted text begin (d) deleted text end This subdivision expires June 30, deleted text begin 2021 deleted text end new text begin 2031 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.

Minnesota Statutes 2020, section 62J.495, subdivision 4, is amended to read:

Subd. 4.

Coordination with national HIT activities.

(a) The commissioner, in
consultation with the e-Health Advisory Committee, shall update the statewide
implementation plan required under subdivision 2 and released June 2008, to be consistent
with the updated federal deleted text begin HIT Strategic Plan released by the Office of the National Coordinator
in accordance with section 3001 of the HITECH Act. The statewide plan shall meet the
requirements for a plan required under section 3013 of the HITECH Act deleted text end new text begin plans new text end .

(b) The commissioner, in consultation with the e-Health Advisory Committee, shall
work to ensure coordination between state, regional, and national efforts to support and
accelerate efforts to effectively use health information technology to improve the quality
and coordination of health care and the continuity of patient care among health care providers,
to reduce medical errors, to improve population health, to reduce health disparities, and to
reduce chronic disease. The commissioner's coordination efforts shall include but not be
limited to:

deleted text begin (1) assisting in the development and support of health information technology regional
extension centers established under section 3012(c) of the HITECH Act to provide technical
assistance and disseminate best practices;
deleted text end

deleted text begin (2) providing supplemental information to the best practices gathered by regional centers
to ensure that the information is relayed in a meaningful way to the Minnesota health care
community;
deleted text end

deleted text begin (3) deleted text end new text begin (1) new text end providing financial and technical support to Minnesota health care providers to
encourage implementation of admission, discharge and transfer alerts, and care summary
document exchange transactions and to evaluate the impact of health information technology
on cost and quality of care. Communications about available financial and technical support
shall include clear information about the interoperable health record requirements in
subdivision 1, including a separate statement in bold-face type clarifying the exceptions to
those requirements;

deleted text begin (4) deleted text end new text begin (2) new text end providing educational resources and technical assistance to health care providers
and patients related to state and national privacy, security, and consent laws governing
clinical health information, including the requirements in sections 144.291 to 144.298. In
carrying out these activities, the commissioner's technical assistance does not constitute
legal advice;

deleted text begin (5) deleted text end new text begin (3) new text end assessing Minnesota's legal, financial, and regulatory framework for health
information exchange, including the requirements in sections 144.291 to 144.298, and
making recommendations for modifications that would strengthen the ability of Minnesota
health care providers to securely exchange data in compliance with patient preferences and
in a way that is efficient and financially sustainable; and

deleted text begin (6) deleted text end new text begin (4) new text end seeking public input on both patient impact and costs associated with requirements
related to patient consent for release of health records for the purposes of treatment, payment,
and health care operations, as required in section 144.293, subdivision 2. The commissioner
shall provide a report to the legislature on the findings of this public input process no later
than February 1, 2017.

(c) The commissioner, in consultation with the e-Health Advisory Committee, shall
monitor national activity related to health information technology and shall coordinate
statewide input on policy development. The commissioner shall coordinate statewide
responses to proposed federal health information technology regulations in order to ensure
that the needs of the Minnesota health care community are adequately and efficiently
addressed in the proposed regulations. The commissioner's responses may include, but are
not limited to:

(1) reviewing and evaluating any standard, implementation specification, or certification
criteria proposed by the national HIT standards deleted text begin committee deleted text end new text begin committees new text end ;

(2) reviewing and evaluating policy proposed by deleted text begin the deleted text end national HIT policy deleted text begin committee deleted text end new text begin
committees new text end relating to the implementation of a nationwide health information technology
infrastructure; new text begin and
new text end

(3) deleted text begin monitoring and responding to activity related to the development of quality measures
and other measures as required by section 4101 of the HITECH Act. Any response related
to quality measures shall consider and address the quality efforts required under chapter
62U; and
deleted text end

deleted text begin (4) deleted text end monitoring and responding to national activity related to privacy, security, and data
stewardship of electronic health information and individually identifiable health information.

(d) To the extent that the state is either required or allowed to apply, or designate an
entity to apply for or carry out activities and programs deleted text begin under section 3013 of the HITECH
Act deleted text end , the commissioner of health, in consultation with the e-Health Advisory Committee
and the commissioner of human services, shall be the lead applicant or sole designating
authority. The commissioner shall make such designations consistent with the goals and
objectives of sections 62J.495 to 62J.497 and 62J.50 to 62J.61.

(e) The commissioner of human services shall apply for funding necessary to administer
the incentive payments to providers authorized under title IV of the American Recovery
and Reinvestment Act.

deleted text begin (f) The commissioner shall include in the report to the legislature information on the
activities of this subdivision and provide recommendations on any relevant policy changes
that should be considered in Minnesota.
deleted text end

Sec. 4.

Minnesota Statutes 2020, section 62J.497, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

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

deleted text begin (b) "Backward compatible" means that the newer version of a data transmission standard
deleted text end deleted text begin would retain, at a minimum, the full functionality of the versions previously adopted, and
deleted text end deleted text begin would permit the successful completion of the applicable transactions with entities that
deleted text end deleted text begin continue to use the older versions.
deleted text end

deleted text begin (c) deleted text end new text begin (b) new text end "Dispense" or "dispensing" has the meaning given in section 151.01, subdivision
30. Dispensing does not include the direct administering of a controlled substance to a
patient by a licensed health care professional.

deleted text begin (d) deleted text end new text begin (c) new text end "Dispenser" means a person authorized by law to dispense a controlled substance,
pursuant to a valid prescription.

deleted text begin (e) deleted text end new text begin (d) new text end "Electronic media" has the meaning given under Code of Federal Regulations,
title 45, part 160.103.

deleted text begin (f) deleted text end new text begin (e) new text end "E-prescribing" means the transmission using electronic media of prescription or
prescription-related information between a prescriber, dispenser, pharmacy benefit manager,
or group purchaser, either directly or through an intermediary, including an e-prescribing
network. E-prescribing includes, but is not limited to, two-way transmissions between the
point of care and the dispenser and two-way transmissions related to eligibility, formulary,
and medication history information.

deleted text begin (g) deleted text end new text begin (f) new text end "Electronic prescription drug program" means a program that provides for
e-prescribing.

deleted text begin (h) deleted text end new text begin (g) new text end "Group purchaser" has the meaning given in section 62J.03, subdivision 6.

deleted text begin (i) deleted text end new text begin (h) new text end "HL7 messages" means a standard approved by the standards development
organization known as Health Level Seven.

deleted text begin (j) deleted text end new text begin (i) new text end "National Provider Identifier" or "NPI" means the identifier described under Code
of Federal Regulations, title 45, part 162.406.

deleted text begin (k) deleted text end new text begin (j) new text end "NCPDP" means the National Council for Prescription Drug Programs, Inc.

deleted text begin (l) deleted text end new text begin (k) new text end "NCPDP Formulary and Benefits Standard" means the new text begin most recent version of the new text end
National Council for Prescription Drug Programs Formulary and Benefits Standard deleted text begin ,
Implementation Guide, Version 1, Release 0, October 2005 deleted text end new text begin or the most recent standard
adopted by the Centers for Medicare and Medicaid Services for e-prescribing under Medicare
Part D as required by section 1860D-4(e)(4)(D) of the Social Security Act and regulations
adopted under it. The standards shall be implemented according to the Centers for Medicare
and Medicaid Services schedule for compliance new text end .

deleted text begin (m) deleted text end new text begin (l) new text end "NCPDP SCRIPT Standard" means the new text begin most recent version of the new text end National
Council for Prescription Drug Programs deleted text begin Prescriber/Pharmacist Interface deleted text end SCRIPT Standard,
deleted text begin Implementation Guide Version 8, Release 1 (Version 8.1), October 2005, deleted text end or the most recent
standard adopted by the Centers for Medicare and Medicaid Services for e-prescribing under
Medicare Part D as required by section 1860D-4(e)(4)(D) of the Social Security Act, and
regulations adopted under it. The standards shall be implemented according to the Centers
for Medicare and Medicaid Services schedule for compliance. deleted text begin Subsequently released versions
of the NCPDP SCRIPT Standard may be used, provided that the new version of the standard
is backward compatible to the current version adopted by the Centers for Medicare and
Medicaid Services.
deleted text end

deleted text begin (n) deleted text end new text begin (m) new text end "Pharmacy" has the meaning given in section 151.01, subdivision 2.

deleted text begin (o) deleted text end new text begin (n) new text end "Prescriber" means a licensed health care practitioner, other than a veterinarian,
as defined in section 151.01, subdivision 23.

deleted text begin (p) deleted text end new text begin (o) new text end "Prescription-related information" means information regarding eligibility for
drug benefits, medication history, or related health or drug information.

deleted text begin (q) deleted text end new text begin (p) new text end "Provider" or "health care provider" has the meaning given in section 62J.03,
subdivision 8.

Sec. 5.

Minnesota Statutes 2020, section 62J.497, subdivision 3, is amended to read:

Subd. 3.

Standards for electronic prescribing.

(a) Prescribers and dispensers must use
the NCPDP SCRIPT Standard for the communication of a prescription or prescription-related
information. deleted text begin The NCPDP SCRIPT Standard shall be used to conduct the following
transactions:
deleted text end

deleted text begin (1) get message transaction;
deleted text end

deleted text begin (2) status response transaction;
deleted text end

deleted text begin (3) error response transaction;
deleted text end

deleted text begin (4) new prescription transaction;
deleted text end

deleted text begin (5) prescription change request transaction;
deleted text end

deleted text begin (6) prescription change response transaction;
deleted text end

deleted text begin (7) refill prescription request transaction;
deleted text end

deleted text begin (8) refill prescription response transaction;
deleted text end

deleted text begin (9) verification transaction;
deleted text end

deleted text begin (10) password change transaction;
deleted text end

deleted text begin (11) cancel prescription request transaction; and
deleted text end

deleted text begin (12) cancel prescription response transaction.
deleted text end

(b) Providers, group purchasers, prescribers, and dispensers must use the NCPDP SCRIPT
Standard for communicating and transmitting medication history information.

(c) Providers, group purchasers, prescribers, and dispensers must use the NCPDP
Formulary and Benefits Standard for communicating and transmitting formulary and benefit
information.

(d) Providers, group purchasers, prescribers, and dispensers must use the national provider
identifier to identify a health care provider in e-prescribing or prescription-related transactions
when a health care provider's identifier is required.

(e) Providers, group purchasers, prescribers, and dispensers must communicate eligibility
information and conduct health care eligibility benefit inquiry and response transactions
according to the requirements of section 62J.536.

Sec. 6.

Minnesota Statutes 2020, section 62J.63, subdivision 1, is amended to read:

Subdivision 1.

deleted text begin Establishment; administration deleted text end new text begin Support for state health care
purchasing and performance measurement new text end .

The commissioner of health shall deleted text begin establish
and administer the Center for Health Care Purchasing Improvement as an administrative
unit within the Department of Health. The Center for Health Care Purchasing Improvement
shall deleted text end support the state in its efforts to be a more prudent and efficient purchaser of quality
health care services deleted text begin . The center shall deleted text end new text begin , new text end aid the state in developing and using more common
strategies and approaches for health care performance measurement and health care
purchasing deleted text begin . The common strategies and approaches shall deleted text end new text begin , new text end promote greater transparency of
health care costs and quality deleted text begin , deleted text end and greater accountability for health care results and
improvement deleted text begin . The center shall also deleted text end new text begin , and new text end identify barriers to more efficient, effective, quality
health care and options for overcoming the barriers.

Sec. 7.

Minnesota Statutes 2020, section 62J.63, subdivision 2, is amended to read:

Subd. 2.

deleted text begin Staffing; deleted text end Duties; scope.

deleted text begin (a) deleted text end The commissioner of health may deleted text begin appoint a director,
and up to three additional senior-level staff or codirectors, and other staff as needed who
are under the direction of the commissioner. The staff of the center are in the unclassified
service. deleted text end new text begin :
new text end

deleted text begin (b) With the authorization of the commissioner of health, and in consultation or
interagency agreement with the appropriate commissioners of state agencies, the director,
or codirectors, may:
deleted text end

deleted text begin (1) initiate projects to develop plan designs for state health care purchasing;
deleted text end

deleted text begin (2) deleted text end new text begin (1) new text end require reports or surveys to evaluate the performance of current health care
purchasing new text begin or administrative simplification new text end strategies;

deleted text begin (3) deleted text end new text begin (2) new text end calculate fiscal impacts, including net savings and return on investment, of health
care purchasing strategies and initiatives;

deleted text begin (4) conduct policy audits of state programs to measure conformity to state statute or
other purchasing initiatives or objectives;
deleted text end

deleted text begin (5) deleted text end new text begin (3) new text end support the Administrative Uniformity Committee under deleted text begin section deleted text end new text begin sections new text end 62J.50
new text begin and 62J.536 new text end and other relevant groups or activities to advance agreement on health care
administrative process streamlining;

deleted text begin (6) consult with the Health Economics Unit of the Department of Health regarding
reports and assessments of the health care marketplace;
deleted text end

deleted text begin (7) consult with the Department of Commerce regarding health care regulatory issues
and legislative initiatives;
deleted text end

deleted text begin (8) work with appropriate Department of Human Services staff and the Centers for
Medicare and Medicaid Services to address federal requirements and conformity issues for
health care purchasing;
deleted text end

deleted text begin (9) assist the Minnesota Comprehensive Health Association in health care purchasing
strategies;
deleted text end

deleted text begin (10) convene medical directors of agencies engaged in health care purchasing for advice,
collaboration, and exploring possible synergies;
deleted text end

deleted text begin (11) deleted text end new text begin (4) new text end contact and participate with other relevant health care task forces, study activities,
and similar efforts with regard to health care performance measurement and
performance-based purchasing; and

deleted text begin (12) deleted text end new text begin (5) new text end assist in seeking external funding through appropriate grants or other funding
opportunities and may administer grants and externally funded projects.

Sec. 8.

Minnesota Statutes 2020, section 62U.04, subdivision 4, is amended to read:

Subd. 4.

Encounter data.

(a) deleted text begin Beginning July 1, 2009, and every six months thereafter, deleted text end
All health plan companies and third-party administrators shall submit encounter data new text begin on a
monthly basis new text end to a private entity designated by the commissioner of health. The data shall
be submitted in a form and manner specified by the commissioner subject to the following
requirements:

(1) the data must be de-identified data as described under the Code of Federal Regulations,
title 45, section 164.514;

(2) the data for each encounter must include an identifier for the patient's health care
home if the patient has selected a health care home and, for claims incurred on or after
January 1, 2019, data deemed necessary by the commissioner to uniquely identify claims
in the individual health insurance market; and

(3) except for the identifier described in clause (2), the data must not include information
that is not included in a health care claim or equivalent encounter information transaction
that is required under section 62J.536.

(b) The commissioner or the commissioner's designee shall only use the data submitted
under paragraph (a) to carry out the commissioner's responsibilities in this section, including
supplying the data to providers so they can verify their results of the peer grouping process
consistent with the recommendations developed pursuant to subdivision 3c, paragraph (d),
and adopted by the commissioner and, if necessary, submit comments to the commissioner
or initiate an appeal.

(c) Data on providers collected under this subdivision are private data on individuals or
nonpublic data, as defined in section 13.02. Notwithstanding the definition of summary data
in section 13.02, subdivision 19, summary data prepared under this subdivision may be
derived from nonpublic data. The commissioner or the commissioner's designee shall
establish procedures and safeguards to protect the integrity and confidentiality of any data
that it maintains.

(d) The commissioner or the commissioner's designee shall not publish analyses or
reports that identify, or could potentially identify, individual patients.

(e) The commissioner shall compile summary information on the data submitted under
this subdivision. The commissioner shall work with its vendors to assess the data submitted
in terms of compliance with the data submission requirements and the completeness of the
data submitted by comparing the data with summary information compiled by the
commissioner and with established and emerging data quality standards to ensure data
quality.

Sec. 9.

Minnesota Statutes 2020, section 62U.04, subdivision 5, is amended to read:

Subd. 5.

Pricing data.

(a) deleted text begin Beginning July 1, 2009, and annually on January 1 thereafter, deleted text end
All health plan companies and third-party administrators shall submit new text begin , on a monthly basis, new text end
data on their contracted prices with health care providers to a private entity designated by
the commissioner of health for the purposes of performing the analyses required under this
subdivision. The data shall be submitted in the form and manner specified by the
commissioner of health.

(b) The commissioner or the commissioner's designee shall only use the data submitted
under this subdivision to carry out the commissioner's responsibilities under this section,
including supplying the data to providers so they can verify their results of the peer grouping
process consistent with the recommendations developed pursuant to subdivision 3c, paragraph
(d), and adopted by the commissioner and, if necessary, submit comments to the
commissioner or initiate an appeal.

(c) Data collected under this subdivision are nonpublic data as defined in section 13.02.
Notwithstanding the definition of summary data in section 13.02, subdivision 19, summary
data prepared under this section may be derived from nonpublic data. The commissioner
shall establish procedures and safeguards to protect the integrity and confidentiality of any
data that it maintains.

Sec. 10.

Minnesota Statutes 2020, section 103H.201, subdivision 1, is amended to read:

Subdivision 1.

Procedure.

(a) If groundwater quality monitoring results show that there
is a degradation of groundwater, the commissioner of health may promulgate health risk
limits under subdivision 2 for substances degrading the groundwater.

(b) Health risk limits shall be determined by two methods depending on their toxicological
end point.

(c) For systemic toxicants that are not carcinogens, the adopted health risk limits shall
be derived using United States Environmental Protection Agency risk assessment methods
using a reference dose, a drinking water equivalent, and a relative source contribution factor.

(d) For toxicants that are known or probable carcinogens, the adopted health risk limits
shall be derived from a quantitative estimate of the chemical's carcinogenic potency published
by the United States Environmental Protection Agency deleted text begin and deleted text end new text begin or new text end determined by the
commissioner to have undergone thorough scientific review.

Sec. 11.

new text begin [144.064] THE VIVIAN ACT.
new text end

new text begin Subdivision 1. new text end

new text begin Short title. new text end

new text begin This section shall be known and may be cited as the "Vivian
Act."
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin For purposes of this section, the following terms have the meanings
given them:
new text end

new text begin (1) "CMV" means the human herpesvirus cytomegalovirus, also called HCMV, human
herpesvirus 5, and HHV-5;
new text end

new text begin (2) "commissioner" means the commissioner of health;
new text end

new text begin (3) "congenital CMV" means the transmission of a CMV infection from a pregnant
mother to her fetus; and
new text end

new text begin (4) "health care practitioner" means a health care professional who provides prenatal or
postnatal care or care to infants.
new text end

new text begin Subd. 3. new text end

new text begin Commissioner duties. new text end

new text begin (a) The commissioner shall make available to health
care practitioners, women who may become pregnant, expectant parents, and parents of
infants up-to-date and evidence-based information about congenital CMV that has been
reviewed by experts with knowledge of the disease. The information shall include the
following:
new text end

new text begin (1) the recommendation to consider testing for congenital CMV if the parent or legal
guardian of the infant elected not to have newborn screening performed under section
144.125, the infant failed a newborn hearing screening, or pregnancy history suggests
increased risk for congenital CMV infection;
new text end

new text begin (2) the incidence of CMV;
new text end

new text begin (3) the transmission of CMV to pregnant women and women who may become pregnant;
new text end

new text begin (4) birth defects caused by congenital CMV;
new text end

new text begin (5) available preventative measures to avoid the infection of women who are pregnant
or may become pregnant; and
new text end

new text begin (6) resources available for families of children born with congenital CMV.
new text end

new text begin (b) The commissioner shall follow existing department practice, inclusive of community
engagement, to ensure that the information in paragraph (a) is culturally and linguistically
appropriate for all recipients.
new text end

new text begin (c) The commissioner shall establish an outreach program to:
new text end

new text begin (1) educate women who may become pregnant, expectant parents, and parents of infants
about CMV; and
new text end

new text begin (2) raise awareness for CMV among health care practitioners.
new text end

new text begin (d) The Advisory Committee on Heritable and Congenital Disorders established under
section 144.1255 shall review congenital CMV for inclusion on the list of tests to be
performed under section 144.125. If the committee recommends and the commissioner
approves the recommendation of adding congenital CMV to the newborn screening panel,
the commissioner shall publish the addition in the State Register and the per specimen fee
for screening under section 144.125, subdivision 1, paragraph (c), shall be increased by
$43, for a total of $220 per specimen, effective upon publication in the State Register.
new text end

Sec. 12.

Minnesota Statutes 2020, section 144.0724, subdivision 1, is amended to read:

Subdivision 1.

Resident reimbursement case mix classifications.

The commissioner
of health shall establish resident reimbursement new text begin case mix new text end classifications based upon the
assessments of residents of nursing homes and boarding care homes conducted under this
section and according to section 256R.17.

Sec. 13.

Minnesota Statutes 2020, section 144.0724, subdivision 2, is amended to read:

Subd. 2.

Definitions.

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

(a) "Assessment reference date" or "ARD" means the specific end point for look-back
periods in the MDS assessment process. This look-back period is also called the observation
or assessment period.

(b) "Case mix index" means the weighting factors assigned to the RUG-IV classifications.

(c) "Index maximization" means classifying a resident who could be assigned to more
than one category, to the category with the highest case mix index.

(d) "Minimum Data Set" or "MDS" means a core set of screening, clinical assessment,
and functional status elements, that include common definitions and coding categories
specified by the Centers for Medicare and Medicaid Services and designated by the
deleted text begin Minnesota deleted text end Department of Health.

(e) "Representative" means a person who is the resident's guardian or conservator, the
person authorized to pay the nursing home expenses of the resident, a representative of the
Office of Ombudsman for Long-Term Care whose assistance has been requested, or any
other individual designated by the resident.

(f) "Resource utilization groups" or "RUG" means the system for grouping a nursing
facility's residents according to their clinical and functional status identified in data supplied
by the facility's Minimum Data Set.

(g) "Activities of daily living" deleted text begin means grooming, deleted text end new text begin includes personal hygiene, new text end dressing,
bathing, transferring, new text begin bed new text end mobility, deleted text begin positioning, deleted text end new text begin locomotion, new text end eating, and toileting.

(h) "Nursing facility level of care determination" means the assessment process that
results in a determination of a resident's or prospective resident's need for nursing facility
level of care as established in subdivision 11 for purposes of medical assistance payment
of long-term care services for:

(1) nursing facility services under section 256B.434 or chapter 256R;

(2) elderly waiver services under chapter 256S;

(3) CADI and BI waiver services under section 256B.49; and

(4) state payment of alternative care services under section 256B.0913.

Sec. 14.

Minnesota Statutes 2020, section 144.0724, subdivision 3a, is amended to read:

Subd. 3a.

Resident reimbursement new text begin case mix new text end classifications beginning January 1,
2012.

(a) Beginning January 1, 2012, resident reimbursement new text begin case mix new text end classifications shall
be based on the Minimum Data Set, version 3.0 assessment instrument, or its successor
version mandated by the Centers for Medicare and Medicaid Services that nursing facilities
are required to complete for all residents. The commissioner of health shall establish resident
classifications according to the RUG-IV, 48 group, resource utilization groups. Resident
classification must be established based on the individual items on the Minimum Data Set,
which must be completed according to the Long Term Care Facility Resident Assessment
Instrument User's Manual Version 3.0 or its successor issued by the Centers for Medicare
and Medicaid Services.

(b) Each resident must be classified based on the information from the Minimum Data
Set according to general categories deleted text begin as defined in the Case Mix Classification Manual for
Nursing Facilities deleted text end issued by the Minnesota Department of Health.

Sec. 15.

Minnesota Statutes 2020, section 144.0724, subdivision 5, is amended to read:

Subd. 5.

Short stays.

(a) A facility must submit to the commissioner of health an
admission assessment for all residents who stay in the facility 14 days or less deleted text begin . deleted text end new text begin , unless the
resident is admitted and discharged from the facility on the same day, in which case the
admission assessment is not required. When an admission assessment is not submitted, the
case mix classification shall be the rate with a case mix index of 1.0.
new text end

(b) Notwithstanding the admission assessment requirements of paragraph (a), a facility
may elect to accept a short stay rate with a case mix index of 1.0 for all facility residents
who stay 14 days or less in lieu of submitting an admission assessment. Facilities shall make
this election annually.

(c) Nursing facilities must elect one of the options described in paragraphs (a) and (b)
by reporting to the commissioner of health, as prescribed by the commissioner. The election
is effective on July 1 each year.

Sec. 16.

Minnesota Statutes 2020, section 144.0724, subdivision 7, is amended to read:

Subd. 7.

Notice of resident reimbursement new text begin case mix new text end classification.

(a) The
commissioner of health shall provide to a nursing facility a notice for each resident of the
deleted text begin reimbursement deleted text end classification established under subdivision 1. The notice must inform the
resident of the new text begin case mix new text end classification deleted text begin that was deleted text end assigned, the opportunity to review the
documentation supporting the classification, the opportunity to obtain clarification from the
commissioner, and the opportunity to request a reconsideration of the classification and the
address and telephone number of the Office of Ombudsman for Long-Term Care. The
commissioner must transmit the notice of resident classification by electronic means to the
nursing facility. deleted text begin A deleted text end new text begin The new text end nursing facility is responsible for the distribution of the notice to
each resident deleted text begin , to the person responsible for the payment of the resident's nursing home
expenses, or to another person designated by the resident deleted text end new text begin or the resident's representative new text end .
This notice must be distributed within three deleted text begin working deleted text end new text begin business new text end days after the facility's receipt
deleted text begin of the electronic file of notice of case mix classifications from the commissioner of health deleted text end .

(b) If a facility submits a deleted text begin modification to the most recent assessment used to establish
a case mix classification conducted under subdivision 3 that results deleted text end new text begin modifying assessment
resulting new text end in a change in new text begin the new text end case mix classification, the facility deleted text begin shall give deleted text end new text begin must provide a new text end
written notice to the resident or the resident's representative deleted text begin about deleted text end new text begin regarding new text end the item new text begin or
items new text end that deleted text begin was deleted text end new text begin were new text end modified and the reason for the deleted text begin modification deleted text end new text begin modifications new text end . The notice
deleted text begin of modified assessment may deleted text end new text begin must new text end be provided deleted text begin at the same time that the resident or resident's
representative is provided the resident's modified notice of classification deleted text end new text begin within three business
days after distribution of the resident case mix classification notice new text end .

Sec. 17.

Minnesota Statutes 2020, section 144.0724, subdivision 8, is amended to read:

Subd. 8.

Request for reconsideration of resident classifications.

(a) The resident, or
resident's representative, or the nursing facility or boarding care home may request that the
commissioner of health reconsider the assigned reimbursement new text begin case mix new text end classification new text begin and
any item or items changed during the audit process new text end . The request for reconsideration must
be submitted in writing to the commissioner deleted text begin within 30 days of the day the resident or the
resident's representative receives the resident classification notice deleted text end new text begin of health new text end .

new text begin (b) For reconsideration requests initiated by the resident or the resident's representative:
new text end

new text begin (1) The resident or the resident's representative must submit in writing a reconsideration
request to the facility administrator within 30 days of receipt of the resident classification
notice. new text end The new text begin written new text end request deleted text begin for reconsideration deleted text end must include the deleted text begin name of the resident, the
name and address of the facility in which the resident resides, the deleted text end reasons for the
reconsideration deleted text begin , and documentation supporting the deleted text end request. deleted text begin The documentation accompanying
the reconsideration request is limited to a copy of the MDS that determined the classification
and other documents that would support or change the MDS findings.
deleted text end

new text begin (2) Within three business days of receiving the reconsideration request, the nursing
facility must submit to the commissioner of health a completed reconsideration request
form, a copy of the resident's or resident's representative's written request, and all supporting
documentation used to complete the assessment being considered. If the facility fails to
provide the required information, the reconsideration will be completed with the information
submitted and the facility cannot make further reconsideration requests on this classification.
new text end

deleted text begin (b) deleted text end new text begin (3) new text end Upon new text begin written new text end request new text begin and within three business days new text end , the nursing facility must
give the resident or the resident's representative a copy of the assessment deleted text begin form deleted text end new text begin being
reconsidered new text end and deleted text begin the other deleted text end new text begin all supporting new text end documentation deleted text begin that was given to the commissioner
of health deleted text end new text begin used new text end to deleted text begin support deleted text end new text begin complete new text end the assessment deleted text begin findings deleted text end . deleted text begin The nursing facility shall also
provide access to and a copy of other information from the resident's record that has been
requested by or on behalf of the resident to support a resident's reconsideration request. A
copy of any requested material must be provided within three working days of receipt of a
written request for the information. deleted text end Notwithstanding any law to the contrary, the facility
may not charge a fee for providing copies of the requested documentation. If a facility fails
to provide the deleted text begin material deleted text end new text begin required documents new text end within this time, it is subject to the issuance of
a correction order and penalty assessment under sections 144.653 and 144A.10.
Notwithstanding those sections, any correction order issued under this subdivision must
require that the nursing facility immediately comply with the request for information new text begin , new text end and
deleted text begin that deleted text end as of the date of the issuance of the correction order, the facility shall forfeit to the state
a $100 fine for the first day of noncompliance, and an increase in the $100 fine by $50
increments for each day the noncompliance continues.

(c) deleted text begin in addition to the information required under paragraphs (a) and (b), a reconsideration
request from a nursing facility must contain the following information: (i) the date the
reimbursement classification notices were received by the facility; (ii) the date the
deleted text end deleted text begin classification notices were distributed to the resident or the resident's representative; and
(iii) deleted text end new text begin For reconsideration requests initiated by the facility:
new text end

new text begin (1) The facility is required to inform the resident or the resident's representative in writing
that a reconsideration of the resident's case mix classification is being requested. The notice
must inform the resident or the resident's representative:
new text end

new text begin (i) of the date and reason for the reconsideration request;
new text end

new text begin (ii) of the potential for a classification and subsequent rate change;
new text end

new text begin (iii) of the extent of the potential rate change;
new text end

new text begin (iv) that copies of the request and supporting documentation are available for review;
and
new text end

new text begin (v) that the resident or the resident's representative has the right to request a
reconsideration.
new text end

new text begin (2) Within 30 days of receipt of the audit exit report or resident classification notice, the
facility must submit to the commissioner of health a completed reconsideration request
form, all supporting documentation used to complete the assessment being reconsidered,
and new text end a copy of deleted text begin a deleted text end new text begin the new text end notice deleted text begin sent to deleted text end new text begin informing new text end the resident or deleted text begin to deleted text end the resident's representative deleted text begin .
This notice must inform the resident or the resident's representative deleted text end that a reconsideration
of the resident's classification is being requested deleted text begin , the reason for the request, that the resident's
rate will change if the request is approved by the commissioner, the extent of the change,
that copies of the facility's request and supporting documentation are available for review,
and that the resident also has the right to request a reconsideration deleted text end .

new text begin (3) new text end If the facility fails to provide the required information deleted text begin listed in item (iii) with the
reconsideration request, the commissioner may request that the facility provide the
information within 14 calendar days. deleted text end new text begin , new text end the reconsideration request deleted text begin must deleted text end new text begin may new text end be denied deleted text begin if the
information is then not provided, deleted text end and the facility may not make further reconsideration
requests on deleted text begin that specific reimbursement deleted text end new text begin this new text end classification.

(d) Reconsideration by the commissioner must be made by individuals not involved in
reviewing the assessment, audit, or reconsideration that established the disputed classification.
The reconsideration must be based upon the assessment that determined the classification
and upon the information provided to the commissioner new text begin of health new text end under paragraphs (a) deleted text begin and
(b) deleted text end new text begin to (c) new text end . If necessary for evaluating the reconsideration request, the commissioner may
conduct on-site reviews. Within 15 deleted text begin working deleted text end new text begin business new text end days of receiving the request for
reconsideration, the commissioner shall affirm or modify the original resident classification.
The original classification must be modified if the commissioner determines that the
assessment resulting in the classification did not accurately reflect characteristics of the
resident at the time of the assessment. deleted text begin The resident and the nursing facility or boarding care
home shall be notified within five working days after the decision is made. deleted text end new text begin The commissioner
must transmit the reconsideration classification notice by electronic means to the nursing
facility. The nursing facility is responsible for the distribution of the notice to the resident
or the resident's representative. The notice must be distributed by the nursing facility within
three business days after receipt. new text end A decision by the commissioner under this subdivision is
the final administrative decision of the agency for the party requesting reconsideration.

(e) The deleted text begin resident deleted text end new text begin case mix new text end classification established by the commissioner shall be the
classification deleted text begin that deleted text end new text begin which new text end applies to the resident while the request for reconsideration is
pending. If a request for reconsideration applies to an assessment used to determine nursing
facility level of care under subdivision 4, paragraph (c), the resident shall continue to be
eligible for nursing facility level of care while the request for reconsideration is pending.

(f) The commissioner may request additional documentation regarding a reconsideration
necessary to make an accurate reconsideration determination.

Sec. 18.

Minnesota Statutes 2020, section 144.0724, subdivision 9, is amended to read:

Subd. 9.

Audit authority.

(a) The commissioner shall audit the accuracy of resident
assessments performed under section 256R.17 through any of the following: desk audits;
on-site review of residents and their records; and interviews with staff, residents, or residents'
families. The commissioner shall reclassify a resident if the commissioner determines that
the resident was incorrectly classified.

(b) The commissioner is authorized to conduct on-site audits on an unannounced basis.

(c) A facility must grant the commissioner access to examine the medical records relating
to the resident assessments selected for audit under this subdivision. The commissioner may
also observe and speak to facility staff and residents.

(d) The commissioner shall consider documentation under the time frames for coding
items on the minimum data set as set out in the Long-Term Care Facility Resident Assessment
Instrument User's Manual published by the Centers for Medicare and Medicaid Services.

(e) The commissioner shall develop an audit selection procedure that includes the
following factors:

(1) Each facility shall be audited annually. If a facility has two successive audits in which
the percentage of change is five percent or less and the facility has not been the subject of
a special audit in the past 36 months, the facility may be audited biannually. A stratified
sample of 15 percent, with a minimum of ten assessments, of the most current assessments
shall be selected for audit. If more than 20 percent of the RUG-IV classifications are changed
as a result of the audit, the audit shall be expanded to a second 15 percent sample, with a
minimum of ten assessments. If the total change between the first and second samples is
35 percent or greater, the commissioner may expand the audit to all of the remaining
assessments.

(2) If a facility qualifies for an expanded audit, the commissioner may audit the facility
again within six months. If a facility has two expanded audits within a 24-month period,
that facility will be audited at least every six months for the next 18 months.

(3) The commissioner may conduct special audits if the commissioner determines that
circumstances exist that could alter or affect the validity of case mix classifications of
residents. These circumstances include, but are not limited to, the following:

(i) frequent changes in the administration or management of the facility;

(ii) an unusually high percentage of residents in a specific case mix classification;

(iii) a high frequency in the number of reconsideration requests received from a facility;

(iv) frequent adjustments of case mix classifications as the result of reconsiderations or
audits;

(v) a criminal indictment alleging provider fraud;

(vi) other similar factors that relate to a facility's ability to conduct accurate assessments;

(vii) an atypical pattern of scoring minimum data set items;

(viii) nonsubmission of assessments;

(ix) late submission of assessments; or

(x) a previous history of audit changes of 35 percent or greater.

(f) deleted text begin Within 15 working days of completing the audit process, the commissioner shall
make available electronically the results of the audit to the facility. If the results of the audit
reflect a change in the resident's case mix classification, a case mix classification notice
will be made available electronically to the facility, using the procedure in subdivision 7,
paragraph (a). The notice must contain the resident's classification and a statement informing
the resident, the resident's authorized representative, and the facility of their right to review
the commissioner's documents supporting the classification and to request a reconsideration
of the classification. This notice must also include the address and telephone number of the
Office of Ombudsman for Long-Term Care. deleted text end new text begin If the audit results in a case mix classification
change, the commissioner must transmit the audit classification notice by electronic means
to the nursing facility within 15 business days of completing an audit. The nursing facility
is responsible for distribution of the notice to each resident or the resident's representative.
This notice must be distributed by the nursing facility within three business days after
receipt. The notice must inform the resident of the case mix classification assigned, the
opportunity to review the documentation supporting the classification, the opportunity to
obtain clarification from the commissioner, the opportunity to request a reconsideration of
the classification, and the address and telephone number of the Office of Ombudsman for
Long-Term Care.
new text end

Sec. 19.

Minnesota Statutes 2020, section 144.0724, subdivision 12, is amended to read:

Subd. 12.

Appeal of nursing facility level of care determination.

(a) A resident or
prospective resident whose level of care determination results in a denial of long-term care
services can appeal the determination as outlined in section 256B.0911, subdivision 3a,
paragraph (h), clause (9).

(b) The commissioner of human services shall ensure that notice of changes in eligibility
due to a nursing facility level of care determination is provided to each affected recipient
or the recipient's guardian at least 30 days before the effective date of the change. The notice
shall include the following information:

(1) how to obtain further information on the changes;

(2) how to receive assistance in obtaining other services;

(3) a list of community resources; and

(4) appeal rights.

deleted text begin A recipient who meets the criteria in section 256B.0922, subdivision 2, paragraph (a), clauses
(1) and (2), may request continued services pending appeal within the time period allowed
to request an appeal under section 256.045, subdivision 3, paragraph (i). This paragraph is
in effect for appeals filed between January 1, 2015, and December 31, 2016.
deleted text end

Sec. 20.

Minnesota Statutes 2020, section 144.125, subdivision 1, is amended to read:

Subdivision 1.

Duty to perform testing.

(a) It is the duty of (1) the administrative officer
or other person in charge of each institution caring for infants 28 days or less of age, (2) the
person required in pursuance of the provisions of section 144.215, to register the birth of a
child, or (3) the nurse midwife or midwife in attendance at the birth, to arrange to have
administered to every infant or child in its care tests for heritable and congenital disorders
according to subdivision 2 and rules prescribed by the state commissioner of health.

(b) Testing, recording of test results, reporting of test results, and follow-up of infants
with heritable congenital disorders, including hearing loss detected through the early hearing
detection and intervention program in section 144.966, shall be performed at the times and
in the manner prescribed by the commissioner of health.

(c) The fee to support the newborn screening program, including tests administered
under this section and section 144.966, shall be deleted text begin $135 deleted text end new text begin $177 new text end per specimen. This fee amount
shall be deposited in the state treasury and credited to the state government special revenue
fund.

(d) The fee to offset the cost of the support services provided under section 144.966,
subdivision 3a, shall be $15 per specimen. This fee shall be deposited in the state treasury
and credited to the general fund.

Sec. 21.

new text begin [144.1461] DIGNITY IN PREGNANCY AND CHILDBIRTH.
new text end

new text begin Subdivision 1. new text end

new text begin Citation. new text end

new text begin This section may be cited as the "Dignity in Pregnancy and
Childbirth Act."
new text end

new text begin Subd. 2. new text end

new text begin Continuing education. new text end

new text begin (a) Hospitals with obstetric care and birth centers must
develop or access a continuing education curriculum and must make available to direct care
employees and contractors who routinely care for patients who are pregnant or postpartum
a continuing education course on anti-racism training and implicit bias. The continuing
education curriculum and course must:
new text end

new text begin (1) be evidence-based;
new text end

new text begin (2) to the extent practicable, conform with standards for continuing education established
by the applicable health-related licensing boards; and
new text end

new text begin (3) include, at a minimum, the following elements:
new text end

new text begin (i) education aimed at identifying personal, interpersonal, institutional, structural, and
cultural barriers to inclusion;
new text end

new text begin (ii) identifying and implementing corrective measures to promote anti-racism practices
and decrease implicit bias at the interpersonal and institutional levels, including the facility's
ongoing policies and practices;
new text end

new text begin (iii) providing information on the ongoing effects of historical and contemporary
exclusion and oppression of Black and Indigenous communities with the greatest health
disparities in maternal and infant mortality and morbidity;
new text end

new text begin (iv) providing information on and discussion of health disparities in the perinatal health
care field, including how systemic racism and implicit bias have different impacts on health
outcomes for different racial and ethnic communities; and
new text end

new text begin (v) soliciting perspectives of diverse local constituency groups and experts on racial,
identity, cultural, and provider-community relationship issues.
new text end

new text begin (b) In addition to the initial continuing education course made available under paragraph
(a), hospitals with obstetric care and birth centers must make available an annual refresher
course that reflects current trends on race, culture, identity, and anti-racism principles and
institutional implicit bias.
new text end

new text begin (c) The commissioner of health, in coordination with the Minnesota Hospital Association,
shall monitor implementation of this subdivision by hospitals with obstetric care and birth
centers and may inspect course records or require reports from hospitals with obstetric care
and birth centers on the continuing education curricula used and courses offered under this
subdivision. Initial continuing education courses under this subdivision must be made
available by December 31, 2022.
new text end

new text begin (d) Hospitals with obstetric care and birth centers must provide a certificate of course
completion to another facility or to a course attendee upon request. A facility may accept
a course certificate from another facility for a health care provider who works at more than
one facility.
new text end

new text begin Subd. 3. new text end

new text begin Midwife and doula care. new text end

new text begin (a) In order to improve maternal and infant health
and birth outcomes in groups with the most significant disparities, including Black
communities, Indigenous communities, and other communities of color; rural communities;
and low-income families, the commissioner of health, in partnership with patient groups
and culturally based community organizations, shall:
new text end

new text begin (1) identify barriers to obtaining midwife and doula services for groups with the most
significant disparities in maternal and infant mortality and morbidity, and develop procedures
and services designed to increase the availability of midwife and doula services for these
groups;
new text end

new text begin (2) promote racial, ethnic, and language diversity in the midwife and doula workforce
that better aligns with the childbearing populations in groups with the most significant
disparities in maternal and infant mortality and morbidity; and
new text end

new text begin (3) explore ways to ensure that midwife and doula training and education are culturally
responsive and tailored to the specific needs of groups with the most significant disparities
in maternal and infant mortality and morbidity, including trauma-informed care, maternal
mood disorders, intimate partner violence, and implicit bias and anti-racism.
new text end

new text begin (b) For purposes of this subdivision, midwife and doula services include traditional
midwife services as defined in section 147D.03; nurse midwife services as defined in section
148.171, subdivision 10; and doula services as defined in section 148.995, subdivision 4;
and the midwife and doula workforce includes traditional midwives, nurse midwives, and
certified doulas.
new text end

Sec. 22.

Minnesota Statutes 2020, section 144.1501, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

(a) For purposes of this section, the following definitions
apply.

(b) "Advanced dental therapist" means an individual who is licensed as a dental therapist
under section 150A.06, and who is certified as an advanced dental therapist under section
150A.106.

new text begin (c) "Alcohol and drug counselor" means an individual who is licensed as an alcohol and
drug counselor under chapter 148F.
new text end

deleted text begin (c) deleted text end new text begin (d) new text end "Dental therapist" means an individual who is licensed as a dental therapist under
section 150A.06.

deleted text begin (d) deleted text end new text begin (e) new text end "Dentist" means an individual who is licensed to practice dentistry.

deleted text begin (e) deleted text end new text begin (f) new text end "Designated rural area" means a statutory and home rule charter city or township
that is outside the seven-county metropolitan area as defined in section 473.121, subdivision
2, excluding the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud.

deleted text begin (f) deleted text end new text begin (g) new text end "Emergency circumstances" means those conditions that make it impossible for
the participant to fulfill the service commitment, including death, total and permanent
disability, or temporary disability lasting more than two years.

deleted text begin (g) deleted text end new text begin (h) new text end "Mental health professional" means an individual providing clinical services in
the treatment of mental illness who is qualified in at least one of the ways specified in section
245.462, subdivision 18.

deleted text begin (h) deleted text end new text begin (i) new text end "Medical resident" means an individual participating in a medical residency in
family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.

deleted text begin (i) deleted text end new text begin (j) new text end "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse anesthetist,
advanced clinical nurse specialist, or physician assistant.

deleted text begin (j) deleted text end new text begin (k) new text end "Nurse" means an individual who has completed training and received all licensing
or certification necessary to perform duties as a licensed practical nurse or registered nurse.

deleted text begin (k) deleted text end new text begin (l) new text end "Nurse-midwife" means a registered nurse who has graduated from a program of
study designed to prepare registered nurses for advanced practice as nurse-midwives.

deleted text begin (l) deleted text end new text begin (m) new text end "Nurse practitioner" means a registered nurse who has graduated from a program
of study designed to prepare registered nurses for advanced practice as nurse practitioners.

deleted text begin (m) deleted text end new text begin (n) new text end "Pharmacist" means an individual with a valid license issued under chapter 151.

deleted text begin (n) deleted text end new text begin (o) new text end "Physician" means an individual who is licensed to practice medicine in the areas
of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.

deleted text begin (o) deleted text end new text begin (p) new text end "Physician assistant" means a person licensed under chapter 147A.

deleted text begin (p) deleted text end new text begin (q) new text end "Public health nurse" means a registered nurse licensed in Minnesota who has
obtained a registration certificate as a public health nurse from the Board of Nursing in
accordance with Minnesota Rules, chapter 6316.

deleted text begin (q) deleted text end new text begin (r) new text end "Qualified educational loan" means a government, commercial, or foundation
loan for actual costs paid for tuition, reasonable education expenses, and reasonable living
expenses related to the graduate or undergraduate education of a health care professional.

deleted text begin (r) deleted text end new text begin (s) new text end "Underserved urban community" means a Minnesota urban area or population
included in the list of designated primary medical care health professional shortage areas
(HPSAs), medically underserved areas (MUAs), or medically underserved populations
(MUPs) maintained and updated by the United States Department of Health and Human
Services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2025.
new text end

Sec. 23.

Minnesota Statutes 2020, section 144.1501, subdivision 2, is amended to read:

Subd. 2.

Creation of account.

(a) A health professional education loan forgiveness
program account is established. The commissioner of health shall use money from the
account to establish a loan forgiveness program:

(1) for medical residents deleted text begin and deleted text end new text begin , new text end mental health professionals new text begin , and alcohol and drug
counselors new text end agreeing to practice in designated rural areas or underserved urban communities
or specializing in the area of pediatric psychiatry;

(2) for midlevel practitioners agreeing to practice in designated rural areas or to teach
at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary program
at the undergraduate level or the equivalent at the graduate level;

(3) for nurses who agree to practice in a Minnesota nursing home; an intermediate care
facility for persons with developmental disability; a hospital if the hospital owns and operates
a Minnesota nursing home and a minimum of 50 percent of the hours worked by the nurse
is in the nursing home; a housing with services establishment as defined in section 144D.01,
subdivision 4; or for a home care provider as defined in section 144A.43, subdivision 4; or
agree to teach at least 12 credit hours, or 720 hours per year in the nursing field in a
postsecondary program at the undergraduate level or the equivalent at the graduate level;

(4) for other health care technicians agreeing to teach at least 12 credit hours, or 720
hours per year in their designated field in a postsecondary program at the undergraduate
level or the equivalent at the graduate level. The commissioner, in consultation with the
Healthcare Education-Industry Partnership, shall determine the health care fields where the
need is the greatest, including, but not limited to, respiratory therapy, clinical laboratory
technology, radiologic technology, and surgical technology;

(5) for pharmacists, advanced dental therapists, dental therapists, and public health nurses
who agree to practice in designated rural areas; and

(6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient
encounters to state public program enrollees or patients receiving sliding fee schedule
discounts through a formal sliding fee schedule meeting the standards established by the
United States Department of Health and Human Services under Code of Federal Regulations,
title 42, section 51, chapter 303.

(b) Appropriations made to the account do not cancel and are available until expended,
except that at the end of each biennium, any remaining balance in the account that is not
committed by contract and not needed to fulfill existing commitments shall cancel to the
fund.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2025.
new text end

Sec. 24.

Minnesota Statutes 2020, section 144.1501, subdivision 3, is amended to read:

Subd. 3.

Eligibility.

(a) To be eligible to participate in the loan forgiveness program, an
individual must:

(1) be a medical or dental resident; a licensed pharmacist; or be enrolled in a training or
education program to become a dentist, dental therapist, advanced dental therapist, mental
health professional, new text begin alcohol and drug counselor, new text end pharmacist, public health nurse, midlevel
practitioner, registered nurse, or a licensed practical nurse. The commissioner may also
consider applications submitted by graduates in eligible professions who are licensed and
in practice; and

(2) submit an application to the commissioner of health.

(b) An applicant selected to participate must sign a contract to agree to serve a minimum
three-year full-time service obligation according to subdivision 2, which shall begin no later
than March 31 following completion of required training, with the exception of a nurse,
who must agree to serve a minimum two-year full-time service obligation according to
subdivision 2, which shall begin no later than March 31 following completion of required
training.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2025.
new text end

Sec. 25.

Minnesota Statutes 2020, section 144.212, is amended by adding a subdivision
to read:

new text begin Subd. 12. new text end

new text begin Homeless youth. new text end

new text begin "Homeless youth" has the meaning given in section 256K.45,
subdivision 1a.
new text end

Sec. 26.

Minnesota Statutes 2020, section 144.225, subdivision 2, is amended to read:

Subd. 2.

Data about births.

(a) Except as otherwise provided in this subdivision, data
pertaining to the birth of a child to a woman who was not married to the child's father when
the child was conceived nor when the child was born, including the original record of birth
and the certified vital record, are confidential data. At the time of the birth of a child to a
woman who was not married to the child's father when the child was conceived nor when
the child was born, the mother may designate demographic data pertaining to the birth as
public. Notwithstanding the designation of the data as confidential, it may be disclosed:

(1) to a parent or guardian of the child;

(2) to the child when the child is 16 years of age or older new text begin , except as provided in clause
(3) new text end ;

new text begin (3) to the child if the child is a homeless youth;
new text end

deleted text begin (3) deleted text end new text begin (4) new text end under paragraph (b), (e), or (f); or

deleted text begin (4) deleted text end new text begin (5) new text end pursuant to a court order. For purposes of this section, a subpoena does not
constitute a court order.

(b) Unless the child is adopted, data pertaining to the birth of a child that are not accessible
to the public become public data if 100 years have elapsed since the birth of the child who
is the subject of the data, or as provided under section 13.10, whichever occurs first.

(c) If a child is adopted, data pertaining to the child's birth are governed by the provisions
relating to adoption records, including sections 13.10, subdivision 5; 144.218, subdivision
1; 144.2252; and 259.89.

(d) The name and address of a mother under paragraph (a) and the child's date of birth
may be disclosed to the county social services, tribal health department, or public health
member of a family services collaborative for purposes of providing services under section
124D.23.

(e) The commissioner of human services shall have access to birth records for:

(1) the purposes of administering medical assistance and the MinnesotaCare program;

(2) child support enforcement purposes; and

(3) other public health purposes as determined by the commissioner of health.

(f) Tribal child support programs shall have access to birth records for child support
enforcement purposes.

Sec. 27.

new text begin [144.2255] CERTIFIED BIRTH RECORD FOR HOMELESS YOUTH.
new text end

new text begin Subdivision 1. new text end

new text begin Application; certified birth record. new text end

new text begin A subject of a birth record who is
a homeless youth in Minnesota or another state may apply to the state registrar or a local
issuance office for a certified birth record according to this section. The state registrar or
local issuance office shall issue a certified birth record or statement of no vital record found
to a subject of a birth record who submits:
new text end

new text begin (1) a completed application signed by the subject of the birth record;
new text end

new text begin (2) a statement that the subject of the birth record is a homeless youth, signed by the
subject of the birth record; and
new text end

new text begin (3) one of the following:
new text end

new text begin (i) a document of identity listed in Minnesota Rules, part 4601.2600, subpart 8, or, at
the discretion of the state registrar or local issuance office, Minnesota Rules, part 4601.2600,
subpart 9;
new text end

new text begin (ii) a statement that complies with Minnesota Rules, part 4601.2600, subparts 6 and 7;
or
new text end

new text begin (iii) a statement verifying that the subject of the birth record is a homeless youth that
complies with the requirements in subdivision 2 and is from an employee of a human services
agency that receives public funding to provide services to homeless youth, runaway youth,
youth with mental illness, or youth with substance use disorders; a school staff person who
provides services to homeless youth; or a school social worker.
new text end

new text begin Subd. 2. new text end

new text begin Statement verifying subject is a homeless youth. new text end

new text begin A statement verifying that
a subject of a birth record is a homeless youth must include:
new text end

new text begin (1) the following information regarding the individual providing the statement: first
name, middle name, if any, and last name; home or business address; telephone number, if
any; and e-mail address, if any;
new text end

new text begin (2) the first name, middle name, if any, and last name of the subject of the birth record;
and
new text end

new text begin (3) a statement specifying the relationship of the individual providing the statement to
the subject of the birth record and verifying that the subject of the birth record is a homeless
youth.
new text end

new text begin The individual providing the statement must also provide a copy of the individual's
employment identification.
new text end

new text begin Subd. 3. new text end

new text begin Expiration; reissuance. new text end

new text begin If a subject of a birth record obtains a certified birth
record under this section using the statement specified in subdivision 1, clause (3), item
(iii), the certified birth record issued shall expire six months after the date of issuance. Upon
expiration of the certified birth record, the subject of the birth record may surrender the
expired birth record to the state registrar or a local issuance office and obtain another birth
record. Each certified birth record obtained under this subdivision shall expire six months
after the date of issuance. If the subject of the birth record does not surrender the expired
birth record, the subject may apply for a certified birth record using the process in subdivision
1.
new text end

new text begin Subd. 4. new text end

new text begin Data practices. new text end

new text begin Data listed under subdivision 1, clauses (2) and (3), item (iii),
are private data on individuals.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment for
applications for and the issuance of certified birth records on or after January 1, 2022.
new text end

Sec. 28.

Minnesota Statutes 2020, section 144.226, is amended by adding a subdivision
to read:

new text begin Subd. 7. new text end

new text begin Transaction fees. new text end

new text begin The state registrar may charge and permit agents to charge
a convenience fee and a transaction fee for electronic transactions and transactions by
telephone or Internet, as well as the fees established under subdivisions 1 to 4. The
convenience fee may not exceed three percent of the cost of the charges for payment. The
state registrar may permit agents to charge and retain a transaction fee as payment agreed
upon under contract. When an electronic convenience fee or transaction fee is charged, the
agent charging the fee is required to post information on their web page informing individuals
of the fee. The information must be near the point of payment, clearly visible, include the
amount of the fee, and state: "This contracted agent is allowed by state law to charge a
convenience fee and transaction fee for this electronic transaction."
new text end

Sec. 29.

Minnesota Statutes 2020, section 144.226, is amended by adding a subdivision
to read:

new text begin Subd. 8. new text end

new text begin Birth record fees waived for homeless youth. new text end

new text begin A subject of a birth record who
is a homeless youth shall not be charged any of the fees specified in this section for a certified
birth record or statement of no vital record found under section 144.2255.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment for
applications for and the issuance of certified birth records on or after January 1, 2022.
new text end

Sec. 30.

Minnesota Statutes 2020, 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; deleted text begin and deleted text end (iv) the relocation or
redistribution does not involve the construction of a new hospital building new text begin ; 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 new text end ;

(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; deleted text begin or
deleted text end

(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 deleted text begin . deleted text end new text begin ;
new text end

new text begin (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; or
new text end

new text begin (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 144.552.
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 144.555, is amended to read:

144.555 deleted text begin HOSPITAL deleted text end new text begin FACILITY OR CAMPUS new text end CLOSINGS new text begin , RELOCATING
SERVICES, OR CEASING TO OFFER CERTAIN SERVICES new text end ; PATIENT
RELOCATIONS.

Subdivision 1.

Notice of closing or curtailing deleted text begin service deleted text end new text begin operations; facilities other than
hospitals new text end .

If a facility licensed under sections 144.50 to 144.56 new text begin , other than a hospital, new text end
voluntarily plans to cease operations or to curtail operations to the extent that patients or
residents must be relocated, the controlling persons of the facility must notify the
commissioner of health at least 90 days before the scheduled cessation or curtailment. The
commissioner shall cooperate with the controlling persons and advise them about relocating
the patients or residents.

new text begin Subd. 1a. new text end

new text begin Notice of closing, curtailing operations, relocating services, or ceasing to
offer certain services; hospitals. new text end

new text begin (a) The controlling persons of a hospital licensed under
sections 144.50 to 144.56 or a hospital campus must notify the commissioner of health and
the public at least 120 days before the hospital or hospital campus voluntarily plans to
implement one of the following scheduled actions:
new text end

new text begin (1) cease operations;
new text end

new text begin (2) curtail operations to the extent that patients must be relocated;
new text end

new text begin (3) relocate the provision of health services to another hospital or another hospital
campus; or
new text end

new text begin (4) cease offering maternity care and newborn care services, intensive care unit services,
inpatient mental health services, or inpatient substance use disorder treatment services.
new text end

new text begin (b) The commissioner shall cooperate with the controlling persons and advise them
about relocating the patients.
new text end

new text begin Subd. 1b. new text end

new text begin Public hearing. new text end

new text begin Within 45 days after receiving notice under subdivision 1a,
the commissioner shall conduct a public hearing on the scheduled cessation of operations,
curtailment of operations, relocation of health services, or cessation in offering health
services. The commissioner must provide adequate public notice of the hearing in a time
and manner determined by the commissioner. The controlling persons of the hospital or
hospital campus must participate in the public hearing. The public hearing must include:
new text end

new text begin (1) an explanation by the controlling persons of the reasons for ceasing or curtailing
operations, relocating health services, or ceasing to offer any of the listed health services;
new text end

new text begin (2) a description of the actions that controlling persons will take to ensure that residents
in the hospital's or campus's service area have continued access to the health services being
eliminated, curtailed, or relocated;
new text end

new text begin (3) an opportunity for public testimony on the scheduled cessation or curtailment of
operations, relocation of health services, or cessation in offering any of the listed health
services, and on the hospital's or campus's plan to ensure continued access to those health
services being eliminated, curtailed, or relocated; and
new text end

new text begin (4) an opportunity for the controlling persons to respond to questions from interested
persons.
new text end

new text begin Subd. 1c. new text end

new text begin Exceptions. new text end

new text begin (a) Notwithstanding the time period in subdivision 1a by which
notice must be provided to the commissioner and the public, the controlling persons of a
hospital or hospital campus must notify the commissioner of health and the public as soon
as practicable after deciding to take an action listed in subdivision 1a, paragraph (a), if the
action is caused by:
new text end

new text begin (1) a natural disaster or other emergency; or
new text end

new text begin (2) an inability of the hospital to provide health services according to the applicable
standard of care due to the hospital's inability to retain or secure essential staff after
reasonable effort.
new text end

new text begin (b) Notwithstanding the time period in subdivision 1b by which a public hearing must
be held, the commissioner must hold a public hearing according to subdivision 1b as soon
as practicable after the controlling persons of the hospital or hospital campus governed by
this subdivision decide to take the action.
new text end

Subd. 2.

Penalty.

Failure to notify the commissioner under subdivision 1 new text begin , 1a, or 1c or
failure to participate in a public hearing under subdivision 1b new text end may result in issuance of a
correction order under section 144.653, subdivision 5.

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 144.9501, subdivision 17, is amended to read:

Subd. 17.

Lead hazard reduction.

"Lead hazard reduction" means abatement or interim
controls undertaken to make a residence, child care facility, school, deleted text begin or deleted text end playground new text begin , or other
location where lead hazards are identified new text end lead-safe by complying with the lead standards
and methods adopted under section 144.9508.

Sec. 33.

Minnesota Statutes 2020, section 144.9502, subdivision 3, is amended to read:

Subd. 3.

Reports of blood lead analysis required.

(a) Every hospital, medical clinic,
medical laboratory, other facility, or individual performing blood lead analysis shall report
the results after the analysis of each specimen analyzed, for both capillary and venous
specimens, and epidemiologic information required in this section to the commissioner of
health, within the time frames set forth in clauses (1) and (2):

(1) within two working days by telephone, fax, or electronic transmission new text begin as prescribed
by the commissioner new text end , with written or electronic confirmation within one month new text begin as prescribed
by the commissioner new text end , for a venous blood lead level equal to or greater than 15 micrograms
of lead per deciliter of whole blood; or

(2) within one month in writing or by electronic transmission new text begin as prescribed by the
commissioner new text end , for any capillary result or for a venous blood lead level less than 15
micrograms of lead per deciliter of whole blood.

(b) If a blood lead analysis is performed outside of Minnesota and the facility performing
the analysis does not report the blood lead analysis results and epidemiological information
required in this section to the commissioner, the provider who collected the blood specimen
must satisfy the reporting requirements of this section. For purposes of this section, "provider"
has the meaning given in section 62D.02, subdivision 9.

(c) The commissioner shall coordinate with hospitals, medical clinics, medical
laboratories, and other facilities performing blood lead analysis to develop a universal
reporting form and mechanism.

Sec. 34.

Minnesota Statutes 2020, section 144.9504, subdivision 2, is amended to read:

Subd. 2.

Lead risk assessment.

(a) new text begin Notwithstanding section 144.9501, subdivision 6a,
for purposes of this subdivision, "child" means an individual under 18 years of age.
new text end

new text begin (b) new text end An assessing agency shall conduct a lead risk assessment of a residence new text begin , residential
or commercial child care facility, playground, school, or other location where lead hazards
are suspected new text end according to the venous blood lead level and time frame set forth in clauses
(1) to (4) for purposes of secondary prevention:

(1) within 48 hours of a child or pregnant female in the residence new text begin , residential or
commercial child care facility, playground, school, or other location where lead hazards are
suspected new text end being identified to the agency as having a venous blood lead level equal to or
greater than 60 micrograms of lead per deciliter of whole blood;

(2) within five working days of a child or pregnant female in the residence new text begin , residential
or commercial child care facility, playground, school, or other location where lead hazards
are suspected new text end being identified to the agency as having a venous blood lead level equal to
or greater than 45 micrograms of lead per deciliter of whole blood;

deleted text begin (3) within ten working days of a child in the residence being identified to the agency as
having a venous blood lead level equal to or greater than 15 micrograms of lead per deciliter
of whole blood; or
deleted text end

deleted text begin (4) deleted text end new text begin (3) new text end within ten working days of a new text begin child or new text end pregnant female in the residence new text begin , residential
or commercial child care facility, playground, school, or other location where lead hazards
are suspected new text end being identified to the agency as having a venous blood lead level equal to
or greater than ten micrograms of lead per deciliter of whole blood deleted text begin . deleted text end new text begin ; or
new text end

new text begin (4) within 20 working days of a child or pregnant female in the residence, residential or
commercial child care facility, playground, school, or other location where lead hazards are
suspected being identified to the agency as having a venous blood lead level equal to or
greater than five micrograms per deciliter of whole blood.
new text end

new text begin An assessing agency may refer investigations at sites other than the child's or pregnant
female's residence to the commissioner.
new text end

deleted text begin (b) deleted text end new text begin (c) new text end Within the limits of available local, state, and federal appropriations, an assessing
agency may also conduct a lead risk assessment for children with any elevated blood lead
level.

deleted text begin (c) deleted text end new text begin (d) new text end In a building with two or more dwelling units, an assessing agency shall assess
the individual unit in which the conditions of this section are met and shall inspect all
common areas accessible to a child. If a child visits one or more other sites such as another
residence, or a residential or commercial child care facility, playground, or school, the
assessing agency shall also inspect the other sites. The assessing agency shall have one
additional day added to the time frame set forth in this subdivision to complete the lead risk
assessment for each additional site.

deleted text begin (d) deleted text end new text begin (e) new text end Within the limits of appropriations, the assessing agency shall identify the known
addresses for the previous 12 months of the child or pregnant female with venous blood
lead levels of at least 15 micrograms per deciliter for the child or at least ten micrograms
per deciliter for the pregnant female; notify the property owners, landlords, and tenants at
those addresses that an elevated blood lead level was found in a person who resided at the
property; and give them primary prevention information. Within the limits of appropriations,
the assessing agency may perform a risk assessment and issue corrective orders in the
properties, if it is likely that the previous address contributed to the child's or pregnant
female's blood lead level. The assessing agency shall provide the notice required by this
subdivision without identifying the child or pregnant female with the elevated blood lead
level. The assessing agency is not required to obtain the consent of the child's parent or
guardian or the consent of the pregnant female for purposes of this subdivision. This
information shall be classified as private data on individuals as defined under section 13.02,
subdivision 12.

deleted text begin (e) deleted text end new text begin (f) new text end The assessing agency shall conduct the lead risk assessment according to rules
adopted by the commissioner under section 144.9508. An assessing agency shall have lead
risk assessments performed by lead risk assessors licensed by the commissioner according
to rules adopted under section 144.9508. If a property owner refuses to allow a lead risk
assessment, the assessing agency shall begin legal proceedings to gain entry to the property
and the time frame for conducting a lead risk assessment set forth in this subdivision no
longer applies. A lead risk assessor or assessing agency may observe the performance of
lead hazard reduction in progress and shall enforce the provisions of this section under
section 144.9509. Deteriorated painted surfaces, bare soil, and dust must be tested with
appropriate analytical equipment to determine the lead content, except that deteriorated
painted surfaces or bare soil need not be tested if the property owner agrees to engage in
lead hazard reduction on those surfaces. The lead content of drinking water must be measured
if another probable source of lead exposure is not identified. Within a standard metropolitan
statistical area, an assessing agency may order lead hazard reduction of bare soil without
measuring the lead content of the bare soil if the property is in a census tract in which soil
sampling has been performed according to rules established by the commissioner and at
least 25 percent of the soil samples contain lead concentrations above the standard in section
144.9508.

deleted text begin (f) deleted text end new text begin (g) new text end Each assessing agency shall establish an administrative appeal procedure which
allows a property owner to contest the nature and conditions of any lead order issued by
the assessing agency. Assessing agencies must consider appeals that propose lower cost
methods that make the residence lead safe. The commissioner shall use the authority and
appeal procedure granted under sections 144.989 to 144.993.

deleted text begin (g) deleted text end new text begin (h) new text end Sections 144.9501 to 144.9512 neither authorize nor prohibit an assessing agency
from charging a property owner for the cost of a lead risk assessment.

Sec. 35.

Minnesota Statutes 2020, section 144.9504, subdivision 5, is amended to read:

Subd. 5.

Lead orders.

(a) An assessing agency, after conducting a lead risk assessment,
shall order a property owner to perform lead hazard reduction on all lead sources that exceed
a standard adopted according to section 144.9508. If lead risk assessments and lead orders
are conducted at times when weather or soil conditions do not permit the lead risk assessment
or lead hazard reduction, external surfaces and soil lead shall be assessed, and lead orders
complied with, if necessary, at the first opportunity that weather and soil conditions allow.

new text begin (b) If, after conducting a lead risk assessment, an assessing agency determines that the
property owner's lead hazard originated from another source location, the assessing agency
may order the responsible person of the source location to:
new text end

new text begin (1) perform lead hazard reduction at the site where the assessing agency conducted the
lead risk assessment; and
new text end

new text begin (2) remediate the conditions at the source location that allowed the lead hazard, pollutant,
or contaminant to migrate from the source location.
new text end

new text begin (c) For purposes of this subdivision, "pollutant or contaminant" has the meaning given
in section 115B.02, subdivision 13, and "responsible person" has the meaning given in
section 115B.03.
new text end

deleted text begin (b) deleted text end new text begin (d) new text end If the paint standard under section 144.9508 is violated, but the paint is intact,
the assessing agency shall not order the paint to be removed unless the intact paint is a
known source of actual lead exposure to a specific person. Before the assessing agency may
order the intact paint to be removed, a reasonable effort must be made to protect the child
and preserve the intact paint by the use of guards or other protective devices and methods.

deleted text begin (c) deleted text end new text begin (e) new text end Whenever windows and doors or other components covered with deteriorated
lead-based paint have sound substrate or are not rotting, those components should be repaired,
sent out for stripping or planed down to remove deteriorated lead-based paint, or covered
with protective guards instead of being replaced, provided that such an activity is the least
cost method. However, a property owner who has been ordered to perform lead hazard
reduction may choose any method to address deteriorated lead-based paint on windows,
doors, or other components, provided that the method is approved in rules adopted under
section 144.9508 and that it is appropriate to the specific property.

deleted text begin (d) deleted text end new text begin (f) new text end Lead orders must require that any source of damage, such as leaking roofs,
plumbing, and windows, be repaired or replaced, as needed, to prevent damage to
lead-containing interior surfaces.

deleted text begin (e) deleted text end new text begin (g) new text end The assessing agency is not required to pay for lead hazard reduction. The
assessing agency shall enforce the lead orders issued to a property owner under this section.

Sec. 36.

Minnesota Statutes 2020, section 145.32, subdivision 1, is amended to read:

Subdivision 1.

Hospital records.

The superintendent or other chief administrative officer
of any public or private hospital, by and with the consent and approval of the board of
directors or other governing body of the hospital, may divest the files and records of that
hospital of any individual case records and, with that consent and approval, may destroy
the records. The records shall first have been transferred and recorded as authorized in
section 145.30.

Portions of individual hospital medical records that comprise an individual permanent
medical record, as defined by the commissioner of health, shall be retained as authorized
in section 145.30. Other portions of the individual medical record, including any
miscellaneous documents, papers, and correspondence in connection with them, may be
divested and destroyed after seven years without transfer to photographic film, electronic
image, or other state-of-the-art electronic preservation technology.

All portions of individual hospital medical records of minors shall be maintained for
seven years deleted text begin following the age of majority deleted text end new text begin or until the individual reaches the age of majority,
whichever occurs last, at which time the individual may request that the patient's hospital
records be destroyed, unless the hospital is required to retain the records as part of the
individual's permanent medical record as defined in accordance with subdivision 2 new text end .

Nothing in this section shall be construed to prohibit the retention of hospital medical
records beyond the periods described in this section. Nor shall anything in this section be
construed to prohibit patient access to hospital medical records as provided in sections
144.291 to 144.298.

new text begin EFFECTIVE DATE. new text end

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

Sec. 37.

Minnesota Statutes 2020, section 145.901, subdivision 2, is amended to read:

Subd. 2.

Access to data.

(a) The commissioner of health has access to medical data as
defined in section 13.384, subdivision 1, paragraph (b), medical examiner data as defined
in section 13.83, subdivision 1, and health records created, maintained, or stored by providers
as defined in section 144.291, subdivision 2, paragraph deleted text begin (i) deleted text end new text begin (c) new text end , without the consent of the
subject of the data, and without the consent of the parent, spouse, other guardian, or legal
representative of the subject of the data, when the subject of the data is a woman who died
during a pregnancy or within 12 months of a fetal death, a live birth, or other termination
of a pregnancy.

The commissioner has access only to medical data and health records related to deaths
that occur on or after July 1, 2000 new text begin , including the names of the providers, clinics, or other
health services such as family home visiting programs; the women, infants, and children
(WIC) program; prescription monitoring programs; and behavioral health services, where
care was received before, during, or related to the pregnancy or death. The commissioner
has access to records maintained by a medical examiner, a coroner, or hospitals or to hospital
discharge data, for the purpose of providing the name and location of any pre-pregnancy,
prenatal, or other care received by the subject of the data up to one year after the end of the
pregnancy new text end .

(b) The provider or responsible authority that creates, maintains, or stores the data shall
furnish the data upon the request of the commissioner. The provider or responsible authority
may charge a fee for providing the data, not to exceed the actual cost of retrieving and
duplicating the data.

(c) The commissioner shall make a good faith reasonable effort to notify the parent,
spouse, other guardian, or legal representative of the subject of the data before collecting
data on the subject. For purposes of this paragraph, "reasonable effort" means one notice
is sent by certified mail to the last known address of the parent, spouse, guardian, or legal
representative informing the recipient of the data collection and offering a public health
nurse support visit if desired.

(d) The commissioner does not have access to coroner or medical examiner data that
are part of an active investigation as described in section 13.83.

new text begin (e) The commissioner may request and receive from a coroner or medical examiner the
name of the health care provider that provided prenatal, postpartum, or other health services
to the subject of the data.
new text end

new text begin (f) The commissioner may access Department of Human Services data to identify sources
of care and services to assist with the evaluation of welfare systems, including housing, to
reduce preventable maternal deaths.
new text end

new text begin (g) The commissioner may request and receive law enforcement reports or incident
reports related to the subject of the data.
new text end

Sec. 38.

Minnesota Statutes 2020, section 145.901, subdivision 4, is amended to read:

Subd. 4.

Classification of data.

(a) Data provided to the commissioner from source
records under subdivision 2, including identifying information on individual providers, data
subjects, or their children, and data derived by the commissioner under subdivision 3 for
the purpose of carrying out maternal death studies, are classified as confidential data on
individuals or confidential data on decedents, as defined in sections 13.02, subdivision 3,
and 13.10, subdivision 1, paragraph (a).

(b) Information classified under paragraph (a) shall not be subject to discovery or
introduction into evidence in any administrative, civil, or criminal proceeding. Such
information otherwise available from an original source shall not be immune from discovery
or barred from introduction into evidence merely because it was utilized by the commissioner
in carrying out maternal death studies.

(c) Summary data on maternal death studies created by the commissioner, which does
not identify individual data subjects or individual providers, shall be public in accordance
with section 13.05, subdivision 7.

new text begin (d) Data provided by the commissioner of human services to the commissioner of health
under this section retain the same classification the data held when retained by the
commissioner of human services, as required under section 13.03, subdivision 4, paragraph
(c).
new text end

Sec. 39.

Minnesota Statutes 2020, section 145.901, is amended by adding a subdivision
to read:

new text begin Subd. 5. new text end

new text begin Maternal Mortality Review Committee. new text end

new text begin (a) The commissioner of health shall
convene a Maternal Mortality Review Committee to conduct maternal death study reviews,
make recommendations, and publicly share summary information. The commissioner shall
appoint members to the review committee, and membership may include but is not limited
to medical examiners or coroners, representatives of health care institutions that provide
care to pregnant women, obstetric and midwifery practitioners, Medicaid representatives,
representatives of state agencies, individuals from communities with disparate rates of
maternal mortality, and other subject matter experts as appropriate. Committee membership
shall not exceed 25 members. The review committee shall review data from source records
obtained under subdivision 2, other than data identifying the subject or the provider.
new text end

new text begin (b) A person attending a Maternal Mortality Review Committee meeting shall not disclose
what transpired at the meeting, except as necessary to carry out the purposes of the review
committee. The proceedings and records of the review committee are protected nonpublic
data as defined in section 13.02, subdivision 13. Discovery and introduction into evidence
in legal proceedings of case review committee proceedings and records, and testimony in
legal proceedings by review committee members and persons presenting information to the
review committee, shall occur in compliance with the requirements in section 256.01,
subdivision 12, paragraph (e).
new text end

Sec. 40.

Minnesota Statutes 2020, section 171.07, is amended by adding a subdivision to
read:

new text begin Subd. 3b. new text end

new text begin Identification card for homeless youth. new text end

new text begin (a) A homeless youth, as defined in
section 256K.45, subdivision 1a, who meets the requirements of this subdivision may obtain
a noncompliant identification card, notwithstanding section 171.06, subdivision 3.
new text end

new text begin (b) An applicant under this subdivision must:
new text end

new text begin (1) provide the applicant's full name, date of birth, and sex;
new text end

new text begin (2) provide the applicant's height in feet and inches, weight in pounds, and eye color;
new text end

new text begin (3) submit a certified copy of a birth certificate issued by a government bureau of vital
statistics or equivalent agency in the applicant's state of birth, which must bear the raised
or authorized seal of the issuing government entity; and
new text end

new text begin (4) submit a statement verifying that the applicant is a homeless youth who resides in
Minnesota that is signed by:
new text end

new text begin (i) an employee of a human services agency receiving public funding to provide services
to homeless youth, runaway youth, youth with mental illness, or youth with substance use
disorders; or
new text end

new text begin (ii) staff at a school who provide services to homeless youth or a school social worker.
new text end

new text begin (c) For a noncompliant identification card under this subdivision:
new text end

new text begin (1) the commissioner must not impose a fee, surcharge, or filing fee under section 171.06,
subdivision 2; and
new text end

new text begin (2) a driver's license agent must not impose a filing fee under section 171.061, subdivision
4.
new text end

new text begin (d) Minnesota Rules, parts 7410.0400 and 7410.0410, or successor rules, do not apply
for an identification card under 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 for
application and issuance of Minnesota identification cards on and after January 1, 2022.
new text end

Sec. 41.

Minnesota Statutes 2020, section 256B.0625, subdivision 52, is amended to read:

Subd. 52.

Lead risk assessments.

(a) Effective October 1, 2007, or six months after
federal approval, whichever is later, medical assistance covers lead risk assessments provided
by a lead risk assessor who is licensed by the commissioner of health under section 144.9505
and employed by an assessing agency as defined in section 144.9501. Medical assistance
covers a onetime on-site investigation of a recipient's home or primary residence to determine
the existence of lead so long as the recipient is under the age of 21 and has a venous blood
lead level specified in section 144.9504, subdivision 2, paragraph deleted text begin (a) deleted text end new text begin (b) new text end .

(b) Medical assistance reimbursement covers the lead risk assessor's time to complete
the following activities:

(1) gathering samples;

(2) interviewing family members;

(3) gathering data, including meter readings; and

(4) providing a report with the results of the investigation and options for reducing
lead-based paint hazards.

Medical assistance coverage of lead risk assessment does not include testing of
environmental substances such as water, paint, or soil or any other laboratory services.
Medical assistance coverage of lead risk assessments is not included in the capitated services
for children enrolled in health plans through the prepaid medical assistance program and
the MinnesotaCare program.

(c) Payment for lead risk assessment must be cost-based and must meet the criteria for
federal financial participation under the Medicaid program. The rate must be based on
allowable expenditures from cost information gathered. Under section 144.9507, subdivision
5, federal medical assistance funds may not replace existing funding for lead-related activities.
The nonfederal share of costs for services provided under this subdivision must be from
state or local funds and is the responsibility of the agency providing the risk assessment.
When the risk assessment is conducted by the commissioner of health, the state share must
be from appropriations to the commissioner of health for this purpose. Eligible expenditures
for the nonfederal share of costs may not be made from federal funds or funds used to match
other federal funds. Any federal disallowances are the responsibility of the agency providing
risk assessment services.

Sec. 42. new text begin RECOMMENDATIONS ON EXPANDING ACCESS TO DATA IN
ALL-PAYER CLAIMS DATABASE.
new text end

new text begin The commissioner of health shall develop recommendations to expand access to data
in the all-payer claims database under Minnesota Statutes, section 62U.04, to additional
outside entities for public health or research purposes. In the recommendations, the
commissioner must address an application process for outside entities to access the data,
how the department will exercise ongoing oversight over data use by outside entities,
purposes for which outside entities may use the data, establishment of a data access
committee to advise the department on selecting outside entities permitted to access the
data, steps outside entities must take to protect data held by outside entities from unauthorized
use, and whether and how data released to outside entities may identify health care facilities,
practices, and professionals. The commissioner, in consultation with the commissioner of
human services, may also address whether the state should participate in a state-university
partnership or network to promote research using Medicaid data. In developing the
recommendations, the commissioner must examine best practices of other states regarding
access to and uses of data in all-payer claims databases. The commissioner shall submit
preliminary recommendations by December 15, 2021, and final recommendations and
proposed amendments to statutes by December 15, 2022, to the chairs and ranking minority
members of the legislative committees with jurisdiction over health policy and civil law.
new text end

Sec. 43. new text begin HEALTH PROFESSIONAL EDUCATION LOAN FORGIVENESS
PROGRAM; TEMPORARY ADDITION OF CERTAIN PROVIDERS.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following definitions
apply.
new text end

new text begin (b) "Alcohol and drug counselor" means an individual who is licensed as an alcohol and
drug counselor under Minnesota Statutes, chapter 148F.
new text end

new text begin (c) "Medical resident" and "mental health professional" have the meanings given in
Minnesota Statutes, section 144.1501, subdivision 1.
new text end

new text begin Subd. 2. new text end

new text begin Loan forgiveness. new text end

new text begin Notwithstanding any provision to the contrary in Minnesota
Statutes, section 144.1501, subdivision 2 or 4, the commissioner of health may award grants
under the health professional education loan forgiveness program under Minnesota Statutes,
section 144.1501, to alcohol and drug counselors, medical residents, and mental health
professionals:
new text end

new text begin (1) agreeing to deliver at least 25 percent of their yearly patient encounters to state public
program enrollees or patients receiving sliding fee schedule discounts through a formal
sliding fee schedule meeting the standards established by the United States Department of
Health and Human Services under Code of Federal Regulations, title 42, section 51, chapter
303; or
new text end

new text begin (2) specializing in the area of pediatric psychiatry and agreeing to deliver at least 25
percent of their yearly patient encounters to state public program enrollees or patients
receiving sliding fee schedule discounts through a formal sliding fee schedule meeting the
standards established by the United States Department of Health and Human Services under
Code of Federal Regulations, title 42, section 51, chapter 303.
new text end

new text begin Subd. 3. new text end

new text begin Expiration. new text end

new text begin This section expires June 30, 2025.
new text end

Sec. 44. new text begin MENTAL HEALTH CULTURAL COMMUNITY CONTINUING
EDUCATION GRANT PROGRAM.
new text end

new text begin The commissioner of health shall develop a grant program, in consultation with the
relevant mental health licensing boards, to provide for the continuing education necessary
for social workers, marriage and family therapists, psychologists, and professional clinical
counselors to become supervisors for individuals pursuing licensure in mental health
professions. Social workers, marriage and family therapists, psychologists, and professional
clinical counselors obtaining continuing education under this section must:
new text end

new text begin (1) be members of communities of color or underrepresented communities as defined
in Minnesota Statutes, section 148E.010, subdivision 20; and
new text end

new text begin (2) work for community mental health providers and agree to deliver at least 25 percent
of their yearly patient encounters to state public program enrollees or patients receiving
sliding fee schedule discounts through a formal sliding fee schedule meeting the standards
established by the United States Department of Health and Human Services under Code of
Federal Regulations, title 42, section 51, chapter 303.
new text end

Sec. 45. new text begin PUBLIC HEALTH INFRASTRUCTURE FUNDS.
new text end

new text begin Subdivision 1. new text end

new text begin Uses of funds. new text end

new text begin The commissioner of health, with guidance from the State
Community Health Services Advisory Committee established under Minnesota Statutes,
section 145A.04, subdivision 15, shall provide funds to community health boards and Tribal
governments for projects to build foundational public health capacity across the state,
improve public health services to underserved populations, pilot new organizational models
for providing public health services including multijurisdictional partnerships, or otherwise
improve the state's public health system so that it satisfies national standards, including
standards for health equity.
new text end

new text begin Subd. 2. new text end

new text begin Distribution of funds. new text end

new text begin The commissioner shall work with the State Community
Health Services Advisory Committee to determine the process for distributing funds under
this section. Community health boards and Tribal governments may be jointly funded under
this section.
new text end

new text begin Subd. 3. new text end

new text begin Evaluation and reporting. new text end

new text begin A community health board, Tribal government, or
multijurisdictional unit receiving funds under this section shall report to the commissioner
data specified by the commissioner for evaluation of the program.
new text end

new text begin Subd. 4. new text end

new text begin No supplantation of current expenditures. new text end

new text begin Funds received under this section
must be used to supplement and not supplant current county or Tribal expenditures for
public health purposes.
new text end

new text begin Subd. 5. new text end

new text begin Oversight. new text end

new text begin The commissioner shall assess the capacity of the public health
system and oversee improvement efforts conducted with funds under this section.
new text end

new text begin Subd. 6. new text end

new text begin Recommendations on changes to organization and funding of public health
system. new text end

new text begin By February 1, 2023, the commissioner shall develop and provide to the chairs and
ranking minority members of the legislative committees with jurisdiction over public health
recommendations on changes to the organization and funding of Minnesota's public health
system.
new text end

Sec. 46. new text begin REVISOR INSTRUCTIONS.
new text end

new text begin (a) The revisor of statutes shall amend the section headnote for Minnesota Statutes,
section 62J.63, to read "HEALTH CARE PURCHASING AND PERFORMANCE
MEASUREMENT."
new text end

new text begin (b) If the fee to support the newborn screening program is increased in accordance with
Minnesota Statutes, section 144.064, subdivision 3, paragraph (d), the revisor of statutes
shall update Minnesota Statutes, section 144.125, subdivision 1, paragraph (c), to include
the revised per-specimen fee.
new text end

Sec. 47. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2020, sections 62J.63, subdivision 3; 144.0721, subdivision 1;
144.0722; 144.0724, subdivision 10; and 144.693, new text end new text begin are repealed.
new text end

ARTICLE 4

HEALTH-RELATED LICENSING BOARDS

Section 1.

Minnesota Statutes 2020, section 148.90, subdivision 2, is amended to read:

Subd. 2.

Members.

(a) The members of the board shall:

(1) be appointed by the governor;

(2) be residents of the state;

(3) serve for not more than two consecutive terms;

(4) designate the officers of the board; and

(5) administer oaths pertaining to the business of the board.

(b) A public member of the board shall represent the public interest and shall not:

(1) be a psychologist or have engaged in the practice of psychology;

(2) be an applicant or former applicant for licensure;

(3) be a member of another health profession and be licensed by a health-related licensing
board as defined under section 214.01, subdivision 2; the commissioner of health; or licensed,
certified, or registered by another jurisdiction;

(4) be a member of a household that includes a psychologist; or

(5) have conflicts of interest or the appearance of conflicts with duties as a board member.

new text begin (c) At the time of their appointments, at least two members of the board must reside
outside of the seven-county metropolitan area.
new text end

new text begin (d) At the time of their appointments, at least two members of the board must be members
of:
new text end

new text begin (1) a community of color; or
new text end

new text begin (2) an underrepresented community, defined as a group that is not represented in the
majority with respect to race, ethnicity, national origin, sexual orientation, gender identity,
or physical ability.
new text end

Sec. 2.

Minnesota Statutes 2020, section 148.911, is amended to read:

148.911 CONTINUING EDUCATION.

new text begin (a) new text end Upon application for license renewal, a licensee shall provide the board with
satisfactory evidence that the licensee has completed continuing education requirements
established by the board. Continuing education programs shall be approved under section
148.905, subdivision 1, clause (10). The board shall establish by rule the number of
continuing education training hours required each year and may specify subject or skills
areas that the licensee shall address.

new text begin (b) At least four of the required continuing education hours must be on increasing the
knowledge, understanding, self-awareness, and practice skills to competently address the
psychological needs of individuals from diverse socioeconomic and cultural backgrounds.
Topics include but are not limited to:
new text end

new text begin (1) understanding culture, its functions, and strengths that exist in varied cultures;
new text end

new text begin (2) understanding clients' cultures and differences among and between cultural groups;
new text end

new text begin (3) understanding the nature of social diversity and oppression;
new text end

new text begin (4) understanding cultural humility; and
new text end

new text begin (5) understanding human diversity, meaning individual client differences that are
associated with the client's cultural group, including race, ethnicity, national origin, religious
affiliation, language, age, gender, gender identity, physical and mental capabilities, sexual
orientation, and socioeconomic status.
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. 3.

Minnesota Statutes 2020, section 148.995, subdivision 2, is amended to read:

Subd. 2.

Certified doula.

"Certified doula" means an individual who has received a
certification to perform doula services from the International Childbirth Education
Association, the Doulas of North America (DONA), the Association of Labor Assistants
and Childbirth Educators (ALACE), Birthworks, the Childbirth and Postpartum Professional
Association (CAPPA), Childbirth International, the International Center for Traditional
Childbearing, deleted text begin or deleted text end Commonsense Childbirth, Inc new text begin ., Modern Doula Education (MDE), or an
organization designated by the commissioner under section 148.9965 new text end .

Sec. 4.

Minnesota Statutes 2020, section 148.996, subdivision 2, is amended to read:

Subd. 2.

Qualifications.

The commissioner shall include on the registry any individual
who:

(1) submits an application on a form provided by the commissioner. The form must
include the applicant's name, address, and contact information;

(2) deleted text begin maintains deleted text end new text begin submits evidence of maintaining new text end a current certification from one of the
organizations listed in section 148.995, subdivision 2 new text begin , or from an organization designated
by the commissioner under section 148.9965 new text end ; and

(3) pays the fees required under section 148.997.

Sec. 5.

Minnesota Statutes 2020, section 148.996, subdivision 4, is amended to read:

Subd. 4.

Renewal.

Inclusion on the registry maintained by the commissioner is valid
for three years new text begin , provided the doula meets the requirement in subdivision 2, clause (2), during
the entire period new text end . At the end of the three-year period, the certified doula may submit a new
application to remain on the doula registry by meeting the requirements described in
subdivision 2.

Sec. 6.

Minnesota Statutes 2020, section 148.996, is amended by adding a subdivision to
read:

new text begin Subd. 6. new text end

new text begin Removal from registry. new text end

new text begin (a) If the commissioner determines that a doula
included on the registry does not meet the requirement in subdivision 2, clause (2), the
commissioner shall notify the affected doula that the doula no longer meets the requirement
in subdivision 2, clause (2), specify steps the doula must take to maintain inclusion on the
registry, and specify the effect of failing to take such steps. The commissioner must provide
this notice by first class mail to the address on file with the commissioner for the affected
doula.
new text end

new text begin (b) Following the provision of notice under paragraph (a), the commissioner shall remove
from the registry any doula who no longer meets the requirement in subdivision 2, clause
(2), and who does not take the steps specified by the commissioner to maintain inclusion
on the registry.
new text end

Sec. 7.

new text begin [148.9965] DESIGNATION OF DOULA CERTIFICATION
ORGANIZATIONS BY COMMISSIONER.
new text end

new text begin Subdivision 1. new text end

new text begin Review and designation by commissioner. new text end

new text begin The commissioner shall
periodically review the doula certification organizations listed in section 148.995, subdivision
2, or designated by the commissioner under this section. The commissioner may: (1)
designate additional organizations from which individuals, if maintaining current doula
certification from such an organization, are eligible for inclusion on the registry of certified
doulas; and (2) remove the designation of a doula certification organization previously
designated by the commissioner.
new text end

new text begin Subd. 2. new text end

new text begin Designation. new text end

new text begin A doula certification organization seeking designation under this
section shall provide the commissioner with evidence that the organization satisfies
designation criteria established by the commissioner. If the commissioner designates a doula
certification organization under this section, the commissioner shall provide notice of the
designation by publication in the State Register and on the Department of Health website
for the registry of certified doulas and shall specify the date after which a certification by
the organization authorizes a doula certified by the organization to be included on the
registry.
new text end

new text begin Subd. 3. new text end

new text begin Removal of designation. new text end

new text begin (a) The commissioner may remove the designation
of a doula certification organization previously designated by the commissioner under this
section upon a determination by the commissioner that the organization does not meet the
commissioner's criteria for designation. If the commissioner removes a designation, the
commissioner shall provide notice of the removal by publication in the State Register and
shall specify the date after which a certification by the organization no longer authorizes a
doula certified by the organization to be included on the registry.
new text end

new text begin (b) Following removal of a designation, the Department of Health website for the registry
of certified doulas shall be modified to reflect the removal.
new text end

Sec. 8.

Minnesota Statutes 2020, section 148B.30, subdivision 1, is amended to read:

Subdivision 1.

Creation.

new text begin (a) new text end There is created a Board of Marriage and Family Therapy
that consists of seven members appointed by the governor. Four members shall be licensed,
practicing marriage and family therapists, each of whom shall for at least five years
immediately preceding appointment, have been actively engaged as a marriage and family
therapist, rendering professional services in marriage and family therapy. One member shall
be engaged in the professional teaching and research of marriage and family therapy. Two
members shall be representatives of the general public who have no direct affiliation with
the practice of marriage and family therapy. All members shall have been a resident of the
state two years preceding their appointment. Of the first board members appointed, three
shall continue in office for two years, two members for three years, and two members,
including the chair, for terms of four years respectively. Their successors shall be appointed
for terms of four years each, except that a person chosen to fill a vacancy shall be appointed
only for the unexpired term of the board member whom the newly appointed member
succeeds. Upon the expiration of a board member's term of office, the board member shall
continue to serve until a successor is appointed and qualified.

new text begin (b) At the time of their appointments, at least two members must reside outside of the
seven-county metropolitan area.
new text end

new text begin (c) At the time of their appointments, at least two members must be members of:
new text end

new text begin (1) a community of color; or
new text end

new text begin (2) an underrepresented community, defined as a group that is not represented in the
majority with respect to race, ethnicity, national origin, sexual orientation, gender identity,
or physical ability.
new text end

Sec. 9.

Minnesota Statutes 2020, section 148B.31, is amended to read:

148B.31 DUTIES OF THE BOARD.

new text begin (a) new text end The board shall:

(1) adopt and enforce rules for marriage and family therapy licensing, which shall be
designed to protect the public;

(2) develop by rule appropriate techniques, including examinations and other methods,
for determining whether applicants and licensees are qualified under sections 148B.29 to
148B.392;

(3) issue licenses to individuals who are qualified under sections 148B.29 to 148B.392;

(4) establish and implement procedures designed to assure that licensed marriage and
family therapists will comply with the board's rules;

(5) study and investigate the practice of marriage and family therapy within the state in
order to improve the standards imposed for the licensing of marriage and family therapists
and to improve the procedures and methods used for enforcement of the board's standards;

(6) formulate and implement a code of ethics for all licensed marriage and family
therapists; and

(7) establish continuing education requirements for marriage and family therapists.

new text begin (b) At least four of the 40 continuing education training hours required under Minnesota
Rules, part 5300.0320, subpart 2, must be on increasing the knowledge, understanding,
self-awareness, and practice skills that enable a marriage and family therapist to serve clients
from diverse socioeconomic and cultural backgrounds. Topics include but are not limited
to:
new text end

new text begin (1) understanding culture, its functions, and strengths that exist in varied cultures;
new text end

new text begin (2) understanding clients' cultures and differences among and between cultural groups;
new text end

new text begin (3) understanding the nature of social diversity and oppression; and
new text end

new text begin (4) understanding cultural humility.
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. 10.

Minnesota Statutes 2020, section 148B.51, is amended to read:

148B.51 BOARD OF BEHAVIORAL HEALTH AND THERAPY.

new text begin (a) new text end The Board of Behavioral Health and Therapy consists of 13 members appointed by
the governor. Five of the members shall be professional counselors licensed or eligible for
licensure under sections 148B.50 to 148B.593. Five of the members shall be alcohol and
drug counselors licensed under chapter 148F. Three of the members shall be public members
as defined in section 214.02. The board shall annually elect from its membership a chair
and vice-chair. The board shall appoint and employ an executive director who is not a
member of the board. The employment of the executive director shall be subject to the terms
described in section 214.04, subdivision 2a. Chapter 214 applies to the Board of Behavioral
Health and Therapy unless superseded by sections 148B.50 to 148B.593.

new text begin (b) At the time of their appointments, at least three members must reside outside of the
seven-county metropolitan area.
new text end

new text begin (c) At the time of their appointments, at least three members must be members of:
new text end

new text begin (1) a community of color; or
new text end

new text begin (2) an underrepresented community, defined as a group that is not represented in the
majority with respect to race, ethnicity, national origin, sexual orientation, gender identity,
or physical ability.
new text end

Sec. 11.

Minnesota Statutes 2020, section 148B.54, subdivision 2, is amended to read:

Subd. 2.

Continuing education.

new text begin (a) new text end At the completion of the first four years of licensure,
a licensee must provide evidence satisfactory to the board of completion of 12 additional
postgraduate semester credit hours or its equivalent in counseling as determined by the
board, except that no licensee shall be required to show evidence of greater than 60 semester
hours or its equivalent. In addition to completing the requisite graduate coursework, each
licensee shall also complete in the first four years of licensure a minimum of 40 hours of
continuing education activities approved by the board under Minnesota Rules, part 2150.2540.
Graduate credit hours successfully completed in the first four years of licensure may be
applied to both the graduate credit requirement and to the requirement for 40 hours of
continuing education activities. A licensee may receive 15 continuing education hours per
semester credit hour or ten continuing education hours per quarter credit hour. Thereafter,
at the time of renewal, each licensee shall provide evidence satisfactory to the board that
the licensee has completed during each two-year period at least the equivalent of 40 clock
hours of professional postdegree continuing education in programs approved by the board
and continues to be qualified to practice under sections 148B.50 to 148B.593.

new text begin (b) At least four of the required 40 continuing education clock hours must be on increasing
the knowledge, understanding, self-awareness, and practice skills that enable a licensed
professional counselor and licensed professional clinical counselor to serve clients from
diverse socioeconomic and cultural backgrounds. Topics include but are not limited to:
new text end

new text begin (1) understanding culture, culture's functions, and strengths that exist in varied cultures;
new text end

new text begin (2) understanding clients' cultures and differences among and between cultural groups;
new text end

new text begin (3) understanding the nature of social diversity and oppression; and
new text end

new text begin (4) understanding cultural humility.
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. 12.

Minnesota Statutes 2020, section 148E.010, is amended by adding a subdivision
to read:

new text begin Subd. 7f. new text end

new text begin Cultural responsiveness. new text end

new text begin "Cultural responsiveness" means increasing the
knowledge, understanding, self-awareness, and practice skills that enable a social worker
to serve clients from diverse socioeconomic and cultural backgrounds including:
new text end

new text begin (1) understanding culture, its functions, and strengths that exist in varied cultures;
new text end

new text begin (2) understanding clients' cultures and differences among and between cultural groups;
new text end

new text begin (3) understanding the nature of social diversity and oppression; and
new text end

new text begin (4) understanding cultural humility.
new text end

Sec. 13.

Minnesota Statutes 2020, section 148E.130, subdivision 1, is amended to read:

Subdivision 1.

Total clock hours required.

(a) A licensee must complete 40 hours of
continuing education for each two-year renewal term. At the time of license renewal, a
licensee must provide evidence satisfactory to the board that the licensee has completed the
required continuing education hours during the previous renewal term. Of the total clock
hours required:

(1) all licensees must complete new text begin :
new text end

new text begin (i) new text end two hours in social work ethics as defined in section 148E.010; new text begin and
new text end

new text begin (ii) four hours in cultural responsiveness;
new text end

(2) licensed independent clinical social workers must complete 12 clock hours in one
or more of the clinical content areas specified in section 148E.055, subdivision 5, paragraph
(a), clause (2);

(3) licensees providing licensing supervision according to sections 148E.100 to 148E.125,
must complete six clock hours in supervision as defined in section 148E.010; and

(4) no more than half of the required clock hours may be completed via continuing
education independent learning as defined in section 148E.010.

(b) If the licensee's renewal term is prorated to be less or more than 24 months, the total
number of required clock hours is prorated proportionately.

Sec. 14.

Minnesota Statutes 2020, section 148E.130, is amended by adding a subdivision
to read:

new text begin Subd. 1b. new text end

new text begin New content clock hours required effective July 1, 2021. new text end

new text begin (a) The content
clock hours in subdivision 1, paragraph (a), clause (1), item (ii), apply to all new licenses
issued effective July 1, 2021, under section 148E.055.
new text end

new text begin (b) Any licensee issued a license prior to July 1, 2021, under section 148E.055 must
comply with the clock hours in subdivision 1, including the content clock hours in subdivision
1, paragraph (a), clause (1), item (ii), at the first two-year renewal term after July 1, 2021.
new text end

ARTICLE 5

PRESCRIPTION DRUGS

Section 1.

Minnesota Statutes 2020, section 16A.151, subdivision 2, is amended to read:

Subd. 2.

Exceptions.

(a) If a state official litigates or settles a matter on behalf of specific
injured persons or entities, this section does not prohibit distribution of money to the specific
injured persons or entities on whose behalf the litigation or settlement efforts were initiated.
If money recovered on behalf of injured persons or entities cannot reasonably be distributed
to those persons or entities because they cannot readily be located or identified or because
the cost of distributing the money would outweigh the benefit to the persons or entities, the
money must be paid into the general fund.

(b) Money recovered on behalf of a fund in the state treasury other than the general fund
may be deposited in that fund.

(c) This section does not prohibit a state official from distributing money to a person or
entity other than the state in litigation or potential litigation in which the state is a defendant
or potential defendant.

(d) State agencies may accept funds as directed by a federal court for any restitution or
monetary penalty under United States Code, title 18, section 3663(a)(3), or United States
Code, title 18, section 3663A(a)(3). Funds received must be deposited in a special revenue
account and are appropriated to the commissioner of the agency for the purpose as directed
by the federal court.

(e) Tobacco settlement revenues as defined in section 16A.98, subdivision 1, paragraph
(t), may be deposited as provided in section 16A.98, subdivision 12.

(f) Any money received by the state resulting from a settlement agreement or an assurance
of discontinuance entered into by the attorney general of the state, or a court order in litigation
brought by the attorney general of the state, on behalf of the state or a state agency, deleted text begin against
one or more opioid manufacturers or opioid wholesale drug distributors deleted text end related to alleged
violations of consumer fraud laws in the marketing, sale, or distribution of opioids in this
state or other alleged illegal actions that contributed to the excessive use of opioids, must
be deposited in a separate account in the state treasury and the commissioner shall notify
the chairs and ranking minority members of the Finance Committee in the senate and the
Ways and Means Committee in the house of representatives that an account has been created.
new text begin Notwithstanding section 11A.20, all investment income and all investment losses attributable
to the investment of this account shall be credited to the account. new text end This paragraph does not
apply to attorney fees and costs awarded to the state or the Attorney General's Office, to
contract attorneys hired by the state or Attorney General's Office, or to other state agency
attorneys. If the licensing fees under section 151.065, subdivision 1, clause (16), and
subdivision 3, clause (14), are reduced and the registration fee under section 151.066,
subdivision 3, is repealed in accordance with section 256.043, subdivision 4, then the
commissioner shall transfer from the separate account created in this paragraph to the opiate
epidemic response fund under section 256.043 an amount that ensures that $20,940,000
each fiscal year is available for distribution in accordance with section 256.043, deleted text begin subdivisions
2 and deleted text end new text begin subdivision new text end 3.

new text begin (g) Notwithstanding paragraph (f), if money is received from a settlement agreement or
an assurance of discontinuance entered into by the attorney general of the state or a court
order in litigation brought by the attorney general of the state on behalf of the state or a state
agency against a consulting firm working for an opioid manufacturer or opioid wholesale
drug distributor and deposited into the separate account created under paragraph (f), the
commissioner shall annually transfer from the separate account to the opiate epidemic
response fund under section 256.043 an amount equal to the estimated amount submitted
to the commissioner by the Board of Pharmacy in accordance with section 151.066,
subdivision 3, paragraph (b). The amount transferred shall be included in the amount available
for distribution in accordance with section 256.043, subdivision 3. This transfer shall occur
each year until the registration fee under section 151.066, subdivision 3, is repealed in
accordance with section 256.043, subdivision 4, or the money deposited in the account in
accordance with this paragraph has been transferred, whichever occurs first.
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 151.066, subdivision 3, is amended to read:

Subd. 3.

Determination of an opiate product registration fee.

(a) The board shall
annually assess an opiate product registration fee on any manufacturer of an opiate that
annually sells, delivers, or distributes an opiate within or into the state 2,000,000 or more
units as reported to the board under subdivision 2.

(b) new text begin For purposes of assessing the annual registration fee under this section and
determining the number of opiate units a manufacturer sold, delivered, or distributed within
or into the state, the board shall not consider any opiate that is used for medication-assisted
therapy for substance use disorders. If there is money deposited into the separate account
as described in section 16A.151, subdivision 2, paragraph (g), the board shall submit to the
commissioner of management and budget an estimate of the difference in the annual fee
revenue collected under this section due to this exception.
new text end

new text begin (c) new text end The annual registration fee for each manufacturer meeting the requirement under
paragraph (a) is $250,000.

deleted text begin (c) deleted text end new text begin (d) new text end In conjunction with the data reported under this section, and notwithstanding
section 152.126, subdivision 6, the board may use the data reported under section 152.126,
subdivision 4, to determine which manufacturers meet the requirement under paragraph (a)
and are required to pay the registration fees under this subdivision.

deleted text begin (d) deleted text end new text begin (e) new text end By April 1 of each year, beginning April 1, 2020, the board shall notify a
manufacturer that the manufacturer meets the requirement in paragraph (a) and is required
to pay the annual registration fee in accordance with section 151.252, subdivision 1,
paragraph (b).

deleted text begin (e) deleted text end new text begin (f) new text end A manufacturer may dispute the board's determination that the manufacturer must
pay the registration fee no later than 30 days after the date of notification. However, the
manufacturer must still remit the fee as required by section 151.252, subdivision 1, paragraph
(b). The dispute must be filed with the board in the manner and using the forms specified
by the board. A manufacturer must submit, with the required forms, data satisfactory to the
board that demonstrates that the assessment of the registration fee was incorrect. The board
must make a decision concerning a dispute no later than 60 days after receiving the required
dispute forms. If the board determines that the manufacturer has satisfactorily demonstrated
that the fee was incorrectly assessed, the board must refund the amount paid in error.

deleted text begin (f) deleted text end new text begin (g) new text end For purposes of this subdivision, a unit means the individual dosage form of the
particular drug product that is prescribed to the patient. One unit equals one tablet, capsule,
patch, syringe, milliliter, or gram.

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.

new text begin [151.335] DELIVERY THROUGH COMMON CARRIER; COMPLIANCE
WITH TEMPERATURE REQUIREMENTS.
new text end

new text begin In addition to complying with the requirements of Minnesota Rules, part 6800.3000, a
mail order or specialty pharmacy that employs the United States Postal Service or other
common carrier to deliver a filled prescription directly to a patient must ensure that the drug
is delivered in compliance with temperature requirements established by the manufacturer
of the drug. The pharmacy must develop written policies and procedures that are consistent
with United States Pharmacopeia, chapters 1079 and 1118, and with nationally recognized
standards issued by standard-setting or accreditation organizations recognized by the board
through guidance. The policies and procedures must be provided to the board upon request.
new text end

Sec. 4.

Minnesota Statutes 2020, section 256.043, subdivision 4, is amended to read:

Subd. 4.

Settlement; sunset.

(a) If the state receives a total sum of $250,000,000 either
as a result of a settlement agreement or an assurance of discontinuance entered into by the
attorney general of the state, or resulting from a court order in litigation brought by the
attorney general of the state on behalf of the state or a state agency deleted text begin , against one or more
opioid manufacturers or opioid wholesale drug distributors deleted text end related to alleged violations of
consumer fraud laws in the marketing, sale, or distribution of opioids in this state, or other
alleged illegal actions that contributed to the excessive use of opioids, or from the fees
collected under sections 151.065, subdivisions 1 and 3, and 151.066, that are deposited into
the opiate epidemic response fund established in this section, or from a combination of both,
the fees specified in section 151.065, subdivisions 1, clause (16), and 3, clause (14), shall
be reduced to $5,260, and the opiate registration fee in section 151.066, subdivision 3, shall
be repealed.

(b) The commissioner of management and budget shall inform the Board of Pharmacy,
the governor, and the legislature when the amount specified in paragraph (a) has been
reached. The board shall apply the reduced license fee for the next licensure period.

(c) Notwithstanding paragraph (a), the reduction of the license fee in section 151.065,
subdivisions 1 and 3, and the repeal of the registration fee in section 151.066 shall not occur
before July 1, 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. 5. new text begin STUDY OF TEMPERATURE MONITORING.
new text end

new text begin The Board of Pharmacy shall conduct a study to determine the appropriateness and
feasibility of requiring mail order and specialty pharmacies to enclose in each medication's
packaging a method by which the patient can easily detect improper storage or temperature
variations that may have occurred during the delivery of a medication. The board shall
report the results of the study by January 15, 2022, to the chairs and ranking minority
members of the legislative committees with jurisdiction over health finance and policy.
new text end

Sec. 6. new text begin OPIATE REGISTRATION FEE REDUCTION.
new text end

new text begin (a) For purposes of assessing the opiate registration fee under Minnesota Statutes, section
151.066, subdivision 3, that is required to be paid on June 1, 2021, in accordance with
Minnesota Statutes, section 151.252, subdivision 1, paragraph (b), the Board of Pharmacy
shall not consider any injectable opiate product distributed to a hospital or hospital pharmacy.
If there is money deposited into the separate account as described in Minnesota Statutes,
section 16A.151, subdivision 2, paragraph (g), the board shall submit to the commissioner
of management and budget an estimate of the difference in the annual opiate registration
fee revenue collected under Minnesota Statutes, section 151.066, due to the exception
described in this paragraph.
new text end

new text begin (b) Any estimated loss to the opiate registration fee revenue attributable to paragraph
(a) must be included in any transfer that occurs under Minnesota Statutes, section 16A.151,
subdivision 2, paragraph (g), in calendar year 2021.
new text end

new text begin (c) If a manufacturer has already paid the opiate registration fee due on June 1, 2021,
the Board of Pharmacy shall return the amount of the fee to the manufacturer if the
manufacturer would not have been required to pay the fee after the calculations described
in paragraph (a) were made.
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 6

TELEHEALTH

Section 1.

new text begin [62A.673] COVERAGE OF SERVICES PROVIDED THROUGH
TELEHEALTH.
new text end

new text begin Subdivision 1. new text end

new text begin Citation. new text end

new text begin This section may be cited as the "Minnesota Telehealth Act."
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

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

new text begin (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.
new text end

new text begin (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 as
defined under section 245.462, subdivision 18, or 245.4871, subdivision 27; a mental health
practitioner as defined under section 245.462, subdivision 17, or 245.4871, subdivision 26;
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.
new text end

new text begin (d) "Health carrier" has the meaning given in section 62A.011, subdivision 2.
new text end

new text begin (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.
new text end

new text begin (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.
new text end

new text begin (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.
new text end

new text begin (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).
new text end

new text begin (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 end

new text begin Subd. 3. new text end

new text begin Coverage of telehealth. new text end

new text begin (a) A health plan sold, issued, or renewed by a health
carrier in Minnesota must (1) cover benefits delivered through telehealth in the same manner
as any other benefits covered under the health plan, and (2) comply with this section.
new text end

new text begin (b) Coverage for services delivered through telehealth must not be limited on the basis
of geography, location, or distance for travel subject to the health care provider network
available to the enrollee through the enrollee's health plan.
new text end

new text begin (c) A health carrier must not create a separate provider network to deliver services
through telehealth that does not include network providers who provide in-person care to
patients for the same service or require an enrollee to use a specific provider within the
network to receive services through telehealth.
new text end

new text begin (d) A health carrier may require a deductible, co-payment, or coinsurance payment for
a health care service provided through telehealth, provided that the deductible, co-payment,
or coinsurance payment is not in addition to, and does not exceed, the deductible, co-payment,
or coinsurance applicable for the same service provided through in-person contact.
new text end

new text begin (e) Nothing in this section:
new text end

new text begin (1) requires a health carrier to provide coverage for services that are not medically
necessary or are not covered under the enrollee's health plan; or
new text end

new text begin (2) prohibits a health carrier from:
new text end

new text begin (i) establishing criteria that a health care provider must meet to demonstrate the safety
or efficacy of delivering a particular service through telehealth for which the health carrier
does not already reimburse other health care providers for delivering the service through
telehealth;
new text end

new text begin (ii) establishing reasonable medical management techniques, provided the criteria or
techniques are not unduly burdensome or unreasonable for the particular service; or
new text end

new text begin (iii) requiring documentation or billing practices designed to protect the health carrier
or patient from fraudulent claims, provided the practices are not unduly burdensome or
unreasonable for the particular service.
new text end

new text begin (f) Nothing in this section requires the use of telehealth when a health care provider
determines that the delivery of a health care service through telehealth is not appropriate or
when an enrollee chooses not to receive a health care service through telehealth.
new text end

new text begin Subd. 4. new text end

new text begin Parity between telehealth and in-person services. new text end

new text begin (a) A health carrier must
not restrict or deny coverage of a health care service that is covered under a health plan
solely:
new text end

new text begin (1) because the health care service provided by the health care provider through telehealth
is not provided through in-person contact; or
new text end

new text begin (2) based on the communication technology or application used to deliver the health
care service through telehealth, provided the technology or application complies with this
section and is appropriate for the particular service.
new text end

new text begin (b) Prior authorization may be required for health care services delivered through
telehealth only if prior authorization is required before the delivery of the same service
through in-person contact.
new text end

new text begin (c) A health carrier may require a utilization review for services delivered through
telehealth, provided the utilization review is conducted in the same manner and uses the
same clinical review criteria as a utilization review for the same services delivered through
in-person contact.
new text end

new text begin (d) A health carrier or health care provider shall not require an enrollee to pay a fee to
download a specific communication technology or application.
new text end

new text begin Subd. 5. new text end

new text begin Reimbursement for services delivered through telehealth. new text end

new text begin (a) A health carrier
must reimburse the health care provider for services delivered through telehealth on the
same basis and at the same rate as the health carrier would apply to those services if the
services had been delivered by the health care provider through in-person contact.
new text end

new text begin (b) A health carrier must not deny or limit reimbursement based solely on a health care
provider delivering the service or consultation through telehealth instead of through in-person
contact.
new text end

new text begin (c) A health carrier must not deny or limit reimbursement based solely on the technology
and equipment used by the health care provider to deliver the health care service or
consultation through telehealth, provided the technology and equipment used by the provider
meets the requirements of this section and is appropriate for the particular service.
new text end

new text begin (d) Nothing in this subdivision prohibits a health carrier and health care provider from
entering into a contract that includes a value-based reimbursement arrangement for the
delivery of covered services that may include services delivered through telehealth, and
such an arrangement shall not be considered a violation of this subdivision.
new text end

new text begin Subd. 6. new text end

new text begin Telehealth equipment. new text end

new text begin (a) A health carrier must not require a health care
provider to use specific telecommunications technology and equipment as a condition of
coverage under this section, provided the health care provider uses telecommunications
technology and equipment that complies with current industry interoperable standards and
complies with standards required under the federal Health Insurance Portability and
Accountability Act of 1996, Public Law 104-191, and regulations promulgated under that
Act, unless authorized under this section.
new text end

new text begin (b) A health carrier must provide coverage for health care services delivered through
telehealth by means of the use of audio-only communication if the communication is a
scheduled appointment and the standard of care for that particular service can be met through
the use of audio-only communication. Substance use disorder treatment services and mental
health care services delivered through telehealth by means of audio-only communication
may be covered without a scheduled appointment if the communication was initiated by
the enrollee while in an emergency or crisis situation and a scheduled appointment was not
possible due to the need of an immediate response. This paragraph expires July 1, 2023.
new text end

new text begin Subd. 7. new text end

new text begin Telemonitoring services. new text end

new text begin A health carrier must provide coverage for
telemonitoring services if:
new text end

new text begin (1) the telemonitoring service is medically appropriate based on the enrollee's medical
condition or status;
new text end

new text begin (2) the enrollee is cognitively and physically capable of operating the monitoring device
or equipment, or the enrollee has a caregiver who is willing and able to assist with the
monitoring device or equipment; and
new text end

new text begin (3) the enrollee resides in a setting that is suitable for telemonitoring and not in a setting
that has health care staff on site.
new text end

new text begin Subd. 8. new text end

new text begin Exception. new text end

new text begin This section does not apply to coverage provided to state public
health care program enrollees under chapter 256B or 256L.
new text end

Sec. 2.

Minnesota Statutes 2020, section 147.033, is amended to read:

147.033 PRACTICE OF deleted text begin TELEMEDICINE deleted text end new text begin TELEHEALTH new text end .

Subdivision 1.

Definition.

For the purposes of this section, deleted text begin "telemedicine" means the
delivery of health care services or consultations while the patient is at an originating site
and the licensed health care provider is at a distant site. A communication between licensed
health care providers that consists solely of a telephone conversation, e-mail, or facsimile
transmission does not constitute telemedicine consultations or services. A communication
between a licensed health care provider and a patient that consists solely of an e-mail or
facsimile transmission does not constitute telemedicine consultations or services.
Telemedicine may be provided by means of real-time two-way interactive audio, and visual
communications, including the application of secure video conferencing or store-and-forward
technology to provide or support health care delivery, that facilitate the assessment, diagnosis,
consultation, treatment, education, and care management of a patient's health care. deleted text end new text begin
"telehealth" has the meaning given in section 62A.673, subdivision 2, paragraph (h).
new text end

Subd. 2.

Physician-patient relationship.

A physician-patient relationship may be
established through deleted text begin telemedicine deleted text end new text begin telehealth new text end .

Subd. 3.

Standards of practice and conduct.

A physician providing health care services
by deleted text begin telemedicine deleted text end new text begin telehealth new text end in this state shall be held to the same standards of practice and
conduct as provided in this chapter for in-person health care services.

Sec. 3.

Minnesota Statutes 2020, section 151.37, subdivision 2, is amended to read:

Subd. 2.

Prescribing and filing.

(a) A licensed practitioner in the course of professional
practice only, may prescribe, administer, and dispense a legend drug, and may cause the
same to be administered by a nurse, a physician assistant, or medical student or resident
under the practitioner's direction and supervision, and may cause a person who is an
appropriately certified, registered, or licensed health care professional to prescribe, dispense,
and administer the same within the expressed legal scope of the person's practice as defined
in Minnesota Statutes. A licensed practitioner may prescribe a legend drug, without reference
to a specific patient, by directing a licensed dietitian or licensed nutritionist, pursuant to
section 148.634; a nurse, pursuant to section 148.235, subdivisions 8 and 9; physician
assistant; medical student or resident; or pharmacist according to section 151.01, subdivision
27, to adhere to a particular practice guideline or protocol when treating patients whose
condition falls within such guideline or protocol, and when such guideline or protocol
specifies the circumstances under which the legend drug is to be prescribed and administered.
An individual who verbally, electronically, or otherwise transmits a written, oral, or electronic
order, as an agent of a prescriber, shall not be deemed to have prescribed the legend drug.
This paragraph applies to a physician assistant only if the physician assistant meets the
requirements of deleted text begin section 147A.18 deleted text end new text begin sections 147A.02 and 147A.09 new text end .

(b) The commissioner of health, if a licensed practitioner, or a person designated by the
commissioner who is a licensed practitioner, may prescribe a legend drug to an individual
or by protocol for mass dispensing purposes where the commissioner finds that the conditions
triggering section 144.4197 or 144.4198, subdivision 2, paragraph (b), exist. The
commissioner, if a licensed practitioner, or a designated licensed practitioner, may prescribe,
dispense, or administer a legend drug or other substance listed in subdivision 10 to control
tuberculosis and other communicable diseases. The commissioner may modify state drug
labeling requirements, and medical screening criteria and documentation, where time is
critical and limited labeling and screening are most likely to ensure legend drugs reach the
maximum number of persons in a timely fashion so as to reduce morbidity and mortality.

(c) A licensed practitioner that dispenses for profit a legend drug that is to be administered
orally, is ordinarily dispensed by a pharmacist, and is not a vaccine, must file with the
practitioner's licensing board a statement indicating that the practitioner dispenses legend
drugs for profit, the general circumstances under which the practitioner dispenses for profit,
and the types of legend drugs generally dispensed. It is unlawful to dispense legend drugs
for profit after July 31, 1990, unless the statement has been filed with the appropriate
licensing board. For purposes of this paragraph, "profit" means (1) any amount received by
the practitioner in excess of the acquisition cost of a legend drug for legend drugs that are
purchased in prepackaged form, or (2) any amount received by the practitioner in excess
of the acquisition cost of a legend drug plus the cost of making the drug available if the
legend drug requires compounding, packaging, or other treatment. The statement filed under
this paragraph is public data under section 13.03. This paragraph does not apply to a licensed
doctor of veterinary medicine or a registered pharmacist. Any person other than a licensed
practitioner with the authority to prescribe, dispense, and administer a legend drug under
paragraph (a) shall not dispense for profit. To dispense for profit does not include dispensing
by a community health clinic when the profit from dispensing is used to meet operating
expenses.

(d) A prescription drug order for the following drugs is not valid, unless it can be
established that the prescription drug order was based on a documented patient evaluation,
including an examination, adequate to establish a diagnosis and identify underlying conditions
and contraindications to treatment:

(1) controlled substance drugs listed in section 152.02, subdivisions 3 to 5;

(2) drugs defined by the Board of Pharmacy as controlled substances under section
152.02, subdivisions 7, 8, and 12;

(3) muscle relaxants;

(4) centrally acting analgesics with opioid activity;

(5) drugs containing butalbital; or

(6) phosphodiesterase type 5 inhibitors when used to treat erectile dysfunction.

deleted text begin For purposes of prescribing drugs listed in clause (6), the requirement for a documented
patient evaluation, including an examination, may be met through the use of telemedicine,
as defined in section 147.033, subdivision 1.
deleted text end

(e) For the purposes of paragraph (d), the requirement for an examination shall be met
if new text begin :
new text end

new text begin (1) new text end an in-person examination has been completed in any of the following circumstances:

deleted text begin (1) deleted text end new text begin (i) new text end the prescribing practitioner examines the patient at the time the prescription or
drug order is issued;

deleted text begin (2) deleted text end new text begin (ii) new text end the prescribing practitioner has performed a prior examination of the patient;

deleted text begin (3) deleted text end new text begin (iii) new text end another prescribing practitioner practicing within the same group or clinic as
the prescribing practitioner has examined the patient;

deleted text begin (4) deleted text end new text begin (iv) new text end a consulting practitioner to whom the prescribing practitioner has referred the
patient has examined the patient; or

deleted text begin (5) deleted text end new text begin (v) new text end the referring practitioner has performed an examination in the case of a consultant
practitioner issuing a prescription or drug order when providing services by means of
telemedicine deleted text begin . deleted text end new text begin ; or
new text end

new text begin (2) the prescription order is for a drug listed in paragraph (d), clause (6), or for medication
assisted therapy for a substance use disorder, and the prescribing practitioner has completed
an examination of the patient via telehealth as defined in section 62A.673, subdivision 2,
paragraph (h).
new text end

(f) Nothing in paragraph (d) or (e) prohibits a licensed practitioner from prescribing a
drug through the use of a guideline or protocol pursuant to paragraph (a).

(g) Nothing in this chapter prohibits a licensed practitioner from issuing a prescription
or dispensing a legend drug in accordance with the Expedited Partner Therapy in the
Management of Sexually Transmitted Diseases guidance document issued by the United
States Centers for Disease Control.

(h) Nothing in paragraph (d) or (e) limits prescription, administration, or dispensing of
legend drugs through a public health clinic or other distribution mechanism approved by
the commissioner of health or a community health board in order to prevent, mitigate, or
treat a pandemic illness, infectious disease outbreak, or intentional or accidental release of
a biological, chemical, or radiological agent.

(i) No pharmacist employed by, under contract to, or working for a pharmacy located
within the state and licensed under section 151.19, subdivision 1, may dispense a legend
drug based on a prescription that the pharmacist knows, or would reasonably be expected
to know, is not valid under paragraph (d).

(j) No pharmacist employed by, under contract to, or working for a pharmacy located
outside the state and licensed under section 151.19, subdivision 1, may dispense a legend
drug to a resident of this state based on a prescription that the pharmacist knows, or would
reasonably be expected to know, is not valid under paragraph (d).

(k) Nothing in this chapter prohibits the commissioner of health, if a licensed practitioner,
or, if not a licensed practitioner, a designee of the commissioner who is a licensed
practitioner, from prescribing legend drugs for field-delivered therapy in the treatment of
a communicable disease according to the Centers For Disease Control and Prevention Partner
Services Guidelines.

Sec. 4.

Minnesota Statutes 2020, section 245G.01, subdivision 13, is amended to read:

Subd. 13.

Face-to-face.

"Face-to-face" means two-way, real-time, interactive and visual
communication between a client and a treatment service provider and includes services
delivered in person or via deleted text begin telemedicine deleted text end new text begin telehealth new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, 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 2020, section 245G.01, subdivision 26, is amended to read:

Subd. 26.

deleted text begin Telemedicine deleted text end new text begin Telehealth new text end .

deleted text begin "Telemedicine" deleted text end new text begin "Telehealth" new text end means the delivery
of a substance use disorder treatment service while the client is at an originating site and
the deleted text begin licensed deleted text end health care provider is at a distant site new text begin via telehealth as defined in section
256B.0625, subdivision 3b, and new text end as specified in section 254B.05, subdivision 5, paragraph
(f).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, 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 2020, section 245G.06, subdivision 1, is amended to read:

Subdivision 1.

General.

Each client must have a person-centered individual treatment
plan developed by an alcohol and drug counselor within ten days from the day of service
initiation for a residential program and within five calendar days on which a treatment
session has been provided from the day of service initiation for a client in a nonresidential
program. Opioid treatment programs must complete the individual treatment plan within
21 days from the day of service initiation. The individual treatment plan must be signed by
the client and the alcohol and drug counselor and document the client's involvement in the
development of the plan. The individual treatment plan is developed upon the qualified staff
member's dated signature. Treatment planning must include ongoing assessment of client
needs. An individual treatment plan must be updated based on new information gathered
about the client's condition, the client's level of participation, and on whether methods
identified have the intended effect. A change to the plan must be signed by the client and
the alcohol and drug counselor. If the client chooses to have family or others involved in
treatment services, the client's individual treatment plan must include how the family or
others will be involved in the client's treatment. new text begin If a client is receiving treatment services
or an assessment via telehealth and the alcohol and drug counselor documents the reason
the client's signature cannot be obtained, the alcohol and drug counselor may document the
client's verbal approval or electronic written approval of the treatment plan or change to the
treatment plan in lieu of the client's signature.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021.
new text end

Sec. 7.

Minnesota Statutes 2020, section 254A.19, subdivision 5, is amended to read:

Subd. 5.

Assessment via deleted text begin telemedicine deleted text end new text begin telehealth new text end .

Notwithstanding Minnesota Rules,
part 9530.6615, subpart 3, item A, a chemical use assessment may be conducted via
deleted text begin telemedicine deleted text end new text begin telehealth as defined in section 256B.0625, subdivision 3b new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, 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 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:

(1) outpatient treatment services that are licensed according to sections 245G.01 to
245G.17, or applicable tribal license;

(2) comprehensive assessments provided according to sections 245.4863, paragraph (a),
and 245G.05;

(3) care 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;

(7) medication-assisted therapy plus enhanced treatment services that meet the
requirements of clause (6) and provide nine hours of clinical services each week;

(8) 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 which
provide, respectively, 30, 15, and five hours of clinical services each week;

(9) 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;

(10) 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;

(11) high-intensity residential treatment services that are licensed according to sections
245G.01 to 245G.17 and 245G.21 or applicable tribal license, which 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

(12) 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 programs as defined in section 254B.01, subdivision 4a, or
programs or subprograms serving special populations, if the program or subprogram meets
the following requirements:

(i) is designed to address the unique needs of individuals who share a common language,
racial, ethnic, or social background;

(ii) is governed with significant input from individuals of that specific background; and

(iii) employs individuals to provide individual or group therapy, at least 50 percent of
whom are of that specific background, except when the common social background of the
individuals served is a traumatic brain injury or cognitive disability and the program employs
treatment staff who have the necessary professional training, as approved by the
commissioner, to serve clients with the specific disabilities that the program is designed to
serve;

(3) 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; and

(4) 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) 25 percent of the counseling staff are licensed mental health professionals, as defined
in section 245.462, subdivision 18, clauses (1) to (6), or are students or licensing candidates
under the supervision of a licensed alcohol and drug counselor supervisor and licensed
mental health professional, except that no more than 50 percent of the mental health staff
may be students or licensing candidates with time documented to be directly related to
provisions of co-occurring services;

(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) In order to 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, chemical dependency services that are otherwise covered
as direct face-to-face services may be provided via deleted text begin two-way interactive video deleted text end new text begin telehealth as
defined in section 256B.0625, subdivision 3b new text end . The use of deleted text begin two-way interactive video deleted text end new text begin telehealth
to deliver services new text end 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. deleted text begin The interactive video equipment and
connection must comply with Medicare standards in effect at the time the service is provided.
deleted text end

(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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, 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 2020, section 256B.0621, subdivision 10, is amended to read:

Subd. 10.

Payment rates.

The commissioner shall set payment rates for targeted case
management under this subdivision. Case managers may bill according to the following
criteria:

(1) for relocation targeted case management, case managers may bill for direct case
management activities, including face-to-face contact, telephone contact, and interactive
video contact deleted text begin according to section 256B.0924, subdivision 4a, deleted text end new text begin as defined in section
256B.0625, subdivision 20b, paragraph (f), new text end in the lesser of:

(i) 180 days preceding an eligible recipient's discharge from an institution; or

(ii) the limits and conditions which apply to federal Medicaid funding for this service;

(2) for home care targeted case management, case managers may bill for direct case
management activities, including face-to-face and telephone contacts; and

(3) billings for targeted case management services under this subdivision shall not
duplicate payments made under other program authorities for the same purpose.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, 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. 10.

Minnesota Statutes 2020, section 256B.0622, subdivision 7a, as amended by
Laws 2021, chapter 30, article 17, section 60, is amended to read:

Subd. 7a.

Assertive community treatment team staff requirements and roles.

(a)
The required treatment staff qualifications and roles for an ACT team are:

(1) the team leader:

(i) shall be a mental health professional. Individuals who are not licensed but who are
eligible for licensure and are otherwise qualified may also fulfill this role but must obtain
full licensure within 24 months of assuming the role of team leader;

(ii) must be an active member of the ACT team and provide some direct services to
clients;

(iii) must be a single full-time staff member, dedicated to the ACT team, who is
responsible for overseeing the administrative operations of the team, providing treatment
supervision of services in conjunction with the psychiatrist or psychiatric care provider, and
supervising team members to ensure delivery of best and ethical practices; and

(iv) must be available to provide overall treatment supervision to the ACT team after
regular business hours and on weekends and holidays. The team leader may delegate this
duty to another qualified member of the ACT team;

(2) the psychiatric care provider:

(i) must be a mental health professional permitted to prescribe psychiatric medications
as part of the mental health professional's scope of practice. The psychiatric care provider
must have demonstrated clinical experience working with individuals with serious and
persistent mental illness;

(ii) shall collaborate with the team leader in sharing overall clinical responsibility for
screening and admitting clients; monitoring clients' treatment and team member service
delivery; educating staff on psychiatric and nonpsychiatric medications, their side effects,
and health-related conditions; actively collaborating with nurses; and helping provide
treatment supervision to the team;

(iii) shall fulfill the following functions for assertive community treatment clients:
provide assessment and treatment of clients' symptoms and response to medications, including
side effects; provide brief therapy to clients; provide diagnostic and medication education
to clients, with medication decisions based on shared decision making; monitor clients'
nonpsychiatric medical conditions and nonpsychiatric medications; and conduct home and
community visits;

(iv) shall serve as the point of contact for psychiatric treatment if a client is hospitalized
for mental health treatment and shall communicate directly with the client's inpatient
psychiatric care providers to ensure continuity of care;

(v) shall have a minimum full-time equivalency that is prorated at a rate of 16 hours per
50 clients. Part-time psychiatric care providers shall have designated hours to work on the
team, with sufficient blocks of time on consistent days to carry out the provider's clinical,
supervisory, and administrative responsibilities. No more than two psychiatric care providers
may share this role; new text begin and
new text end

deleted text begin (vi) may not provide specific roles and responsibilities by telemedicine unless approved
by the commissioner; and
deleted text end

deleted text begin (vii) deleted text end new text begin (vi) new text end shall provide psychiatric backup to the program after regular business hours
and on weekends and holidays. The psychiatric care provider may delegate this duty to
another qualified psychiatric provider;

(3) the nursing staff:

(i) shall consist of one to three registered nurses or advanced practice registered nurses,
of whom at least one has a minimum of one-year experience working with adults with
serious mental illness and a working knowledge of psychiatric medications. No more than
two individuals can share a full-time equivalent position;

(ii) are responsible for managing medication, administering and documenting medication
treatment, and managing a secure medication room; and

(iii) shall develop strategies, in collaboration with clients, to maximize taking medications
as prescribed; screen and monitor clients' mental and physical health conditions and
medication side effects; engage in health promotion, prevention, and education activities;
communicate and coordinate services with other medical providers; facilitate the development
of the individual treatment plan for clients assigned; and educate the ACT team in monitoring
psychiatric and physical health symptoms and medication side effects;

(4) the co-occurring disorder specialist:

(i) shall be a full-time equivalent co-occurring disorder specialist who has received
specific training on co-occurring disorders that is consistent with national evidence-based
practices. The training must include practical knowledge of common substances and how
they affect mental illnesses, the ability to assess substance use disorders and the client's
stage of treatment, motivational interviewing, and skills necessary to provide counseling to
clients at all different stages of change and treatment. The co-occurring disorder specialist
may also be an individual who is a licensed alcohol and drug counselor as described in
section 148F.01, subdivision 5, or a counselor who otherwise meets the training, experience,
and other requirements in section 245G.11, subdivision 5. No more than two co-occurring
disorder specialists may occupy this role; and

(ii) shall provide or facilitate the provision of co-occurring disorder treatment to clients.
The co-occurring disorder specialist shall serve as a consultant and educator to fellow ACT
team members on co-occurring disorders;

(5) the vocational specialist:

(i) shall be a full-time vocational specialist who has at least one-year experience providing
employment services or advanced education that involved field training in vocational services
to individuals with mental illness. An individual who does not meet these qualifications
may also serve as the vocational specialist upon completing a training plan approved by the
commissioner;

(ii) shall provide or facilitate the provision of vocational services to clients. The vocational
specialist serves as a consultant and educator to fellow ACT team members on these services;
and

(iii) must not refer individuals to receive any type of vocational services or linkage by
providers outside of the ACT team;

(6) the mental health certified peer specialist:

(i) shall be a full-time equivalent. No more than two individuals can share this position.
The mental health certified peer specialist is a fully integrated team member who provides
highly individualized services in the community and promotes the self-determination and
shared decision-making abilities of clients. This requirement may be waived due to workforce
shortages upon approval of the commissioner;

(ii) must provide coaching, mentoring, and consultation to the clients to promote recovery,
self-advocacy, and self-direction, promote wellness management strategies, and assist clients
in developing advance directives; and

(iii) must model recovery values, attitudes, beliefs, and personal action to encourage
wellness and resilience, provide consultation to team members, promote a culture where
the clients' points of view and preferences are recognized, understood, respected, and
integrated into treatment, and serve in a manner equivalent to other team members;

(7) the program administrative assistant shall be a full-time office-based program
administrative assistant position assigned to solely work with the ACT team, providing a
range of supports to the team, clients, and families; and

(8) additional staff:

(i) shall be based on team size. Additional treatment team staff may include mental
health professionals; clinical trainees; certified rehabilitation specialists; mental health
practitioners; or mental health rehabilitation workers. These individuals shall have the
knowledge, skills, and abilities required by the population served to carry out rehabilitation
and support functions; and

(ii) shall be selected based on specific program needs or the population served.

(b) Each ACT team must clearly document schedules for all ACT team members.

(c) Each ACT team member must serve as a primary team member for clients assigned
by the team leader and are responsible for facilitating the individual treatment plan process
for those clients. The primary team member for a client is the responsible team member
knowledgeable about the client's life and circumstances and writes the individual treatment
plan. The primary team member provides individual supportive therapy or counseling, and
provides primary support and education to the client's family and support system.

(d) Members of the ACT team must have strong clinical skills, professional qualifications,
experience, and competency to provide a full breadth of rehabilitation services. Each staff
member shall be proficient in their respective discipline and be able to work collaboratively
as a member of a multidisciplinary team to deliver the majority of the treatment,
rehabilitation, and support services clients require to fully benefit from receiving assertive
community treatment.

(e) Each ACT team member must fulfill training requirements established by the
commissioner.

Sec. 11.

Minnesota Statutes 2020, section 256B.0625, subdivision 3b, as amended by
Laws 2021, chapter 30, article 17, section 71, is amended to read:

Subd. 3b.

deleted text begin Telemedicine deleted text end new text begin Telehealth new text end services.

(a) Medical assistance covers medically
necessary services and consultations delivered by a deleted text begin licensed deleted text end health care provider deleted text begin via
telemedicine deleted text end new text begin through telehealth new text end in the same manner as if the service or consultation was
delivered deleted text begin in person deleted text end new text begin through in-person contact new text end . deleted text begin Coverage is limited to three telemedicine
services per enrollee per calendar week, except as provided in paragraph (f). Telemedicine deleted text end
Services new text begin or consultations delivered through telehealth new text end shall be paid at the full allowable
rate.

(b) The commissioner deleted text begin shall deleted text end new text begin may new text end establish criteria that a health care provider must attest
to in order to demonstrate the safety or efficacy of delivering a particular service deleted text begin via
telemedicine deleted text end new text begin through telehealth new text end . The attestation may include that the health care provider:

(1) has identified the categories or types of services the health care provider will provide
deleted text begin via telemedicine deleted text end new text begin through telehealth new text end ;

(2) has written policies and procedures specific to deleted text begin telemedicine deleted text end services new text begin delivered through
telehealth new text end that are regularly reviewed and updated;

(3) has policies and procedures that adequately address patient safety before, during,
and after the deleted text begin telemedicine deleted text end service is deleted text begin rendered deleted text end new text begin delivered through telehealth new text end ;

(4) has established protocols addressing how and when to discontinue telemedicine
services; and

(5) has an established quality assurance process related to deleted text begin telemedicine deleted text end new text begin delivering new text end services new text begin
through telehealth new text end .

(c) As a condition of payment, a licensed health care provider must document each
occurrence of a health service deleted text begin provided by telemedicine deleted text end new text begin delivered through telehealth new text end to a
medical assistance enrollee. Health care service records for services deleted text begin provided by telemedicine deleted text end new text begin
delivered through telehealth new text end must meet the requirements set forth in Minnesota Rules, part
9505.2175, subparts 1 and 2, and must document:

(1) the type of service deleted text begin provided by telemedicine deleted text end new text begin delivered through telehealth new text end ;

(2) the time the service began and the time the service ended, including an a.m. and p.m.
designation;

(3) the deleted text begin licensed deleted text end health care provider's basis for determining that deleted text begin telemedicine deleted text end new text begin telehealth new text end
is an appropriate and effective means for delivering the service to the enrollee;

(4) the mode of transmission deleted text begin of deleted text end new text begin used to deliver new text end the deleted text begin telemedicine deleted text end service new text begin through telehealth
new text end 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 deleted text begin telemedicine deleted text end consultation with
another physician new text begin through telehealth new text end , the written opinion from the consulting physician
providing the deleted text begin telemedicine deleted text end new text begin telehealth new text end consultation; and

(7) compliance with the criteria attested to by the health care provider in accordance
with paragraph (b).

new text begin (d) Telehealth visits, as described in this subdivision provided through audio and visual
communication, may be used to 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.
new text end

new 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.
new text end

deleted text begin (d) deleted text end new text begin (f) new text end For purposes of this subdivision, unless otherwise covered under this chapter deleted text begin ,
"telemedicine" is defined as the delivery of health care services or consultations while the
patient is at an originating site and the licensed health care provider is at a distant site. A
communication between licensed health care providers, or a licensed health care provider
and a patient that consists solely of a telephone conversation, e-mail, or facsimile transmission
does not constitute telemedicine consultations or services. Telemedicine may be provided
by means of real-time two-way, interactive audio and visual communications, including the
application of secure video conferencing or store-and-forward technology to provide or
support health care delivery, which facilitate the assessment, diagnosis, consultation,
treatment, education, and care management of a patient's health care. deleted text end new text begin :
new text end

new text begin (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 specified by law;
new text end

deleted text begin (e) For purposes of this section, "licensed deleted text end new text begin (2) " new text end health care provider" means a deleted text begin licensed deleted text end
health care provider deleted text begin under section 62A.671, subdivision 6 deleted text end new text begin as defined under section 62A.673 new text end ,
a community paramedic as defined under section 144E.001, subdivision 5f, deleted text begin a clinical trainee
who is qualified according to section 245I.04, subdivision 6, a mental health practitioner
qualified according to section 245I.04, subdivision 4, and deleted text end a community health worker who
meets the criteria under subdivision 49, paragraph (a) deleted text begin ; "health care provider" is defined
under section 62A.671, subdivision 3 deleted text end new text begin , a mental health certified peer specialist under section
256B.0615, subdivision 5, a mental health certified family peer specialist under section
256B.0616, subdivision 5, a mental health rehabilitation worker under section 256B.0623,
subdivision 5, paragraph (a), clause (4), and paragraph (b), a mental health behavioral aide
under section 256B.0943, subdivision 7, paragraph (b), clause (3), 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 new text end ; and

new text begin (3) new text end "originating site new text begin , new text end " deleted text begin is defined under section 62A.671, subdivision 7 deleted text end new text begin "distant site," and
"store-and-forward technology" have the meanings given in section 62A.673, subdivision
2 new text end .

deleted text begin (f) The limit on coverage of three telemedicine services per enrollee per calendar week
does not apply if:
deleted text end

deleted text begin (1) the telemedicine services provided by the licensed health care provider are for the
treatment and control of tuberculosis; and
deleted text end

deleted text begin (2) the services are provided in a manner consistent with the recommendations and best
practices specified by the Centers for Disease Control and Prevention and the commissioner
of health.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, 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 256B.0625, is amended by adding a subdivision
to read:

new text begin Subd. 3h. new text end

new text begin Telemonitoring services. new text end

new text begin (a) Medical assistance covers telemonitoring services
if:
new text end

new text begin (1) the telemonitoring service is medically appropriate based on the recipient's medical
condition or status;
new text end

new text begin (2) the recipient's health care provider has identified that telemonitoring services would
likely prevent the recipient's admission or readmission to a hospital, emergency room, or
nursing facility;
new text end

new text begin (3) the recipient is cognitively and physically capable of operating the monitoring device
or equipment, or the recipient has a caregiver who is willing and able to assist with the
monitoring device or equipment; and
new text end

new text begin (4) the recipient resides in a setting that is suitable for telemonitoring and not in a setting
that has health care staff on site.
new text end

new text begin (b) For purposes of this subdivision, "telemonitoring services" means the remote
monitoring of data related to a recipient's vital signs or biometric data by a monitoring
device or equipment that transmits the data electronically to a provider for analysis. The
assessment and monitoring of the health data transmitted by telemonitoring must be
performed by one of the following licensed health care professionals: physician, podiatrist,
registered nurse, advanced practice registered nurse, physician assistant, respiratory therapist,
or licensed professional working under the supervision of a medical director.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, 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. 13.

Minnesota Statutes 2020, section 256B.0625, subdivision 13h, is amended to
read:

Subd. 13h.

Medication therapy management services.

(a) Medical assistance covers
medication therapy management services for a recipient taking prescriptions to treat or
prevent one or more chronic medical conditions. For purposes of this subdivision,
"medication therapy management" means the provision of the following pharmaceutical
care services by a licensed pharmacist to optimize the therapeutic outcomes of the patient's
medications:

(1) performing or obtaining necessary assessments of the patient's health status;

(2) formulating a medication treatment plan, which may include prescribing medications
or products in accordance with section 151.37, subdivision 14, 15, or 16;

(3) monitoring and evaluating the patient's response to therapy, including safety and
effectiveness;

(4) performing a comprehensive medication review to identify, resolve, and prevent
medication-related problems, including adverse drug events;

(5) documenting the care delivered and communicating essential information to the
patient's other primary care providers;

(6) providing verbal education and training designed to enhance patient understanding
and appropriate use of the patient's medications;

(7) providing information, support services, and resources designed to enhance patient
adherence with the patient's therapeutic regimens; and

(8) coordinating and integrating medication therapy management services within the
broader health care management services being provided to the patient.

Nothing in this subdivision shall be construed to expand or modify the scope of practice of
the pharmacist as defined in section 151.01, subdivision 27.

(b) To be eligible for reimbursement for services under this subdivision, a pharmacist
must meet the following requirements:

(1) have a valid license issued by the Board of Pharmacy of the state in which the
medication therapy management service is being performed;

(2) have graduated from an accredited college of pharmacy on or after May 1996, or
completed a structured and comprehensive education program approved by the Board of
Pharmacy and the American Council of Pharmaceutical Education for the provision and
documentation of pharmaceutical care management services that has both clinical and
didactic elements; new text begin and
new text end

deleted text begin (3) be practicing in an ambulatory care setting as part of a multidisciplinary team or
have developed a structured patient care process that is offered in a private or semiprivate
patient care area that is separate from the commercial business that also occurs in the setting,
or in home settings, including long-term care settings, group homes, and facilities providing
assisted living services, but excluding skilled nursing facilities; and
deleted text end

deleted text begin (4) deleted text end new text begin (3) new text end make use of an electronic patient record system that meets state standards.

(c) For purposes of reimbursement for medication therapy management services, the
commissioner may enroll individual pharmacists as medical assistance providers. The
commissioner may also establish deleted text begin contact requirements between the pharmacist and recipient,
including limiting deleted text end new text begin limits on new text end the number of reimbursable consultations per recipient.

(d) deleted text begin If there are no pharmacists who meet the requirements of paragraph (b) practicing
within a reasonable geographic distance of the patient, a pharmacist who meets the
requirements may provide The deleted text end new text begin Medication therapy management new text end services new text begin may be provided
new text end via deleted text begin two-way interactive video deleted text end new text begin telehealth as defined in subdivision 3b and may be delivered
into a patient's residence new text end . Reimbursement shall be at the same rates and under the same
conditions that would otherwise apply to the services provided. To qualify for reimbursement
under this paragraph, the pharmacist providing the services must meet the requirements of
paragraph (b) deleted text begin , and must be located within an ambulatory care setting that meets the
requirements of paragraph (b), clause (3). The patient must also be located within an
ambulatory care setting that meets the requirements of paragraph (b), clause (3). Services
provided under this paragraph may not be transmitted into the patient's residence deleted text end .

deleted text begin (e) Medication therapy management services may be delivered into a patient's residence
via secure interactive video if the medication therapy management services are performed
electronically during a covered home care visit by an enrolled provider. Reimbursement
shall be at the same rates and under the same conditions that would otherwise apply to the
services provided. To qualify for reimbursement under this paragraph, the pharmacist
providing the services must meet the requirements of paragraph (b) and must be located
within an ambulatory care setting that meets the requirements of paragraph (b), clause (3).
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, 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. 14.

Minnesota Statutes 2020, section 256B.0625, subdivision 20, is amended to read:

Subd. 20.

Mental health case management.

(a) To the extent authorized by rule of the
state agency, medical assistance covers case management services to persons with serious
and persistent mental illness and children with severe emotional disturbance. Services
provided under this section must meet the relevant standards in sections 245.461 to 245.4887,
the Comprehensive Adult and Children's Mental Health Acts, Minnesota Rules, parts
9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.

(b) Entities meeting program standards set out in rules governing family community
support services as defined in section 245.4871, subdivision 17, are eligible for medical
assistance reimbursement for case management services for children with severe emotional
disturbance when these services meet the program standards in Minnesota Rules, parts
9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.

(c) Medical assistance and MinnesotaCare payment for mental health case management
shall be made on a monthly basis. In order to receive payment for an eligible child, the
provider must document at least a face-to-face contact new text begin either in person or by interactive
video that meets the requirements of subdivision 20b new text end with the child, the child's parents, or
the child's legal representative. To receive payment for an eligible adult, the provider must
document:

(1) at least a face-to-face contact with the adult or the adult's legal representative deleted text begin or a
contact by interactive video deleted text end new text begin either in person or by interactive video new text end that meets the
requirements of subdivision 20b; or

(2) at least a telephone contact with the adult or the adult's legal representative and
document a face-to-face contact deleted text begin or a contact by interactive video deleted text end new text begin either in person or by
interactive video new text end that meets the requirements of subdivision 20b with the adult or the adult's
legal representative within the preceding two months.

(d) Payment for mental health case management provided by county or state staff shall
be based on the monthly rate methodology under section 256B.094, subdivision 6, paragraph
(b), with separate rates calculated for child welfare and mental health, and within mental
health, separate rates for children and adults.

(e) Payment for mental health case management provided by Indian health services or
by agencies operated by Indian tribes may be made according to this section or other relevant
federally approved rate setting methodology.

(f) Payment for mental health case management provided by vendors who contract with
a county or Indian tribe shall be based on a monthly rate negotiated by the host county or
tribe. The negotiated rate must not exceed the rate charged by the vendor for the same
service to other payers. If the service is provided by a team of contracted vendors, the county
or tribe may negotiate a team rate with a vendor who is a member of the team. The team
shall determine how to distribute the rate among its members. No reimbursement received
by contracted vendors shall be returned to the county or tribe, except to reimburse the county
or tribe for advance funding provided by the county or tribe to the vendor.

(g) If the service is provided by a team which includes contracted vendors, tribal staff,
and county or state staff, the costs for county or state staff participation in the team shall be
included in the rate for county-provided services. In this case, the contracted vendor, the
tribal agency, and the county may each receive separate payment for services provided by
each entity in the same month. In order to prevent duplication of services, each entity must
document, in the recipient's file, the need for team case management and a description of
the roles of the team members.

(h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for
mental health case management shall be provided by the recipient's county of responsibility,
as defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds
used to match other federal funds. If the service is provided by a tribal agency, the nonfederal
share, if any, shall be provided by the recipient's tribe. When this service is paid by the state
without a federal share through fee-for-service, 50 percent of the cost shall be provided by
the recipient's county of responsibility.

(i) Notwithstanding any administrative rule to the contrary, prepaid medical assistance
and MinnesotaCare include mental health case management. When the service is provided
through prepaid capitation, the nonfederal share is paid by the state and the county pays no
share.

(j) The commissioner may suspend, reduce, or terminate the reimbursement to a provider
that does not meet the reporting or other requirements of this section. The county of
responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal agency,
is responsible for any federal disallowances. The county or tribe may share this responsibility
with its contracted vendors.

(k) The commissioner shall set aside a portion of the federal funds earned for county
expenditures under this section to repay the special revenue maximization account under
section 256.01, subdivision 2, paragraph (o). The repayment is limited to:

(1) the costs of developing and implementing this section; and

(2) programming the information systems.

(l) Payments to counties and tribal agencies for case management expenditures under
this section shall only be made from federal earnings from services provided under this
section. When this service is paid by the state without a federal share through fee-for-service,
50 percent of the cost shall be provided by the state. Payments to county-contracted vendors
shall include the federal earnings, the state share, and the county share.

(m) Case management services under this subdivision do not include therapy, treatment,
legal, or outreach services.

(n) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital,
and the recipient's institutional care is paid by medical assistance, payment for case
management services under this subdivision is limited to the lesser of:

(1) the last 180 days of the recipient's residency in that facility and may not exceed more
than six months in a calendar year; or

(2) the limits and conditions which apply to federal Medicaid funding for this service.

(o) Payment for case management services under this subdivision shall not duplicate
payments made under other program authorities for the same purpose.

(p) If the recipient is receiving care in a hospital, nursing facility, or residential setting
licensed under chapter 245A or 245D that is staffed 24 hours a day, seven days a week,
mental health targeted case management services must actively support identification of
community alternatives for the recipient and discharge planning.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, 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. 15.

Minnesota Statutes 2020, section 256B.0625, subdivision 20b, is amended to
read:

Subd. 20b.

deleted text begin Mental health deleted text end Targeted case management through interactive video.

(a)
deleted text begin Subject to federal approval, contact made for targeted case management by interactive video
shall be eligible for payment if: deleted text end new text begin Minimum required face-to-face contacts for targeted case
management may be provided through interactive video if interactive video is in the best
interests of the person and is deemed appropriate by the person receiving targeted case
management or the person's legal guardian and the case management provider.
new text end

deleted text begin (1) the person receiving targeted case management services is residing in:
deleted text end

deleted text begin (i) a hospital;
deleted text end

deleted text begin (ii) a nursing facility; or
deleted text end

deleted text begin (iii) a residential setting licensed under chapter 245A or 245D or a boarding and lodging
establishment or lodging establishment that provides supportive services or health supervision
services according to section 157.17 that is staffed 24 hours a day, seven days a week;
deleted text end

deleted text begin (2) interactive video is in the best interests of the person and is deemed appropriate by
the person receiving targeted case management or the person's legal guardian, the case
management provider, and the provider operating the setting where the person is residing;
deleted text end

deleted text begin (3) the use of interactive video is approved as part of the person's written personal service
or case plan, taking into consideration the person's vulnerability and active personal
relationships; and
deleted text end

deleted text begin (4) interactive video is used for up to, but not more than, 50 percent of the minimum
required face-to-face contact.
deleted text end

(b) The person receiving targeted case management or the person's legal guardian has
the right to choose and consent to the use of interactive video under this subdivision and
has the right to refuse the use of interactive video at any time.

(c) The commissioner deleted text begin shall deleted text end new text begin may new text end establish criteria that a targeted case management
provider must attest to in order to demonstrate the safety or efficacy of deleted text begin delivering the service
via interactive video. The attestation may include that the case management provider has: deleted text end new text begin
meeting the minimum face-to-face contact requirements for targeted case management
through interactive video.
new text end

deleted text begin (1) written policies and procedures specific to interactive video services that are regularly
reviewed and updated;
deleted text end

deleted text begin (2) policies and procedures that adequately address client safety before, during, and after
the interactive video services are rendered;
deleted text end

deleted text begin (3) established protocols addressing how and when to discontinue interactive video
services; and
deleted text end

deleted text begin (4) established a quality assurance process related to interactive video services.
deleted text end

(d) As a condition of payment, the targeted case management provider must document
the following for each occurrence of targeted case management provided by interactive
video new text begin for the purpose of face-to-face contact new text end :

(1) the time the deleted text begin service deleted text end new text begin contact new text end began and the time the deleted text begin service deleted text end new text begin contact new text end ended, including
an a.m. and p.m. designation;

(2) the basis for determining that interactive video is an appropriate and effective means
for deleted text begin delivering the service to deleted text end new text begin contacting new text end the person receiving new text begin targeted new text end case management
services;

(3) the mode of transmission deleted text begin of the interactive video deleted text end new text begin used to deliver the new text end services and
records deleted text begin evidencing deleted text end new text begin stating new text end that a particular mode of transmission was utilized; new text begin and
new text end

(4) the location of the originating site and the distant site deleted text begin ; and deleted text end new text begin .
new text end

deleted text begin (5) compliance with the criteria attested to by the targeted case management provider
as provided in paragraph (c).
deleted text end

new text begin (e) Interactive video must not be used to meet minimum face-to-face contact requirements
for children who are in out-of-home placement or receiving case management services for
child protection reasons.
new text end

new text begin (f) For purposes of this subdivision, "interactive video" means the delivery of targeted
case management services in real time through the use of two-way interactive audio and
visual communication.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, 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.0625, subdivision 46, is amended to read:

Subd. 46.

Mental health deleted text begin telemedicine deleted text end new text begin telehealth new text end .

deleted text begin Effective January 1, 2006, and deleted text end Subject
to federal approval, mental health services that are otherwise covered by medical assistance
as direct face-to-face services may be provided via deleted text begin two-way interactive video deleted text end new text begin telehealth in
accordance with subdivision 3b new text end . deleted text begin Use of two-way interactive video must be medically
appropriate to the condition and needs of the person being served. Reimbursement is at the
same rates and under the same conditions that would otherwise apply to the service. The
interactive video equipment and connection must comply with Medicare standards in effect
at the time the service is provided.
deleted text end

Sec. 17.

Minnesota Statutes 2020, section 256B.0911, subdivision 1a, is amended to read:

Subd. 1a.

Definitions.

For purposes of this section, the following definitions apply:

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

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

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

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

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

(5) deleted text begin face-to-face deleted text end long-term care consultation assessments new text begin conducted according to
subdivision 3a new text end , which may be completed in a hospital, nursing facility, intermediate care
facility for persons with developmental disabilities (ICF/DDs), regional treatment centers,
or the person's current or planned residence;

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

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

(8) providing access to assistance to transition people back to community settings after
institutional admission;

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

(10) providing information about independent living to ensure that an informed choice
about independent living can be made; and

(11) providing information about self-directed services and supports, including
self-directed funding options, to ensure that an informed choice about self-directed options
can be made.

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

(1) service eligibility determination for the following state plan services:

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

(ii) consumer support grants under section 256.476; or

(iii) community first services and supports under section 256B.85;

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

(i) relocation targeted case management services available under section 256B.0621,
subdivision 2, clause (4);

(ii) case management services targeted to vulnerable adults or developmental disabilities
under section 256B.0924; and

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

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

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

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

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

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

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

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

(h) "Available service and setting options" or "available options," with respect to the
home and community-based waivers under chapter 256S and sections 256B.092 and 256B.49,
means all services and settings defined under the waiver plan for which a waiver applicant
or waiver participant is eligible.

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

Sec. 18.

Minnesota Statutes 2020, section 256B.0911, subdivision 3a, as amended by
Laws 2021, chapter 30, article 12, section 2, 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 in order to determine waiver or alternative care program eligibility,
must be visited by a long-term care consultation team within 20 calendar days after the date
on which an assessment was requested or recommended. Upon statewide implementation
of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person
requesting personal care assistance services. The commissioner shall provide at least a
90-day notice to lead agencies prior to the effective date of this requirement. deleted text begin Face-to-face deleted text end
Assessments must be conducted according to paragraphs (b) to deleted text begin (i) deleted text end new text begin (r) new text end .

(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) new text begin Except as provided in paragraph (r), new text end 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 elderly waiver customized
living or adult day services under chapter 256S, with the permission of the person being
assessed or the person's designated or legal representative, the client's current or proposed
provider of services may submit a copy of the provider's nursing assessment or written
report outlining its recommendations regarding the client's care needs. The person conducting
the assessment must notify the provider of the date by which this information is to be
submitted. This information shall be provided to the person conducting the assessment prior
to the assessment. For a person who is to be assessed for waiver services under section
256B.092 or 256B.49, with the permission of the person being assessed or the person's
designated legal representative, the person's current provider of services may submit a
written report outlining recommendations regarding the person's care needs the person
completed in consultation with someone who is known to the person and has interaction
with the person on a regular basis. The provider must submit the report at least 60 days
before the end of the person's current service agreement. The certified assessor must consider
the content of the submitted report prior to finalizing the person's assessment or reassessment.

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

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

(g) The written community support plan must include:

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

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

(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) deleted text begin Face-to-face deleted text end new text begin An new text end assessment new text begin that is new text end 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 new text begin the
new text end 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 deleted text begin face-to-face deleted text end
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.

new text begin (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 reassessed, or
the person's legal representative, 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. 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.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, 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.0911, subdivision 3f, is amended to read:

Subd. 3f.

Long-term care reassessments and community support plan updates.

(a)
Prior to a deleted text begin face-to-face deleted text end 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. deleted text begin Face-to-face deleted text end 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.

Sec. 20.

Minnesota Statutes 2020, section 256B.0924, subdivision 6, is amended to read:

Subd. 6.

Payment for targeted case management.

(a) Medical assistance and
MinnesotaCare payment for targeted case management shall be made on a monthly basis.
In order to receive payment for an eligible adult, the provider must document at least one
contact per month and not more than two consecutive months without a face-to-face contact
new text begin either in person or by interactive video that meets the requirements in section 256B.0625,
subdivision 20b new text end with the adult or the adult's legal representative, family, primary caregiver,
or other relevant persons identified as necessary to the development or implementation of
the goals of the personal service plan.

(b) Payment for targeted case management provided by county staff under this subdivision
shall be based on the monthly rate methodology under section 256B.094, subdivision 6,
paragraph (b), calculated as one combined average rate together with adult mental health
case management under section 256B.0625, subdivision 20, except for calendar year 2002.
In calendar year 2002, the rate for case management under this section shall be the same as
the rate for adult mental health case management in effect as of December 31, 2001. Billing
and payment must identify the recipient's primary population group to allow tracking of
revenues.

(c) Payment for targeted case management provided by county-contracted vendors shall
be based on a monthly rate negotiated by the host county. The negotiated rate must not
exceed the rate charged by the vendor for the same service to other payers. If the service is
provided by a team of contracted vendors, the county may negotiate a team rate with a
vendor who is a member of the team. The team shall determine how to distribute the rate
among its members. No reimbursement received by contracted vendors shall be returned
to the county, except to reimburse the county for advance funding provided by the county
to the vendor.

(d) If the service is provided by a team that includes contracted vendors and county staff,
the costs for county staff participation on the team shall be included in the rate for
county-provided services. In this case, the contracted vendor and the county may each
receive separate payment for services provided by each entity in the same month. In order
to prevent duplication of services, the county must document, in the recipient's file, the need
for team targeted case management and a description of the different roles of the team
members.

(e) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for
targeted case management shall be provided by the recipient's county of responsibility, as
defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds
used to match other federal funds.

(f) The commissioner may suspend, reduce, or terminate reimbursement to a provider
that does not meet the reporting or other requirements of this section. The county of
responsibility, as defined in sections 256G.01 to 256G.12, is responsible for any federal
disallowances. The county may share this responsibility with its contracted vendors.

(g) The commissioner shall set aside five percent of the federal funds received under
this section for use in reimbursing the state for costs of developing and implementing this
section.

(h) Payments to counties for targeted case management expenditures under this section
shall only be made from federal earnings from services provided under this section. Payments
to contracted vendors shall include both the federal earnings and the county share.

(i) Notwithstanding section 256B.041, county payments for the cost of case management
services provided by county staff shall not be made to the commissioner of management
and budget. For the purposes of targeted case management services provided by county
staff under this section, the centralized disbursement of payments to counties under section
256B.041 consists only of federal earnings from services provided under this section.

(j) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital,
and the recipient's institutional care is paid by medical assistance, payment for targeted case
management services under this subdivision is limited to the lesser of:

(1) the last 180 days of the recipient's residency in that facility; or

(2) the limits and conditions which apply to federal Medicaid funding for this service.

(k) Payment for targeted case management services under this subdivision shall not
duplicate payments made under other program authorities for the same purpose.

(l) Any growth in targeted case management services and cost increases under this
section shall be the responsibility of the counties.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, 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.094, subdivision 6, is amended to read:

Subd. 6.

Medical assistance reimbursement of case management services.

(a) Medical
assistance reimbursement for services under this section shall be made on a monthly basis.
Payment is based on face-to-face new text begin contacts either in person or by interactive video, new text end or
telephone contacts between the case manager and the client, client's family, primary caregiver,
legal representative, or other relevant person identified as necessary to the development or
implementation of the goals of the individual service plan regarding the status of the client,
the individual service plan, or the goals for the client. These contacts must meet the deleted text begin minimum
standards in clauses (1) and (2) deleted text end new text begin following requirements new text end :

(1) there must be a face-to-face contact new text begin either in person or by interactive video that meets
the requirements of section 256B.0625, subdivision 20b, new text end at least once a month except as
provided in clause (2); and

(2) for a client placed outside of the county of financial responsibility, or a client served
by tribal social services placed outside the reservation, in an excluded time facility under
section 256G.02, subdivision 6, or through the Interstate Compact for the Placement of
Children, section 260.93, and the placement in either case is more than 60 miles beyond
the county or reservation boundaries, there must be at least one contact per month and not
more than two consecutive months without a face-to-face new text begin , in-person new text end contact.

(b) Except as provided under paragraph (c), the payment rate is established using time
study data on activities of provider service staff and reports required under sections 245.482
and 256.01, subdivision 2, paragraph (p).

(c) Payments for tribes may be made according to section 256B.0625 or other relevant
federally approved rate setting methodology for child welfare targeted case management
provided by Indian health services and facilities operated by a tribe or tribal organization.

(d) Payment for case management provided by county or tribal social services contracted
vendors shall be based on a monthly rate negotiated by the host county or tribal social
services. The negotiated rate must not exceed the rate charged by the vendor for the same
service to other payers. If the service is provided by a team of contracted vendors, the county
or tribal social services may negotiate a team rate with a vendor who is a member of the
team. The team shall determine how to distribute the rate among its members. No
reimbursement received by contracted vendors shall be returned to the county or tribal social
services, except to reimburse the county or tribal social services for advance funding provided
by the county or tribal social services to the vendor.

(e) If the service is provided by a team that includes contracted vendors and county or
tribal social services staff, the costs for county or tribal social services staff participation in
the team shall be included in the rate for county or tribal social services provided services.
In this case, the contracted vendor and the county or tribal social services may each receive
separate payment for services provided by each entity in the same month. To prevent
duplication of services, each entity must document, in the recipient's file, the need for team
case management and a description of the roles and services of the team members.

Separate payment rates may be established for different groups of providers to maximize
reimbursement as determined by the commissioner. The payment rate will be reviewed
annually and revised periodically to be consistent with the most recent time study and other
data. Payment for services will be made upon submission of a valid claim and verification
of proper documentation described in subdivision 7. Federal administrative revenue earned
through the time study, or under paragraph (c), shall be distributed according to earnings,
to counties, reservations, or groups of counties or reservations which have the same payment
rate under this subdivision, and to the group of counties or reservations which are not
certified providers under section 256F.10. The commissioner shall modify the requirements
set out in Minnesota Rules, parts 9550.0300 to 9550.0370, as necessary to accomplish this.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, 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 2020, section 256B.0943, subdivision 1, as amended by Laws
2021, chapter 30, article 17, section 81, is amended to read:

Subdivision 1.

Definitions.

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

(a) "Children's therapeutic services and supports" means the flexible package of mental
health services for children who require varying therapeutic and rehabilitative levels of
intervention to treat a diagnosed emotional disturbance, as defined in section 245.4871,
subdivision 15, or a diagnosed mental illness, as defined in section 245.462, subdivision
20. The services are time-limited interventions that are delivered using various treatment
modalities and combinations of services designed to reach treatment outcomes identified
in the individual treatment plan.

(b) "Clinical trainee" means a staff person who is qualified according to section 245I.04,
subdivision 6.

(c) "Crisis planning " has the meaning given in section 245.4871, subdivision 9a.

(d) "Culturally competent provider" means a provider who understands and can utilize
to a client's benefit the client's culture when providing services to the client. A provider
may be culturally competent because the provider is of the same cultural or ethnic group
as the client or the provider has developed the knowledge and skills through training and
experience to provide services to culturally diverse clients.

(e) "Day treatment program" for children means a site-based structured mental health
program consisting of psychotherapy for three or more individuals and individual or group
skills training provided by a team, under the treatment supervision of a mental health
professional.

(f) " Standard diagnostic assessment" means the assessment described in 245I.10,
subdivision 6.

(g) "Direct service time" means the time that a mental health professional, clinical trainee,
mental health practitioner, or mental health behavioral aide spends face-to-face with a client
and the client's family or providing covered deleted text begin telemedicine deleted text end services new text begin through telehealth as
defined under section 256B.0625, subdivision 3b new text end . Direct service time includes time in which
the provider obtains a client's history, develops a client's treatment plan, records individual
treatment outcomes, or provides service components of children's therapeutic services and
supports. Direct service time does not include time doing work before and after providing
direct services, including scheduling or maintaining clinical records.

(h) "Direction of mental health behavioral aide" means the activities of a mental health
professional, clinical trainee, or mental health practitioner in guiding the mental health
behavioral aide in providing services to a client. The direction of a mental health behavioral
aide must be based on the client's individual treatment plan and meet the requirements in
subdivision 6, paragraph (b), clause (5).

(i) "Emotional disturbance" has the meaning given in section 245.4871, subdivision 15.

(j) "Individual behavioral plan" means a plan of intervention, treatment, and services
for a child written by a mental health professional or a clinical trainee or mental health
practitioner under the treatment supervision of a mental health professional, to guide the
work of the mental health behavioral aide. The individual behavioral plan may be
incorporated into the child's individual treatment plan so long as the behavioral plan is
separately communicable to the mental health behavioral aide.

(k) "Individual treatment plan" means the plan described in section 245I.10, subdivisions
7 and 8.

(l) "Mental health behavioral aide services" means medically necessary one-on-one
activities performed by a mental health behavioral aide qualified according to section
245I.04, subdivision 16, to assist a child retain or generalize psychosocial skills as previously
trained by a mental health professional, clinical trainee, or mental health practitioner and
as described in the child's individual treatment plan and individual behavior plan. Activities
involve working directly with the child or child's family as provided in subdivision 9,
paragraph (b), clause (4).

(m) "Mental health certified family peer specialist" means a staff person who is qualified
according to section 245I.04, subdivision 12.

(n) "Mental health practitioner" means a staff person who is qualified according to section
245I.04, subdivision 4.

(o) "Mental health professional" means a staff person who is qualified according to
section 245I.04, subdivision 2.

(p) "Mental health service plan development" includes:

(1) the development, review, and revision of a child's individual treatment plan, including
involvement of the client or client's parents, primary caregiver, or other person authorized
to consent to mental health services for the client, and including arrangement of treatment
and support activities specified in the individual treatment plan; and

(2) administering and reporting the standardized outcome measurements in section
245I.10, subdivision 6, paragraph (d), clauses (3) and (4), and other standardized outcome
measurements approved by the commissioner, as periodically needed to evaluate the
effectiveness of treatment.

(q) "Mental illness," for persons at least age 18 but under age 21, has the meaning given
in section 245.462, subdivision 20, paragraph (a).

(r) "Psychotherapy" means the treatment described in section 256B.0671, subdivision
11.

(s) "Rehabilitative services" or "psychiatric rehabilitation services" means interventions
to: (1) restore a child or adolescent to an age-appropriate developmental trajectory that had
been disrupted by a psychiatric illness; or (2) enable the child to self-monitor, compensate
for, cope with, counteract, or replace psychosocial skills deficits or maladaptive skills
acquired over the course of a psychiatric illness. Psychiatric rehabilitation services for
children combine coordinated psychotherapy to address internal psychological, emotional,
and intellectual processing deficits, and skills training to restore personal and social
functioning. Psychiatric rehabilitation services establish a progressive series of goals with
each achievement building upon a prior achievement.

(t) "Skills training" means individual, family, or group training, delivered by or under
the supervision of a mental health professional, designed to facilitate the acquisition of
psychosocial skills that are medically necessary to rehabilitate the child to an age-appropriate
developmental trajectory heretofore disrupted by a psychiatric illness or to enable the child
to self-monitor, compensate for, cope with, counteract, or replace skills deficits or
maladaptive skills acquired over the course of a psychiatric illness. Skills training is subject
to the service delivery requirements under subdivision 9, paragraph (b), clause (2).

(u) "Treatment supervision" means the supervision described in section 245I.06.

Sec. 23.

Minnesota Statutes 2020, 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 modality must document the required qualifications to meet
fidelity to the specific model.

(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 deleted text begin face-to-face deleted text end 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.

(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 deleted text begin face-to-face deleted text end meeting with the person
and the person's family to review the CMDE or ITP progress monitoring and to integrate
and coordinate services across providers and service-delivery systems to develop the ITP.
This service must be provided by the QSP and may include the CMDE provider or a level
I provider 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 deleted text begin face-to-face deleted text end new text begin in-person new text end 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 by a licensed health care provider via deleted text begin telemedicine deleted text end new text begin telehealth new text end , as defined under
section 256B.0625, subdivision 3b, in the same manner as if the service or consultation was
delivered in person.

Sec. 24.

Minnesota Statutes 2020, section 256B.49, subdivision 14, is amended to read:

Subd. 14.

Assessment and reassessment.

(a) Assessments and reassessments shall be
conducted by certified assessors according to section 256B.0911, subdivision 2b.

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

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

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

Sec. 25.

Minnesota Statutes 2020, section 256S.05, subdivision 2, is amended to read:

Subd. 2.

Nursing facility level of care determination required.

Notwithstanding other
assessments identified in section 144.0724, subdivision 4, only deleted text begin face-to-face deleted text end assessments
conducted according to section 256B.0911, subdivisions 3, 3a, and 3b, that result in a nursing
facility level of care determination at initial and subsequent assessments shall be accepted
for purposes of a participant's initial and ongoing participation in the elderly waiver and a
service provider's access to service payments under this chapter.

Sec. 26. new text begin COMMISSIONER OF HUMAN SERVICES; EXTENSION OF COVID-19
HUMAN SERVICES PROGRAM MODIFICATIONS.
new text end

new text begin Notwithstanding Laws 2020, First Special Session chapter 7, section 1, subdivision 2,
as amended by Laws 2020, Third Special Session chapter 1, section 3, 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 modifications issued by
the commissioner of human services pursuant to Executive Orders 20-11 and 20-12, and
including any amendments to the modification issued before the peacetime emergency
expires, shall remain in effect until July 1, 2023:
new text end

new text begin (1) CV16: expanding access to telemedicine services for Children's Health Insurance
Program, Medical Assistance, and MinnesotaCare enrollees; and
new text end

new text begin (2) CV21: allowing telemedicine alternative for school-linked mental health services
and intermediate school district mental health services.
new text end

Sec. 27. new text begin STUDIES OF TELEHEALTH EXPANSION AND PAYMENT PARITY.
new text end

new text begin (a) The commissioner of health, in consultation with the commissioners of human services
and commerce, shall study the impact of telehealth expansion and payment parity under
this article on the coverage and provision of health care services under private sector health
insurance.
new text end

new text begin (b) The commissioner of human services, in consultation with the commissioners of
health and commerce, shall study the impact of telehealth expansion and payment parity
under this article on the coverage and provision of health care services under public health
care programs.
new text end

new text begin (c) The studies required under paragraphs (a) and (b) must review and make
recommendations relating to:
new text end

new text begin (1) the impact of telehealth expansion and payment parity on access to health care
services, quality of care, health outcomes, patient satisfaction, and value-based payments
and innovation in health care delivery;
new text end

new text begin (2) the impact of telehealth expansion and payment parity on reducing health care
disparities and providing equitable access to health care services for underserved
communities;
new text end

new text begin (3) whether audio-only communication as a permitted option for delivering services (i)
supports equitable access to health care services, including behavioral health services, for
the elderly, rural communities, and communities of color, and (ii) eliminates barriers to care
for vulnerable and underserved populations without reducing the quality of care, worsening
health outcomes, or decreasing satisfaction with care;
new text end

new text begin (4) the services and populations, if any, for which increased access to telehealth improves
or negatively impacts health outcomes;
new text end

new text begin (5) the extent to which services provided through telehealth:
new text end

new text begin (i) substitute for an in-person visit;
new text end

new text begin (ii) are services that were previously not billed or reimbursed; or
new text end

new text begin (iii) are in addition to or are duplicative of services that the patient has received or will
receive as part of an in-person visit;
new text end

new text begin (6) the effect of telehealth expansion and payment parity on public and private sector
health care costs, including health insurance premiums; and
new text end

new text begin (7) the impact of telehealth expansion and payment parity, especially in rural areas, on
patient access to, and the availability of, in-person care, including specialty care.
new text end

new text begin (d) In addition, the studies must report:
new text end

new text begin (1) the criteria payers used during the study period to determine which patients were
medically appropriate to be served through telehealth, and which categories of service were
medically appropriate to be delivered through telehealth, including but not limited to the
use of audio-only communication; and
new text end

new text begin (2) the methods payers used to ensure that patients were allowed to choose to receive a
service through telehealth or in person during the study period.
new text end

new text begin (e) When conducting the studies, the commissioners shall consult with public program
enrollees and other patients, providers, communities impacted by telehealth expansion and
payment parity, and other stakeholders. Notwithstanding Minnesota Statutes, section 62U.04,
subdivision 11, the commissioners may use data available under that section to conduct the
studies and may consult with experts in payment policy and health care delivery. Health
plan companies shall submit information requested by the commissioners for purposes of
the studies in the form and manner specified by the commissioners.
new text end

new text begin (f) The commissioners shall present a preliminary report to the chairs and ranking
minority members of the legislative committees with jurisdiction over health and human
services policy and finance and commerce by January 15, 2023. The preliminary report
must include qualitative and any available quantitative findings, and recommendations on
whether audio-only communication should be allowed as a telehealth option beyond June
30, 2023. The commissioners shall present a final report to the chairs and ranking minority
members of these specified legislative committees by January 15, 2024.
new text end

Sec. 28. new text begin REVISOR INSTRUCTION.
new text end

new text begin In Minnesota Statutes and Minnesota Rules, the revisor of statutes shall substitute the
term "telemedicine" with "telehealth" whenever the term appears and substitute Minnesota
Statutes, section 62A.673, whenever references to Minnesota Statutes, sections 62A.67,
62A.671, and 62A.672 appear.
new text end

Sec. 29. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2020, sections 62A.67; 62A.671; and 62A.672, new text end new text begin are repealed
effective July 1, 2021.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2020, sections 256B.0596; and 256B.0924, subdivision 4a, new text end new text begin are
repealed effective July 1, 2021, 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

new text begin (c) new text end new text begin Laws 2021, chapter 30, article 17, section 71, new text end new text begin is repealed effective the day following
final enactment.
new text end

ARTICLE 7

ECONOMIC SUPPORTS

Section 1.

Minnesota Statutes 2020, section 119B.09, subdivision 4, is amended to read:

Subd. 4.

Eligibility; annual income; calculation.

(a) Annual income of the applicant
family is the current monthly income of the family multiplied by 12 or the income for the
12-month period immediately preceding the date of application, or income calculated by
the method which provides the most accurate assessment of income available to the family.

(b) Self-employment income must be calculated based on deleted text begin gross receipts less operating
expenses deleted text end new text begin section 256P.05, subdivision 2 new text end .

(c) Income changes are processed under section 119B.025, subdivision 4. Included lump
sums counted as income under section 256P.06, subdivision 3, must be annualized over 12
months. Income must be verified with documentary evidence. If the applicant does not have
sufficient evidence of income, verification must be obtained from the source of the income.

new text begin EFFECTIVE DATE. new text end

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

Sec. 2.

Minnesota Statutes 2020, section 256D.051, is amended by adding a subdivision
to read:

new text begin Subd. 20. new text end

new text begin SNAP employment and training. new text end

new text begin The commissioner shall implement a
Supplemental Nutrition Assistance Program (SNAP) employment and training program
that meets the SNAP employment and training participation requirements of the United
States Department of Agriculture governed by Code of Federal Regulations, title 7, section
273.7. The commissioner shall operate a SNAP employment and training program in which
SNAP recipients elect to participate. In order to receive SNAP assistance beyond the time
limit, unless residing in an area covered by a time-limit waiver governed by Code of Federal
Regulations, title 7, section 273.24, nonexempt SNAP recipients who do not meet federal
SNAP work requirements must participate in an employment and training program. In
addition to county and Tribal agencies that administer SNAP, the commissioner may contract
with third-party providers for SNAP employment and training services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 3.

Minnesota Statutes 2020, section 256D.051, is amended by adding a subdivision
to read:

new text begin Subd. 21. new text end

new text begin County and Tribal agency duties. new text end

new text begin County or Tribal agencies that administer
SNAP shall inform adult SNAP recipients about employment and training services and
providers in the recipient's area. County or Tribal agencies that administer SNAP may elect
to subcontract with a public or private entity approved by the commissioner to provide
SNAP employment and training services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 4.

Minnesota Statutes 2020, section 256D.051, is amended by adding a subdivision
to read:

new text begin Subd. 22. new text end

new text begin Duties of commissioner. new text end

new text begin In addition to any other duties imposed by law, the
commissioner shall:
new text end

new text begin (1) supervise the administration of SNAP employment and training services to county,
Tribal, and contracted agencies under this section and Code of Federal Regulations, title 7,
section 273.7;
new text end

new text begin (2) disburse money allocated and reimbursed for SNAP employment and training services
to county, Tribal, and contracted agencies;
new text end

new text begin (3) accept and supervise the disbursement of any funds that may be provided by the
federal government or other sources for SNAP employment and training services;
new text end

new text begin (4) cooperate with other agencies, including any federal agency or agency of another
state, in all matters concerning the powers and duties of the commissioner under this section;
new text end

new text begin (5) coordinate with the commissioner of employment and economic development to
deliver employment and training services statewide;
new text end

new text begin (6) work in partnership with counties, tribes, and other agencies to enhance the reach
and services of a statewide SNAP employment and training program; and
new text end

new text begin (7) identify eligible nonfederal funds to earn federal reimbursement for SNAP
employment and training services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 5.

Minnesota Statutes 2020, section 256D.051, is amended by adding a subdivision
to read:

new text begin Subd. 23. new text end

new text begin Participant duties. new text end

new text begin Unless residing in an area covered by a time-limit waiver,
nonexempt SNAP recipients must meet federal SNAP work requirements to receive SNAP
assistance beyond the time limit.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 6.

Minnesota Statutes 2020, section 256D.051, is amended by adding a subdivision
to read:

new text begin Subd. 24. new text end

new text begin Program funding. new text end

new text begin (a) The United States Department of Agriculture annually
allocates SNAP employment and training funds to the commissioner of human services for
the operation of the SNAP employment and training program.
new text end

new text begin (b) The United States Department of Agriculture authorizes the disbursement of SNAP
employment and training reimbursement funds to the commissioner of human services for
the operation of the SNAP employment and training program.
new text end

new text begin (c) Except for funds allocated for state program development and administrative purposes
or designated by the United States Department of Agriculture for a specific project, the
commissioner of human services shall disburse money allocated for federal SNAP
employment and training to counties and tribes that administer SNAP based on a formula
determined by the commissioner that includes but is not limited to the county's or tribe's
proportion of adult SNAP recipients as compared to the statewide total.
new text end

new text begin (d) The commissioner of human services shall disburse federal funds that the
commissioner receives as reimbursement for SNAP employment and training costs to the
state agency, county, tribe, or contracted agency that incurred the costs being reimbursed.
new text end

new text begin (e) The commissioner of human services may reallocate unexpended money disbursed
under this section to county, Tribal, or contracted agencies that demonstrate a need for
additional funds.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 7.

Minnesota Statutes 2020, section 256E.30, subdivision 2, is amended to read:

Subd. 2.

Allocation of money.

(a) State money appropriated and community service
block grant money allotted to the state and all money transferred to the community service
block grant from other block grants shall be allocated annually to community action agencies
and Indian reservation governments under paragraphs (b) and (c), and to migrant and seasonal
farmworker organizations under paragraph (d).

(b) The available annual money will provide base funding to all community action
agencies and the Indian reservations. Base funding amounts per agency are as follows: for
agencies with low income populations up to deleted text begin 1,999, $25,000; 2,000 to deleted text end 23,999, $50,000; and
24,000 or more, $100,000.

(c) All remaining money of the annual money available after the base funding has been
determined must be allocated to each agency and reservation in proportion to the size of
the poverty level population in the agency's service area compared to the size of the poverty
level population in the state.

(d) Allocation of money to migrant and seasonal farmworker organizations must not
exceed three percent of the total annual money available. Base funding allocations must be
made for all community action agencies and Indian reservations that received money under
this subdivision, in fiscal year 1984, and for community action agencies designated under
this section with a service area population of 35,000 or greater.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021.
new text end

Sec. 8.

Minnesota Statutes 2020, section 256J.08, subdivision 15, is amended to read:

Subd. 15.

Countable income.

"Countable income" means earned and unearned income
that is deleted text begin not excluded under section 256J.21, subdivision 2 deleted text end new text begin described in section 256P.06,
subdivision 3 new text end , or disregarded under section 256J.21, subdivision 3 new text begin , or section 256P.03 new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 9.

Minnesota Statutes 2020, section 256J.08, subdivision 53, is amended to read:

Subd. 53.

Lump sum.

"Lump sum" means nonrecurring income deleted text begin that is not excluded in
section 256J.21 deleted text end new text begin as described in section 256P.06, subdivision 3, clause (2), item (ix) new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 10.

Minnesota Statutes 2020, section 256J.10, is amended to read:

256J.10 MFIP ELIGIBILITY REQUIREMENTS.

To be eligible for MFIP, applicants must meet the general eligibility requirements in
sections 256J.11 to 256J.15, the property limitations in section 256P.02, and the income
limitations in deleted text begin section deleted text end new text begin sections new text end 256J.21 new text begin and 256P.06 new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 11.

Minnesota Statutes 2020, section 256J.21, subdivision 3, is amended to read:

Subd. 3.

Initial income test.

The agency shall determine initial eligibility by considering
all earned and unearned income deleted text begin that is not excluded under subdivision 2 deleted text end new text begin as defined in section
256P.06 new text end . To be eligible for MFIP, the assistance unit's countable income minus the earned
income disregards in paragraph (a) and section 256P.03 must be below the family wage
level according to section 256J.24 new text begin , subdivision 7, new text end for that size assistance unit.

(a) The initial eligibility determination must disregard the following items:

(1) the earned income disregard as determined in section 256P.03;

(2) dependent care costs must be deducted from gross earned income for the actual
amount paid for dependent care up to a maximum of $200 per month for each child less
than two years of age, and $175 per month for each child two years of age and older;

(3) all payments made according to a court order for spousal support or the support of
children not living in the assistance unit's household shall be disregarded from the income
of the person with the legal obligation to pay support; and

(4) an allocation for the unmet need of an ineligible spouse or an ineligible child under
the age of 21 for whom the caregiver is financially responsible and who lives with the
caregiver according to section 256J.36.

(b) After initial eligibility is established, the assistance payment calculation is based on
the monthly income test.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 12.

Minnesota Statutes 2020, section 256J.21, subdivision 5, is amended to read:

Subd. 5.

Distribution of income.

new text begin (a) new text end The income of all members of the assistance unit
must be counted. Income may also be deemed from ineligible persons to the assistance unit.
Income must be attributed to the person who earns it or to the assistance unit according to
paragraphs deleted text begin (a) to deleted text end new text begin (b) and new text end (c).

deleted text begin (a) Funds distributed from a trust, whether from the principal holdings or sale of trust
property or from the interest and other earnings of the trust holdings, must be considered
income when the income is legally available to an applicant or participant. Trusts are
presumed legally available unless an applicant or participant can document that the trust is
not legally available.
deleted text end

(b) Income from jointly owned property must be divided equally among property owners
unless the terms of ownership provide for a different distribution.

(c) Deductions are not allowed from the gross income of a financially responsible
household member or by the members of an assistance unit to meet a current or prior debt.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 13.

Minnesota Statutes 2020, section 256J.24, subdivision 5, is amended to read:

Subd. 5.

MFIP transitional standard.

(a) The MFIP transitional standard is based on
the number of persons in the assistance unit eligible for both food and cash assistance. The
amount of the transitional standard is published annually by the Department of Human
Services.

(b) The amount of the MFIP cash assistance portion of the transitional standard is
increased $100 per month per household. This increase shall be reflected in the MFIP cash
assistance portion of the transitional standard published annually by the commissioner.

new text begin (c) On October 1 of each year, the commissioner of human services shall adjust the cash
assistance portion under paragraph (a) for inflation based on the CPI-U for the prior calendar
year.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for the fiscal year beginning on July 1,
2021.
new text end

Sec. 14.

Minnesota Statutes 2020, section 256J.33, subdivision 1, is amended to read:

Subdivision 1.

Determination of eligibility.

new text begin (a) new text end A county agency must determine MFIP
eligibility prospectively for a payment month based on retrospectively assessing income
and the county agency's best estimate of the circumstances that will exist in the payment
month.

new text begin (b) new text end new text begin new text end Except as described in section 256J.34, subdivision 1, when prospective eligibility
exists, A county agency must calculate the amount of the assistance payment using
retrospective budgeting. To determine MFIP eligibility and the assistance payment amount,
a county agency must apply countable income, described in deleted text begin section deleted text end new text begin sections 256P.06 and new text end
256J.37, subdivisions 3 to 10, received by members of an assistance unit or by other persons
whose income is counted for the assistance unit, described under sections deleted text begin and deleted text end
256J.37, subdivisions 1 to 2 new text begin , and 256P.06, subdivision 1 new text end .

new text begin (c) new text end This income must be applied to the MFIP standard of need or family wage level
subject to this section and sections 256J.34 to 256J.36. new text begin Countable new text end income new text begin as described in
section 256P.06, subdivision 3, new text end received in a calendar month deleted text begin and not otherwise excluded
under section deleted text end deleted text begin 256J.21, subdivision 2 deleted text end deleted text begin , deleted text end must be applied to the needs of an assistance unit.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 15.

Minnesota Statutes 2020, section 256J.33, subdivision 4, is amended to read:

Subd. 4.

Monthly income test.

A county agency must apply the monthly income test
retrospectively for each month of MFIP eligibility. An assistance unit is not eligible when
the countable income equals or exceeds the MFIP standard of need or the family wage level
for the assistance unit. The income applied against the monthly income test must include:

(1) gross earned income from employment new text begin as described in chapter 256P new text end , prior to
mandatory payroll deductions, voluntary payroll deductions, wage authorizations, and after
the disregards in section 256J.21, subdivision 4, and the allocations in section 256J.36 deleted text begin ,
unless the employment income is specifically excluded under section 256J.21, subdivision
2 deleted text end ;

(2) gross earned income from self-employment less deductions for self-employment
expenses in section 256J.37, subdivision 5, but prior to any reductions for personal or
business state and federal income taxes, personal FICA, personal health and life insurance,
and after the disregards in section 256J.21, subdivision 4, and the allocations in section
256J.36;

(3) unearned income new text begin as described in section 256P.06, subdivision 3, new text end after deductions
for allowable expenses in section 256J.37, subdivision 9, and allocations in section 256J.36 deleted text begin ,
unless the income has been specifically excluded in section 256J.21, subdivision 2 deleted text end ;

(4) gross earned income from employment as determined under clause (1) which is
received by a member of an assistance unit who is a minor child or minor caregiver and
less than a half-time student;

(5) child support received by an assistance unit, excluded under deleted text begin section 256J.21,
subdivision 2, clause (49), or deleted text end section 256P.06, subdivision 3, clause (2), item (xvi);

(6) spousal support received by an assistance unit;

(7) the income of a parent when that parent is not included in the assistance unit;

(8) the income of an eligible relative and spouse who seek to be included in the assistance
unit; and

(9) the unearned income of a minor child included in the assistance unit.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 16.

Minnesota Statutes 2020, section 256J.37, subdivision 1, is amended to read:

Subdivision 1.

Deemed income from ineligible assistance unit members.

The income
of ineligible assistance unit members new text begin , except individuals identified in section 256J.24,
subdivision 3, paragraph (a), clause (1), new text end must be deemed after allowing the following
disregards:

(1) an earned income disregard as determined under section 256P.03;

(2) all payments made by the ineligible person according to a court order for spousal
support or the support of children not living in the assistance unit's household; and

(3) an amount for the unmet needs of the ineligible persons who live in the household
who, if eligible, would be assistance unit members under section 256J.24, subdivision 2 or
4, paragraph (b). This amount is equal to the difference between the MFIP transitional
standard when the ineligible persons are included in the assistance unit and the MFIP
transitional standard when the ineligible persons are not included in the assistance unit.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 17.

Minnesota Statutes 2020, section 256J.37, subdivision 1b, is amended to read:

Subd. 1b.

Deemed income from parents of minor caregivers.

In households where
minor caregivers live with a parent or parents new text begin or a stepparent new text end who do not receive MFIP for
themselves or their minor children, the income of the parents new text begin or a stepparent new text end must be deemed
after allowing the following disregards:

(1) income of the parents equal to 200 percent of the federal poverty guideline for a
family size not including the minor parent and the minor parent's child in the household
deleted text begin according to section 256J.21, subdivision 2, clause (43) deleted text end ; and

(2) all payments made by parents according to a court order for spousal support or the
support of children not living in the parent's household.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 18.

Minnesota Statutes 2020, section 256J.95, subdivision 9, is amended to read:

Subd. 9.

Property and income limitations.

The asset limits and exclusions in section
256P.02 apply to applicants and participants of DWP. All payments, deleted text begin unless excluded in
section 256J.21 deleted text end new text begin as described in section 256P.06, subdivision 3 new text end , must be counted as income
to determine eligibility for the diversionary work program. The agency shall treat income
as outlined in section 256J.37, except for subdivision 3a. The initial income test and the
disregards in section 256J.21, subdivision 3, shall be followed for determining eligibility
for the diversionary work program.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 19.

Minnesota Statutes 2020, section 256P.01, subdivision 3, is amended to read:

Subd. 3.

Earned income.

"Earned income" means deleted text begin cash or in-kind deleted text end income earned through
the receipt of wages, salary, commissions, bonuses, tips, gratuities, profit from employment
activities, net profit from self-employment activities, payments made by an employer for
regularly accrued vacation or sick leave, severance pay based on accrued leave time,
deleted text begin payments from training programs at a rate at or greater than the state's minimum wage, deleted text end
royalties, honoraria, or other profit from activity that results from the client's work, deleted text begin service, deleted text end
effort, or labor new text begin for purposes other than student financial assistance, rehabilitation programs,
student training programs, or service programs such as AmeriCorps new text end . The income must be
in return for, or as a result of, legal activity.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 20.

Minnesota Statutes 2020, 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 new text begin , 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 end .

new text begin EFFECTIVE DATE. new text end

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

Sec. 21.

Minnesota Statutes 2020, 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 deleted text begin (4) deleted text end new text begin (5) new text end must not exceed $10,000 for applicants and
participants. For purposes of this subdivision, personal property is limited to:

(1) cash;

(2) bank accounts;

(3) liquid stocks and bonds that can be readily accessed without a financial penalty; deleted text begin and
deleted text end

(4) vehicles not excluded under subdivision 3 deleted text begin . deleted text end new text begin ; and
new text end

new text begin (5) the full value of business accounts used to pay expenses not related to the business.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 22.

Minnesota Statutes 2020, section 256P.04, subdivision 4, is amended to read:

Subd. 4.

Factors to be verified.

(a) The agency shall verify the following at application:

(1) identity of adults;

(2) age, if necessary to determine eligibility;

(3) immigration status;

(4) income;

(5) spousal support and child support payments made to persons outside the household;

(6) vehicles;

(7) checking and savings accounts new text begin , including but not limited to any business accounts
used to pay expenses not related to the business new text end ;

(8) inconsistent information, if related to eligibility;

(9) residence;

(10) Social Security number; and

(11) use of nonrecurring income under section 256P.06, subdivision 3, clause (2), item
(ix), for the intended purpose for which it was given and received.

(b) Applicants who are qualified noncitizens and victims of domestic violence as defined
under section 256J.08, subdivision 73, deleted text begin clause (7) deleted text end new text begin clauses (8) and (9) new text end , are not required to
verify the information in paragraph (a), clause (10). When a Social Security number is not
provided to the agency for verification, this requirement is satisfied when each member of
the assistance unit cooperates with the procedures for verification of Social Security numbers,
issuance of duplicate cards, and issuance of new numbers which have been established
jointly between the Social Security Administration and the commissioner.

new text begin EFFECTIVE DATE. new text end

new text begin Paragraph (a) is effective May 1, 2022. Paragraph (b) is effective
July 1, 2021.
new text end

Sec. 23.

Minnesota Statutes 2020, section 256P.04, subdivision 8, is amended to read:

Subd. 8.

Recertification.

The agency shall recertify eligibility deleted text begin in an annual interview
with the participant. The interview may be conducted by telephone, by Internet telepresence,
or face-to-face in the county office or in another location mutually agreed upon. A participant
must be given the option of a telephone interview or Internet telepresence to recertify
eligibility deleted text end new text begin annually new text end . During deleted text begin the interview deleted text end new text begin recertification new text end , the agency shall verify the following:

(1) income, unless excluded, including self-employment earnings;

(2) assets when the value is within $200 of the asset limit; and

(3) inconsistent information, if related to eligibility.

new text begin EFFECTIVE DATE. new text end

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

Sec. 24.

Minnesota Statutes 2020, section 256P.05, is amended to read:

256P.05 SELF-EMPLOYMENT EARNINGS.

Subdivision 1.

Exempted programs.

Participants who qualify for deleted text begin child care assistance
programs under chapter 119B, deleted text end Minnesota supplemental aid under chapter 256D deleted text begin , deleted text end and housing
support under chapter 256I on the basis of eligibility for Supplemental Security Income are
exempt from this section. new text begin Participants who qualify for child care assistance programs under
chapter 119B are exempt from subdivision 3.
new text end

Subd. 2.

Self-employment income determinations.

new text begin Applicants and participants must
choose one of the methods described in this subdivision for determining self-employment
earned income. new text end An agency must determine self-employment income, which is either:

(1) one-half of gross earnings from self-employment; or

(2) taxable income as determined from an Internal Revenue Service tax form that has
been filed with the Internal Revenue Service deleted text begin within the last deleted text end new text begin for the most recent new text end year new text begin and
according to guidance provided for the Supplemental Nutrition Assistance Program new text end . A
12-month average using deleted text begin net deleted text end taxable income shall be used to budget monthly income.

Subd. 3.

Self-employment budgeting.

(a) The self-employment budget period begins
in the month of application or in the first month of self-employment. deleted text begin Applicants and
participants must choose one of the methods described in subdivision 2 for determining
self-employment earned income.
deleted text end

(b) Applicants and participants who elect to use taxable income as described in
subdivision 2, clause (2), to determine self-employment income must continue to use this
method until recertification, unless there is an unforeseen significant change in gross income
equaling a decline in gross income of the amount equal to or greater than the earned income
disregard as defined in section 256P.03 from the income used to determine the benefit for
the current month.

(c) For applicants and participants who elect to use one-half of gross earnings as described
in subdivision 2, clause (1), to determine self-employment income, earnings must be counted
as income in the month received.

new text begin EFFECTIVE DATE. new text end

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

Sec. 25.

Minnesota Statutes 2020, section 256P.06, subdivision 2, is amended to read:

Subd. 2.

deleted text begin Exempted individuals deleted text end new text begin Exemptions new text end .

(a) The following members of an assistance
unit under chapters 119B and 256J are exempt from having their earned income count
deleted text begin towards deleted text end new text begin toward new text end the income of an assistance unit:

(1) children under six years old;

(2) caregivers under 20 years of age enrolled at least half-time in school; and

(3) minors enrolled in school full time.

(b) The following members of an assistance unit are exempt from having their earned
and unearned income count deleted text begin towards deleted text end new text begin toward new text end the income of an assistance unit for 12
consecutive calendar months, beginning the month following the marriage date, for benefits
under chapter 256J if the household income does not exceed 275 percent of the federal
poverty guideline:

(1) a new spouse to a caretaker in an existing assistance unit; and

(2) the spouse designated by a newly married couple, both of whom were already
members of an assistance unit under chapter 256J.

(c) If members identified in paragraph (b) also receive assistance under section 119B.05,
they are exempt from having their earned and unearned income count deleted text begin towards deleted text end new text begin toward new text end the
income of the assistance unit if the household income prior to the exemption does not exceed
67 percent of the state median income for recipients for 26 consecutive biweekly periods
beginning the second biweekly period after the marriage date.

new text begin (d) For individuals who are members of an assistance unit under chapters 256I and 256J,
the assistance standard effective in January 2020 for a household of one under chapter 256J
shall be counted as income under chapter 256I, and any subsequent increases to unearned
income under chapter 256J shall be exempt.
new text end

Sec. 26.

Minnesota Statutes 2020, 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 new text begin that is received by an adult member of the
assistance unit unless the individual receiving unemployment insurance income is:
new text end

new text begin (A) 18 years of age and enrolled in a secondary school; or
new text end

new text begin (B) 18 or 19 years of age, a caregiver, and is enrolled in school at least half-time new text end ;

(viii) retirement, survivors, and disability insurance payments;

(ix) nonrecurring income over $60 per quarter unless deleted text begin earmarked and used for the purpose
for which it is intended. Income and use of this income is subject to verification requirements
under section 256P.04 deleted text end new text begin 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 new text end ;

(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;

(xiii) income and payments from service and rehabilitation programs that meet or exceed
the state's minimum wage rate;

(xiv) income from members of the United States armed forces unless excluded from
income taxes according to federal or state law;

(xv) all child support payments for programs under chapters 119B, 256D, and 256I;

(xvi) 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 and
deleted text end

(xvii) spousal support deleted text begin . deleted text end new text begin ; and
new text end

new text begin (xviii) workers' compensation.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021, except the amendment
to clause (2), item (vii), is effective the day following final enactment.
new text end

Sec. 27.

Laws 2020, First Special Session chapter 7, section 1, as amended by Laws 2020,
Third Special Session chapter 1, section 3, is amended by adding a subdivision to read:

new text begin Subd. 5. new text end

new text begin Waivers and modifications; extension to December 31, 2021. new text end

new text begin 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,
including any amendments to the waivers or modifications issued before the peacetime
emergency expires, shall remain in effect through December 31, 2021, unless necessary
federal approval is not received at any time for a waiver or modification:
new text end

new text begin (1) Executive Orders 20-42, 21-03, and 21-15: ensuring that emergency economic relief
does not prevent eligibility for essential human services programs; and
new text end

new text begin (2) CV.04.A.4: cash assistance, modifying the interview requirement for recertifications
of eligibility, issued by the commissioner of human services pursuant to Executive Order
20-12.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment or
retroactively from the date that the peacetime emergency declared by the governor in
response to the COVID-19 outbreak ends, whichever is earlier.
new text end

Sec. 28. new text begin DIRECTION TO COMMISSIONER; LONG-TERM HOMELESS
SUPPORTIVE SERVICES REPORT.
new text end

new text begin (a) No later than January 15, 2023, the commissioner of human services shall produce
information which shows the projects funded under Minnesota Statutes, section 256K.26,
and make this information available on the Department of Human Services website.
new text end

new text begin (b) This information must be updated annually for two additional years and the
commissioner must make this information available on the Department of Human Services
website by January 15, 2024, and January 15, 2025, respectively.
new text end

Sec. 29. new text begin 2022 REPORT TO LEGISLATURE ON RUNAWAY AND HOMELESS
YOUTH.
new text end

new text begin Subdivision 1. new text end

new text begin Report development. new text end

new text begin The commissioner of human services is exempt
from preparing the report required under Minnesota Statutes, section 256K.45, subdivision
2, in 2023 and shall instead update the information in the 2007 legislative report on runaway
and homeless youth. In developing the updated report, the commissioner must use existing
data, studies, and analysis provided by state, county, and other entities including:
new text end

new text begin (1) Minnesota Housing Finance Agency analysis on housing availability;
new text end

new text begin (2) the Minnesota state plan to end homelessness;
new text end

new text begin (3) the continuum of care counts of youth experiencing homelessness and assessments
as provided by Department of Housing and Urban Development (HUD) required coordinated
entry systems;
new text end

new text begin (4) the biannual Department of Human Services report on the Homeless Youth Act;
new text end

new text begin (5) the Wilder Research homeless study;
new text end

new text begin (6) the Voices of Youth Count sponsored by Hennepin County; and
new text end

new text begin (7) privately funded analysis, including:
new text end

new text begin (i) nine evidence-based principles to support youth in overcoming homelessness;
new text end

new text begin (ii) the return on investment analysis conducted for YouthLink by Foldes Consulting;
and
new text end

new text begin (iii) the evaluation of Homeless Youth Act resources conducted by Rainbow Research.
new text end

new text begin Subd. 2. new text end

new text begin Key elements; due date. new text end

new text begin (a) The report must include three key elements where
significant learning has occurred in the state since the 2007 report, including:
new text end

new text begin (1) the unique causes of youth homelessness;
new text end

new text begin (2) targeted responses to youth homelessness, including the significance of positive
youth development as fundamental to each targeted response; and
new text end

new text begin (3) recommendations based on existing reports and analysis on how to end youth
homelessness.
new text end

new text begin (b) To the extent that data is available, the report must include:
new text end

new text begin (1) a general accounting of the federal and philanthropic funds leveraged to support
homeless youth activities;
new text end

new text begin (2) a general accounting of the increase in volunteer responses to support youth
experiencing homelessness; and
new text end

new text begin (3) a data-driven accounting of geographic areas or distinct populations that have gaps
in service or are not yet served by homeless youth responses.
new text end

new text begin (c) The commissioner of human services shall consult with and incorporate the expertise
of community-based providers of homeless youth services and other expert stakeholders to
complete the report. The commissioner shall submit the report to the chairs and ranking
minority members of the legislative committees with jurisdiction over youth homelessness
by December 15, 2022.
new text end

Sec. 30. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2020, sections 256D.051, subdivisions 1, 1a, 2, 2a, 3, 3a, 3b, 6b, 6c,
7, 8, 9, and 18; 256D.052, subdivision 3; 256J.21, subdivisions 1 and 2; and 259A.70, new text end new text begin are
repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021, except that the repeal
of Minnesota Statutes, section 259A.70, is effective July 1, 2021.
new text end

ARTICLE 8

CHILD CARE ASSISTANCE

Section 1.

Minnesota Statutes 2020, section 119B.03, is amended by adding a subdivision
to read:

new text begin Subd. 4a. new text end

new text begin Temporary reprioritization. new text end

new text begin (a) Notwithstanding subdivision 4, priority for
child care assistance under the basic sliding fee assistance program shall be determined
according to this subdivision beginning July 1, 2021, through May 31, 2024.
new text end

new text begin (b) First priority must be given to eligible non-MFIP families who do not have a high
school diploma or commissioner of education-selected high school equivalency certification
or who need remedial and basic skill courses in order to pursue employment or to pursue
education leading to employment and who need child care assistance to participate in the
education program. This includes student parents as defined under section 119B.011,
subdivision 19b. Within this priority, the following subpriorities must be used:
new text end

new text begin (1) child care needs of minor parents;
new text end

new text begin (2) child care needs of parents under 21 years of age; and
new text end

new text begin (3) child care needs of other parents within the priority group described in this paragraph.
new text end

new text begin (c) Second priority must be given to families in which at least one parent is a veteran,
as defined under section 197.447.
new text end

new text begin (d) Third priority must be given to eligible families who do not meet the specifications
of paragraph (b), (c), (e), or (f).
new text end

new text begin (e) Fourth priority must be given to families who are eligible for portable basic sliding
fee assistance through the portability pool under subdivision 9.
new text end

new text begin (f) Fifth priority must be given to eligible families receiving services under section
119B.011, subdivision 20a, if the parents have completed their MFIP or DWP transition
year, or if the parents are no longer receiving or eligible for DWP supports.
new text end

new text begin (g) Families under paragraph (f) must be added to the basic sliding fee waiting list on
the date they complete their transition year under section 119B.011, subdivision 20.
new text end

Sec. 2.

Minnesota Statutes 2020, section 119B.03, subdivision 6, is amended to read:

Subd. 6.

Allocation formula.

The new text begin allocation component of new text end basic sliding fee state and
federal funds shall be allocated on a calendar year basis. Funds shall be allocated first in
amounts equal to each county's guaranteed floor according to subdivision 8, with any
remaining available funds allocated according to the following formula:

(a) One-fourth of the funds shall be allocated in proportion to each county's total
expenditures for the basic sliding fee child care program reported during the most recent
fiscal year completed at the time of the notice of allocation.

(b) Up to one-fourth of the funds shall be allocated in proportion to the number of families
participating in the transition year child care program as reported during and averaged over
the most recent six months completed at the time of the notice of allocation. Funds in excess
of the amount necessary to serve all families in this category shall be allocated according
to paragraph deleted text begin (f) deleted text end new text begin (e) new text end .

deleted text begin (c) Up to one-fourth of the funds shall be allocated in proportion to the average of each
county's most recent six months of reported first, second, and third priority waiting list as
defined in subdivision 2 and the reinstatement list of those families whose assistance was
terminated with the approval of the commissioner under Minnesota Rules, part 3400.0183,
subpart 1. Funds in excess of the amount necessary to serve all families in this category
shall be allocated according to paragraph (f).
deleted text end

deleted text begin (d) deleted text end new text begin (c) new text end Up to deleted text begin one-fourth deleted text end new text begin one-half new text end of the funds shall be allocated in proportion to the
average of each county's most recent deleted text begin six deleted text end new text begin 12 new text end months of reported waiting list as defined in
subdivision 2 and the reinstatement list of those families whose assistance was terminated
with the approval of the commissioner under Minnesota Rules, part 3400.0183, subpart 1.
Funds in excess of the amount necessary to serve all families in this category shall be
allocated according to paragraph deleted text begin (f) deleted text end new text begin (e) new text end .

deleted text begin (e) deleted text end new text begin (d) new text end The amount necessary to serve all families in paragraphs (b) deleted text begin , (c), deleted text end and deleted text begin (d) deleted text end new text begin (c) new text end shall
be calculated based on the basic sliding fee average cost of care per family in the county
with the highest cost in the most recently completed calendar year.

deleted text begin (f) deleted text end new text begin (e) new text end Funds in excess of the amount necessary to serve all families in paragraphs (b) deleted text begin ,
(c), deleted text end and deleted text begin (d) deleted text end new text begin (c) new text end shall be allocated in proportion to each county's total expenditures for the
basic sliding fee child care program reported during the most recent fiscal year completed
at the time of the notice of allocation.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022. The 2022 calendar year
shall be a phase-in year for the allocation formula in this section using phase-in provisions
determined by the commissioner of human services.
new text end

Sec. 3.

Minnesota Statutes 2020, section 119B.11, subdivision 2a, is amended to read:

Subd. 2a.

Recovery of overpayments.

(a) An amount of child care assistance paid to a
recipient new text begin or provider new text end in excess of the payment due is recoverable by the county agency new text begin or
commissioner new text end under paragraphs (b) and deleted text begin (c) deleted text end new text begin (e) new text end , even when the overpayment was caused by
deleted text begin agency error or deleted text end circumstances outside the responsibility and control of the family or provider. new text begin
Overpayments designated solely as agency error, and not the result of acts or omissions on
the part of a provider or recipient, must not be established or collected.
new text end

(b) An overpayment must be recouped or recovered from the family if the overpayment
benefited the family by causing the family to pay less for child care expenses than the family
otherwise would have been required to pay under child care assistance program requirements. new text begin
The recoupment or recovery shall proceed as follows:
new text end

new text begin (1) new text end if the family remains eligible for child care assistance, the overpayment must be
recovered through recoupment as identified in Minnesota Rules, part 3400.0187, except
that the overpayments must be calculated and collected on a service period basis deleted text begin . deleted text end new text begin ;
new text end

new text begin (2) new text end if the family no longer remains eligible for child care assistance new text begin and the overpayments
were the result of fraud under section 256.98 or 256.046, theft under section 609.52, false
claims under the state or federal False Claims Act, or a federal crime relating to theft of
government funds or fraudulent receipt of benefits for a program administered by the county
or commissioner, the county or commissioner shall seek voluntary repayment from the
family and shall initiate civil court proceedings to recover the overpayment if the county
or commissioner is unable to recoup the overpayment through voluntary repayment;
new text end

new text begin (3) if the family no longer remains eligible for child care assistance, the overpayments
were not the result of fraud, theft, or a federal crime as described in clause (2), and the
overpayment is less than $50 new text end , the county new text begin or commissioner new text end may choose to initiate efforts to
recover overpayments from the family deleted text begin for overpayment less than $50. If the overpayment
is greater than or equal to $50, the county shall seek voluntary repayment of the overpayment
from the family. If the county is unable to recoup the overpayment through voluntary
repayment, the county shall initiate civil court proceedings to recover the overpayment
unless the county's costs to recover the overpayment will exceed the amount of the
overpayment. deleted text end new text begin ; or
new text end

new text begin (4) if the family no longer remains eligible for child care assistance, the overpayments
were not the result of fraud, theft, or a federal crime as described in clause (2), and the
overpayment is greater than or equal to $50, the county or commissioner shall seek voluntary
repayment of the overpayment from the family. If the county or commissioner is unable to
recoup the overpayment through voluntary repayment, the county or commissioner shall
initiate civil court proceedings to recover the overpayment unless the county's or
commissioner's costs to recover the overpayment will exceed the amount of the overpayment.
new text end

new text begin (c) The commissioner's authority to recoup and recover overpayments from families in
paragraph (b) is limited to investigations conducted under chapter 245E.
new text end

new text begin (d) new text end A family with an outstanding debt under this subdivision is not eligible for child care
assistance until:

(1) the debt is paid in full; deleted text begin or
deleted text end

(2) satisfactory arrangements are made with the county new text begin or commissioner new text end to retire the
debt consistent with the requirements of this chapter and Minnesota Rules, chapter 3400,
and the family is in compliance with the arrangements deleted text begin . deleted text end new text begin ; or
new text end

new text begin (3) the commissioner determines that it is in the best interests of the state to compromise
debts owed to the state pursuant to section 16D.15.
new text end

deleted text begin (c) deleted text end new text begin (e) new text end The county new text begin or commissioner new text end must recover an overpayment from a provider if the
overpayment did not benefit the family by causing it to receive more child care assistance
or to pay less for child care expenses than the family otherwise would have been eligible
to receive or required to pay under child care assistance program requirements, and benefited
the provider by causing the provider to receive more child care assistance than otherwise
would have been paid on the family's behalf under child care assistance program
requirements. new text begin The recovery shall proceed as follows:
new text end

new text begin (1) new text end if the provider continues to care for children receiving child care assistance, the
overpayment must be recovered through deleted text begin reductions in child care assistance payments for
services as described in an agreement with the county. deleted text end new text begin recoupment as identified in Minnesota
Rules, part 3400.0187, and new text end the provider may not charge families using that provider more
to cover the cost of recouping the overpayment deleted text begin . deleted text end new text begin ;
new text end

new text begin (2) new text end if the provider no longer cares for children receiving child care assistance new text begin and the
overpayment was the result of fraud under section 256.98 or 256.046, theft under section
609.52, false claims under the state or federal False Claims Act, or a federal crime relating
to theft of government funds or fraudulent billing for a program administered by the county
or commissioner, the county or commissioner shall seek voluntary repayment from the
provider and shall initiate civil court proceedings to recover the overpayment if the county
or commissioner is unable to recoup the overpayment through voluntary repayment;
new text end

new text begin (3) if the provider no longer cares for children receiving child care assistance, the
overpayment was not the result of fraud, theft, or a federal crime as described under clause
(2), and the overpayment is less than $50 new text end , the county new text begin or commissioner new text end may choose to initiate
efforts to recover deleted text begin overpayments of less than $50 from the provider. If the overpayment is
greater than or equal to $50, the county shall seek voluntary repayment of the overpayment
from the provider. If the county is unable to recoup the overpayment through voluntary
repayment, the county shall initiate civil court proceedings to recover the overpayment
unless the county's costs to recover the overpayment will exceed the amount of the
overpayment. deleted text end new text begin the overpayment; or
new text end

new text begin (4) if the provider no longer cares for children receiving child care assistance, the
overpayment was not the result of fraud, theft, or a federal crime as described under clause
(2), and the overpayment is greater than or equal to $50, the county or commissioner shall
seek voluntary repayment of the overpayment from the provider. If the county or
commissioner is unable to recoup the overpayment through voluntary repayment, the county
or commissioner shall initiate civil court proceedings to recover the overpayment unless
the county's or commissioner's costs to recover the overpayment will exceed the amount of
the overpayment.
new text end

new text begin (f) new text end A provider with an outstanding debt under this subdivision is not eligible to care for
children receiving child care assistance until:

(1) the debt is paid in full; deleted text begin or
deleted text end

(2) satisfactory arrangements are made with the county new text begin or commissioner new text end to retire the
debt consistent with the requirements of this chapter and Minnesota Rules, chapter 3400,
and the provider is in compliance with the arrangements deleted text begin . deleted text end new text begin ; or
new text end

new text begin (3) the commissioner determines that it is in the best interests of the state to compromise
debts owed to the state pursuant to section 16D.15.
new text end

deleted text begin (d) deleted text end new text begin (g) new text end When both the family and the provider acted together to intentionally cause the
overpayment, both the family and the provider are jointly liable for the overpayment
regardless of who benefited from the overpayment. The county new text begin or commissioner new text end must
recover the overpayment as provided in paragraphs (b) and deleted text begin (c) deleted text end new text begin (e) new text end . When the family or the
provider is in compliance with a repayment agreement, the party in compliance is eligible
to receive child care assistance or to care for children receiving child care assistance despite
the other party's noncompliance with repayment arrangements.

new text begin (h) Neither a county agency nor the commissioner shall recover an overpayment from
a family or a provider that occurred more than six years before the county or the
commissioner determined the amount of the overpayment. This paragraph does not apply
to overpayments that are the result of fraud under section 256.046 or 256.98, theft under
section 609.52, false claims under the state or federal False Claims Act, or a federal crime
relating to theft of government funds or fraudulent receipt of benefits.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 4.

Minnesota Statutes 2020, section 119B.125, subdivision 1, is amended to read:

Subdivision 1.

Authorization.

deleted text begin Except as provided in subdivision 5, deleted text end A county or the
commissioner must authorize the provider chosen by an applicant or a participant before
the county can authorize payment for care provided by that provider. The commissioner
must establish the requirements necessary for authorization of providers. A provider must
be reauthorized every two years. A legal, nonlicensed family child care provider also must
be reauthorized when another person over the age of 13 joins the household, a current
household member turns 13, or there is reason to believe that a household member has a
factor that prevents authorization. The provider is required to report all family changes that
would require reauthorization. When a provider has been authorized for payment for
providing care for families in more than one county, the county responsible for
reauthorization of that provider is the county of the family with a current authorization for
that provider and who has used the provider for the longest length of time.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 5.

Minnesota Statutes 2020, section 119B.13, subdivision 1, is amended to read:

Subdivision 1.

Subsidy restrictions.

(a) new text begin Beginning November 15, 2021, new text end the maximum
rate paid for child care assistance in any county or county price cluster under the child care
fund shall be new text begin :
new text end

new text begin (1) for all infants and toddlers, new text end the greater of the deleted text begin 25th deleted text end new text begin 40th new text end percentile of the deleted text begin 2018 deleted text end new text begin 2021 new text end
child care provider rate survey or the rates in effect at the time of the update deleted text begin . deleted text end new text begin ; and
new text end

new text begin (2) for all preschool and school-age children, the greater of the 30th percentile of the
2021 child care provider rate survey or the rates in effect at the time of the update.
new text end

new text begin (b) Beginning the first full service period on or after January 1, 2025, the maximum rate
paid for child care assistance in a county or county price cluster under the child care fund
shall be:
new text end

new text begin (1) for all infants and toddlers, the greater of the 40th percentile of the 2024 child care
provider rate survey or the rates in effect at the time of the update; and
new text end

new text begin (2) for all preschool and school-age children, the greater of the 30th percentile of the
2024 child care provider rate survey or the rates in effect at the time of the update.
new text end

new text begin The rates under paragraph (a) continue until the rates under this paragraph go into effect.
new text end

new text begin (c) new text end For a child care provider located within the boundaries of a city located in two or
more of the counties of Benton, Sherburne, and Stearns, the maximum rate paid for child
care assistance shall be equal to the maximum rate paid in the county with the highest
maximum reimbursement rates or the provider's charge, whichever is less. The commissioner
may: (1) assign a county with no reported provider prices to a similar price cluster; and (2)
consider county level access when determining final price clusters.

deleted text begin (b) deleted text end new text begin (d) new text end A rate which includes a special needs rate paid under subdivision 3 may be in
excess of the maximum rate allowed under this subdivision.

deleted text begin (c) deleted text end new text begin (e) new text end The department shall monitor the effect of this paragraph on provider rates. The
county shall pay the provider's full charges for every child in care up to the maximum
established. The commissioner shall determine the maximum rate for each type of care on
an hourly, full-day, and weekly basis, including special needs and disability care.

deleted text begin (d) deleted text end new text begin (f) new text end If a child uses one provider, the maximum payment for one day of care must not
exceed the daily rate. The maximum payment for one week of care must not exceed the
weekly rate.

deleted text begin (e) deleted text end new text begin (g) new text end If a child uses two providers under section 119B.097, the maximum payment
must not exceed:

(1) the daily rate for one day of care;

(2) the weekly rate for one week of care by the child's primary provider; and

(3) two daily rates during two weeks of care by a child's secondary provider.

deleted text begin (f) deleted text end new text begin (h) new text end Child care providers receiving reimbursement under this chapter must not be paid
activity fees or an additional amount above the maximum rates for care provided during
nonstandard hours for families receiving assistance.

deleted text begin (g) deleted text end new text begin (i) new text end If the provider charge is greater than the maximum provider rate allowed, the
parent is responsible for payment of the difference in the rates in addition to any family
co-payment fee.

deleted text begin (h) All maximum provider rates changes shall be implemented on the Monday following
the effective date of the maximum provider rate.
deleted text end

deleted text begin (i) Beginning September 21, 2020, deleted text end new text begin (j) new text end The maximum registration fee paid for child care
assistance in any county or county price cluster under the child care fund shall be new text begin set as
follows: (1) beginning November 15, 2021, new text end the greater of the deleted text begin 25th deleted text end new text begin 40th new text end percentile of the
deleted text begin 2018 deleted text end new text begin 2021 new text end child care provider rate survey or the registration fee in effect at the time of the
update deleted text begin . deleted text end new text begin ; and (2) beginning the first full service period on or after January 1, 2025, the
maximum registration fee shall be the greater of the 40th percentile of the 2024 child care
provider rate survey or the registration fee in effect at the time of the update. The registration
fees under clause (1) continue until the registration fees under clause (2) go into effect.
new text end

new text begin (k) new text end Maximum registration fees must be set for licensed family child care and for child
care centers. For a child care provider located in the boundaries of a city located in two or
more of the counties of Benton, Sherburne, and Stearns, the maximum registration fee paid
for child care assistance shall be equal to the maximum registration fee paid in the county
with the highest maximum registration fee or the provider's charge, whichever is less.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective November 15, 2021.
new text end

Sec. 6.

Minnesota Statutes 2020, section 119B.13, subdivision 1a, is amended to read:

Subd. 1a.

Legal nonlicensed family child care provider rates.

(a) Legal nonlicensed
family child care providers receiving reimbursement under this chapter must be paid on an
hourly basis for care provided to families receiving assistance.

(b) The maximum rate paid to legal nonlicensed family child care providers must be deleted text begin 68 deleted text end new text begin
90 new text end percent of the county maximum hourly rate for licensed family child care providers. In
counties or county price clusters where the maximum hourly rate for licensed family child
care providers is higher than the maximum weekly rate for those providers divided by 50,
the maximum hourly rate that may be paid to legal nonlicensed family child care providers
is the rate equal to the maximum weekly rate for licensed family child care providers divided
by 50 and then multiplied by deleted text begin 0.68 deleted text end new text begin 0.90 new text end . The maximum payment to a provider for one day
of care must not exceed the maximum hourly rate times ten. The maximum payment to a
provider for one week of care must not exceed the maximum hourly rate times 50.

(c) A rate which includes a special needs rate paid under subdivision 3 may be in excess
of the maximum rate allowed under this subdivision.

(d) Legal nonlicensed family child care providers receiving reimbursement under this
chapter may not be paid registration fees for families receiving assistance.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective November 15, 2021.
new text end

Sec. 7.

Minnesota Statutes 2020, section 119B.13, subdivision 6, is amended to read:

Subd. 6.

Provider payments.

(a) A provider shall bill only for services documented
according to section 119B.125, subdivision 6. The provider shall bill for services provided
within ten days of the end of the service period. Payments under the child care fund shall
be made within 21 days of receiving a complete bill from the provider. Counties or the state
may establish policies that make payments on a more frequent basis.

(b) If a provider has received an authorization of care and been issued a billing form for
an eligible family, the bill must be submitted within 60 days of the last date of service on
the bill. A bill submitted more than 60 days after the last date of service must be paid if the
county determines that the provider has shown good cause why the bill was not submitted
within 60 days. Good cause must be defined in the county's child care fund plan under
section 119B.08, subdivision 3, and the definition of good cause must include county error.
Any bill submitted more than a year after the last date of service on the bill must not be
paid.

(c) If a provider provided care for a time period without receiving an authorization of
care and a billing form for an eligible family, payment of child care assistance may only be
made retroactively for a maximum of deleted text begin six deleted text end new text begin three new text end months from the date the provider is issued
an authorization of care and billing form. new text begin For a family at application, if a provider provided
child care during a time period without receiving an authorization of care and a billing form,
a county may only make child care assistance payments to the provider retroactively from
the date that child care began, or from the date that the family's eligibility began under
section 119B.09, subdivision 7, or from the date that the family meets authorization
requirements, not to exceed six months from the date that the provider is issued an
authorization of care and billing form, whichever is later.
new text end

(d) A county or the commissioner may refuse to issue a child care authorization to a
new text begin certified, new text end licensed new text begin , new text end or legal nonlicensed provider, revoke an existing child care authorization
to a new text begin certified, new text end licensed new text begin , new text end or legal nonlicensed provider, stop payment issued to a new text begin certified,
new text end licensed new text begin , new text end or legal nonlicensed provider, or refuse to pay a bill submitted by a new text begin certified,
new text end licensed new text begin , new text end or legal nonlicensed provider if:

(1) the provider admits to intentionally giving the county materially false information
on the provider's billing forms;

(2) a county or the commissioner finds by a preponderance of the evidence that the
provider intentionally gave the county materially false information on the provider's billing
forms, or provided false attendance records to a county or the commissioner;

(3) the provider is in violation of child care assistance program rules, until the agency
determines those violations have been corrected;

(4) the provider is operating after:

(i) an order of suspension of the provider's license issued by the commissioner;

(ii) an order of revocation of the provider's license new text begin issued by the commissioner new text end ; or

(iii) deleted text begin a final order of conditional license issued by the commissioner for as long as the
conditional license is in effect deleted text end new text begin an order of decertification issued to the provider new text end ;

(5) the provider submits false attendance reports or refuses to provide documentation
of the child's attendance upon request;

(6) the provider gives false child care price information; or

(7) the provider fails to report decreases in a child's attendance as required under section
119B.125, subdivision 9.

(e) For purposes of paragraph (d), clauses (3), (5), (6), and (7), the county or the
commissioner may withhold the provider's authorization or payment for a period of time
not to exceed three months beyond the time the condition has been corrected.

(f) A county's payment policies must be included in the county's child care plan under
section 119B.08, subdivision 3. If payments are made by the state, in addition to being in
compliance with this subdivision, the payments must be made in compliance with section
16A.124.

new text begin (g) If the commissioner or responsible county agency suspends or refuses payment to a
provider under paragraph (d), clause (1) or (2), or chapter 245E and the provider has:
new text end

new text begin (1) a disqualification for wrongfully obtaining assistance under section 256.98,
subdivision 8, paragraph (c);
new text end

new text begin (2) an administrative disqualification under section 256.046, subdivision 3; or
new text end

new text begin (3) a termination under section 245E.02, subdivision 4, paragraph (c), clause (4), or
245E.06;
new text end

new text begin then the provider forfeits the payment to the commissioner or the responsible county agency,
regardless of the amount assessed in an overpayment, charged in a criminal complaint, or
ordered as criminal restitution.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin The amendments to paragraph (c) are effective July 1, 2021. The
amendments to paragraphs (d) and (g) are effective August 1, 2021.
new text end

Sec. 8.

Minnesota Statutes 2020, section 119B.13, subdivision 7, is amended to read:

Subd. 7.

Absent days.

(a) Licensed child care providers and license-exempt centers
must not be reimbursed for more than 25 full-day absent days per child, excluding holidays,
in a calendar year, or for more than ten consecutive full-day absent days. "Absent day"
means any day that the child is authorized and scheduled to be in care with a licensed
provider or license-exempt center, and the child is absent from the care for the entire day.
Legal nonlicensed family child care providers must not be reimbursed for absent days. If a
child attends for part of the time authorized to be in care in a day, but is absent for part of
the time authorized to be in care in that same day, the absent time must be reimbursed but
the time must not count toward the absent days limit. Child care providers must only be
reimbursed for absent days if the provider has a written policy for child absences and charges
all other families in care for similar absences.

(b) Notwithstanding paragraph (a), children with documented medical conditions that
cause more frequent absences may exceed the 25 absent days limit, or ten consecutive
full-day absent days limit. Absences due to a documented medical condition of a parent or
sibling who lives in the same residence as the child receiving child care assistance do not
count against the absent days limit in a calendar year. Documentation of medical conditions
must be on the forms and submitted according to the timelines established by the
commissioner. A public health nurse or school nurse may verify the illness in lieu of a
medical practitioner. If a provider sends a child home early due to a medical reason,
including, but not limited to, fever or contagious illness, the child care center director or
lead teacher may verify the illness in lieu of a medical practitioner.

(c) Notwithstanding paragraph (a), children in families may exceed the absent days limit
if at least one parent: (1) is under the age of 21; (2) does not have a high school diploma or
commissioner of education-selected high school equivalency certification; and (3) is a
student in a school district or another similar program that provides or arranges for child
care, parenting support, social services, career and employment supports, and academic
support to achieve high school graduation, upon request of the program and approval of the
county. If a child attends part of an authorized day, payment to the provider must be for the
full amount of care authorized for that day.

(d) Child care providers must be reimbursed for up to ten federal or state holidays or
designated holidays per year when the provider charges all families for these days and the
holiday or designated holiday falls on a day when the child is authorized to be in attendance.
Parents may substitute other cultural or religious holidays for the ten recognized state and
federal holidays. Holidays do not count toward the absent days limit.

(e) A family deleted text begin or child care provider deleted text end must not be assessed an overpayment for an absent
day payment unless (1) there was an error in the amount of care authorized for the family,
new text begin or new text end (2) all of the allowed full-day absent payments for the child have been paid deleted text begin , or (3) the
family or provider did not timely report a change as required under law deleted text end .

(f) The provider and family shall receive notification of the number of absent days used
upon initial provider authorization for a family and ongoing notification of the number of
absent days used as of the date of the notification.

(g) For purposes of this subdivision, "absent days limit" means 25 full-day absent days
per child, excluding holidays, in a calendar year; and ten consecutive full-day absent days.

(h) For purposes of this subdivision, "holidays limit" means ten full-day holidays per
child, excluding absent days, in a calendar year.

(i) If a day meets the criteria of an absent day or a holiday under this subdivision, the
provider must bill that day as an absent day or holiday. A provider's failure to properly bill
an absent day or a holiday results in an overpayment, regardless of whether the child reached,
or is exempt from, the absent days limit or holidays limit for the calendar year.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 9.

Minnesota Statutes 2020, section 119B.25, is amended to read:

119B.25 CHILD CARE IMPROVEMENT GRANTS.

Subdivision 1.

Purpose.

The purpose of this section is to enhance and expand child care
sites, to encourage private investment in child care and early childhood education sites, to
promote availability of quality, affordable child care throughout Minnesota, and to provide
for cooperation between private nonprofit child care organizations, family child care and
center providers and the department.

Subd. 2.

Grants.

new text begin (a) new text end The commissioner shall distribute money provided by this section
through deleted text begin a grant deleted text end new text begin grants new text end to deleted text begin a deleted text end new text begin one or more new text end nonprofit deleted text begin corporation organized deleted text end new text begin corporations new text end to
plan, develop, and finance early childhood education and child care sites. deleted text begin The deleted text end new text begin A new text end nonprofit
corporation must have demonstrated the ability to analyze financing projects, have knowledge
of other sources of public and private financing for child care and early childhood education
sites, and have a relationship with regional resource and referral programs. The board of
directors of deleted text begin the deleted text end new text begin a new text end nonprofit corporation must include members who are knowledgeable about
early childhood education, child care, development and improvement, and financing.

new text begin (b) new text end The commissioners of the Departments of Human Services deleted text begin and deleted text end new text begin , new text end Employment and
Economic Development, and deleted text begin the commissioner of deleted text end the Housing Finance Agency shall advise
the deleted text begin board on the deleted text end new text begin boards of any nonprofit corporations that use the grant money provided
under this section for new text end loan deleted text begin program deleted text end new text begin programs as described in subdivision 3, paragraph (a),
clauses (1) to (4) new text end . deleted text begin The grant must be used to make loans to improve child care or early
childhood education sites, or loans to plan, design, and construct or expand licensed and
legal unlicensed sites to increase the availability of child care or early childhood education. deleted text end
All loans made by deleted text begin the deleted text end new text begin a new text end nonprofit corporation new text begin under this section new text end must comply with section
363A.16.

Subd. 3.

Financing program.

new text begin (a) new text end A nonprofit corporation that receives a grant under
this section shall use the money deleted text begin to deleted text end new text begin for one or more of the following activities new text end :

(1) new text begin to new text end establish a revolving loan fund to make loans to existing, expanding, and new
licensed and legal unlicensed child care and early childhood education sites;

(2) new text begin to new text end establish a fund to guarantee private loans to improve or construct a child care or
early childhood education site;

(3) new text begin to new text end establish a fund to provide forgivable loans or grants to match all or part of a loan
made under this section;

(4) new text begin to new text end establish a fund as a reserve against bad debt; deleted text begin and
deleted text end

(5) deleted text begin establish a fund deleted text end to provide business planning assistance for child care providers deleted text begin . deleted text end new text begin ;
new text end

new text begin (6) to provide training and consultation for child care providers to build and strengthen
their businesses and acquire key business skills; and
new text end

new text begin (7) to provide grants to child care providers for facility improvements, minor renovations,
and related equipment and services, including assistance to meet licensing requirements,
needed to establish, maintain, or expand licensed and legal unlicensed child care and early
childhood education sites.
new text end

deleted text begin The deleted text end new text begin (b) A new text end nonprofit corporation new text begin establishing loans under this section new text end shall establish the
terms and conditions for loans and loan guarantees including, but not limited to, interest
rates, repayment agreements, private match requirements, and conditions for loan forgiveness.
deleted text begin The deleted text end new text begin A new text end nonprofit corporation shall establish a minimum interest rate for loans to ensure that
necessary loan administration costs are covered. deleted text begin The deleted text end new text begin A new text end nonprofit corporation may use
interest earnings for administrative expenses.

Subd. 4.

Reporting.

A nonprofit corporation that receives a grant under this section
shall:

(1) annually report by September 30 to the commissioner the purposes for which the new text begin
grant new text end money was used in the past fiscal year, including a description of projects supported
by the financing, an account of loans new text begin and grants new text end made deleted text begin during the calendar year deleted text end , the financing
program's assets and liabilities, and an explanation of administrative expenses; and

(2) annually submit to the commissioner a copy of the report of an independent audit
performed in accordance with generally accepted accounting practices and auditing standards.

Sec. 10.

Minnesota Statutes 2020, section 245E.07, subdivision 1, is amended to read:

Subdivision 1.

Grounds for and methods of monetary recovery.

(a) The department
may obtain monetary recovery from a provider who has been improperly paid by the child
care assistance program, regardless of whether the error was intentional deleted text begin or county error deleted text end .
new text begin Overpayments designated solely as agency error, and not the result of acts or omissions on
the part of a provider or recipient, must not be established or collected. new text end The department
does not need to establish a pattern as a precondition of monetary recovery of erroneous or
false billing claims, duplicate billing claims, or billing claims based on false statements or
financial misconduct.

(b) The department shall obtain monetary recovery from providers by the following
means:

(1) permitting voluntary repayment of money, either in lump-sum payment or installment
payments;

(2) using any legal collection process;

(3) deducting or withholding program payments; or

(4) utilizing the means set forth in chapter 16D.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 11. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; FEDERAL
FUND AND CHILD CARE AND DEVELOPMENT BLOCK GRANT
ALLOCATIONS.
new text end

new text begin (a) The commissioner of human services shall allocate $1,500,000 in fiscal year 2022
from the federal fund to award grants to community-based organizations working with
family, friend, and neighbor caregivers, with a particular emphasis on such caregivers
serving children from low-income families, families of color, Tribal communities, or families
with limited English language proficiency, to promote healthy development, social-emotional
learning, early literacy, and school readiness.
new text end

new text begin (b) The commissioner of human services shall allocate $13,500,000 in fiscal year 2022
from the federal fund and $9,000,000 in fiscal year 2022 from the child care and development
block grant for grants under Minnesota Statutes, section 119B.25, subdivision 3, paragraph
(a), clause (7).
new text end

new text begin (c) The commissioner of human services shall allocate $1,500,000 in fiscal year 2022
from the federal fund and $1,500,000 in fiscal year 2022 from the child care and development
block grant for workforce development grants to organizations operating child care resource
and referral programs under Minnesota Statutes, section 119B.19, to provide economically
challenged individuals the jobs skills training, career counseling, and job placement assistance
necessary to begin a career path in child care. By January 1, 2024, the commissioner shall
report to the chairs and ranking minority members of the legislative committees with
jurisdiction over early care and education the outcomes of the grant program, including the
effects on the child care workforce.
new text end

new text begin (d) The commissioner of human services shall allocate $3,000,000 in fiscal year 2022
from the federal fund for business training grants under Minnesota Statutes, section 119B.25,
subdivision 3, paragraph (a), clause (6).
new text end

new text begin (e) The commissioner of human services shall allocate $35,444,000 in fiscal year 2022,
$66,398,000 in fiscal year 2023, $81,755,000 in fiscal year 2024, and $57,737,000 in fiscal
year 2025 from the child care and development block grant for rate and registration fee
increases under Minnesota Statutes, section 119B.13, subdivision 1, paragraphs (a) and (h),
including amounts for reprioritization of the basic sliding fee waiting list under Minnesota
Statutes, section 119B.03, subdivision 4a, amounts for additional funding for the basic
sliding fee child care assistance program under Minnesota Statutes, section 119B.03, and
amounts to increase child care assistance rates for legal, nonlicensed family child care
providers under Minnesota Statutes, section 119B.13, subdivision 1a. The commissioner
may not increase the rate differential percentage established under Minnesota Statutes,
section 119B.13, subdivision 3a or 3b. If increased federal discretionary child care
development block grant funding is used to pay for the rate increase in this clause, the
commissioner, in consultation with the commissioner of management and budget, may
adjust the amount of working family credit expenditures as needed to meet the state's
maintenance of effort requirements for the TANF block grant.
new text end

new text begin (f) The allocations in this section are available until June 30, 2025.
new text end

Sec. 12. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2020, section 119B.125, subdivision 5, new text end new text begin is repealed effective August
1, 2021.
new text end

ARTICLE 9

CHILD PROTECTION

Section 1.

Minnesota Statutes 2020, section 256N.25, subdivision 2, is amended to read:

Subd. 2.

Negotiation of agreement.

(a) When a child is determined to be eligible for
Northstar kinship assistance or adoption assistance, the financially responsible agency, or,
if there is no financially responsible agency, the agency designated by the commissioner,
must negotiate with the caregiver to develop an agreement under subdivision 1. If and when
the caregiver and agency reach concurrence as to the terms of the agreement, both parties
shall sign the agreement. The agency must submit the agreement, along with the eligibility
determination outlined in sections 256N.22, subdivision 7, and 256N.23, subdivision 7, to
the commissioner for final review, approval, and signature according to subdivision 1.

(b) A monthly payment is provided as part of the adoption assistance or Northstar kinship
assistance agreement to support the care of children unless the child is eligible for adoption
assistance and determined to be an at-risk child, in which case no payment will be made
unless and until the caregiver obtains written documentation from a qualified expert that
the potential disability upon which eligibility for the agreement was based has manifested
itself.

(1) The amount of the payment made on behalf of a child eligible for Northstar kinship
assistance or adoption assistance is determined through agreement between the prospective
relative custodian or the adoptive parent and the financially responsible agency, or, if there
is no financially responsible agency, the agency designated by the commissioner, using the
assessment tool established by the commissioner in section 256N.24, subdivision 2, and the
associated benefit and payments outlined in section 256N.26. Except as provided under
section 256N.24, subdivision 1, paragraph (c), the assessment tool establishes the monthly
benefit level for a child under foster care. The monthly payment under a Northstar kinship
assistance agreement or adoption assistance agreement may be negotiated up to the monthly
benefit level under foster care. In no case may the amount of the payment under a Northstar
kinship assistance agreement or adoption assistance agreement exceed the foster care
maintenance payment which would have been paid during the month if the child with respect
to whom the Northstar kinship assistance or adoption assistance payment is made had been
in a foster family home in the state.

(2) The rate schedule for the agreement is determined based on the age of the child on
the date that the prospective adoptive parent or parents or relative custodian or custodians
sign the agreement.

(3) The income of the relative custodian or custodians or adoptive parent or parents must
not be taken into consideration when determining eligibility for Northstar kinship assistance
or adoption assistance or the amount of the payments under section 256N.26.

(4) With the concurrence of the relative custodian or adoptive parent, the amount of the
payment may be adjusted periodically using the assessment tool established by the
commissioner in section 256N.24, subdivision 2, and the agreement renegotiated under
subdivision 3 when there is a change in the child's needs or the family's circumstances.

(5) An adoptive parent of an at-risk child with an adoption assistance agreement may
request a reassessment of the child under section 256N.24, subdivision 10, and renegotiation
of the adoption assistance agreement under subdivision 3 to include a monthly payment, if
the caregiver has written documentation from a qualified expert that the potential disability
upon which eligibility for the agreement was based has manifested itself. Documentation
of the disability must be limited to evidence deemed appropriate by the commissioner.

(c) For Northstar kinship assistance agreements:

(1) the initial amount of the monthly Northstar kinship assistance payment must be
equivalent to the foster care rate in effect at the time that the agreement is signed deleted text begin less any
offsets under section 256N.26, subdivision 11 deleted text end , or a lesser negotiated amount if agreed to
by the prospective relative custodian and specified in that agreement, unless the Northstar
kinship assistance agreement is entered into when a child is under the age of six; and

(2) the amount of the monthly payment for a Northstar kinship assistance agreement for
a child who is under the age of six must be as specified in section 256N.26, subdivision 5.

(d) For adoption assistance agreements:

(1) for a child in foster care with the prospective adoptive parent immediately prior to
adoptive placement, the initial amount of the monthly adoption assistance payment must
be equivalent to the foster care rate in effect at the time that the agreement is signed deleted text begin less
any offsets in section 256N.26, subdivision 11 deleted text end , or a lesser negotiated amount if agreed to
by the prospective adoptive parents and specified in that agreement, unless the child is
identified as at-risk or the adoption assistance agreement is entered into when a child is
under the age of six;

(2) for an at-risk child who must be assigned level A as outlined in section 256N.26, no
payment will be made unless and until the potential disability manifests itself, as documented
by an appropriate professional, and the commissioner authorizes commencement of payment
by modifying the agreement accordingly;

(3) the amount of the monthly payment for an adoption assistance agreement for a child
under the age of six, other than an at-risk child, must be as specified in section 256N.26,
subdivision 5;

(4) for a child who is in the Northstar kinship assistance program immediately prior to
adoptive placement, the initial amount of the adoption assistance payment must be equivalent
to the Northstar kinship assistance payment in effect at the time that the adoption assistance
agreement is signed or a lesser amount if agreed to by the prospective adoptive parent and
specified in that agreement, unless the child is identified as an at-risk child; and

(5) for a child who is not in foster care placement or the Northstar kinship assistance
program immediately prior to adoptive placement or negotiation of the adoption assistance
agreement, the initial amount of the adoption assistance agreement must be determined
using the assessment tool and process in this section and the corresponding payment amount
outlined in section 256N.26.

Sec. 2.

Minnesota Statutes 2020, section 256N.25, subdivision 3, is amended to read:

Subd. 3.

Renegotiation of agreement.

(a) A relative custodian or adoptive parent of a
child with a Northstar kinship assistance or adoption assistance agreement may request
renegotiation of the agreement when there is a change in the needs of the child or in the
family's circumstances. When a relative custodian or adoptive parent requests renegotiation
of the agreement, a reassessment of the child must be completed consistent with section
256N.24, subdivisions 10 and 11. If the reassessment indicates that the child's level has
changed, the financially responsible agency or, if there is no financially responsible agency,
the agency designated by the commissioner or the commissioner's designee, and the caregiver
must renegotiate the agreement to include a payment with the level determined through the
reassessment process. The agreement must not be renegotiated unless the commissioner,
the financially responsible agency, and the caregiver mutually agree to the changes. The
effective date of any renegotiated agreement must be determined by the commissioner.

(b) An adoptive parent of an at-risk child with an adoption assistance agreement may
request renegotiation of the agreement to include a monthly payment under section 256N.26
if the caregiver has written documentation from a qualified expert that the potential disability
upon which eligibility for the agreement was based has manifested itself. Documentation
of the disability must be limited to evidence deemed appropriate by the commissioner. Prior
to renegotiating the agreement, a reassessment of the child must be conducted as outlined
in section 256N.24, subdivision 10. The reassessment must be used to renegotiate the
agreement to include an appropriate monthly payment. The agreement must not be
renegotiated unless the commissioner, the financially responsible agency, and the caregiver
mutually agree to the changes. The effective date of any renegotiated agreement must be
determined by the commissioner.

deleted text begin (c) Renegotiation of a Northstar kinship assistance or adoption assistance agreement is
required when one of the circumstances outlined in section 256N.26, subdivision 13, occurs.
deleted text end

Sec. 3.

Minnesota Statutes 2020, section 256N.26, subdivision 11, is amended to read:

Subd. 11.

Child income or income attributable to the child.

(a) A monthly Northstar
kinship assistance or adoption assistance payment must be considered as income and
resources attributable to the child. Northstar kinship assistance and adoption assistance are
exempt from garnishment, except as permissible under the laws of the state where the child
resides.

(b) When a child is placed into foster care, any income and resources attributable to the
child are treated as provided in sections 252.27 and 260C.331, or 260B.331, as applicable
to the child being placed.

(c) deleted text begin Consideration of income and resources attributable to the child must be part of the
negotiation process outlined in section 256N.25, subdivision 2. In some circumstances, the
receipt of other income on behalf of the child may impact the amount of the monthly payment
received by the relative custodian or adoptive parent on behalf of the child through Northstar
Care for Children. deleted text end Supplemental Security Income (SSI), retirement survivor's disability
insurance (RSDI), veteran's benefits, railroad retirement benefits, and black lung benefits
are considered income and resources attributable to the child.

Sec. 4.

Minnesota Statutes 2020, section 256N.26, subdivision 13, is amended to read:

Subd. 13.

Treatment of retirement survivor's disability insurance, veteran's benefits,
railroad retirement benefits, and black lung benefits.

deleted text begin (a) deleted text end If a child placed in foster care
receives retirement survivor's disability insurance, veteran's benefits, railroad retirement
benefits, or black lung benefits 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. If it is anticipated that a
child will be eligible to receive retirement survivor's disability insurance, veteran's benefits,
railroad retirement benefits, or black lung benefits after finalization of the adoption or
assignment of permanent legal and physical custody, the permanent caregiver shall apply
to be the payee of those benefits on the child's behalf. deleted text begin The monthly amount of the other
benefits must be considered an offset to the amount of the payment the child is determined
eligible for under Northstar Care for Children.
deleted text end

deleted text begin (b) If a child becomes eligible for retirement survivor's disability insurance, veteran's
benefits, railroad retirement benefits, or black lung benefits, after the initial amount of the
payment under Northstar Care for Children is finalized, the permanent caregiver shall contact
the commissioner to redetermine the payment under Northstar Care for Children. The
monthly amount of the other benefits must be considered an offset to the amount of the
payment the child is determined eligible for under Northstar Care for Children.
deleted text end

deleted text begin (c) If a child ceases to be eligible for retirement survivor's disability insurance, veteran's
benefits, railroad retirement benefits, or black lung benefits after the initial amount of the
payment under Northstar Care for Children is finalized, the permanent caregiver shall contact
the commissioner to redetermine the payment under Northstar Care for Children. The
monthly amount of the payment under Northstar Care for Children must be the amount the
child was determined to be eligible for prior to consideration of any offset.
deleted text end

deleted text begin (d) If the monthly payment received on behalf of the child under retirement survivor's
disability insurance, veteran's benefits, railroad retirement benefits, or black lung benefits
changes after the adoption assistance or Northstar kinship assistance agreement is finalized,
the permanent caregiver shall notify the commissioner as to the new monthly payment
amount, regardless of the amount of the change in payment. If the monthly payment changes
by $75 or more, even if the change occurs incrementally over the duration of the term of
the adoption assistance or Northstar kinship assistance agreement, the monthly payment
under Northstar Care for Children must be adjusted without further consent to reflect the
amount of the increase or decrease in the offset amount. Any subsequent change to the
payment must be reported and handled in the same manner. A change of monthly payments
of less than $75 is not a permissible reason to renegotiate the adoption assistance or Northstar
kinship assistance agreement under section 256N.25, subdivision 3. The commissioner shall
review and revise the limit at which the adoption assistance or Northstar kinship assistance
agreement must be renegotiated in accordance with subdivision 9.
deleted text end

Sec. 5.

Minnesota Statutes 2020, section 260C.163, subdivision 3, is amended to read:

Subd. 3.

Appointment of counsel.

(a) The child, parent, guardian or custodian has the
right to effective assistance of counsel in connection with a proceeding in juvenile court as
provided in this subdivision.

(b) Except in proceedings where the sole basis for the petition is habitual truancy, if the
child desires counsel but is unable to employ it, the court shall appoint counsel to represent
the child who is ten years of age or older under section 611.14, clause (4), or other counsel
at public expense.

(c) deleted text begin Except in proceedings where the sole basis for the petition is habitual truancy, if the
parent, guardian, or custodian desires counsel but is unable to employ it, the court shall
appoint counsel to represent the parent, guardian, or custodian in any case in which it feels
that such an appointment is appropriate if the person would be financially unable to obtain
counsel under the guidelines set forth in section 611.17. deleted text end new text begin In all child protection proceedings
where a child risks removal from the care of the child's parent, guardian, or custodian,
including a child in need of protection or services petition, an action pursuing removal of
a child from the child's home, a termination of parental rights petition, or a petition for
permanent out-of-home placement, if the parent, guardian, or custodian desires counsel and
is eligible for counsel under section 611.17, the court shall appoint counsel to represent
each parent, guardian, or custodian prior to the first hearing on the petition and at all stages
of the proceedings. new text end Court appointed counsel shall be at county expense as outlined in
paragraph (h).

(d) In any proceeding where the subject of a petition for a child in need of protection or
services is ten years of age or older, the responsible social services agency shall, within 14
days after filing the petition or at the emergency removal hearing under section 260C.178,
subdivision 1, if the child is present, fully and effectively inform the child of the child's
right to be represented by appointed counsel upon request and shall notify the court as to
whether the child desired counsel. Information provided to the child shall include, at a
minimum, the fact that counsel will be provided without charge to the child, that the child's
communications with counsel are confidential, and that the child has the right to participate
in all proceedings on a petition, including the opportunity to personally attend all hearings.
The responsible social services agency shall also, within 14 days of the child's tenth birthday,
fully and effectively inform the child of the child's right to be represented by counsel if the
child reaches the age of ten years while the child is the subject of a petition for a child in
need of protection or services or is a child under the guardianship of the commissioner.

(e) In any proceeding where the sole basis for the petition is habitual truancy, the child,
parent, guardian, and custodian do not have the right to appointment of a public defender
or other counsel at public expense. However, before any out-of-home placement, including
foster care or inpatient treatment, can be ordered, the court must appoint a public defender
or other counsel at public expense in accordance with this subdivision.

(f) Counsel for the child shall not also act as the child's guardian ad litem.

(g) In any proceeding where the subject of a petition for a child in need of protection or
services is not represented by an attorney, the court shall determine the child's preferences
regarding the proceedings, including informing the child of the right to appointed counsel
and asking whether the child desires counsel, if the child is of suitable age to express a
preference.

(h) Court-appointed counsel for the parent, guardian, or custodian under this subdivision
is at county expense. If the county has contracted with counsel deleted text begin meeting qualifications under
paragraph (i) deleted text end , the court shall appoint the counsel retained by the county, unless a conflict
of interest exists. If a conflict exists, after consulting with the chief judge of the judicial
district or the judge's designee, the county shall contract with competent counsel to provide
the necessary representation. The court may appoint only one counsel at public expense for
the first court hearing to represent the interests of the parents, guardians, and custodians,
unless, at any time during the proceedings upon petition of a party, the court determines
and makes written findings on the record that extraordinary circumstances exist that require
counsel to be appointed to represent a separate interest of other parents, guardians, or
custodians subject to the jurisdiction of the juvenile court.

deleted text begin (i) Counsel retained by the county under paragraph (h) must meet the qualifications
deleted text end deleted text begin established by the Judicial Council in at least one of the following: (1) has a minimum of
deleted text end deleted text begin two years' experience handling child protection cases; (2) has training in handling child
deleted text end deleted text begin protection cases from a course or courses approved by the Judicial Council; or (3) is
deleted text end deleted text begin supervised by an attorney who meets the minimum qualifications under clause (1) or (2).
deleted text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 6. new text begin DIRECTION TO THE COMMISSIONER; INITIAL IMPLEMENTATION
OF COURT-APPOINTED COUNSEL IN CHILD PROTECTION PROCEEDINGS.
new text end

new text begin (a) The commissioner of human services shall consult with counties and court
administration regarding the availability of and process for collecting data related to
court-appointed counsel under Minnesota Statutes, section 260C.163, subdivision 3, including
but not limited to:
new text end

new text begin (1) data documenting the presence of court-appointed counsel for qualifying parents,
guardians, or custodians at each emergency protective hearing;
new text end

new text begin (2) total annual court-appointed parent representation expenditures for each county;
new text end

new text begin (3) an appropriate formula to be used for distributing funding to counties to defray the
costs of court-appointed counsel in child protection proceedings;
new text end

new text begin (4) an appropriate allocation timeline for distributing funds to counties; and
new text end

new text begin (5) additional demographic information that would assist counties in obtaining title IV-E
reimbursement.
new text end

new text begin (b) By July 1, 2022, the commissioner must report to the chairs and ranking minority
members of the legislative committees with jurisdiction over human services and judiciary
policy and finance with the findings from the consultation with counties and court
administration and a plan for regular reporting of this data.
new text end

ARTICLE 10

CHILD PROTECTION POLICY

Section 1.

new text begin [260E.055] DUTY TO REPORT; PRIVATE OR PUBLIC YOUTH
RECREATION PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following terms have
the meanings given.
new text end

new text begin (b) "Abuse" means egregious harm, physical abuse, sexual abuse, substantial child
endangerment, or threatened injury as these terms are defined under section 260E.03.
new text end

new text begin (c) "Adverse action" includes but is not limited to:
new text end

new text begin (1) discharge, suspension, termination, or transfer from the private or public youth
recreation program;
new text end

new text begin (2) discharge from or termination of employment;
new text end

new text begin (3) demotion or reduction in remuneration for services; or
new text end

new text begin (4) restriction or prohibition of access to the private or public youth recreation program
or persons affiliated with it.
new text end

new text begin (d) "Employee" means a person who is 18 years of age or older who performs services
for hire for an employer and has full-time, part-time, or short-term responsibilities for the
care of the child including but not limited to day care, counseling, teaching, and coaching.
An employee does not include an independent contractor or volunteer.
new text end

new text begin (e) "Municipality" has the meaning given in section 466.01, subdivision 1.
new text end

new text begin (f) "Private or public youth recreation program" includes but is not limited to day camps
or programs involving athletics, theater, arts, religious education, outdoor education, youth
empowerment, or socialization.
new text end

new text begin Subd. 2. new text end

new text begin Duty to report. new text end

new text begin (a) An employee or supervisor of a private or public youth
recreation program shall immediately report information to the local welfare agency, agency
responsible for assessing or investigating the report, police department, county sheriff,
Tribal social services agency, or Tribal police department if:
new text end

new text begin (1) the employee or supervisor knows or has reason to believe that another employee or
supervisor is abusing or has abused a child within the preceding three years; or
new text end

new text begin (2) a child discloses to the employee or supervisor that the child is being abused or has
been abused within the preceding three years.
new text end

new text begin (b) An oral report shall be made immediately by telephone or otherwise. An oral report
shall be followed within 72 hours, exclusive of weekends and holidays, by a report in writing.
Any report shall be of sufficient content to identify the child, any person believed to be
responsible for the abuse of the child, the nature and extent of the abuse, and the name and
address of the reporter. The agency receiving the report shall accept a report notwithstanding
refusal by a reporter to provide the reporter's name or address if the report is otherwise
sufficient under this paragraph.
new text end

new text begin Subd. 3. new text end

new text begin Retaliation prohibited. new text end

new text begin (a) An employer of any person required to make a
report under this section shall not retaliate against the person for reporting in good faith, or
against a child with respect to whom a report is made, because of the report.
new text end

new text begin (b) The employer of any person required to report under this section who retaliates
against the person because of a report under this section is liable to that person for actual
damages and, in addition, a penalty of up to $10,000.
new text end

new text begin (c) There shall be a rebuttable presumption that any adverse action taken within 90 days
of a report is retaliatory.
new text end

new text begin Subd. 4. new text end

new text begin Immunity. new text end

new text begin (a) The following persons are immune from civil or criminal liability
if the person is acting in good faith:
new text end

new text begin (1) an employee or supervisor who reports pursuant to this section or, following the
submission of a report, cooperates with an assessment or investigation under this chapter;
and
new text end

new text begin (2) a municipality or private entity providing a private or public youth recreation program
that provides training on making a report under this section, assists in making a report under
this section, or following the submission of a report, cooperates with an investigation or
assessment under this chapter.
new text end

new text begin (b) This subdivision does not provide immunity to any person for failure to make a
required report or for committing abuse.
new text end

new text begin Subd. 5. new text end

new text begin Penalties for failure to report; false reports. new text end

new text begin (a) A person who is required to
report under this section but fails to report is guilty of a petty misdemeanor.
new text end

new text begin (b) Section 260E.08, paragraph (d), applies to reports made under this section.
new text end

new text begin Subd. 6. new text end

new text begin Construction with other law. new text end

new text begin As used in this section, "reports" does not include
mandated or voluntary reports under section 260E.06 and nothing in this section shall govern
reports made pursuant to section 260E.06.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 2.

new text begin [260E.065] TRAINING FOR REPORTERS.
new text end

new text begin The local welfare agency must offer training to a person required to make a report under
section 260E.055 or 260E.06. The training may be offered online or in person and must
provide an explanation of the legal obligations of a reporter, consequences for failure to
report, and instruction on how to detect and report suspected maltreatment or suspected
abuse, as defined under section 260E.055, subdivision 1, paragraph (b). A local welfare
agency may fulfill the requirement under this section by directing reporters to trainings
offered by the commissioner.
new text end

Sec. 3. new text begin LEGISLATIVE TASK FORCE; CHILD PROTECTION.
new text end

new text begin (a) A legislative task force is created to:
new text end

new text begin (1) review the efforts being made to implement the recommendations of the Governor's
Task Force on the Protection of Children;
new text end

new text begin (2) expand the efforts into related areas of the child welfare system;
new text end

new 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;
new text end

new 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;
new text end

new text begin (5) 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, 2022, to implement appropriate
modifications;
new text end

new text begin (6) evaluate and consider the intersection of educational neglect and the child protection
system; and
new text end

new text begin (7) identify additional areas within the child welfare system that need to be addressed
by the legislature.
new text end

new text begin (b) Members of the legislative task force shall include:
new text end

new text begin (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
new text end

new text begin (2) six members from the senate, including three members appointed by the senate
majority leader and three members appointed by the senate minority leader.
new text end

new text begin (c) Members of the task force shall serve a term that expires on December 31 of the
even-numbered 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.
new text end

new text begin (d) Initial appointments to the task force shall be made by July 15, 2021. The chair shall
convene the first meeting of the task force by August 15, 2021.
new text end

new text begin (e) The task force may provide oversight and monitoring of:
new text end

new text begin (1) the efforts by the Department of Human Services, counties, and Tribes to implement
laws related to child protection;
new text end

new text begin (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;
new text end

new text begin (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
new text end

new text begin (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.
new text end

new 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.
new text end

new text begin (g) This section expires December 31, 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

ARTICLE 11

BEHAVIORAL HEALTH

Section 1.

Minnesota Statutes 2020, section 245.462, subdivision 17, is amended to read:

Subd. 17.

Mental health practitioner.

(a) "Mental health practitioner" means a person
providing services to adults with mental illness or children with emotional disturbance who
is qualified in at least one of the ways described in paragraphs (b) to (g). A mental health
practitioner for a child client must have training working with children. A mental health
practitioner for an adult client must have training working with adults.

(b) For purposes of this subdivision, a practitioner is qualified through relevant
coursework if the practitioner 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 supervised experience in the delivery of services to adults
or children with:

(i) mental illness, substance use disorder, or emotional disturbance; or

(ii) traumatic brain injury or developmental disabilities and completes training on mental
illness, recovery from mental illness, mental health de-escalation techniques, co-occurring
mental illness and substance abuse, and psychotropic medications and side effects;

(2) is fluent in the non-English language of the ethnic group to which at least 50 percent
of the practitioner's clients belong, completes 40 hours of training in the delivery of services
to adults with mental illness or children with emotional disturbance, and receives clinical
supervision from a mental health professional at least once a week until the requirement of
2,000 hours of supervised experience is met;

(3) is working in a day treatment program under section 245.4712, subdivision 2; deleted text begin or
deleted text end

(4) has completed a practicum or internship that (i) requires direct interaction with adults
or children served, and (ii) is focused on behavioral sciences or related fields deleted text begin . deleted text end new 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) For purposes of this subdivision, a practitioner is qualified through work experience
if the person:

(1) has at least 4,000 hours of supervised experience in the delivery of services to adults
or children with:

(i) mental illness, substance use disorder, or emotional disturbance; or

(ii) traumatic brain injury or developmental disabilities and completes training on mental
illness, recovery from mental illness, mental health de-escalation techniques, co-occurring
mental illness and substance abuse, and psychotropic medications and side effects; or

(2) has at least 2,000 hours of supervised experience in the delivery of services to adults
or children with:

(i) mental illness, emotional disturbance, or substance use disorder, and receives clinical
supervision as required by applicable statutes and rules from a mental health professional
at least once a week until the requirement of 4,000 hours of supervised experience is met;
or

(ii) traumatic brain injury or developmental disabilities; completes training on mental
illness, recovery from mental illness, mental health de-escalation techniques, co-occurring
mental illness and substance abuse, and psychotropic medications and side effects; and
receives clinical supervision as required by applicable statutes and rules at least once a week
from a mental health professional until the requirement of 4,000 hours of supervised
experience is met.

(d) For purposes of this subdivision, a practitioner is qualified through a graduate student
internship if the practitioner is a graduate student in behavioral sciences or related fields
and is formally assigned by an accredited college or university to an agency or facility for
clinical training.

(e) For purposes of this subdivision, a practitioner is qualified by a bachelor's or master's
degree if the practitioner:

(1) holds a master's or other graduate degree in behavioral sciences or related fields; or

(2) holds a bachelor's degree in behavioral sciences or related fields and completes a
practicum or internship that (i) requires direct interaction with adults or children served,
and (ii) is focused on behavioral sciences or related fields.

(f) For purposes of this subdivision, a practitioner is qualified as a vendor of medical
care if the practitioner meets the definition of vendor of medical care in section 256B.02,
subdivision 7, paragraphs (b) and (c), and is serving a federally recognized tribe.

(g) For purposes of medical assistance coverage of diagnostic assessments, explanations
of findings, and psychotherapy under section 256B.0625, subdivision 65, a mental health
practitioner working as a clinical trainee means that the practitioner's clinical supervision
experience is helping the practitioner gain knowledge and skills necessary to practice
effectively and independently. This may include supervision of direct practice, treatment
team collaboration, continued professional learning, and job management. The practitioner
must also:

(1) comply with requirements for licensure or board certification as a mental health
professional, according to the qualifications under Minnesota Rules, part 9505.0371, subpart
5, item A, including supervised practice in the delivery of mental health services for the
treatment of mental illness; or

(2) be a student in a bona fide field placement or internship under a program leading to
completion of the requirements for licensure as a mental health professional according to
the qualifications under Minnesota Rules, part 9505.0371, subpart 5, item A.

(h) For purposes of this subdivision, "behavioral sciences or related fields" has the
meaning given in section 256B.0623, subdivision 5, paragraph (d).

(i) Notwithstanding the licensing requirements established by a health-related licensing
board, as defined in section 214.01, subdivision 2, this subdivision supersedes any other
statute or rule.

Sec. 2.

Minnesota Statutes 2020, section 245.4876, is amended by adding a subdivision
to read:

new text begin Subd. 3a. new text end

new text begin Individual treatment plans. new text end

new text begin All providers of outpatient services, day treatment
services, professional home-based family treatment, residential treatment, and acute care
hospital inpatient treatment, and all regional treatment centers that provide mental health
services for children must develop an individual treatment plan for each child client. The
individual treatment plan must be based on a diagnostic assessment. To the extent appropriate,
the child and the child's family shall be involved in all phases of developing and
implementing the individual treatment plan. Providers of residential treatment, professional
home-based family treatment, and acute care hospital inpatient treatment, and regional
treatment centers must develop the individual treatment plan within ten working days of
client intake or admission and must review the individual treatment plan every 90 days after
intake. Providers of day treatment services must develop the individual treatment plan before
the completion of five working days in which service is provided or within 30 days after
the diagnostic assessment is completed or obtained, whichever occurs first. Providers of
outpatient services must develop the individual treatment plan within 30 days after the
diagnostic assessment is completed or obtained or by the end of the second session of an
outpatient service, not including the session in which the diagnostic assessment was provided,
whichever occurs first. Providers of outpatient and day treatment services 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 September 30, 2021, and expires July
1, 2022.
new text end

Sec. 3.

Minnesota Statutes 2020, section 245.4882, subdivision 1, is amended to read:

Subdivision 1.

Availability of residential treatment services.

County boards must
provide or contract for enough residential treatment services to meet the needs of each child
with severe emotional disturbance residing in the county and needing this level of care.
Length of stay is based on the child's residential treatment need and shall be deleted text begin subject to the
six-month review process established in section 260C.203, and for children in voluntary
placement for treatment, the court review process in section 260D.06 deleted text end new text begin reviewed every 90
days new text end . Services must be appropriate to the child's age and treatment needs and must be made
available as close to the county as possible. Residential treatment must be designed to:

(1) help the child improve family living and social interaction skills;

(2) help the child gain the necessary skills to return to the community;

(3) stabilize crisis admissions; and

(4) work with families throughout the placement to improve the ability of the families
to care for children with severe emotional disturbance in the home.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective September 30, 2021.
new text end

Sec. 4.

Minnesota Statutes 2020, section 245.4882, subdivision 3, is amended to read:

Subd. 3.

Transition to community.

Residential treatment facilities and regional treatment
centers serving children must plan for and assist those children and their families in making
a transition to less restrictive community-based services. new text begin Discharge planning for the child
to return to the community must include identification of and referrals to appropriate home
and community supports that meet the needs of the child and family. Discharge planning
must begin within 30 days after the child enters residential treatment and be updated every
60 days. new text end Residential treatment facilities must also arrange for appropriate follow-up care
in the community. Before a child is discharged, the residential treatment facility or regional
treatment center shall provide notification to the child's case manager, if any, so that the
case manager can monitor and coordinate the transition and make timely arrangements for
the child's appropriate follow-up care in the community.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective September 30, 2021.
new text end

Sec. 5.

Minnesota Statutes 2020, section 245.4885, subdivision 1, as amended by Laws
2021, chapter 30, article 10, section 1, is amended to read:

Subdivision 1.

Admission criteria.

(a) Prior to admission or placement, except in the
case of an emergency, all children referred for treatment of severe emotional disturbance
in a treatment foster care setting, residential treatment facility, or informally admitted to a
regional treatment center shall undergo an assessment to determine the appropriate level of
care if deleted text begin public deleted text end new text begin county new text end funds are used to pay for the child's services.

(b) The deleted text begin responsible social services agency deleted text end new text begin county board new text end shall determine the appropriate
level of care for a child when county-controlled funds are used to pay for the child's deleted text begin services
or placement in a qualified residential treatment facility under chapter deleted text end deleted text begin 260C deleted text end deleted text begin and licensed
by the commissioner under chapter deleted text end deleted text begin 245A deleted text end deleted text begin . In accordance with section 260C.157, a juvenile
treatment screening team shall conduct a screening of a child before the team may recommend
whether to place a child deleted text end new text begin residential treatment under this chapter, including residential
treatment provided new text end in a qualified residential treatment program as defined in section
260C.007, subdivision 26d. When a deleted text begin social services agency deleted text end new text begin county board new text end does not have
responsibility for a child's placement and the child is enrolled in a prepaid health program
under section 256B.69, the enrolled child's contracted health plan must determine the
appropriate level of care for the child. When Indian Health Services funds or funds of a
tribally owned facility funded under the Indian Self-Determination and Education Assistance
Act, Public Law 93-638, are deleted text begin to be deleted text end used for deleted text begin a deleted text end new text begin the new text end child, the Indian Health Services or 638
tribal health facility must determine the appropriate level of care for the child. When more
than one entity bears responsibility for a child's coverage, the entities shall coordinate level
of care determination activities for the child to the extent possible.

(c) The deleted text begin responsible social services agency must make the child's level of care
determination available to the child's juvenile treatment screening team, as permitted under
chapter deleted text end deleted text begin 13 deleted text end deleted text begin . The level of care determination shall inform the juvenile treatment screening
team process and the assessment in section 260C.704 when considering whether to place
the child in a qualified residential treatment program. When the responsible social services
agency is not involved in determining a child's placement, the deleted text end child's level of care
determination shall determine whether the proposed treatment:

(1) is necessary;

(2) is appropriate to the child's individual treatment needs;

(3) cannot be effectively provided in the child's home; and

(4) provides a length of stay as short as possible consistent with the individual child's
needs.

(d) When a level of care determination is conducted, the deleted text begin responsible social services
agency deleted text end new text begin county board new text end or other entity may not determine that a screening of a child deleted text begin under
section 260C.157 or deleted text end new text begin , new text end referral new text begin , new text end or admission to a deleted text begin treatment foster care setting or deleted text end residential
treatment facility is not appropriate solely because services were not first provided to the
child in a less restrictive setting and the child failed to make progress toward or meet
treatment goals in the less restrictive setting. The level of care determination must be based
on a diagnostic assessment of a child that deleted text begin includes a functional assessment which deleted text end evaluates
the child's family, school, and community living situations; and an assessment of the child's
need for care out of the home using a validated tool which assesses a child's functional status
and assigns an appropriate level of care to the child. The validated tool must be approved
by the commissioner of human services and may be the validated tool approved for the
child's assessment under section 260C.704 if the juvenile treatment screening team
recommended placement of the child in a qualified residential treatment program. If a
diagnostic assessment deleted text begin including a functional assessment deleted text end has been completed by a mental
health professional within the past 180 days, a new diagnostic assessment need not be
completed unless in the opinion of the current treating mental health professional the child's
mental health status has changed markedly since the assessment was completed. The child's
parent shall be notified if an assessment will not be completed and of the reasons. A copy
of the notice shall be placed in the child's file. Recommendations developed as part of the
level of care determination process shall include specific community services needed by
the child and, if appropriate, the child's family, and shall indicate whether these services
are available and accessible to the child and the child's family. new text begin The child and the child's
family must be invited to any meeting where the level of care determination is discussed
and decisions regarding residential treatment are made. The child and the child's family
may invite other relatives, friends, or advocates to attend these meetings.
new text end

(e) During the level of care determination process, the child, child's family, or child's
legal representative, as appropriate, must be informed of the child's eligibility for case
management services and family community support services and that an individual family
community support plan is being developed by the case manager, if assigned.

deleted text begin (f) When the responsible social services agency has authority, the agency must engage
the child's parents in case planning under sections 260C.212 and 260C.708 and chapter
260D unless a court terminates the parent's rights or court orders restrict the parent from
participating in case planning, visitation, or parental responsibilities.
deleted text end

deleted text begin (g) deleted text end new text begin (f) new text end The level of care determination, placement decision, and recommendations for
mental health services must be documented in the child's record deleted text begin , as required in chapters
deleted text end deleted text begin 260C deleted text end deleted text begin and 260D deleted text end new text begin and made available to the child's family, as appropriate new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective September 30, 2021.
new text end

Sec. 6.

Minnesota Statutes 2020, 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 placement. 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 new text begin , including
supervision of clinical trainees who are Black, indigenous, or people of color new text end ;

(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.

Sec. 7.

Minnesota Statutes 2020, section 245.4901, as amended by Laws 2021, chapter
30, article 17, section 44, is amended to read:

245.4901 SCHOOL-LINKED deleted text begin MENTAL deleted text end new text begin BEHAVIORAL new text end HEALTH GRANTS.

Subdivision 1.

Establishment.

The commissioner of human services shall establish a
school-linked deleted text begin mental deleted text end new text begin behavioral new text end health grant program to provide early identification and
intervention for students with mental health new text begin and substance use disorder new text end needs and to build
the capacity of schools to support students with mental health new text begin and substance use disorder new text end
needs in the classroom.

Subd. 2.

Eligible applicants.

An eligible applicant for new text begin a new text end school-linked deleted text begin mental deleted text end new text begin behavioral new text end
health deleted text begin grants deleted text end new text begin grant new text end is an entity new text begin or provider new text end that is:

(1) a mental health clinic certified under section 245I.20;

(2) a community mental health center under section 256B.0625, subdivision 5;

(3) an Indian health service facility or a facility owned and operated by a tribe or tribal
organization operating under United States Code, title 25, section 5321;

(4) a provider of children's therapeutic services and supports as defined in section
256B.0943; deleted text begin or
deleted text end

(5) enrolled in medical assistance as a mental health or substance use disorder provider
agency and employs at least two full-time equivalent mental health professionals qualified
according to section 245I.04, subdivision 2, or two alcohol and drug counselors licensed or
exempt from licensure under chapter 148F who are qualified to provide clinical services to
children and families deleted text begin . deleted text end new text begin ;
new text end

new text begin (6) licensed under chapter 245G and in compliance with the applicable requirements in
chapters 245A, 245C, and 260E, section 626.557, and Minnesota Rules, chapter 9544; or
new text end

new text begin (7) a licensed professional in private practice as defined in section 245G.01, subdivision
17, who meets the requirements of section 254B.05, subdivision 1, paragraph (b).
new text end

Subd. 3.

Allowable grant activities and related expenses.

(a) Allowable grant activities
and related expenses may include but are not limited to:

(1) identifying and diagnosing mental health conditions new text begin and substance use disorders new text end of
students;

(2) delivering mental health new text begin and substance use disorder new text end treatment and services to students
and their families, including via telemedicine consistent with section 256B.0625, subdivision
3b;

(3) supporting families in meeting their child's needs, including navigating health care,
social service, and juvenile justice systems;

(4) providing transportation for students receiving school-linked deleted text begin mental deleted text end new text begin behavioral new text end health
services when school is not in session;

(5) building the capacity of schools to meet the needs of students with mental health new text begin and
substance use disorder new text end concerns, including school staff development activities for licensed
and nonlicensed staff; and

(6) purchasing equipment, connection charges, on-site coordination, set-up fees, and
site fees in order to deliver school-linked deleted text begin mental deleted text end new text begin behavioral new text end health services via telemedicine.

(b) Grantees shall obtain all available third-party reimbursement sources as a condition
of receiving a grant. For purposes of this grant program, a third-party reimbursement source
excludes a public school as defined in section 120A.20, subdivision 1. Grantees shall serve
students regardless of health coverage status or ability to pay.

Subd. 4.

Data collection and outcome measurement.

Grantees shall provide data to
the commissioner for the purpose of evaluating the effectiveness of the school-linked deleted text begin mental deleted text end new text begin
behavioral new text end health grant program.

Sec. 8.

new text begin [245.4902] CULTURALLY INFORMED AND CULTURALLY RESPONSIVE
MENTAL HEALTH TASK FORCE.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment; duties. new text end

new text begin The Culturally Informed and Culturally
Responsive Mental Health Task Force is established to evaluate and make recommendations
on improving the provision of culturally informed and culturally responsive mental health
services throughout Minnesota. The task force must make recommendations on:
new text end

new text begin (1) recruiting mental health providers from diverse racial and ethnic communities;
new text end

new text begin (2) training all mental health providers on cultural competency and cultural humility;
new text end

new text begin (3) assessing the extent to which mental health provider organizations embrace diversity
and demonstrate proficiency in culturally competent mental health treatment and services;
and
new text end

new text begin (4) increasing the number of mental health organizations owned, managed, or led by
individuals who are Black, indigenous, or people of color.
new text end

new text begin Subd. 2. new text end

new text begin Membership. new text end

new text begin (a) The task force must consist of the following 16 members:
new text end

new text begin (1) the commissioner of human services or the commissioner's designee;
new text end

new text begin (2) one representative from the Board of Psychology;
new text end

new text begin (3) one representative from the Board of Marriage and Family Therapy;
new text end

new text begin (4) one representative from the Board of Behavioral Health and Therapy;
new text end

new text begin (5) one representative from the Board of Social Work;
new text end

new text begin (6) three members representing undergraduate and graduate-level mental health
professional education programs, one appointed by the governor, one appointed by the
speaker of the house of representatives, and one appointed by the senate majority leader;
new text end

new text begin (7) three mental health providers who are members of communities of color or
underrepresented communities, as defined in section 148E.010, subdivision 20, one appointed
by the governor, one appointed by the speaker of the house of representatives, and one
appointed by the senate majority leader;
new text end

new text begin (8) two members representing mental health advocacy organizations, appointed by the
governor;
new text end

new text begin (9) two mental health providers, appointed by the governor; and
new text end

new text begin (10) one expert in providing training and education in cultural competency and cultural
responsiveness, appointed by the governor.
new text end

new text begin (b) Appointments to the task force must be made no later than June 1, 2022.
new text end

new text begin (c) Member compensation and reimbursement for expenses are governed by section
15.059, subdivision 3.
new text end

new text begin Subd. 3. new text end

new text begin Chairs; meetings. new text end

new text begin The members of the task force must elect two cochairs of
the task force no earlier than July 1, 2022, and the cochairs must convene the first meeting
of the task force no later than August 15, 2022. The task force must meet upon the call of
the cochairs, sufficiently often to accomplish the duties identified in this section. The task
force is subject to the open meeting law under chapter 13D.
new text end

new text begin Subd. 4. new text end

new text begin Administrative support. new text end

new text begin The Department of Human Services must provide
administrative support and meeting space for the task force.
new text end

new text begin Subd. 5. new text end

new text begin Reports. new text end

new text begin No later than January 1, 2023, and by January 1 of each year thereafter,
the task force must submit a written report to the members of the legislative committees
with jurisdiction over health and human services on the recommendations developed under
subdivision 1.
new text end

new text begin Subd. 6. new text end

new text begin Expiration. new text end

new text begin The task force expires on January 1, 2025.
new text end

Sec. 9.

Minnesota Statutes 2020, section 254B.01, subdivision 4a, is amended to read:

Subd. 4a.

Culturally specific new text begin or culturally responsive new text end program.

(a) "Culturally specific
new text begin or culturally responsive new text end program" means a substance use disorder treatment service program
or subprogram that is deleted text begin recovery-focused and deleted text end new text begin culturally responsive or new text end culturally specific when
the program new text begin attests that it new text end :

(1) improves service quality to and outcomes of a specific deleted text begin population deleted text end new text begin community that
shares a common language, racial, ethnic, or social background new text end by advancing health equity
to help eliminate health disparities; deleted text begin and
deleted text end

(2) ensures effective, equitable, comprehensive, and respectful quality care services that
are responsive to an individual within a specific deleted text begin population's deleted text end new text begin community's new text end values, beliefs
and practices, health literacy, preferred language, and other communication needs deleted text begin . deleted text end new text begin ; and
new text end

new text begin (3) is compliant with the national standards for culturally and linguistically appropriate
services or other equivalent standards, as determined by the commissioner.
new text end

(b) A tribally licensed substance use disorder program that is designated as serving a
culturally specific population by the applicable tribal government is deemed to satisfy this
subdivision.

new text begin (c) A program satisfies the requirements of this subdivision if it attests that the program:
new text end

new text begin (1) is designed to address the unique needs of individuals who share a common language,
racial, ethnic, or social background;
new text end

new text begin (2) is governed with significant input from individuals of that specific background; and
new text end

new text begin (3) employs individuals to provide treatment services, at least 50 percent of whom are
members of the specific community being served.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner shall notify the revisor of statutes when federal
approval is obtained.
new text end

Sec. 10.

Minnesota Statutes 2020, section 254B.01, is amended by adding a subdivision
to read:

new text begin Subd. 4b. new text end

new text begin Disability responsive program. new text end

new text begin "Disability responsive program" means a
program that:
new text end

new text begin (1) is designed to serve individuals with disabilities, including individuals with traumatic
brain injuries, developmental disabilities, cognitive disabilities, and physical disabilities;
and
new text end

new text begin (2) employs individuals to provide treatment services who have the necessary professional
training, as approved by the commissioner, to serve individuals with the specific disabilities
that the program is designed to serve.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner shall notify the revisor of statutes when federal
approval is obtained.
new text end

Sec. 11.

Minnesota Statutes 2020, 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:

(1) outpatient treatment services that are licensed according to sections 245G.01 to
245G.17, or applicable tribal license;

(2) comprehensive assessments provided according to sections 245.4863, paragraph (a),
and 245G.05;

(3) care 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;

(7) medication-assisted therapy plus enhanced treatment services that meet the
requirements of clause (6) and provide nine hours of clinical services each week;

(8) 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 which
provide, respectively, 30, 15, and five hours of clinical services each week;

(9) 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;

(10) 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;

(11) high-intensity residential treatment services that are licensed according to sections
245G.01 to 245G.17 and 245G.21 or applicable tribal license, which 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

(12) 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 new text begin or culturally responsive new text end programs as defined in section 254B.01,
subdivision 4a deleted text begin , or deleted text end new text begin ;
new text end

new text begin (3) disability responsive programs as defined in section 254B.01, subdivision 4b;
new text end

deleted text begin programs or subprograms serving special populations, if the program or subprogram
meets the following requirements:
deleted text end

deleted text begin (i) is designed to address the unique needs of individuals who share a common language,
racial, ethnic, or social background;
deleted text end

deleted text begin (ii) is governed with significant input from individuals of that specific background; and
deleted text end

deleted text begin (iii) employs individuals to provide individual or group therapy, at least 50 percent of
whom are of that specific background, except when the common social background of the
individuals served is a traumatic brain injury or cognitive disability and the program employs
treatment staff who have the necessary professional training, as approved by the
commissioner, to serve clients with the specific disabilities that the program is designed to
serve;
deleted text end

deleted text begin (3) deleted text end new text begin (4) new text end 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; deleted text begin and deleted text end new text begin or
new text end

deleted text begin (4) deleted text end new text begin (5) new text end 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) 25 percent of the counseling staff are licensed mental health professionals, as defined
in section 245.462, subdivision 18, clauses (1) to (6), or are students or licensing candidates
under the supervision of a licensed alcohol and drug counselor supervisor and licensed
mental health professional, except that no more than 50 percent of the mental health staff
may be students or licensing candidates with time documented to be directly related to
provisions of co-occurring services;

(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) In order to 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, deleted text begin chemical dependency deleted text end new text begin substance use disorder new text end services
that are otherwise covered as direct face-to-face services may be provided via two-way
interactive video. The use of two-way interactive video 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.
The interactive video equipment and connection must comply with Medicare standards in
effect at the time the service is provided.

(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.

new text begin (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 end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later.
new text end

Sec. 12.

Minnesota Statutes 2020, section 254B.12, is amended by adding a subdivision
to read:

new text begin Subd. 4. new text end

new text begin Culturally specific or culturally responsive program and disability
responsive program provider rate increase. new text end

new text begin For the chemical dependency services listed
in section 254B.05, subdivision 5, provided by programs that meet the requirements of
section 254B.05, subdivision 5, paragraph (c), clauses (1), (2), and (3), on or after January
1, 2022, payment rates shall increase by five percent over the rates in effect on January 1,
2021. The commissioner shall increase prepaid medical assistance capitation rates as
appropriate to reflect this increase.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner shall notify the revisor of statutes when federal
approval is obtained.
new text end

Sec. 13.

new text begin [254B.151] SUBSTANCE USE DISORDER COMMUNITY OF PRACTICE.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment; purpose. new text end

new text begin The commissioner of human services, in
consultation with substance use disorder subject matter experts, shall establish a substance
use disorder community of practice. The purposes of the community of practice are to
improve treatment outcomes for individuals with substance use disorders and reduce
disparities by using evidence-based and best practices through peer-to-peer and
person-to-provider sharing.
new text end

new text begin Subd. 2. new text end

new text begin Participants; meetings. new text end

new text begin (a) The community of practice must include the
following participants:
new text end

new text begin (1) researchers or members of the academic community who are substance use disorder
subject matter experts, who do not have financial relationships with treatment providers;
new text end

new text begin (2) substance use disorder treatment providers;
new text end

new text begin (3) representatives from recovery community organizations;
new text end

new text begin (4) a representative from the Department of Human Services;
new text end

new text begin (5) a representative from the Department of Health;
new text end

new text begin (6) a representative from the Department of Corrections;
new text end

new text begin (7) representatives from county social services agencies;
new text end

new text begin (8) representatives from tribal nations or tribal social services providers; and
new text end

new text begin (9) representatives from managed care organizations.
new text end

new text begin (b) The community of practice must include individuals who have used substance use
disorder treatment services and must highlight the voices and experiences of individuals
who are Black, indigenous, people of color, and people from other communities that are
disproportionately impacted by substance use disorders.
new text end

new text begin (c) The community of practice must meet regularly and must hold its first meeting before
January 1, 2022.
new text end

new text begin (d) Compensation and reimbursement for expenses for participants in paragraph (b) are
governed by section 15.059, subdivision 3.
new text end

new text begin Subd. 3. new text end

new text begin Duties. new text end

new text begin (a) The community of practice must:
new text end

new text begin (1) identify gaps in substance use disorder treatment services;
new text end

new text begin (2) enhance collective knowledge of issues related to substance use disorder;
new text end

new text begin (3) understand evidence-based practices, best practices, and promising approaches to
address substance use disorder;
new text end

new text begin (4) use knowledge gathered through the community of practice to develop strategic plans
to improve outcomes for individuals who participate in substance use disorder treatment
and related services in Minnesota;
new text end

new text begin (5) increase knowledge about the challenges and opportunities learned by implementing
strategies; and
new text end

new text begin (6) develop capacity for community advocacy.
new text end

new text begin (b) The commissioner, in collaboration with subject matter experts and other participants,
may issue reports and recommendations to the legislative chairs and ranking minority
members of committees with jurisdiction over health and human services policy and finance
and local and regional governments.
new text end

Sec. 14.

Minnesota Statutes 2020, 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 deleted text begin fiscal deleted text end new text begin calendar new text end
year to the chairs and ranking minority members of the legislative committees with
jurisdiction over health and human services policy and finance, by deleted text begin March deleted text end new text begin December new text end 1 of
each year, beginning March 1, 2020.

(b) deleted text begin The commissioner of human services shall award grants from the opiate epidemic
response fund under section 256.043. deleted text end 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. new text begin 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. new text end No more than deleted text begin three deleted text end new text begin ten new text end percent of the grant amount may be used by a grantee
for administration.

Sec. 15.

Minnesota Statutes 2020, section 256.043, subdivision 3, is amended to read:

Subd. 3.

Appropriations from fund.

(a) After the appropriations in Laws 2019, chapter
63, article 3, section 1, deleted text begin paragraphs deleted text end new text begin paragraph new text end (e), deleted text begin (f), (g), and (h) deleted text end are made, $249,000 is
appropriated to the commissioner of human services for the provision of administrative
services to the Opiate Epidemic Response Advisory Council and for the administration of
the grants awarded under paragraph (e).

(b) $126,000 is appropriated to the Board of Pharmacy for the collection of the registration
fees under section 151.066.

(c) $672,000 is appropriated to the commissioner of public safety for the Bureau of
Criminal Apprehension. Of this amount, $384,000 is for drug scientists and lab supplies
and $288,000 is for special agent positions focused on drug interdiction and drug trafficking.

(d) After the appropriations in paragraphs (a) to (c) are made, 50 percent of the remaining
amount is appropriated to the commissioner of human services for distribution to county
social service and tribal social service agencies to provide child protection services to
children and families who are affected by addiction. The commissioner shall distribute this
money proportionally to counties and tribal social service agencies based on out-of-home
placement episodes where parental drug abuse is the primary reason for the out-of-home
placement using data from the previous calendar year. County and tribal social service
agencies receiving funds from the opiate epidemic response fund must annually report to
the commissioner on how the funds were used to provide child protection services, including
measurable outcomes, as determined by the commissioner. County social service agencies
and tribal social service agencies must not use funds received under this paragraph to supplant
current state or local funding received for child protection services for children and families
who are affected by addiction.

(e) After making the appropriations in paragraphs (a) to (d), the remaining amount in
the fund is appropriated to the commissioner to award grants as specified by the Opiate
Epidemic Response Advisory Council in accordance with section 256.042, unless otherwise
appropriated by the legislature.

new text begin (f) Beginning in fiscal year 2022 and each year thereafter, funds for county social service
and tribal social service agencies under paragraph (d) and grant funds specified by the Opiate
Epidemic Response Advisory Council under paragraph (e) shall be distributed on a calendar
year basis.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin The amendment to paragraph (a) is effective July 1, 2024.
new text end

Sec. 16.

Minnesota Statutes 2020, section 256B.0624, subdivision 7, as amended by Laws
2021, chapter 30, article 16, section 4, is amended to read:

Subd. 7.

Crisis stabilization services.

(a) Crisis stabilization services must be provided
by qualified staff of a crisis stabilization services provider entity and must meet the following
standards:

(1) a crisis treatment plan must be developed that meets the criteria in subdivision 11;

(2) staff must be qualified as defined in subdivision 8;

(3) crisis stabilization services must be delivered according to the crisis treatment plan
and include face-to-face contact with the recipient by qualified staff for further assessment,
help with referrals, updating of the crisis treatment plan, skills training, and collaboration
with other service providers in the community; and

(4) if a provider delivers crisis stabilization services while the recipient is absent, the
provider must document the reason for delivering services while the recipient is absent.

(b) If crisis stabilization services are provided in a supervised, licensed residential setting
that serves no more than four adult residents, and one or more individuals are present at the
setting to receive residential crisis stabilization, the residential staff must include, for at
least eight hours per day, at least one mental health professional, clinical trainee, certified
rehabilitation specialist, or mental health practitioner. new text begin The commissioner shall establish a
statewide per diem rate for crisis stabilization services provided under this paragraph to
medical assistance enrollees. The rate for a provider shall not exceed the rate charged by
that provider for the same service to other payers. Payment shall not be made to more than
one entity for each individual for services provided under this paragraph on a given day.
The commissioner shall set rates prospectively for the annual rate period. The commissioner
shall require providers to submit annual cost reports on a uniform cost reporting form and
shall use submitted cost reports to inform the rate-setting process. The commissioner shall
recalculate the statewide per diem every year.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 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. 17.

Minnesota Statutes 2020, section 256B.0625, subdivision 20, is amended to read:

Subd. 20.

Mental health case management.

(a) To the extent authorized by rule of the
state agency, medical assistance covers case management services to persons with serious
and persistent mental illness and children with severe emotional disturbance. Services
provided under this section must meet the relevant standards in sections 245.461 to 245.4887,
the Comprehensive Adult and Children's Mental Health Acts, Minnesota Rules, parts
9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.

(b) Entities meeting program standards set out in rules governing family community
support services as defined in section 245.4871, subdivision 17, are eligible for medical
assistance reimbursement for case management services for children with severe emotional
disturbance when these services meet the program standards in Minnesota Rules, parts
9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.

(c) Medical assistance and MinnesotaCare payment for mental health case management
shall be made on a monthly basis. In order to receive payment for an eligible child, the
provider must document at least a face-to-face contact with the child, the child's parents, or
the child's legal representative. To receive payment for an eligible adult, the provider must
document:

(1) at least a face-to-face contact with the adult or the adult's legal representative or a
contact by interactive video that meets the requirements of subdivision 20b; or

(2) at least a telephone contact with the adult or the adult's legal representative and
document a face-to-face contact or a contact by interactive video that meets the requirements
of subdivision 20b with the adult or the adult's legal representative within the preceding
two months.

(d) Payment for mental health case management provided by county or state staff shall
be based on the monthly rate methodology under section 256B.094, subdivision 6, paragraph
(b), with separate rates calculated for child welfare and mental health, and within mental
health, separate rates for children and adults.

(e) Payment for mental health case management provided by Indian health services or
by agencies operated by Indian tribes may be made according to this section or other relevant
federally approved rate setting methodology.

(f) Payment for mental health case management provided by vendors who contract with
a county deleted text begin or Indian tribe shall be based on a monthly rate negotiated by the host county or
tribe deleted text end new text begin must be calculated in accordance with section 256B.076, subdivision 2. Payment for
mental health case management provided by vendors who contract with a Tribe must be
based on a monthly rate negotiated by the Tribe new text end . The deleted text begin negotiated deleted text end rate must not exceed the
rate charged by the vendor for the same service to other payers. If the service is provided
by a team of contracted vendors, the deleted text begin county or tribe may negotiate a team rate with a vendor
who is a member of the team. The deleted text end team shall determine how to distribute the rate among
its members. No reimbursement received by contracted vendors shall be returned to the
county or tribe, except to reimburse the county or tribe for advance funding provided by
the county or tribe to the vendor.

(g) If the service is provided by a team which includes contracted vendors, tribal staff,
and county or state staff, the costs for county or state staff participation in the team shall be
included in the rate for county-provided services. In this case, the contracted vendor, the
tribal agency, and the county may each receive separate payment for services provided by
each entity in the same month. In order to prevent duplication of services, each entity must
document, in the recipient's file, the need for team case management and a description of
the roles of the team members.

(h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for
mental health case management shall be provided by the recipient's county of responsibility,
as defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds
used to match other federal funds. If the service is provided by a tribal agency, the nonfederal
share, if any, shall be provided by the recipient's tribe. When this service is paid by the state
without a federal share through fee-for-service, 50 percent of the cost shall be provided by
the recipient's county of responsibility.

(i) Notwithstanding any administrative rule to the contrary, prepaid medical assistance
and MinnesotaCare include mental health case management. When the service is provided
through prepaid capitation, the nonfederal share is paid by the state and the county pays no
share.

(j) The commissioner may suspend, reduce, or terminate the reimbursement to a provider
that does not meet the reporting or other requirements of this section. The county of
responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal agency,
is responsible for any federal disallowances. The county or tribe may share this responsibility
with its contracted vendors.

(k) The commissioner shall set aside a portion of the federal funds earned for county
expenditures under this section to repay the special revenue maximization account under
section 256.01, subdivision 2, paragraph (o). The repayment is limited to:

(1) the costs of developing and implementing this section; and

(2) programming the information systems.

(l) Payments to counties and tribal agencies for case management expenditures under
this section shall only be made from federal earnings from services provided under this
section. When this service is paid by the state without a federal share through fee-for-service,
50 percent of the cost shall be provided by the state. Payments to county-contracted vendors
shall include the federal earnings, the state share, and the county share.

(m) Case management services under this subdivision do not include therapy, treatment,
legal, or outreach services.

(n) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital,
and the recipient's institutional care is paid by medical assistance, payment for case
management services under this subdivision is limited to the lesser of:

(1) the last 180 days of the recipient's residency in that facility and may not exceed more
than six months in a calendar year; or

(2) the limits and conditions which apply to federal Medicaid funding for this service.

(o) Payment for case management services under this subdivision shall not duplicate
payments made under other program authorities for the same purpose.

(p) If the recipient is receiving care in a hospital, nursing facility, or residential setting
licensed under chapter 245A or 245D that is staffed 24 hours a day, seven days a week,
mental health targeted case management services must actively support identification of
community alternatives for the recipient and discharge planning.

Sec. 18.

Minnesota Statutes 2020, section 256B.0759, subdivision 2, is amended to read:

Subd. 2.

Provider participation.

new text begin (a) Outpatient new text end substance use disorder treatment
providers may elect to participate in the demonstration project and meet the requirements
of subdivision 3. To participate, a provider must notify the commissioner of the provider's
intent to participate in a format required by the commissioner and enroll as a demonstration
project provider.

new text begin (b) Programs licensed by the Department of Human Services as residential treatment
programs according to section 245G.21 that receive payment under this chapter must enroll
as demonstration project providers and meet the requirements of subdivision 3 by January
1, 2024. Programs that do not meet the requirements of this paragraph are ineligible for
payment for services provided under section 256B.0625.
new text end

new text begin (c) Programs licensed by the Department of Human Services as withdrawal management
programs according to chapter 245F that receive payment under this chapter must enroll as
demonstration project providers and meet the requirements of subdivision 3 by January 1,
2024. Programs that do not meet the requirements of this paragraph are ineligible for payment
for services provided under section 256B.0625.
new text end

new text begin (d) Out-of-state residential substance use disorder treatment programs that receive
payment under this chapter must enroll as demonstration project providers and meet the
requirements of subdivision 3 by January 1, 2024. Programs that do not meet the requirements
of this paragraph are ineligible for payment for services provided under section 256B.0625.
new text end

new text begin (e) Tribally licensed programs may elect to participate in the demonstration project and
meet the requirements of subdivision 3. The Department of Human Services must consult
with Tribal nations to discuss participation in the substance use disorder demonstration
project.
new text end

new text begin (f) The commissioner shall allow providers enrolled in the demonstration project before
July 1, 2021, to receive applicable rate enhancements authorized under subdivision 4 for
all services provided on or after the date of enrollment, except that the commissioner shall
allow a provider to receive applicable rate enhancements authorized under subdivision 4
for services provided on or after July 22, 2020, to fee-for-service enrollees, and on or after
January 1, 2021, to managed care enrollees, if the provider meets all of the following
requirements:
new text end

new text begin (1) the provider attests that during the time period for which the provider is seeking the
rate enhancement, the provider took meaningful steps in their plan approved by the
commissioner to meet the demonstration project requirements in subdivision 3; and
new text end

new text begin (2) the provider submits attestation and evidence, including all information requested
by the commissioner, of meeting the requirements of subdivision 3 to the commissioner in
a format required by the commissioner.
new text end

new text begin The commissioner may recoup any rate enhancements paid under this paragraph to a
provider that does not meet the requirements of subdivision 3 by July 1, 2021.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, or upon federal approval,
whichever is later, except paragraph (f) is effective the day following final enactment. The
commissioner shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 19.

Minnesota Statutes 2020, section 256B.0759, subdivision 4, is amended to read:

Subd. 4.

Provider payment rates.

(a) Payment rates for participating providers must
be increased for services provided to medical assistance enrollees. To receive a rate increase,
participating providers must meet demonstration project requirements and provide evidence
of formal referral arrangements with providers delivering step-up or step-down levels of
care. new text begin Providers that have enrolled in the demonstration project but have not met the provider
standards under subdivision 3 as of July 1, 2022, are not eligible for a rate increase under
this subdivision until the date that the provider meets the provider standards in subdivision
3. Services provided from July 1, 2022, to the date that the provider meets the provider
standards under subdivision 3 shall be reimbursed at rates according to section 254B.05,
subdivision 5, paragraph (b). Rate increases paid under this subdivision to a provider for
services provided between July 1, 2021, and July 1, 2022, are not subject to recoupment
when the provider is taking meaningful steps to meet demonstration project requirements
that are not otherwise required by law, and the provider provides documentation to the
commissioner, upon request, of the steps being taken.
new text end

new text begin (b) The commissioner may temporarily suspend payments to the provider according to
section 256B.04, subdivision 21, paragraph (d), if the provider does not meet the requirements
in paragraph (a). Payments withheld from the provider must be made once the commissioner
determines that the requirements in paragraph (a) are met.
new text end

deleted text begin (b) deleted text end new text begin (c) new text end For substance use disorder services under section 254B.05, subdivision 5,
paragraph (b), clause (8), provided on or after July 1, 2020, payment rates must be increased
by deleted text begin 15 deleted text end new text begin 25 new text end percent over the rates in effect on December 31, 2019.

deleted text begin (c) deleted text end new text begin (d) new text end For substance use disorder services under section 254B.05, subdivision 5,
paragraph (b), clauses (1), (6), and (7), and adolescent treatment programs that are licensed
as outpatient treatment programs according to sections 245G.01 to 245G.18, provided on
or after January 1, 2021, payment rates must be increased by deleted text begin ten deleted text end new text begin 20 new text end percent over the rates
in effect on December 31, 2020.

deleted text begin (d) deleted text end new text begin (e) new text end Effective January 1, 2021, and contingent on annual federal approval, managed
care plans and county-based purchasing plans must reimburse providers of the substance
use disorder services meeting the criteria described in paragraph (a) who are employed by
or under contract with the plan an amount that is at least equal to the fee-for-service base
rate payment for the substance use disorder services described in paragraphs deleted text begin (b) deleted text end new text begin (c) new text end and deleted text begin (c) deleted text end new text begin
(d) new text end . The commissioner must monitor the effect of this requirement on the rate of access to
substance use disorder services and residential substance use disorder rates. Capitation rates
paid to managed care organizations and county-based purchasing plans must reflect the
impact of this requirement. This paragraph expires if federal approval is not received at any
time as required under this paragraph.

deleted text begin (e) deleted text end new text begin (f) new text end Effective July 1, 2021, contracts between managed care plans and county-based
purchasing plans and providers to whom paragraph deleted text begin (d) deleted text end new text begin (e) new text end applies must allow recovery of
payments from those providers if, for any contract year, federal approval for the provisions
of paragraph deleted text begin (d) deleted text end new text begin (e) new text end is not received, and capitation rates are adjusted as a result. Payment
recoveries must not exceed the amount equal to any decrease in rates that results from this
provision.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, or upon federal approval,
whichever occurs later, except paragraphs (c) and (d) are effective January 1, 2022, or upon
federal approval, whichever is later. The commissioner shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 20.

Minnesota Statutes 2020, section 256B.0759, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Medium intensity residential program participation. new text end

new text begin Medium intensity
residential programs that qualify to participate in the demonstration project shall use the
specified base payment rate of $132.90 per day, and shall be eligible for the rate increases
specified in subdivision 4.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 21.

Minnesota Statutes 2020, section 256B.0759, is amended by adding a subdivision
to read:

new text begin Subd. 7. new text end

new text begin Public access. new text end

new text begin The state shall post the final documents, for example, monitoring
reports, close out report, approved evaluation design, interim evaluation report, and
summative evaluation report, on the state's Medicaid website within 30 calendar days of
approval by CMS.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021.
new text end

Sec. 22.

Minnesota Statutes 2020, section 256B.0759, is amended by adding a subdivision
to read:

new text begin Subd. 8. new text end

new text begin Federal approval; demonstration project extension. new text end

new text begin The commissioner shall
seek a five-year extension of the demonstration project under this section and to receive
enhanced federal financial participation.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021.
new text end

Sec. 23.

Minnesota Statutes 2020, section 256B.0759, is amended by adding a subdivision
to read:

new text begin Subd. 9. new text end

new text begin Demonstration project evaluation work group. new text end

new text begin Beginning October 1, 2021,
the commissioner shall assemble a work group of relevant stakeholders, including but not
limited to demonstration project participants and the Minnesota Association of Resources
for Recovery and Chemical Health, that shall meet at least quarterly for the duration of the
demonstration to evaluate the long-term sustainability of any improvements to quality or
access to substance use disorder treatment services caused by participation in the
demonstration project. The work group shall also determine how to implement successful
outcomes of the demonstration project once the project expires.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021.
new text end

Sec. 24.

new text begin [256B.076] CASE MANAGEMENT SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Generally. new text end

new text begin (a) It is the policy of this state to ensure that individuals on
medical assistance receive cost-effective and coordinated care, including efforts to address
the profound effects of housing instability, food insecurity, and other social determinants
of health. Therefore, subject to federal approval, medical assistance covers targeted case
management services as described in this section.
new text end

new text begin (b) The commissioner, in collaboration with tribes, counties, providers, and individuals
served, must propose further modifications to targeted case management services to ensure
a program that complies with all federal requirements, delivers services in a cost-effective
and efficient manner, creates uniform expectations for targeted case management services,
addresses health disparities, and promotes person- and family-centered services.
new text end

new text begin Subd. 2. new text end

new text begin Rate setting. new text end

new text begin (a) The commissioner must develop and implement a statewide
rate methodology for any county that subcontracts targeted case management services to a
vendor. The commissioner must publish the final draft of the proposed rate methodology
at least 30 days prior to posting the state plan amendment for public comment and must
take stakeholder feedback into consideration by providing an opportunity for the public to
provide feedback on the proposed rate methodology. The commissioner must respond to
comments received before the submission of the state plan amendment, explaining the
commissioner's decisions regarding the responses and identifying any changes made in an
effort to respond to public feedback. On January 1, 2022, or upon federal approval, whichever
is later, a county must use this methodology for any targeted case management services
paid by medical assistance and delivered through a subcontractor.
new text end

new text begin (b) In setting this rate, the commissioner must include the following:
new text end

new text begin (1) prevailing wages;
new text end

new text begin (2) employee-related expense factor;
new text end

new text begin (3) paid time off and training factors;
new text end

new text begin (4) supervision and span of control;
new text end

new text begin (5) distribution of time factor;
new text end

new text begin (6) administrative factor;
new text end

new text begin (7) absence factor;
new text end

new text begin (8) program support factor;
new text end

new text begin (9) caseload sizes as published by the commissioner; and
new text end

new text begin (10) culturally specific program factor as described in subdivision 3.
new text end

new text begin (c) A county may request that the commissioner authorize a rate based on a different
caseload size when a subcontractor is assigned to serve individuals with needs, such as
homelessness or specific linguistic or cultural needs, that significantly differ from other
eligible populations. A county must include the following in the request:
new text end

new text begin (1) the number of clients to be served by a full-time equivalent staffer;
new text end

new text begin (2) the specific factors that require a case manager to provide a significantly different
number of hours of reimbursable services to a client; and
new text end

new text begin (3) how the county intends to monitor caseload size and outcomes.
new text end

new text begin (d) The commissioner must adjust only the factor for caseload size in paragraph (b),
clause (9), in response to a request under paragraph (c). The commissioner must not duplicate
costs assumed by the culturally specific program factor in paragraph (b), clause (10), in
response to a request under paragraph (c). With agreement of counties and in consultation
with other stakeholders, the commissioner may introduce factors and adjustments other than
those listed in paragraphs (b) and (c), subject to federal approval.
new text end

new text begin Subd. 3. new text end

new text begin Culturally specific program. new text end

new text begin (a) "Culturally specific program" means a targeted
case management program that:
new text end

new text begin (1) ensures effective, equitable, comprehensive, and respectful quality care services that
are responsive to individuals within a specific population's values, beliefs, practices, health
literacy, preferred language, and other communication needs;
new text end

new text begin (2) is designed to address the unique needs of individuals who share a common language
or racial, ethnic, or social background;
new text end

new text begin (3) is governed with significant input from individuals of the specific background that
the program is designed to serve; and
new text end

new text begin (4) employs individuals to provide targeted case management, at least 50 percent of
whom are of the specific background that the program is designed to serve.
new text end

new text begin (b) The culturally specific program factor in subdivision 2, paragraph (b), clause (10),
adjusts the targeted case management rate for culturally specific programs to reflect the
staffing and programmatic costs necessary to provide culturally specific targeted case
management.
new text end

Sec. 25.

Minnesota Statutes 2020, section 256B.0924, subdivision 6, is amended to read:

Subd. 6.

Payment for targeted case management.

(a) Medical assistance and
MinnesotaCare payment for targeted case management shall be made on a monthly basis.
In order to receive payment for an eligible adult, the provider must document at least one
contact per month and not more than two consecutive months without a face-to-face contact
with the adult or the adult's legal representative, family, primary caregiver, or other relevant
persons identified as necessary to the development or implementation of the goals of the
personal service plan.

(b) Payment for targeted case management provided by county staff under this subdivision
shall be based on the monthly rate methodology under section 256B.094, subdivision 6,
paragraph (b), calculated as one combined average rate together with adult mental health
case management under section 256B.0625, subdivision 20, except for calendar year 2002.
In calendar year 2002, the rate for case management under this section shall be the same as
the rate for adult mental health case management in effect as of December 31, 2001. Billing
and payment must identify the recipient's primary population group to allow tracking of
revenues.

(c) Payment for targeted case management provided by county-contracted vendors shall
be based on a monthly rate deleted text begin negotiated by the host county deleted text end new text begin calculated in accordance with
section 256B.076, subdivision 2 new text end . The deleted text begin negotiated deleted text end rate must not exceed the rate charged by
the vendor for the same service to other payers. If the service is provided by a team of
contracted vendors, the deleted text begin county may negotiate a team rate with a vendor who is a member
of the team. The deleted text end team shall determine how to distribute the rate among its members. No
reimbursement received by contracted vendors shall be returned to the county, except to
reimburse the county for advance funding provided by the county to the vendor.

(d) If the service is provided by a team that includes contracted vendors and county staff,
the costs for county staff participation on the team shall be included in the rate for
county-provided services. In this case, the contracted vendor and the county may each
receive separate payment for services provided by each entity in the same month. In order
to prevent duplication of services, the county must document, in the recipient's file, the need
for team targeted case management and a description of the different roles of the team
members.

(e) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for
targeted case management shall be provided by the recipient's county of responsibility, as
defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds
used to match other federal funds.

(f) The commissioner may suspend, reduce, or terminate reimbursement to a provider
that does not meet the reporting or other requirements of this section. The county of
responsibility, as defined in sections 256G.01 to 256G.12, is responsible for any federal
disallowances. The county may share this responsibility with its contracted vendors.

(g) The commissioner shall set aside five percent of the federal funds received under
this section for use in reimbursing the state for costs of developing and implementing this
section.

(h) Payments to counties for targeted case management expenditures under this section
shall only be made from federal earnings from services provided under this section. Payments
to contracted vendors shall include both the federal earnings and the county share.

(i) Notwithstanding section 256B.041, county payments for the cost of case management
services provided by county staff shall not be made to the commissioner of management
and budget. For the purposes of targeted case management services provided by county
staff under this section, the centralized disbursement of payments to counties under section
256B.041 consists only of federal earnings from services provided under this section.

(j) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital,
and the recipient's institutional care is paid by medical assistance, payment for targeted case
management services under this subdivision is limited to the lesser of:

(1) the last 180 days of the recipient's residency in that facility; or

(2) the limits and conditions which apply to federal Medicaid funding for this service.

(k) Payment for targeted case management services under this subdivision shall not
duplicate payments made under other program authorities for the same purpose.

(l) Any growth in targeted case management services and cost increases under this
section shall be the responsibility of the counties.

Sec. 26.

Minnesota Statutes 2020, section 256B.094, subdivision 6, is amended to read:

Subd. 6.

Medical assistance reimbursement of case management services.

(a) Medical
assistance reimbursement for services under this section shall be made on a monthly basis.
Payment is based on face-to-face or telephone contacts between the case manager and the
client, client's family, primary caregiver, legal representative, or other relevant person
identified as necessary to the development or implementation of the goals of the individual
service plan regarding the status of the client, the individual service plan, or the goals for
the client. These contacts must meet the minimum standards in clauses (1) and (2):

(1) there must be a face-to-face contact at least once a month except as provided in clause
(2); and

(2) for a client placed outside of the county of financial responsibility, or a client served
by tribal social services placed outside the reservation, in an excluded time facility under
section 256G.02, subdivision 6, or through the Interstate Compact for the Placement of
Children, section 260.93, and the placement in either case is more than 60 miles beyond
the county or reservation boundaries, there must be at least one contact per month and not
more than two consecutive months without a face-to-face contact.

(b) Except as provided under paragraph (c), the payment rate is established using time
study data on activities of provider service staff and reports required under sections 245.482
and 256.01, subdivision 2, paragraph (p).

(c) Payments for tribes may be made according to section 256B.0625 or other relevant
federally approved rate setting methodology for child welfare targeted case management
provided by Indian health services and facilities operated by a tribe or tribal organization.

(d) Payment for case management provided by county deleted text begin or tribal social services deleted text end contracted
vendors deleted text begin shall be based on a monthly rate negotiated by the host county or tribal social
services deleted text end new text begin must be calculated in accordance with section 256B.076, subdivision 2. Payment
for case management provided by vendors who contract with a Tribe must be based on a
monthly rate negotiated by the Tribe new text end . The deleted text begin negotiated deleted text end rate must not exceed the rate charged
by the vendor for the same service to other payers. If the service is provided by a team of
contracted vendors, the deleted text begin county or tribal social services may negotiate a team rate with a
vendor who is a member of the team. The deleted text end team shall determine how to distribute the rate
among its members. No reimbursement received by contracted vendors shall be returned
to the county or tribal social services, except to reimburse the county or tribal social services
for advance funding provided by the county or tribal social services to the vendor.

(e) If the service is provided by a team that includes contracted vendors and county or
tribal social services staff, the costs for county or tribal social services staff participation in
the team shall be included in the rate for county or tribal social services provided services.
In this case, the contracted vendor and the county or tribal social services may each receive
separate payment for services provided by each entity in the same month. To prevent
duplication of services, each entity must document, in the recipient's file, the need for team
case management and a description of the roles and services of the team members.

Separate payment rates may be established for different groups of providers to maximize
reimbursement as determined by the commissioner. The payment rate will be reviewed
annually and revised periodically to be consistent with the most recent time study and other
data. Payment for services will be made upon submission of a valid claim and verification
of proper documentation described in subdivision 7. Federal administrative revenue earned
through the time study, or under paragraph (c), shall be distributed according to earnings,
to counties, reservations, or groups of counties or reservations which have the same payment
rate under this subdivision, and to the group of counties or reservations which are not
certified providers under section 256F.10. The commissioner shall modify the requirements
set out in Minnesota Rules, parts 9550.0300 to 9550.0370, as necessary to accomplish this.

Sec. 27.

Minnesota Statutes 2020, section 256B.0946, subdivision 1, as amended by Laws
2021, chapter 30, article 17, section 91, 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 deleted text begin (5) deleted text end new text begin
(6) new text end 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; deleted text begin and
deleted text end

(5) new text begin individual treatment plan development as defined in Minnesota Rules, part 9505.0371,
subpart 7; and
new text end

new text begin (6) new text end 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, 2021, 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 2020, section 256B.0946, subdivision 4, as amended by Laws
2021, chapter 30, article 17, section 95, is amended to read:

Subd. 4.

Service delivery payment requirements.

(a) To be eligible for payment under
this section, a provider must develop and practice written policies and procedures for
intensive treatment in foster care, consistent with subdivision 1, paragraph (b), and comply
with the following requirements in paragraphs (b) to deleted text begin (l) deleted text end new text begin (n) new text end .

(b) Each previous and current mental health, school, and physical health treatment
provider must be contacted to request documentation of treatment and assessments that the
eligible client has received. This information must be reviewed and incorporated into the
standard diagnostic assessment and team consultation and treatment planning review process.

(c) Each client receiving treatment must be assessed for a trauma history, and the client's
treatment plan must document how the results of the assessment will be incorporated into
treatment.

(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 90 days or prior to discharge from the service, whichever comes first.

(e) Each client receiving treatment services must have an individual treatment plan that
is reviewed, evaluated, and approved every 90 days using the team consultation and treatment
planning process.

(f) Clinical care consultation must be provided in accordance with the client's individual
treatment plan.

(g) Each client must have a crisis plan within ten days of initiating services and must
have access to clinical phone support 24 hours per day, seven days per week, during the
course of treatment. The crisis plan must demonstrate coordination with the local or regional
mobile crisis intervention team.

(h) Services must be delivered and documented at least three days per week, equaling
at least six hours of treatment per week deleted text begin , unless reduced units of service are specified on the
treatment plan deleted text end new text begin . If the mental health professional, client, and family agree, service units may
be temporarily reduced for a period of no more than 60 days in order to meet the needs of
the client and family, or new text end as part of transition or on a discharge plan to another service or
level of care. new text begin The reasons for service reduction must be identified, documented, and included
in the treatment plan. Billing and payment are prohibited for days on which no services are
delivered and documented.
new text end

(i) Location of service delivery must be in the client's home, day care setting, school, or
other community-based setting that is specified on the client's individualized treatment plan.

(j) Treatment must be developmentally and culturally appropriate for the client.

(k) Services must be delivered in continual collaboration and consultation with the
client's medical providers and, in particular, with prescribers of psychotropic medications,
including those prescribed on an off-label basis. Members of the service team must be aware
of the medication regimen and potential side effects.

(l) Parents, siblings, foster parents, and members of the child's permanency plan must
be involved in treatment and service delivery unless otherwise noted in the treatment plan.

(m) Transition planning for the child must be conducted starting with the first treatment
plan and must be addressed throughout treatment to support the child's permanency plan
and postdischarge mental health service needs.

new text begin (n) In order for a provider to receive the daily per-client encounter rate, at least one of
the services listed in subdivision 1, paragraph (b), clauses (1) to (3), must be provided. The
services listed in subdivision 1, paragraph (b), clauses (4) and (5), may be included as part
of the daily per-client encounter rate.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, 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. 29.

Minnesota Statutes 2020, section 256B.0947, subdivision 2, as amended by Laws
2021, chapter 30, article 17, section 98, 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 new text begin are eight years of age or older and under 26 years of age who new text end 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.

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.

(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. 30.

Minnesota Statutes 2020, section 256B.0947, subdivision 3, as amended by Laws
2021, chapter 30, article 17, section 99, is amended to read:

Subd. 3.

Client eligibility.

An eligible recipient is an individual who:

(1) is deleted text begin age 16, 17, 18, 19, or 20 deleted text end new text begin eight years of age or older and under 26 years of age new text end ; deleted text begin and
deleted text end

(2) is diagnosed with a serious mental illness or co-occurring mental illness and substance
use disorder, for which intensive nonresidential rehabilitative mental health services are
needed;

(3) has received a level of care assessment as defined in section 245I.02, subdivision
19, that indicates a need for intensive integrated intervention without 24-hour medical
monitoring and a need for extensive collaboration among multiple providers;

(4) has received a functional assessment as defined in section 245I.02, subdivision 17,
that indicates functional impairment and a history of difficulty in functioning safely and
successfully in the community, school, home, or job; or who is likely to need services from
the adult mental health system deleted text begin within the next two years deleted text end new text begin during adulthood new text end ; and

(5) has had a recent standard diagnostic assessment that documents that intensive
nonresidential rehabilitative mental health services are medically necessary to ameliorate
identified symptoms and functional impairments and to achieve individual transition goals.

Sec. 31.

Minnesota Statutes 2020, section 256B.0947, subdivision 5, as amended by Laws
2021, chapter 30, article 17, section 101, is amended to read:

Subd. 5.

Standards for intensive nonresidential rehabilitative providers.

(a) Services
must meet the standards in this section and chapter 245I as required in section 245I.011,
subdivision 5.

new text begin (b) The treatment team must have specialized training in providing services to the specific
age group of youth that the team serves. An individual treatment team must serve youth
who are: (1) at least eight years of age or older and under 16 years of age, or (2) at least 14
years of age or older and under 26 years of age.
new text end

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

(1) Based on professional qualifications and client needs, clinically qualified core team
members are assigned on a rotating basis as the client's lead worker to coordinate a client's
care. The core team must comprise at least four full-time equivalent direct care staff and
must minimally include:

(i) a mental health professional who serves as team leader to provide administrative
direction and treatment supervision to the team;

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

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

(iv) a mental health certified peer specialist who is qualified according to section 245I.04,
subdivision 10, and is also a former children's mental health consumer.

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

(i) additional mental health professionals;

(ii) a vocational specialist;

(iii) an educational specialist with knowledge and experience working with youth
regarding special education requirements and goals, special education plans, and coordination
of educational activities with health care activities;

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

(v) a clinical trainee qualified according to section 245I.04, subdivision 6;

(vi) a mental health practitioner qualified according to section 245I.04, subdivision 4;

(vii) a case management service provider, as defined in section 245.4871, subdivision
4;

(viii) a housing access specialist; and

(ix) a family peer specialist as defined in subdivision 2, paragraph (m).

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

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

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

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

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

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

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

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

deleted text begin (d) deleted text end new text begin (e) new text end The staffing ratio must not exceed ten clients to one full-time equivalent treatment
team position.

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

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

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

deleted text begin (h) deleted text end new text begin (i) new text end A regional treatment team may serve multiple counties.

Sec. 32. new text begin DIRECTION TO THE COMMISSIONER; RATE RECOMMENDATIONS
FOR OPIOID TREATMENT PROGRAMS.
new text end

new text begin The commissioner of human services shall evaluate the rate structure for opioid treatment
programs licensed under Minnesota Statutes, section 245G.22, and report recommendations,
including a revised rate structure and proposed draft legislation, to the chairs and ranking
minority members of the legislative committees with jurisdiction over human services policy
and finance by December 1, 2021.
new text end

Sec. 33. new text begin DIRECTION TO THE COMMISSIONER; ADULT MENTAL HEALTH
INITIATIVES REFORM.
new text end

new text begin By February 1, 2022, and prior to the implementation of a new funding formula, the
commissioner of human services must provide a report on the funding formula to reform
adult mental health initiatives to the chairs and ranking minority members of the legislative
committees with jurisdiction over health and human services finance and policy. In
developing the funding formula, the commissioner must consult with stakeholders, including
adult mental health initiatives, counties, Tribal nations, adult mental health providers, and
individuals with lived experiences. The report must include background information, the
underlying rationale and methodology for the new formula, and stakeholder feedback.
new text end

Sec. 34. new text begin DIRECTION TO THE COMMISSIONER; CHILDREN'S MENTAL
HEALTH RESIDENTIAL TREATMENT WORK GROUP.
new text end

new text begin The commissioner of human services, in consultation with counties, children's mental
health residential providers, and children's mental health advocates, must organize a work
group and develop recommendations on how to efficiently and effectively fund room and
board costs for children's mental health residential treatment under the children's mental
health act. The work group may also provide recommendations on how to address systemic
barriers in transitioning children into the community and community-based treatment options.
The commissioner shall submit the recommendations to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance by February 15, 2022.
new text end

Sec. 35. new text begin FIRST EPISODE OF PSYCHOSIS GRANT PROGRAM; AUTHORIZED
USES OF GRANT FUNDS.
new text end

new text begin (a) Grant funds awarded by the commissioner of human services pursuant to Minnesota
Statutes, section 245.4889, subdivision 1, paragraph (b), clause (15), must be used to:
new text end

new text begin (1) provide intensive treatment and support for adolescents and adults experiencing or
at risk of experiencing a first psychotic episode. Intensive treatment and support includes
medication management, psychoeducation for an individual and an individual's family, case
management, employment support, education support, cognitive behavioral approaches,
social skills training, peer support, crisis planning, and stress management. Projects must
use all available funding streams;
new text end

new text begin (2) conduct outreach and provide training and guidance to mental health and health care
professionals, including postsecondary health clinics, on early psychosis symptoms, screening
tools, and best practices; and
new text end

new text begin (3) ensure access for individuals to first psychotic episode services under this section,
including ensuring access to first psychotic episode services for individuals who live in
rural areas.
new text end

new text begin (b) Grant funds may also be used to pay for housing or travel expenses or to address
other barriers preventing individuals and their families from participating in first psychotic
episode services.
new text end

Sec. 36. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; MENTAL
HEALTH GRANT PROGRAMS STATUTE REVISION.
new text end

new text begin The commissioner of human services, in coordination with the Office of Senate Counsel,
Research, and Fiscal Analysis, the Office of the House Research Department, and the revisor
of statutes, shall prepare legislation for the 2022 legislative session to enact as statutes the
grant programs authorized and funded under Minnesota Statutes, section 245.4661,
subdivision 9. The draft statutes shall at least include the eligibility criteria, target populations,
authorized uses of grant funds, and outcome measures for each grant. The commissioner
shall provide a courtesy copy of the proposed legislation to the chairs and ranking minority
members of the legislative committees with jurisdiction over mental health grants.
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. 37. new text begin DIRECTION TO THE COMMISSIONER; SOBER HOUSING PROGRAM
RECOMMENDATIONS.
new text end

new text begin (a) The commissioner of human services, in consultation with stakeholders, must develop
recommendations on:
new text end

new text begin (1) increasing access to sober housing programs;
new text end

new text begin (2) promoting person-centered practices and cultural responsiveness in sober housing
programs;
new text end

new text begin (3) potential oversight of sober housing programs; and
new text end

new text begin (4) providing consumer protections for individuals in sober housing programs with
substance use disorders and individuals with co-occurring mental illnesses.
new text end

new text begin (b) Stakeholders include but are not limited to the Minnesota Association of Sober
Homes; the Minnesota Association of Resources for Recovery and Chemical Health;
Minnesota Recovery Connection; NAMI Minnesota; the National Alliance of Recovery
Residencies (NARR); Oxford Houses, Inc.; sober housing programs based in Minnesota
that are not members of the Minnesota Association of Sober Homes; a member of Alcoholics
Anonymous; and residents and former residents of sober housing programs based in
Minnesota. Stakeholders must equitably represent geographic areas of the state and must
include individuals in recovery and providers representing Black, Indigenous, people of
color, or immigrant communities.
new text end

new text begin (c) The commissioner must complete and submit a report on the recommendations in
this section to the chairs and ranking minority members of the legislative committees with
jurisdiction over health and human services policy and finance on or before September 1,
2022.
new text end

Sec. 38. new text begin DIRECTION TO THE COMMISSIONER; SUBSTANCE USE DISORDER
TREATMENT PAPERWORK REDUCTION.
new text end

new text begin (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.
new text end

new text begin (b) The commissioner of health shall make available needed information and resources
from the Division of Health Policy.
new text end

new text begin (c) The Office of MN.IT Services shall provide advance consultation and implementation
of the changes needed in data systems.
new text end

new text begin (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.
new text end

new text begin (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.
new text end

new text begin (f) By December 15, 2022, 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.
new text end

Sec. 39. new text begin DIRECTION TO THE COMMISSIONER; TRIBAL OVERPAYMENT
PROTOCOLS.
new text end

new text begin The commissioner of human services, in consultation with Tribal nations, shall develop
protocols that must be used to address and resolve any future overpayment involving any
Tribal nation in Minnesota.
new text end

Sec. 40. new text begin DIRECTION TO THE COMMISSIONER; CULTURALLY AND
LINGUISTICALLY APPROPRIATE SERVICES.
new text end

new text begin The commissioner of human services, in consultation with substance use disorder
treatment providers, lead agencies, and individuals who receive substance use disorder
treatment services, shall develop a statewide implementation and transition plan for culturally
and linguistically appropriate services (CLAS) national standards, including technical
assistance for providers to transition to CLAS standards and to improve disparate treatment
outcomes. The commissioner must consult with individuals who are Black, indigenous,
people of color, and linguistically diverse in the development of the implementation and
transition plans under this section.
new text end

Sec. 41. new text begin SUBSTANCE USE DISORDER TREATMENT PATHFINDER
COMPANION PILOT PROJECT.
new text end

new text begin (a) Anoka County and an academic institution acting as a research partner, in consultation
with the North Metro Mental Health Roundtable, shall conduct a one-year pilot project
beginning September 1, 2021, to evaluate the effects on treatment outcomes of the use by
individuals in substance use disorder recovery of the telephone-based Pathfinder Companion
application, which allows individuals in recovery to connect with peers, resources, providers,
and others helping with recovery after an individual is discharged from treatment, and the
use by providers of the computer-based Pathfinder Bridge application, which allows providers
to prioritize care, connect directly with patients, and monitor long-term outcomes and
recovery effectiveness.
new text end

new text begin (b) Prior to launching the program, Anoka County must secure the participation of an
academic research institution as a research partner and the project must receive approval
from the institution's institutional review board.
new text end

new text begin (c) The pilot project must monitor and evaluate the effects on treatment outcomes of
using the Pathfinder Companion and Pathfinder Bridge applications in order to determine
whether the addition of digital recovery support services alongside traditional methods of
recovery treatment improves treatment outcomes. The participating research partner shall
design and conduct the program evaluation.
new text end

new text begin (d) Anoka County and the participating research partner, in consultation with the North
Metro Mental Health Roundtable, shall report to the commissioner of human services and
the chairs and ranking minority members of the legislative committees with jurisdiction
over substance use disorder treatment by January 15, 2023, on the results of the pilot project.
new text end

Sec. 42. new text begin FEDERAL COMMUNITY MENTAL HEALTH SERVICES BLOCK
GRANT ALLOCATION; SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES
ADMINISTRATION SPENDING PLAN.
new text end

new text begin The commissioner of human services shall allocate $7,511,000 in fiscal year 2022, $0
in fiscal year 2023, $1,000,000 in fiscal year 2024, and $1,000,000 in fiscal year 2025 from
the community mental health services block grant amount in the federal fund for items
proposed by the commissioner to the federal Substance Abuse and Mental Health Services
Administration in the spending plan submitted on April 3, 2021, and approved on June 11,
2021. The commissioner may modify the proposed spending plan if necessary to comply
with federal requirements.
new text end

Sec. 43. new text begin FEDERAL COMMUNITY MENTAL HEALTH SERVICES BLOCK
GRANT ALLOCATION; SCHOOL-LINKED BEHAVIORAL HEALTH GRANTS.
new text end

new text begin The commissioner of human services shall allocate $2,500,000 in fiscal year 2022,
$2,500,000 in fiscal year 2023, $2,500,000 in fiscal year 2024, and $2,500,000 in fiscal
year 2025 from the community mental health services block grant amount in the federal
fund for mental health services provided through the school-linked behavioral health grant
program under Minnesota Statutes, section 245.4901.
new text end

Sec. 44. new text begin FEDERAL SUBSTANCE ABUSE PREVENTION AND TREATMENT
BLOCK GRANT ALLOCATION; SCHOOL-LINKED BEHAVIORAL HEALTH
GRANTS.
new text end

new text begin The commissioner of human services shall allocate $1,750,000 in fiscal year 2022,
$1,750,000 in fiscal year 2023, $1,750,000 in fiscal year 2024, and $1,750,000 in fiscal
year 2025 from the substance abuse prevention and treatment block grant amount in the
federal fund for substance use disorder treatment services provided through the school-linked
behavioral health grant program under Minnesota Statutes, section 245.4901.
new text end

Sec. 45. new text begin FEDERAL SUBSTANCE ABUSE PREVENTION AND TREATMENT
BLOCK GRANT ALLOCATION; SUBSTANCE USE DISORDER TREATMENT
PATHFINDER COMPANION PILOT PROJECT.
new text end

new text begin (a) The commissioner of human services shall allocate $550,000 in fiscal year 2022
from the substance abuse prevention and treatment block grant amount in the federal fund
for a grant to Anoka County to conduct a substance use disorder treatment pathfinder
companion pilot project. This is a onetime allocation and is available until January 15, 2023.
new text end

new text begin (b) Of the allocation in paragraph (a), $200,000 is for licensed use of the pathfinder
companion application for individuals participating in the pilot project, and up to $50,000
is for licensed use of the pathfinder bridge application for providers participating in the pilot
project.
new text end

Sec. 46. new text begin FEDERAL SUBSTANCE ABUSE PREVENTION AND TREATMENT
BLOCK GRANT ALLOCATION; OPIATE EPIDEMIC RESPONSE GRANTS.
new text end

new text begin (a) The commissioner of human services shall allocate $2,700,000 in fiscal year 2022
and $2,700,000 in fiscal year 2023 from the substance abuse prevention and treatment block
grant amount in the federal fund for grants to be awarded according to the recommendations
of the Opiate Epidemic Response Advisory Council under Minnesota Statutes, section
256.042.
new text end

new text begin (b) The commissioner shall include information on the grants awarded under this section
in the annual report under Minnesota Statutes, section 256.042, subdivision 5, paragraph
(a).
new text end

Sec. 47. new text begin FEDERAL SUBSTANCE ABUSE PREVENTION AND TREATMENT
BLOCK GRANT ALLOCATION; SUBSTANCE ABUSE AND MENTAL HEALTH
SERVICES ADMINISTRATION SPENDING PLAN.
new text end

new text begin The commissioner of human services shall allocate $10,767,000 in fiscal year 2022 from
the substance abuse prevention and treatment block grant amount in the federal fund for
items proposed by the commissioner to the federal Substance Abuse and Mental Health
Services Administration in the spending plan submitted on April 3, 2021, and approved on
June 11, 2021. The commissioner may modify the proposed spending plan if necessary to
comply with federal requirements.
new text end

Sec. 48. new text begin OPIATE EPIDEMIC RESPONSE ADVISORY COUNCIL; INITIAL
MEMBERSHIP TERMS.
new text end

new text begin Notwithstanding Minnesota Statutes, section 256.042, subdivision 2, paragraph (c), the
initial term for members of the Opiate Epidemic Response Advisory Council established
under Minnesota Statutes, section 256.042, identified in Minnesota Statutes, section 256.042,
subdivision 2, paragraph (a), clauses (1), (3), (5), (7), (9), (11), (13), (15), and (17), ends
September 30, 2022. The initial term for members identified under Minnesota Statutes,
section 256.042, subdivision 2, paragraph (a), clauses (2), (4), (6), (8), (10), (12), (14), and
(16), ends September 30, 2023.
new text end

Sec. 49. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2020, section 256B.0596, new text end new text begin is repealed.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2020, section 245.4871, subdivision 32a, new text end new text begin is repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin Paragraph (b) is effective September 30, 2021.
new text end

ARTICLE 12

DIRECT CARE AND TREATMENT

Section 1.

Minnesota Statutes 2020, section 246.54, subdivision 1b, is amended to read:

Subd. 1b.

Community behavioral health hospitals.

A county's payment of the cost of
care provided at state-operated community-based behavioral health hospitals new text begin for adults and
children new text end shall be according to the following schedule:

(1) 100 percent for each day during the stay, including the day of admission, when the
facility determines that it is clinically appropriate for the client to be discharged; and

(2) the county shall not be entitled to reimbursement from the client, the client's estate,
or from the client's relatives, except as provided in section 246.53.

Sec. 2. new text begin DIRECTION TO COMMISSIONER; SAFETY NET SERVICES.
new text end

new text begin (a) The commissioner must assess state-operated direct care and treatment services to
identify the extent to which the services function as safety net services and to make
recommendations that:
new text end

new text begin (1) enhance the continuum of services;
new text end

new text begin (2) improve access to services that support people with disabilities, older adults, and
people with behavioral health conditions who are living in their own homes, family homes,
and community-based settings;
new text end

new text begin (3) identify the state's role and community's role in maintaining the capacity to serve
people based on the availability of existing services; and
new text end

new text begin (4) provide an assessment and recommendations that identify new care delivery models
addressing community needs and the needs of people served by state facilities such as:
new text end

new text begin (i) urgent emergency settings;
new text end

new text begin (ii) facilities that provide a higher level of care to meet complex needs, but do not require
commitment or state safety net services;
new text end

new text begin (iii) programs that provide complex services, but require wrap-around services or specific
resources for people to reside at home or in community settings; and
new text end

new text begin (iv) programs providing care to meet people's needs in traditional community settings.
new text end

new text begin (b) The assessment and recommendations under paragraph (a), clause (4), must identify
the resources necessary to implement identified care delivery models, including but not
limited to funding, housing, resources, wrap-around staffing, compensation, and workforce
development, and how the care delivery model will respond to patient needs based on
specific criteria and minimize the gaps in service that may occur between acute care and
routine care. The commissioner must seek input from stakeholders in a manner that balances
input from advocacy and consumer-focused organizations and people who use services.
new text end

new text begin (c) The commissioner must submit a report to the chairs and ranking minority members
of the legislative committees with jurisdiction over health and human services policy and
finance by October 15, 2023, on recommendations for crisis respite, caregiver respite for
older adults, crisis stabilization, and community residential short- and long-term stay options.
The report must identify sustainable rate reimbursement methodologies for recommended
modifications to safety net services. The report must include fiscal estimates and proposed
legislation necessary to enact the report's recommendations.
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 13

DISABILITY SERVICES AND CONTINUING CARE FOR OLDER ADULTS

Section 1.

Minnesota Statutes 2020, section 144.0724, subdivision 4, is amended to read:

Subd. 4.

Resident assessment schedule.

(a) A facility must conduct and electronically
submit to the deleted text begin commissioner of health deleted text end new text begin federal database new text end MDS assessments that conform with
the assessment schedule defined by deleted text begin Code of Federal Regulations, title 42, section 483.20,
and published by the United States Department of Health and Human Services, Centers for
Medicare and Medicaid Services, in deleted text end the Long Term Care new text begin Facility Resident new text end Assessment
Instrument User's Manual, version 3.0, deleted text begin and subsequent updates when deleted text end new text begin or its successor new text end issued
by the Centers for Medicare and Medicaid Services. The commissioner of health may
substitute successor manuals or question and answer documents published by the United
States Department of Health and Human Services, Centers for Medicare and Medicaid
Services, to replace or supplement the current version of the manual or document.

(b) The assessments new text begin required under the Omnibus Budget Reconciliation Act of 1987
(OBRA) new text end used to determine a case mix classification for reimbursement include the following:

(1) a new admission new text begin comprehensive new text end assessment new text begin , which must have an assessment reference
date (ARD) within 14 calendar days after admission, excluding readmissions new text end ;

(2) an annual new text begin comprehensive new text end assessment new text begin , new text end which must have an deleted text begin assessment reference date
(ARD) deleted text end new text begin ARD new text end within 92 days of deleted text begin the deleted text end new text begin a new text end previous new text begin quarterly review new text end assessment deleted text begin and the deleted text end new text begin or a new text end
previous comprehensive assessment new text begin , which must occur at least once every 366 days new text end ;

(3) a significant change in status new text begin comprehensive new text end assessment new text begin , which new text end must deleted text begin be completed deleted text end new text begin
have an ARD new text end within 14 days deleted text begin of the identification of deleted text end new text begin after the facility determines, or should
have determined, that there has been new text end a significant change new text begin in the resident's physical or mental
condition new text end , whether new text begin an new text end improvement or new text begin a new text end decline, and regardless of the amount of time since
the last deleted text begin significant change in status deleted text end new text begin comprehensive new text end assessment new text begin or quarterly review
assessment new text end ;

(4) deleted text begin all deleted text end new text begin a new text end quarterly deleted text begin assessments deleted text end new text begin review assessment new text end must have an deleted text begin assessment reference
date (ARD) deleted text end new text begin ARD new text end within 92 days of the ARD of the previous new text begin quarterly review assessment
or a previous comprehensive new text end assessment;

(5) any significant correction to a prior comprehensive assessment, if the assessment
being corrected is the current one being used for RUG classification; deleted text begin and
deleted text end

(6) any significant correction to a prior quarterly new text begin review new text end assessment, if the assessment
being corrected is the current one being used for RUG classification deleted text begin . deleted text end new text begin ;
new text end

new text begin (7) a required significant change in status assessment when:
new text end

new text begin (i) all speech, occupational, and physical therapies have ended. The ARD of this
assessment must be set on day eight after all therapy services have ended; and
new text end

new text begin (ii) isolation for an infectious disease has ended. The ARD of this assessment must be
set on day 15 after isolation has ended; and
new text end

new text begin (8) any modifications to the most recent assessments under clauses (1) to (7).
new text end

(c) In addition to the assessments listed in paragraph (b), the assessments used to
determine nursing facility level of care include the following:

(1) preadmission screening completed under section 256.975, subdivisions 7a to 7c, by
the Senior LinkAge Line or other organization under contract with the Minnesota Board on
Aging; and

(2) a nursing facility level of care determination as provided for under section 256B.0911,
subdivision 4e, as part of a face-to-face long-term care consultation assessment completed
under section 256B.0911, by a county, tribe, or managed care organization under contract
with the Department of Human Services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, and applies to all assessments
with an assessment reference date of July 1, 2021, or later.
new text end

Sec. 2.

Minnesota Statutes 2020, section 144A.073, subdivision 2, is amended to read:

Subd. 2.

Request for proposals.

At the authorization by the legislature of additional
medical assistance expenditures for exceptions to the moratorium on nursing homes, the
commissioner shall publish in the State Register a request for proposals for nursing home
and certified boarding care home projects for conversion, relocation, renovation, replacement,
upgrading, or addition. The public notice of this funding and the request for proposals must
specify how the approval criteria will be prioritized by the commissioner. The notice must
describe the information that must accompany a request and state that proposals must be
submitted to the commissioner within 150 days of the date of publication. The notice must
include the amount of the legislative appropriation available for the additional costs to the
medical assistance program of projects approved under this section. If money is appropriated,
the commissioner shall initiate the application and review process described in this section
at least once each biennium. A second application and review process must occur if remaining
funds are either greater than $300,000 or more than 50 percent of the baseline appropriation
for the biennium. Authorized funds may be awarded in full in the first review process of
the biennium. Appropriated funds not encumbered within a biennium shall carry forward deleted text begin
to the following biennium deleted text end . To be considered for approval, a proposal must include the
following information:

(1) whether the request is for renovation, replacement, upgrading, conversion, addition,
or relocation;

(2) a description of the problems the project is designed to address;

(3) a description of the proposed project;

(4) an analysis of projected costs of the nursing facility proposed project, including:

(i) initial construction and remodeling costs;

(ii) site preparation costs;

(iii) equipment and technology costs;

(iv) financing costs, the current estimated long-term financing costs of the proposal,
which is to include details of any proposed funding mechanism already arranged or being
considered, including estimates of the amount and sources of money, reserves if required,
annual payments schedule, interest rates, length of term, closing costs and fees, insurance
costs, any completed marketing study or underwriting review; and

(v) estimated operating costs during the first two years after completion of the project;

(5) for proposals involving replacement of all or part of a facility, the proposed location
of the replacement facility and an estimate of the cost of addressing the problem through
renovation;

(6) for proposals involving renovation, an estimate of the cost of addressing the problem
through replacement;

(7) the proposed timetable for commencing construction and completing the project;

(8) a statement of any licensure or certification issues, such as certification survey
deficiencies;

(9) the proposed relocation plan for current residents if beds are to be closed according
to section 144A.161; and

(10) other information required by permanent rule of the commissioner of health in
accordance with subdivisions 4 and 8.

Sec. 3.

Minnesota Statutes 2020, section 144A.073, is amended by adding a subdivision
to read:

new text begin Subd. 17. new text end

new text begin Moratorium exception funding. new text end

new text begin (a) During the biennium beginning July 1,
2021, and during each biennium thereafter, the commissioner of health may approve
moratorium exception projects under this section for which the full biennial state share of
medical assistance costs does not exceed $4,000,000, plus any carryover of previous
appropriations for this purpose.
new text end

new text begin (b) For the purposes of this subdivision, "biennium" has the meaning given in section
16A.011, subdivision 6.
new text end

Sec. 4.

Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to
read:

new text begin Subd. 6f. new text end

new text begin Family adult foster care home. new text end

new text begin "Family adult foster care home" means an
adult foster care home:
new text end

new text begin (1) that is licensed by the Department of Human Services;
new text end

new text begin (2) that is the primary residence of the license holder; and
new text end

new text begin (3) in which the license holder is the primary caregiver.
new text end

Sec. 5.

Minnesota Statutes 2020, 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 new text begin family child foster care home or family adult foster care home
new text end 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 deleted text begin that are required to be registered under chapter deleted text end deleted text begin 144D deleted text end new text begin where at
least 80 percent of the residents are 55 years of age or older new text end ;

(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;
deleted text begin or
deleted text end

(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 deleted text begin . deleted text end new text begin ; or
new text end

new text begin (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:
new text end

new text begin (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;
new text end

new text begin (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
new text end

new text begin (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.
new text end

(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 August 1, 2021, except for paragraph
(a), clause (6), which is effective July 1, 2022.
new text end

Sec. 6.

Minnesota Statutes 2020, section 256.476, subdivision 11, is amended to read:

Subd. 11.

Consumer support grant program after July 1, 2001.

Effective July 1,
2001, the commissioner shall allocate consumer support grant resources to serve additional
individuals based on a review of Medicaid authorization and payment information of persons
eligible for a consumer support grant from the most recent fiscal year. The commissioner
shall use the following methodology to calculate maximum allowable monthly consumer
support grant levels:

(1) For individuals whose program of origination is medical assistance home care under
sections 256B.0651, 256B.0653, and 256B.0654, the maximum allowable monthly grant
levels are calculated by:

(i) determining the service authorization for each individual based on the individual's
home care assessment;

(ii) calculating the overall ratio of actual payments to service authorizations by program;

(iii) applying the overall ratio to 50 percent of the service authorization level of each
home care rating; and

(iv) adjusting the result for any authorized rate changes provided by the legislature.

new text begin (2) The monthly consumer support grant level for individuals who are eligible for ten
or more hours of personal care assistance services or community first services and supports
per day shall be increased by 7.5 percent of the monthly grant amount calculated under
clause (1) when the individual uses direct support services provided by a worker who has
completed training as identified in section 256B.0659, subdivision 11, paragraph (d), or
section 256B.85, subdivision 16, paragraph (e).
new text end

deleted text begin (2) deleted text end new text begin (3) new text end The commissioner shall ensure the methodology is consistent with the home care
programs.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, 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 256.477, is amended to read:

256.477 SELF-ADVOCACY GRANTS.

new text begin Subdivision 1. new text end

new text begin The Rick Cardenas Statewide Self-Advocacy Network. new text end

(a) The
commissioner shall make available a grant for the purposes of establishing and maintaining
deleted text begin a deleted text end new text begin the Rick Cardenas new text end Statewide Self-Advocacy Network for persons with intellectual and
developmental disabilities. The new text begin Rick Cardenas Statewide new text end Self-Advocacy Network shall:

(1) ensure that persons with intellectual and developmental disabilities are informed of
their rights in employment, housing, transportation, voting, government policy, and other
issues pertinent to the intellectual and developmental disability community;

(2) provide public education and awareness of the civil and human rights issues persons
with intellectual and developmental disabilities face;

(3) provide funds, technical assistance, and other resources for self-advocacy groups
across the state; deleted text begin and
deleted text end

(4) organize systems of communications to facilitate an exchange of information between
self-advocacy groups new text begin ;
new text end

new text begin (5) train and support the activities of a statewide network of peer-to-peer mentors for
persons with developmental disabilities focused on building awareness among people with
developmental disabilities of service options; assisting people with developmental disabilities
choose service options; and developing the advocacy skills of people with developmental
disabilities necessary for them to move toward full inclusion in community life, including
by developing and delivering a curriculum to support the peer-to-peer network;
new text end

new text begin (6) provide outreach activities, including statewide conferences and disability networking
opportunities, focused on self-advocacy, informed choice, and community engagement
skills; and
new text end

new text begin (7) provide an annual leadership program for persons with intellectual and developmental
disabilities new text end .

(b) An organization receiving a grant under paragraph (a) must be an organization
governed by people with intellectual and developmental disabilities that administers a
statewide network of disability groups in order to maintain and promote self-advocacy
services and supports for persons with intellectual and developmental disabilities throughout
the state.

new text begin (c) An organization receiving a grant under this subdivision may use a portion of grant
revenue determined by the commissioner for administration and general operating costs.
new text end

new text begin Subd. 2. new text end

new text begin Subgrants for outreach to persons in institutional settings. new text end

new text begin The commissioner
shall make available to an organization described under subdivision 1 a grant for subgrants
to organizations in Minnesota to conduct outreach to persons working and living in
institutional settings to provide education and information about community options. Subgrant
funds must be used to deliver peer-led skill training sessions in six regions of the state to
help persons with intellectual and developmental disabilities understand community service
options related to:
new text end

new text begin (1) housing;
new text end

new text begin (2) employment;
new text end

new text begin (3) education;
new text end

new text begin (4) transportation;
new text end

new text begin (5) emerging service reform initiatives contained in the state's Olmstead plan; the
Workforce Innovation and Opportunity Act, Public Law 113-128; and federal home and
community-based services regulations; and
new text end

new text begin (6) connecting with individuals who can help persons with intellectual and developmental
disabilities make an informed choice and plan for a transition in services.
new text end

Sec. 8.

new text begin [256.4772] MINNESOTA INCLUSION INITIATIVE GRANT.
new text end

new text begin Subdivision 1. new text end

new text begin Grant program established. new text end

new text begin The commissioner of human services shall
establish the Minnesota inclusion initiative grant program to encourage self-advocacy groups
of persons with intellectual and developmental disabilities to develop and organize projects
that increase the inclusion of persons with intellectual and developmental disabilities in the
community, improve community integration outcomes, educate decision-makers and the
public about persons with intellectual and developmental disabilities, including the systemic
barriers that prevent them from being included in the community, and to advocate for changes
that increase access to formal and informal supports and services necessary for greater
inclusion of persons with intellectual and developmental disabilities in the community.
new text end

new text begin Subd. 2. new text end

new text begin Administration. new text end

new text begin The commissioner of human services, as authorized by section
256.01, subdivision 2, paragraph (a), clause (6), shall issue a request for proposals to contract
with a public or private entity to (1) serve as a fiscal host for the money appropriated for
the purposes described in this section, and (2) develop guidelines, criteria, and procedures
for awarding grants. The fiscal host shall establish an advisory committee consisting of
self-advocates, nonprofit advocacy organizations, and Department of Human Services staff
to review applications and award grants under this section.
new text end

new text begin Subd. 3. new text end

new text begin Applications. new text end

new text begin (a) Entities seeking grants under this section shall apply to the
advisory committee of the fiscal host under contract with 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 (b) The advisory committee may award grants to applicants only for projects that meet
the requirements of subdivision 4.
new text end

new text begin Subd. 4. new text end

new text begin Use of grant money. new text end

new text begin Projects funded by grant money must have person-centered
goals, call attention to issues that limit inclusion of persons with intellectual and
developmental disabilities, address barriers to inclusion that persons with intellectual and
developmental disabilities face in their communities, or increase the inclusion of persons
with intellectual and developmental disabilities in their communities. Applicants may
propose strategies to increase inclusion of persons with intellectual and developmental
disabilities in their communities by:
new text end

new text begin (1) decreasing barriers to workforce participation experienced by persons with intellectual
and developmental disabilities;
new text end

new text begin (2) overcoming barriers to accessible and reliable transportation options for persons with
intellectual and developmental disabilities;
new text end

new text begin (3) identifying and addressing barriers to voting experienced by persons with intellectual
and developmental disabilities;
new text end

new text begin (4) advocating for increased accessible housing for persons with intellectual and
developmental disabilities;
new text end

new text begin (5) working with governmental agencies or businesses on accessibility issues under the
Americans with Disabilities Act;
new text end

new text begin (6) increasing collaboration between self-advocacy groups and other organizations to
effectively address systemic issues that impact persons with intellectual and developmental
disabilities;
new text end

new text begin (7) increasing capacity for inclusion in a community; or
new text end

new text begin (8) providing public education and awareness of the civil and human rights of persons
with intellectual and developmental disabilities.
new text end

new text begin Subd. 5. new text end

new text begin Reports. new text end

new text begin (a) Grant recipients shall provide the advisory committee with a report
about the activities funded by the grant program in a format and at a time specified by the
advisory committee. The advisory committee shall require grant recipients to include in the
grant recipient's report at least the information necessary for the advisory committee to meet
the advisory committee's obligation under paragraph (b).
new text end

new text begin (b) The advisory committee shall provide the commissioner with a report that describes
all of the activities and outcomes of projects funded by the grant program in a format and
at a time determined by the commissioner.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval of Minnesota's
initial state spending plan as described in guidance issued by the Centers for Medicare and
Medicaid Services for implementation of section 9817 of the federal American Rescue Plan
Act of 2021.
new text end

Sec. 9.

new text begin [256.4776] PARENT-TO-PARENT PEER SUPPORT.
new text end

new text begin (a) The commissioner shall make 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 any type of disability or special health care needs. An eligible alliance member
must have an established parent-to-parent peer support program that is statewide and
represents diverse cultures and geographic locations, that conducts outreach and provides
individualized support to any parent or guardian of a child with a disability or special health
care need, including newly identified parents of such a child or parents experiencing
transitions or changes in their child's care, and that implements best practices for peer-to-peer
support, including providing support from trained parent staff and volunteer support parents
who have received Parent to Parent USA's specialized parent-to-parent peer support training.
new text end

new text begin (b) Grant recipients must use grant money for the purposes specified in paragraph (a).
new text end

new text begin (c) For purposes of this section, "special health care needs" means disabilities, chronic
illnesses or conditions, health-related educational or behavioral problems, or the risk of
developing disabilities, conditions, illnesses, or problems.
new text end

new text begin (d) Grant recipients must report to the commissioner of human services annually by
January 15 about the services and programs funded by this grant. The report must include
measurable outcomes from the previous year, including the number of families served by
the organization's parent-to-parent programs and the number of volunteer support parents
trained by the organization's parent-to-parent programs.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval of Minnesota's
initial state spending plan as described in guidance issued by the Centers for Medicare and
Medicaid Services for implementation of section 9817 of the federal American Rescue Plan
Act of 2021.
new text end

Sec. 10.

Minnesota Statutes 2020, section 256.479, is amended to read:

256.479 CUSTOMIZED LIVING QUALITY IMPROVEMENT GRANTS.

(a) The commissioner of human services shall develop incentive-based grants to providers
of customized living services under the brain injury, community access for disability
inclusion, and elderly waivers for achieving outcomes specified in a contract. The
commissioner may solicit proposals from providers and implement those that, on a
competitive basis, best meet the state's policy objectives. deleted text begin Until June 30, 2021, the
commissioner shall give preference to providers that serve at least 75 percent elderly waiver
participants.
deleted text end

(b) deleted text begin Effective July 1, 2021, deleted text end To be eligible for a grant under this section, deleted text begin a provider must
serve at least 75 waiver participants, and deleted text end at least 75 percent of the clients served by the
provider must be waiver participants. For providers of customized living services under the
brain injury or community access for disability inclusion, the deleted text begin required 75 deleted text end waiver participants
must reside at multiple locations each with six or more residents. The commissioner shall
give greater preference to those providers serving a higher percentage of waiver participants.

(c) The commissioner shall limit expenditures under this subdivision to the amount
appropriated for this purpose.

(d) In establishing the specified outcomes and related criteria, the commissioner shall
consider the following state policy objectives:

(1) provide more efficient, higher quality services;

(2) encourage home and community-based services providers to innovate;

(3) equip home and community-based services providers with organizational tools and
expertise to improve their quality;

(4) incentivize home and community-based services providers to invest in better services;
and

(5) disseminate successful performance improvement strategies statewide.

Sec. 11.

Minnesota Statutes 2020, section 256B.0653, is amended by adding a subdivision
to read:

new text begin Subd. 8. new text end

new text begin Payment rates for home health agency services. new text end

new text begin The commissioner shall
annually adjust payments for home health agency services to reflect the change in the federal
Centers for Medicare and Medicaid Services Home Health Agency Market Basket. The
commissioner shall use the indices as forecasted for the midpoint of the prior rate year to
the midpoint of the current rate year.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, or upon federal approval,
whichever occurs later, for services delivered on or after January 1, 2022. 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 256B.0654, is amended by adding a subdivision
to read:

new text begin Subd. 5. new text end

new text begin Payment rates for home care nursing services. new text end

new text begin The commissioner shall
annually adjust payments for home care nursing services to reflect the change in the federal
Centers for Medicare and Medicaid Services Home Health Agency Market Basket. The
commissioner shall use the indices as forecasted for the midpoint of the prior rate year to
the midpoint of the current rate year.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, or upon federal approval,
whichever occurs later, for services delivered on or after January 1, 2022. 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 256B.0659, subdivision 11, is amended to read:

Subd. 11.

Personal care assistant; requirements.

(a) A personal care assistant must
meet the following requirements:

(1) be at least 18 years of age with the exception of persons who are 16 or 17 years of
age with these additional requirements:

(i) supervision by a qualified professional every 60 days; and

(ii) employment by only one personal care assistance provider agency responsible for
compliance with current labor laws;

(2) be employed by a personal care assistance provider agency;

(3) enroll with the department as a personal care assistant after clearing a background
study. Except as provided in subdivision 11a, before a personal care assistant provides
services, the personal care assistance provider agency must initiate a background study on
the personal care assistant under chapter 245C, and the personal care assistance provider
agency must have received a notice from the commissioner that the personal care assistant
is:

(i) not disqualified under section 245C.14; or

(ii) disqualified, but the personal care assistant has received a set aside of the
disqualification under section 245C.22;

(4) be able to effectively communicate with the recipient and personal care assistance
provider agency;

(5) be able to provide covered personal care assistance services according to the recipient's
personal care assistance care plan, respond appropriately to recipient needs, and report
changes in the recipient's condition to the supervising qualified professional, physician, or
advanced practice registered nurse;

(6) not be a consumer of personal care assistance services;

(7) maintain daily written records including, but not limited to, time sheets under
subdivision 12;

(8) effective January 1, 2010, complete standardized training as determined by the
commissioner before completing enrollment. The training must be available in languages
other than English and to those who need accommodations due to disabilities. Personal care
assistant training must include successful completion of the following training components:
basic first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic
roles and responsibilities of personal care assistants including information about assistance
with lifting and transfers for recipients, emergency preparedness, orientation to positive
behavioral practices, fraud issues, and completion of time sheets. Upon completion of the
training components, the personal care assistant must demonstrate the competency to provide
assistance to recipients;

(9) complete training and orientation on the needs of the recipient; and

(10) be limited to providing and being paid for up to 310 hours per month of personal
care assistance services regardless of the number of recipients being served or the number
of personal care assistance provider agencies enrolled with. The number of hours worked
per day shall not be disallowed by the department unless in violation of the law.

(b) A legal guardian may be a personal care assistant if the guardian is not being paid
for the guardian services and meets the criteria for personal care assistants in paragraph (a).

(c) Persons who do not qualify as a personal care assistant include parents, stepparents,
and legal guardians of minors; spouses; paid legal guardians of adults; family foster care
providers, except as otherwise allowed in section 256B.0625, subdivision 19a; and staff of
a residential setting.

(d) Personal care assistance services qualify for the enhanced rate described in subdivision
17a if the personal care assistant providing the services:

(1) provides covered services to a recipient who qualifies for deleted text begin 12 deleted text end new text begin ten new text end or more hours per
day of personal care assistance services; and

(2) satisfies the current requirements of Medicare for training and competency or
competency evaluation of home health aides or nursing assistants, as provided in the Code
of Federal Regulations, title 42, section 483.151 or 484.36, or alternative state-approved
training or competency requirements.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever occurs later. The commissioner shall notify the revisor of statutes when federal
approval is obtained.
new text end

Sec. 14.

Minnesota Statutes 2020, section 256B.0659, subdivision 17a, is amended to
read:

Subd. 17a.

Enhanced rate.

An enhanced rate of 107.5 percent of the rate paid for
personal care assistance services shall be paid for services provided to persons who qualify
for deleted text begin 12 deleted text end new text begin ten new text end 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). deleted text begin The
enhanced rate for personal care assistance services includes, and is not in addition to, any
rate adjustments implemented by the commissioner on July 1, 2019, to comply with the
deleted text end deleted text begin terms of a collective bargaining agreement between the state of Minnesota and an exclusive
representative of individual providers under section 179A.54, that provides for wage increases
for individual providers who serve participants assessed to need 12 or more hours of personal
care assistance services per day. deleted text end new text begin 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.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever occurs later. The commissioner shall notify the revisor of statutes when federal
approval is obtained.
new text end

Sec. 15.

Minnesota Statutes 2020, section 256B.0911, subdivision 1a, is amended to read:

Subd. 1a.

Definitions.

For purposes of this section, the following definitions apply:

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

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

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

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

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

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

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

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

(8) providing access to assistance to transition people back to community settings after
institutional admission;

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

(10) providing information about independent living to ensure that an informed choice
about independent living can be made; and

(11) providing information about self-directed services and supports, including
self-directed funding options, to ensure that an informed choice about self-directed options
can be made.

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

(1) service eligibility determination for the following state plan services:

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

(ii) consumer support grants under section 256.476; or

(iii) community first services and supports under section 256B.85;

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

(i) relocation targeted case management services available under section 256B.0621,
subdivision 2, clause (4);

(ii) case management services targeted to vulnerable adults or developmental disabilities
under section 256B.0924; and

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

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

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

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

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

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

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

(g) "Informed choice" deleted text begin means a voluntary choice of services, settings, living arrangement,
and work by a person from all available service and setting options based on accurate and
complete information concerning all available service and setting options and concerning
the person's own preferences, abilities, goals, and objectives. In order for a person to make
an informed choice, all available options must be developed and presented to the person in
a way the person can understand to empower the person to make fully informed choices deleted text end new text begin
has the meaning given in section 256B.4905, subdivision 1a new text end .

(h) "Available service and setting options" or "available options," with respect to the
home and community-based waivers under chapter 256S and sections 256B.092 and 256B.49,
means all services and settings defined under the waiver plan for which a waiver applicant
or waiver participant is eligible.

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

Sec. 16.

Minnesota Statutes 2020, section 256B.092, subdivision 4, is amended to read:

Subd. 4.

Home and community-based services for developmental disabilities.

(a)
The commissioner shall make payments to approved vendors participating in the medical
assistance program to pay costs of providing home and community-based services, including
case management service activities provided as an approved home and community-based
service, to medical assistance eligible persons with developmental disabilities who have
been screened under subdivision 7 and according to federal requirements. Federal
requirements include those services and limitations included in the federally approved
application for home and community-based services for persons with developmental
disabilities and subsequent amendments.

deleted text begin (b) Effective July 1, 1995, contingent upon federal approval and state appropriations
made available for this purpose, and in conjunction with Laws 1995, chapter 207, article 8,
section 40, the commissioner of human services shall allocate resources to county agencies
for home and community-based waivered services for persons with developmental disabilities
authorized but not receiving those services as of June 30, 1995, based upon the average
resource need of persons with similar functional characteristics. To ensure service continuity
for service recipients receiving home and community-based waivered services for persons
with developmental disabilities prior to July 1, 1995, the commissioner shall make available
to the county of financial responsibility home and community-based waivered services
resources based upon fiscal year 1995 authorized levels.
deleted text end

deleted text begin (c) Home and community-based resources for all recipients shall be managed by the
county of financial responsibility within an allowable reimbursement average established
for each county. Payments for home and community-based services provided to individual
recipients shall not exceed amounts authorized by the county of financial responsibility.
For specifically identified former residents of nursing facilities, the commissioner shall be
responsible for authorizing payments and payment limits under the appropriate home and
community-based service program. Payment is available under this subdivision only for
persons who, if not provided these services, would require the level of care provided in an
intermediate care facility for persons with developmental disabilities.
deleted text end

deleted text begin (d) deleted text end new text begin (b) new text end The commissioner shall comply with the requirements in the federally approved
transition plan for the home and community-based services waivers for the elderly authorized
under this section.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2024, 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.092, subdivision 5, is amended to read:

Subd. 5.

Federal waivers.

(a) The commissioner shall apply for any federal waivers
necessary to secure, to the extent allowed by law, federal financial participation under United
States Code, title 42, sections 1396 et seq., as amended, for the provision of services to
persons who, in the absence of the services, would need the level of care provided in a
regional treatment center or a community intermediate care facility for persons with
developmental disabilities. The commissioner may seek amendments to the waivers or apply
for additional waivers under United States Code, title 42, sections 1396 et seq., as amended,
to contain costs. The commissioner shall ensure that payment for the cost of providing home
and community-based alternative services under the federal waiver plan shall not exceed
the cost of intermediate care services including day training and habilitation services that
would have been provided without the waivered services.

The commissioner shall seek an amendment to the 1915c home and community-based
waiver to allow properly licensed adult foster care homes to provide residential services to
up to five individuals with developmental disabilities. If the amendment to the waiver is
approved, adult foster care providers that can accommodate five individuals shall increase
their capacity to five beds, provided the providers continue to meet all applicable licensing
requirements.

(b) The commissioner, in administering home and community-based waivers for persons
with developmental disabilities, shall ensure that day services for eligible persons are not
provided by the person's residential service provider, unless the person or the person's legal
representative is offered a choice of providers and agrees in writing to provision of day
services by the residential service provider. The coordinated service and support plan for
individuals who choose to have their residential service provider provide their day services
must describe how health, safety, protection, and habilitation needs will be met, including
how frequent and regular contact with persons other than the residential service provider
will occur. The coordinated service and support plan must address the provision of services
during the day outside the residence on weekdays.

(c) When a lead agency is evaluating denials, reductions, or terminations of home and
community-based services under section 256B.0916 for an individual, the lead agency 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. 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.

new text begin (d) The commissioner shall seek federal approval to allow for the reconfiguration of the
1915(c) home and community-based waivers in this section, as authorized under section
1915(c) of the federal Social Security Act, to implement a two-waiver program structure.
new text end

new text begin (e) The transition to two disability home and community-based services waiver programs
must align with the independent living first policy under section 256B.4905. Unless
superseded by any other state or federal law, waiver eligibility criteria shall be the same for
each waiver. The waiver program that a person uses shall be determined by the support
planning process and whether the person chooses to live in a provider-controlled setting or
in the person's own home.
new text end

new text begin (f) Prior to July 1, 2024, the commissioner shall seek federal approval for the 1915(c)
home and community-based waivers in this section, as authorized under section 1915(c) of
the federal Social Security Act, to implement an individual resource allocation methodology.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2024, or 90 days after 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.092, is amended by adding a subdivision
to read:

new text begin Subd. 11a. new text end

new text begin Residential support services criteria. new text end

new text begin (a) For the purposes of this subdivision,
"residential support services" means the following residential support services reimbursed
under section 256B.4914: community residential services, customized living services, and
24-hour customized living services.
new text end

new text begin (b) In order to increase independent living options for people with disabilities and in
accordance with section 256B.4905, subdivisions 3 and 4, and consistent with section
245A.03, subdivision 7, the commissioner must establish and implement criteria to access
residential support services. The criteria for accessing residential support services must
prohibit the commissioner from authorizing residential support services unless at least all
of the following conditions are met:
new text end

new text begin (1) the individual has complex behavioral health or complex medical needs; and
new text end

new text begin (2) the individual's service planning team has considered all other available residential
service options and determined that those options are inappropriate to meet the individual's
support needs.
new text end

new text begin Nothing in this subdivision shall be construed as permitting the commissioner to establish
criteria prohibiting the authorization of residential support services for individuals described
in the statewide priorities established in subdivision 12, the transition populations in
subdivision 13, and the licensing moratorium exception criteria under section 245A.03,
subdivision 7, paragraph (a).
new text end

new text begin (c) Individuals with active service agreements for residential support services on the
date that the criteria for accessing residential support services become effective are exempt
from the requirements of this subdivision, and the exemption from the criteria for accessing
residential support services continues to apply for renewals of those service agreements.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective 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. 19.

Minnesota Statutes 2020, section 256B.092, subdivision 12, is amended to read:

Subd. 12.

deleted text begin Waivered deleted text end new text begin Waiver new text end services statewide priorities.

(a) The commissioner shall
establish statewide priorities for individuals on the waiting list for developmental disabilities
(DD) waiver services, as of January 1, 2010. The statewide priorities must include, but are
not limited to, individuals who continue to have a need for waiver services after they have
maximized the use of state plan services and other funding resources, including natural
supports, prior to accessing waiver services, and who meet at least one of the following
criteria:

(1) no longer require the intensity of services provided where they are currently living;
or

(2) make a request to move from an institutional setting.

(b) After the priorities in paragraph (a) are met, priority must also be given to individuals
who meet at least one of the following criteria:

(1) have unstable living situations due to the age, incapacity, or sudden loss of the primary
caregivers;

(2) are moving from an institution due to bed closures;

(3) experience a sudden closure of their current living arrangement;

(4) require protection from confirmed abuse, neglect, or exploitation;

(5) experience a sudden change in need that can no longer be met through state plan
services or other funding resources alone; or

(6) meet other priorities established by the department.

(c) When allocating new text begin new enrollment new text end resources to lead agencies, the commissioner must
take into consideration the number of individuals waiting who meet statewide priorities deleted text begin and
the lead agencies' current use of waiver funds and existing service options deleted text end . deleted text begin The commissioner
has the authority to transfer funds between counties, groups of counties, and tribes to
accommodate statewide priorities and resource needs while accounting for a necessary base
level reserve amount for each county, group of counties, and tribe.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2024, or 90 days after 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 2020, section 256B.097, is amended by adding a subdivision
to read:

new text begin Subd. 7. new text end

new text begin Regional quality councils and systems improvement. new text end

new text begin The commissioner of
human services shall maintain the regional quality councils initially established under
Minnesota Statutes 2020, section 256B.097, subdivision 4. The regional quality councils
shall:
new text end

new text begin (1) support efforts and initiatives that drive overall systems and social change to promote
inclusion of people who have disabilities in the state of Minnesota;
new text end

new text begin (2) improve person-centered outcomes in disability services; and
new text end

new text begin (3) identify or enhance quality of life indicators for people who have disabilities.
new text end

Sec. 21.

Minnesota Statutes 2020, section 256B.097, is amended by adding a subdivision
to read:

new text begin Subd. 8. new text end

new text begin Membership and staff. new text end

new text begin (a) Regional quality councils shall be comprised of
key stakeholders including, but not limited to:
new text end

new text begin (1) individuals who have disabilities;
new text end

new text begin (2) family members of people who have disabilities;
new text end

new text begin (3) disability service providers;
new text end

new text begin (4) disability advocacy groups;
new text end

new text begin (5) lead agency staff; and
new text end

new text begin (6) staff of state agencies with jurisdiction over special education and disability services.
new text end

new text begin (b) Membership in a regional quality council must be representative of the communities
in which the council operates, with an emphasis on individuals with lived experience from
diverse racial and cultural backgrounds.
new text end

new text begin (c) Each regional quality council may hire staff to perform the duties assigned in
subdivision 9.
new text end

Sec. 22.

Minnesota Statutes 2020, section 256B.097, is amended by adding a subdivision
to read:

new text begin Subd. 9. new text end

new text begin Duties. new text end

new text begin (a) Each regional quality council shall:
new text end

new text begin (1) identify issues and barriers that impede Minnesotans who have disabilities from
optimizing choice of home and community-based services;
new text end

new text begin (2) promote informed-decision making, autonomy, and self-direction;
new text end

new text begin (3) analyze and review quality outcomes and critical incident data, and immediately
report incidents of life safety concerns to the Department of Human Services Licensing
Division;
new text end

new text begin (4) inform a comprehensive system for effective incident reporting, investigation, analysis,
and follow-up;
new text end

new text begin (5) collaborate on projects and initiatives to advance priorities shared with state agencies,
lead agencies, educational institutions, advocacy organizations, community partners, and
other entities engaged in disability service improvements;
new text end

new text begin (6) establish partnerships and working relationships with individuals and groups in the
regions;
new text end

new text begin (7) identify and implement regional and statewide quality improvement projects;
new text end

new text begin (8) transform systems and drive social change in alignment with the disability rights and
disability justice movements identified by leaders who have disabilities;
new text end

new text begin (9) provide information and training programs for persons who have disabilities and
their families and legal representatives on formal and informal support options and quality
expectations;
new text end

new text begin (10) make recommendations to state agencies and other key decision-makers regarding
disability services and supports;
new text end

new text begin (11) submit every two years a report to legislative committees with jurisdiction over
disability services on the status, outcomes, improvement priorities, and activities in the
region;
new text end

new text begin (12) support people by advocating to resolve complaints between the counties, providers,
persons receiving services, and their families and legal representatives; and
new text end

new text begin (13) recruit, train, and assign duties to regional quality council teams, including council
members, interns, and volunteers, taking into account the skills necessary for the team
members to be successful in this work.
new text end

new text begin (b) Each regional quality council may engage in quality improvement initiatives related
to, but not limited to:
new text end

new text begin (1) the home and community-based services waiver programs for persons with
developmental disabilities under section 256B.092, subdivision 4, or section 256B.49,
including brain injuries and services for those persons who qualify for nursing facility level
of care or hospital facility level of care and any other services licensed under chapter 245D;
new text end

new text begin (2) home care services under section 256B.0651;
new text end

new text begin (3) family support grants under section 252.32;
new text end

new text begin (4) consumer support grants under section 256.476;
new text end

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

new text begin (6) services provided through an intermediate care facility for persons with developmental
disabilities.
new text end

new text begin (c) Each regional quality council's work must be informed and directed by the needs
and desires of persons who have disabilities in the region in which the council operates.
new text end

Sec. 23.

Minnesota Statutes 2020, section 256B.097, is amended by adding a subdivision
to read:

new text begin Subd. 10. new text end

new text begin Compensation. new text end

new text begin (a) A member of a regional quality council who does not
receive a salary or wages from an employer may be paid a per diem and reimbursed for
expenses related to the member's participation in efforts and initiatives described in
subdivision 9 in the same manner and in an amount not to exceed the amount authorized
by the commissioner's plan adopted under section 43A.18, subdivision 2.
new text end

new text begin (b) Regional quality councils may charge fees for their services.
new text end

Sec. 24.

Minnesota Statutes 2020, section 256B.439, is amended by adding a subdivision
to read:

new text begin Subd. 3c. new text end

new text begin Contact information for consumer surveys for home and community-based
services. new text end

new text begin For purposes of conducting the consumer surveys under subdivision 3a, the
commissioner may request contact information of clients and associated key representatives.
Providers must furnish the contact information available to the provider and must provide
notice to clients and associated key representatives that their contact information has been
provided to the commissioner.
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. 25.

Minnesota Statutes 2020, section 256B.439, is amended by adding a subdivision
to read:

new text begin Subd. 3d. new text end

new text begin Resident experience survey and family survey for assisted living
facilities. new text end

new text begin The commissioner shall develop and administer a resident experience survey for
assisted living facility residents and a family survey for families of assisted living facility
residents. Money appropriated to the commissioner to administer the resident experience
survey and family survey is available in either fiscal year of the biennium in which it is
appropriated.
new text end

Sec. 26.

Minnesota Statutes 2020, section 256B.49, subdivision 11, is amended to read:

Subd. 11.

Authority.

(a) The commissioner is authorized to apply for home and
community-based service waivers, as authorized under section 1915(c) of the new text begin federal new text end Social
Security Act to serve persons under the age of 65 who are determined to require the level
of care provided in a nursing home and persons who require the level of care provided in a
hospital. The commissioner shall apply for the home and community-based waivers in order
to:

(1) promote the support of persons with disabilities in the most integrated settings;

(2) expand the availability of services for persons who are eligible for medical assistance;

(3) promote cost-effective options to institutional care; and

(4) obtain federal financial participation.

(b) The provision of deleted text begin waivered deleted text end new text begin waiver new text end services to medical assistance recipients with
disabilities shall comply with the requirements outlined in the federally approved applications
for home and community-based services and subsequent amendments, including provision
of services according to a service plan designed to meet the needs of the individual. For
purposes of this section, the approved home and community-based application is considered
the necessary federal requirement.

(c) The commissioner shall provide interested persons serving on agency advisory
committees, task forces, the Centers for Independent Living, and others who request to be
on a list to receive, notice of, and an opportunity to comment on, at least 30 days before
any effective dates, (1) any substantive changes to the state's disability services program
manual, or (2) changes or amendments to the federally approved applications for home and
community-based waivers, prior to their submission to the federal Centers for Medicare
and Medicaid Services.

(d) The commissioner shall seek approval, as authorized under section 1915(c) of the
new text begin federal new text end Social Security Act, to allow medical assistance eligibility under this section for
children under age 21 without deeming of parental income or assets.

(e) The commissioner shall seek approval, as authorized under section 1915(c) of the
Social Act, to allow medical assistance eligibility under this section for individuals under
age 65 without deeming the spouse's income or assets.

(f) The commissioner shall comply with the requirements in the federally approved
transition plan for the home and community-based services waivers authorized under this
section.

new text begin (g) The commissioner shall seek federal approval to allow for the reconfiguration of the
1915(c) home and community-based waivers in this section, as authorized under section
1915(c) of the federal Social Security Act, to implement a two-waiver program structure.
new text end

new text begin (h) The commissioner shall seek federal approval for the 1915(c) home and
community-based waivers in this section, as authorized under section 1915(c) of the federal
Social Security Act, to implement an individual resource allocation methodology.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2024, or 90 days after 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.49, subdivision 11a, is amended to read:

Subd. 11a.

deleted text begin Waivered deleted text end new text begin Waiver new text end services statewide priorities.

(a) The commissioner shall
establish statewide priorities for individuals on the waiting list for community alternative
care, community access for disability inclusion, and brain injury waiver services, as of
January 1, 2010. The statewide priorities must include, but are not limited to, individuals
who continue to have a need for waiver services after they have maximized the use of state
plan services and other funding resources, including natural supports, prior to accessing
waiver services, and who meet at least one of the following criteria:

(1) no longer require the intensity of services provided where they are currently living;
or

(2) make a request to move from an institutional setting.

(b) After the priorities in paragraph (a) are met, priority must also be given to individuals
who meet at least one of the following criteria:

(1) have unstable living situations due to the age, incapacity, or sudden loss of the primary
caregivers;

(2) are moving from an institution due to bed closures;

(3) experience a sudden closure of their current living arrangement;

(4) require protection from confirmed abuse, neglect, or exploitation;

(5) experience a sudden change in need that can no longer be met through state plan
services or other funding resources alone; or

(6) meet other priorities established by the department.

(c) When allocating new text begin new enrollment new text end resources to lead agencies, the commissioner must
take into consideration the number of individuals waiting who meet statewide priorities deleted text begin and
the lead agencies' current use of waiver funds and existing service options deleted text end . deleted text begin The commissioner
has the authority to transfer funds between counties, groups of counties, and tribes to
accommodate statewide priorities and resource needs while accounting for a necessary base
level reserve amount for each county, group of counties, and tribe.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2024, 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 2020, section 256B.49, subdivision 17, is amended to read:

Subd. 17.

Cost of services and supports.

(a) The commissioner shall ensure that the
average per capita expenditures estimated in any fiscal year for home and community-based
waiver recipients does not exceed the average per capita expenditures that would have been
made to provide institutional services for recipients in the absence of the waiver.

deleted text begin (b) The commissioner shall implement on January 1, 2002, one or more aggregate,
need-based methods for allocating to local agencies the home and community-based waivered
service resources available to support recipients with disabilities in need of the level of care
provided in a nursing facility or a hospital. The commissioner shall allocate resources to
single counties and county partnerships in a manner that reflects consideration of:
deleted text end

deleted text begin (1) an incentive-based payment process for achieving outcomes;
deleted text end

deleted text begin (2) the need for a state-level risk pool;
deleted text end

deleted text begin (3) the need for retention of management responsibility at the state agency level; and
deleted text end

deleted text begin (4) a phase-in strategy as appropriate.
deleted text end

deleted text begin (c) Until the allocation methods described in paragraph (b) are implemented, the annual
allowable reimbursement level of home and community-based waiver services shall be the
greater of:
deleted text end

deleted text begin (1) the statewide average payment amount which the recipient is assigned under the
waiver reimbursement system in place on June 30, 2001, modified by the percentage of any
provider rate increase appropriated for home and community-based services; or
deleted text end

deleted text begin (2) an amount approved by the commissioner based on the recipient's extraordinary
needs that cannot be met within the current allowable reimbursement level. The increased
reimbursement level must be necessary to allow the recipient to be discharged from an
institution or to prevent imminent placement in an institution. The additional reimbursement
may be used to secure environmental modifications; assistive technology and equipment;
and increased costs for supervision, training, and support services necessary to address the
recipient's extraordinary needs. The commissioner may approve an increased reimbursement
level for up to one year of the recipient's relocation from an institution or up to six months
of a determination that a current waiver recipient is at imminent risk of being placed in an
institution.
deleted text end

deleted text begin (d) deleted text end new text begin (b) new text end Beginning July 1, 2001, medically necessary home care nursing services will be
authorized under this section as complex and regular care according to sections 256B.0651
to 256B.0654 and 256B.0659. The rate established by the commissioner for registered nurse
or licensed practical nurse services under any home and community-based waiver as of
January 1, 2001, shall not be reduced.

deleted text begin (e) deleted text end new text begin (c) new text end Notwithstanding section 252.28, subdivision 3, paragraph (d), if the 2009
legislature adopts a rate reduction that impacts payment to providers of adult foster care
services, the commissioner may issue adult foster care licenses that permit a capacity of
five adults. The application for a five-bed license must meet the requirements of section
245A.11, subdivision 2a. Prior to admission of the fifth recipient of adult foster care services,
the county must negotiate a revised per diem rate for room and board and waiver services
that reflects the legislated rate reduction and results in an overall average per diem reduction
for all foster care recipients in that home. The revised per diem must allow the provider to
maintain, as much as possible, the level of services or enhanced services provided in the
residence, while mitigating the losses of the legislated rate reduction.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2024, 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. 29.

Minnesota Statutes 2020, section 256B.49, is amended by adding a subdivision
to read:

new text begin Subd. 28. new text end

new text begin Customized living moratorium for brain injury and community access
for disability inclusion waivers. new text end

new text begin (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.
new text end

new text begin (b) The commissioner may approve an exception to paragraph (a) when an existing
customized living setting changes ownership at the same address.
new text end

new text begin (c) Customized living settings operational on or before June 30, 2021, are considered
existing customized living settings.
new text end

new text begin (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) and that was not
operational on or before June 30, 2021, the authorizing lead agency is financially responsible
for all home and community-based service payments in the setting.
new text end

new text begin (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 end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021. This section applies only
to customized living services as defined under the brain injury or community access for
disability inclusion waiver plans under Minnesota Statutes, section 256B.49.
new text end

Sec. 30.

Minnesota Statutes 2020, section 256B.49, is amended by adding a subdivision
to read:

new text begin Subd. 29. new text end

new text begin Residential support services criteria. new text end

new text begin (a) For the purposes of this subdivision,
"residential support services" means the following residential support services reimbursed
under section 256B.4914: community residential services, customized living services, and
24-hour customized living services.
new text end

new text begin (b) In order to increase independent living options for people with disabilities and in
accordance with section 256B.4905, subdivisions 3 and 4, and consistent with section
245A.03, subdivision 7, the commissioner must establish and implement criteria to access
residential support services. The criteria for accessing residential support services must
prohibit the commissioner from authorizing residential support services unless at least all
of the following conditions are met:
new text end

new text begin (1) the individual has complex behavioral health or complex medical needs; and
new text end

new text begin (2) the individual's service planning team has considered all other available residential
service options and determined that those options are inappropriate to meet the individual's
support needs.
new text end

new text begin Nothing in this subdivision shall be construed as permitting the commissioner to establish
criteria prohibiting the authorization of residential support services for individuals described
in the statewide priorities established in subdivision 12, the transition populations in
subdivision 13, and the licensing moratorium exception criteria under section 245A.03,
subdivision 7, paragraph (a).
new text end

new text begin (c) Individuals with active service agreements for residential support services on the
date that the criteria for accessing residential support services become effective are exempt
from the requirements of this subdivision, and the exemption from the criteria for accessing
residential support services continues to apply for renewals of those service agreements.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective 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. 31.

Minnesota Statutes 2020, section 256B.4905, is amended by adding a subdivision
to read:

new text begin Subd. 1a. new text end

new text begin Informed choice. new text end

new text begin For purposes of this section, "informed choice" means a
choice that adults who have disabilities and, with support from their families or legal
representatives, that children who have disabilities make regarding services and supports
that best meets the adult's or children's needs and preferences. Before making an informed
choice, an individual who has disabilities must be provided, in an accessible format and
manner that meets the individual's needs, the tools, information, and opportunities that the
individual requires to understand all of the individual's options.
new text end

Sec. 32.

Minnesota Statutes 2020, section 256B.4905, is amended by adding a subdivision
to read:

new text begin Subd. 2a. new text end

new text begin Informed choice policy. new text end

new text begin (a) It is the policy of this state that all adults who
have disabilities and, with support from their families or legal representatives, all children
who have disabilities:
new text end

new text begin (1) may make informed choices to select and utilize disability services and supports;
and
new text end

new text begin (2) are offered an informed decision-making process sufficient to make informed choices.
new text end

new text begin (b) It is the policy of this state that disability waivers services support the presumption
that adults who have disabilities and, with support from their families or legal representatives,
children who have disabilities may make informed choices; and that all adults who have
disabilities and all families of children who have disabilities and are accessing waiver
services under sections 256B.092 and 256B.49 are provided an informed decision-making
process that satisfies the requirements of subdivision 3a.
new text end

Sec. 33.

Minnesota Statutes 2020, section 256B.4905, is amended by adding a subdivision
to read:

new text begin Subd. 3a. new text end

new text begin Informed decision making. new text end

new text begin "Informed decision making" means a process
that provides accessible, correct, and complete information to help an individual who is
accessing waiver services under sections 256B.092 and 256B.49 make an informed choice.
This information must be accessible and understandable to the individual so that the
individual is able to demonstrate understanding of the options. Any written information
provided in the process must be accessible and the process must be experiential whenever
possible. The process must also consider and offer to the individual, in a person-centered
manner, the following:
new text end

new text begin (1) reasonable accommodations as needed or requested by the individual to fully
participate in the informed decision-making process and acquire the information necessary
to make an informed choice;
new text end

new text begin (2) discussion of the individual's own preferences, abilities, goals, and objectives;
new text end

new text begin (3) identification of the person's cultural needs and access to culturally responsive services
and providers;
new text end

new text begin (4) information about the benefits of inclusive and individualized services and supports;
new text end

new text begin (5) presentation and discussion of all options with the person;
new text end

new text begin (6) documentation, in a manner prescribed by the commissioner, of each option discussed;
new text end

new text begin (7) exploration and development of new or other options;
new text end

new text begin (8) facilitation of opportunities to visit alternative locations or to engage in experiences
to understand how any service option might work for the person;
new text end

new text begin (9) opportunities to meet with other individuals with disabilities who live, work, and
receive services different from the person's own services;
new text end

new text begin (10) development of a transition plan, when needed or requested by the person, to
facilitate the choice to move from one service type or setting to another, and authorization
of the services and supports necessary to effectuate the plan;
new text end

new text begin (11) identification of any barriers to assisting or implementing the person's informed
choice and authorization of the services and supports necessary to overcome those barriers;
and
new text end

new text begin (12) ample time and timely opportunity to consider available options before the individual
makes a final choice or changes a choice.
new text end

Sec. 34.

Minnesota Statutes 2020, section 256B.4905, is amended by adding a subdivision
to read:

new text begin Subd. 4a. new text end

new text begin Informed choice in employment policy. new text end

new text begin It is the policy of this state that
working-age individuals who have disabilities:
new text end

new text begin (1) can work and achieve competitive integrated employment with appropriate services
and supports, as needed;
new text end

new text begin (2) make informed choices about their postsecondary education, work, and career goals;
and
new text end

new text begin (3) will be offered the opportunity to make an informed choice, at least annually, to
pursue postsecondary education or to work and earn a competitive wage.
new text end

Sec. 35.

Minnesota Statutes 2020, section 256B.4905, is amended by adding a subdivision
to read:

new text begin Subd. 5a. new text end

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

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

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

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

Sec. 36.

Minnesota Statutes 2020, section 256B.4905, is amended by adding a subdivision
to read:

new text begin Subd. 7. new text end

new text begin Informed choice in community living policy. new text end

new text begin It is the policy of this state that
all adults who have disabilities:
new text end

new text begin (1) can live in the communities of the individual's choosing with appropriate services
and supports as needed; and
new text end

new text begin (2) have the right, at least annually, to make an informed decision-making process that
can help them make an informed choice to live outside of a provider-controlled setting.
new text end

Sec. 37.

Minnesota Statutes 2020, section 256B.4905, is amended by adding a subdivision
to read:

new text begin Subd. 8. new text end

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

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

new text begin (1) the disability waivers under sections 256B.092 and 256B.49 support the presumption
that all adults who have disabilities can and want to live in the communities of the individual's
choosing with services and supports, as needed; and
new text end

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

Sec. 38.

Minnesota Statutes 2020, section 256B.4905, is amended by adding a subdivision
to read:

new text begin Subd. 9. new text end

new text begin Informed choice in self-direction policy. new text end

new text begin It is the policy of this state that adults
who have disabilities and families of children who have disabilities:
new text end

new text begin (1) can direct the adult's or child's needed services and supports; and
new text end

new text begin (2) have the right to make an informed choice to self-direct the adult's or child's services
and supports before being offered options that do not allow the adult or family to self-direct
the adult's or child's services and supports.
new text end

Sec. 39.

Minnesota Statutes 2020, section 256B.4905, is amended by adding a subdivision
to read:

new text begin Subd. 10. new text end

new text begin Informed choice in self-direction implementation for disability waiver
services. new text end

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

new text begin (1) disability waivers under sections 256B.092 and 256B.49 support the presumption
that adults who have disabilities and families of children who have disabilities can direct
all of their services and supports, including self-directed funding options; and
new text end

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

Sec. 40.

Minnesota Statutes 2020, section 256B.4905, is amended by adding a subdivision
to read:

new text begin Subd. 11. new text end

new text begin Informed choice in technology policy. new text end

new text begin It is the policy of this state that all
adults who have disabilities and children who have disabilities:
new text end

new text begin (1) can use assistive technology, remote supports, or a combination of both to enhance
the adult's or child's independence and quality of life; and
new text end

new text begin (2) have the right, at least annually, to make an informed choice about the adult's or
child's use of assistive technology and remote supports.
new text end

Sec. 41.

Minnesota Statutes 2020, section 256B.4905, is amended by adding a subdivision
to read:

new text begin Subd. 12. new text end

new text begin Informed choice in technology implementation for disability waiver
services. new text end

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

new text begin (1) disability waivers under sections 256B.092 and 256B.49 support the presumption
that all adults who have disabilities and children who have disabilities may use assistive
technology, remote supports, or both to enhance the adult's or child's independence and
quality of life; and
new text end

new text begin (2) each individual accessing waiver services is offered, after an informed decision-
making process and during a person-centered planning process, the opportunity to choose
assistive technology, remote support, or both to ensure equitable access.
new text end

Sec. 42.

Minnesota Statutes 2020, section 256B.4914, subdivision 5, is amended to read:

Subd. 5.

Base wage index and standard component values.

(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 developing and calculating
the proposed 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 most recent edition of the Occupational Handbook must be used. The base wage index
must be calculated as follows:

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

(i) 15 percent of the subtotal of 50 percent of the median wage for personal and home
health aide (SOC code 39-9021); 30 percent of the median wage for nursing assistant (SOC
code 31-1014); 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 20 percent of the median wage for home health aide
(SOC code 31-1011); 20 percent of the median wage for personal and home health aide
(SOC code 39-9021); 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);

(2) for adult day services, 70 percent of the median wage for nursing assistant (SOC
code 31-1014); and 30 percent of the median wage for personal care aide (SOC code
39-9021);

(3) for day services, day support services, and prevocational services, 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 60 percent of the median wage for social
and human services aide (SOC code 21-1093);

(4) for residential asleep-overnight staff, the wage is the minimum wage in Minnesota
for large employers, except in a family foster care setting, the wage is 36 percent of the
minimum wage in Minnesota for large employers;

(5) for positive supports analyst staff, 100 percent of the median wage for mental health
counselors (SOC code 21-1014);

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

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

(8) for supportive living services staff, 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 60 percent of the median wage for social and human services aide (SOC code
21-1093);

(9) for housing access coordination staff, 100 percent of the median wage for community
and social services specialist (SOC code 21-1099);

(10) for in-home family support and individualized home supports with family training
staff, 20 percent of the median wage for nursing aide (SOC code 31-1012); 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);

(11) 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);

(12) for independent living skills 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
rehabilitation counselor (SOC code 21-1015); 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 staff, 50 percent of the median wage for personal
and home care aide (SOC code 39-9021); and 50 percent of the median wage for nursing
assistant (SOC code 31-1014);

(17) for adult companion staff, 50 percent of the median wage for personal and home
care aide (SOC code 39-9021); and 50 percent of the median wage for nursing assistant
(SOC code 31-1014);

(18) for night supervision staff, 20 percent of the median wage for home health aide
(SOC code 31-1011); 20 percent of the median wage for personal and home health aide
(SOC code 39-9021); 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);

(19) for respite staff, 50 percent of the median wage for personal and home care aide
(SOC code 39-9021); and 50 percent of the median wage for nursing assistant (SOC code
31-1014);

(20) for personal support staff, 50 percent of the median wage for personal and home
care aide (SOC code 39-9021); and 50 percent of the median wage for nursing assistant
(SOC code 31-1014);

(21) 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 specialists, which is
100 percent of the median wage for clinical counseling and school psychologist (SOC code
19-3031);

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

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

(b) Component values for corporate foster care services, corporate supportive living
services daily, community residential services, and integrated community support services
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) general administrative support ratio: 13.25 percent;

(6) program-related expense ratio: 1.3 percent; and

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

(c) Component values for family foster care 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) general administrative support ratio: 3.3 percent;

(6) program-related expense ratio: 1.3 percent; and

(7) absence factor: 1.7 percent.

(d) Component values for day training and habilitation, day support services, and
prevocational services 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: 5.6 percent;

(6) client programming and support ratio: ten percent;

(7) general administrative support ratio: 13.25 percent;

(8) program-related expense ratio: 1.8 percent; and

(9) absence and utilization factor ratio: 9.4 percent.

(e) Component values for adult day services 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: 5.6 percent;

(6) client programming and support ratio: 7.4 percent;

(7) general administrative support ratio: 13.25 percent;

(8) program-related expense ratio: 1.8 percent; and

(9) absence and utilization factor ratio: 9.4 percent.

(f) 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 supports ratio: 15.5 percent;

(6) client programming and supports ratio: 4.7 percent;

(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.

(g) Component values for unit-based services without programming except respite 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;

(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.

(h) Component values for unit-based services without programming for respite 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) general administrative support ratio: 13.25 percent;

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

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

(i) deleted text begin On July 1, 2022, and every two years thereafter, deleted text end The commissioner shall update the
base wage index in paragraph (a) deleted text begin based on wage data by SOC from the Bureau of Labor
Statistics available 30 months and one day prior to the scheduled update. The commissioner
shall deleted text end new text begin , new text end publish these updated values new text begin , new text end and load them into the rate management system new text begin as
follows:
new text end

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

new text begin (2) on November 1, 2024, based on wage data by SOC from the Bureau of Labor Statistics
available as of December 31, 2021; and
new text end

new text begin (3) on July 1, 2026, and every two years thereafter, based on wage data by SOC from
the Bureau of Labor Statistics available 30 months and one day prior to the scheduled update new text end .

(j) Beginning February 1, 2021, 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. The report must include recommendations to update the
competitive workforce factor using:

(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 10a, paragraph (g).

The commissioner shall not recommend an increase or decrease of the competitive workforce
factor from the current value by more than two percentage points. If, after a biennial analysis
for the next report, the competitive workforce factor is less than or equal to zero, the
commissioner shall recommend a competitive workforce factor of zero.

(k) deleted text begin On July 1, 2022, and every two years thereafter, deleted text end The commissioner shall update the
framework components in paragraph (d), clause (6); paragraph (e), clause (6); paragraph
(f), clause (6); and paragraph (g), clause (6); subdivision 6, paragraphs (b), clauses (9) and
(10), and (e), clause (10); and subdivision 7, clauses (11), (17), and (18), for changes in the
Consumer Price Index. The commissioner shall adjust these values higher or lower deleted text begin by the
percentage change in the CPI-U from the date of the previous update to the data available
30 months and one day prior to the scheduled update. The commissioner shall deleted text end new text begin , new text end publish these
updated values new text begin , new text end and load them into the rate management system new text begin as follows:
new text end

new text begin (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;
new text end

new text begin (2) on November 1, 2024, by the percentage change in the CPI-U from the date of the
previous update to the data available as of December 31, 2021; and
new text end

new text begin (3) on July 1, 2026, and every two years thereafter, by the percentage change in the
CPI-U from the date of the previous update to the data available 30 months and one day
prior to the scheduled update new text end .

(l) Upon the implementation of the updates under paragraphs (i) and (k), rate adjustments
authorized under section 256B.439, subdivision 7; Laws 2013, chapter 108, article 7, section
60; and Laws 2014, chapter 312, article 27, section 75, shall be removed from service rates
calculated under this section.

(m) 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 paragraphs (i) and (k).

(n) In this subdivision, if Bureau of Labor Statistics occupational codes or Consumer
Price Index items are unavailable in the future, the commissioner shall recommend to the
legislature codes or items to update and replace missing component values.

new text begin (o) At least 80 percent of the marginal increase in revenue from the rate adjustment
applied to the service rates calculated under this section in paragraphs (i) and (k) 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. For the purposes of this paragraph,
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 January 1, 2022, including retention and recruitment
bonuses and tuition reimbursement.
new text end

new text begin 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 paragraph. A provider agency or individual provider that
receives a rate subject to the requirements of this paragraph 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 paragraph, 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 paragraph, 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 end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall inform the revisor of statutes
when federal approval is obtained.
new text end

Sec. 43.

Minnesota Statutes 2020, section 256B.4914, subdivision 6, is amended to read:

Subd. 6.

Payments for residential support services.

(a) For purposes of this subdivision,
residential support services includes 24-hour customized living services, community
residential services, customized living services, family residential services, foster care
services, integrated community supports, and supportive living services daily.

(b) Payments for community residential services, corporate foster care services, corporate
supportive living services daily, family residential services, and family foster care services
must be calculated as follows:

(1) determine the number of shared staffing and individual direct staff hours to meet a
recipient's needs provided on site or through monitoring technology;

(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics
Minnesota-specific rates or rates derived by the commissioner as provided in subdivision
5;

(3) except for subdivision 5, paragraph (a), clauses (4) and (21) to (23), multiply the
result of clause (2) by the product of one plus the competitive workforce factor in subdivision
5, paragraph (b), clause (1);

(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 shared and individual direct staff hours provided on site or
through monitoring technology and nursing hours by the appropriate staff wages;

(6) multiply the number of shared and individual direct staff hours provided on site or
through monitoring technology and nursing hours by the product of the supervision span
of control ratio in subdivision 5, paragraph (b), clause (2), and the appropriate supervision
wage in subdivision 5, paragraph (a), clause (21);

(7) combine the results of clauses (5) and (6), excluding any shared and individual direct
staff hours provided through monitoring technology, and multiply the result by one plus
the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (b),
clause (3). This is defined as the direct staffing cost;

(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared
and individual direct staff hours provided through monitoring technology, by one plus the
employee-related cost ratio in subdivision 5, paragraph (b), clause (4);

(9) for client programming and supports, the commissioner shall add $2,179; and

(10) for transportation, if provided, the commissioner shall add $1,680, or $3,000 if
customized for adapted transport, based on the resident with the highest assessed need.

(c) The total rate must be calculated using the following steps:

(1) subtotal paragraph (b), clauses (8) to (10), and the direct staffing cost of any shared
and individual direct staff hours provided through monitoring technology that was excluded
in clause (8);

(2) sum the standard general and administrative rate, the program-related expense ratio,
and the absence and utilization ratio;

(3) divide the result of clause (1) by one minus the result of clause (2). This is the total
payment amount; and

(4) adjust the result of clause (3) by a factor to be determined by the commissioner to
adjust for regional differences in the cost of providing services.

(d) The payment methodology for customized living deleted text begin , deleted text end new text begin and new text end 24-hour customized living deleted text begin ,
and residential care services deleted text end must be the customized living tool. deleted text begin Revisions to deleted text end new text begin The
commissioner shall revise new text end the customized living tool deleted text begin must be made deleted text end to reflect the services
and activities unique to disability-related recipient needs deleted text begin . deleted text end new text begin , and adjust for regional differences
in the cost of providing services. The rate adjustments described in section 256S.205 do not
apply to rates paid under this section. Customized living and 24-hour customized living
rates determined under this section shall not include more than 24 hours of support in a
daily unit. The commissioner shall establish the following acuity-based customized living
tool input limits, based on case mix, for customized living and 24-hour customized living
rates determined under this section:
new text end

new text begin (1) no more than two hours of mental health management per day for people assessed
for case mixes A, D, and G;
new text end

new text begin (2) no more than four hours of activities of daily living assistance per day for people
assessed for case mix B; and
new text end

new text begin (3) no more than six hours of activities of daily living assistance per day for people
assessed for case mix D.
new text end

(e) Payments for integrated community support services must be calculated as follows:

(1) the base shared staffing deleted text begin shall deleted text end new text begin must new text end be eight hours divided by the number of people
receiving support in the integrated community support setting;

(2) the individual staffing hours deleted text begin shall deleted text end new text begin must new text end be the average number of direct support hours
provided directly to the service recipient;

(3) the personnel hourly wage rate must be based on the most recent Bureau of Labor
Statistics Minnesota-specific rates or rates derived by the commissioner as provided in
subdivision 5;

(4) except for subdivision 5, paragraph (a), clauses (4) and (21) to (23), multiply the
result of clause (3) by the product of one plus the competitive workforce factor in subdivision
5, paragraph (b), clause (1);

(5) 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 (4);

(6) multiply the number of shared and individual direct staff hours in clauses (1) and
(2) by the appropriate staff wages;

(7) multiply the number of shared and individual direct staff hours in clauses (1) and
(2) by the product of the supervisory span of control ratio in subdivision 5, paragraph (b),
clause (2), and the appropriate supervisory wage in subdivision 5, paragraph (a), clause
(21);

(8) combine the results of clauses (6) and (7) and multiply the result by one plus the
employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (b), clause
(3). This is defined as the direct staffing cost;

(9) for employee-related expenses, multiply the direct staffing cost by one plus the
employee-related cost ratio in subdivision 5, paragraph (b), clause (4); and

(10) for client programming and supports, the commissioner shall add $2,260.21 divided
by 365.

(f) The total rate must be calculated as follows:

(1) add the results of paragraph (e), clauses (9) and (10);

(2) add the standard general and administrative rate, the program-related expense ratio,
and the absence and utilization factor ratio;

(3) divide the result of clause (1) by one minus the result of clause (2). This is the total
payment amount; and

(4) adjust the result of clause (3) by a factor to be determined by the commissioner to
adjust for regional differences in the cost of providing services.

deleted text begin (g) The payment methodology for customized living and 24-hour customized living
services must be the customized living tool. The commissioner shall revise the customized
living tool to reflect the services and activities unique to disability-related recipient needs
and adjust for regional differences in the cost of providing services.
deleted text end

deleted text begin (h) deleted text end new text begin (g) new text end The number of days authorized for all individuals enrolling in residential services
must include every day that services start and end.

new text begin EFFECTIVE DATE. new text end

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

Sec. 44.

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

new text begin Subd. 18. new text end

new text begin ICF/DD rate increases effective January 1, 2022. new text end

new text begin (a) For the rate period
beginning January 1, 2022, the commissioner must increase operating payments for each
facility reimbursed under this section equal to five percent of the operating payment rates
in effect on December 31, 2021.
new text end

new text begin (b) For each facility, the commissioner must apply the rate increase based on occupied
beds, using the percentage specified in this subdivision multiplied by the total payment rate,
including the variable rate but excluding the property-related payment rate in effect on
December 31, 2021. The total rate increase must include the adjustment provided in section
256B.501, subdivision 12.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall inform the revisor of statutes
when federal approval is obtained.
new text end

Sec. 45.

Minnesota Statutes 2020, section 256B.5013, subdivision 1, is amended to read:

Subdivision 1.

Variable rate adjustments.

(a) deleted text begin For rate years beginning on or after
October 1, 2000, deleted text end When there is a documented increase in the needs of a current ICF/DD
recipient, the county of financial responsibility may recommend a variable rate to enable
the facility to meet the individual's increased needs. Variable rate adjustments made under
this subdivision replace payments for persons with special needs for crisis intervention
services under section 256B.501, subdivision 8a. deleted text begin Effective July 1, 2003, facilities with a
base rate above the 50th percentile of the statewide average reimbursement rate for a Class
A facility or Class B facility, whichever matches the facility licensure, are not eligible for
a variable rate adjustment. Variable rate adjustments may not exceed a 12-month period,
except when approved for purposes established in paragraph (b), clause (1). deleted text end new text begin Once approved,
variable rate adjustments must continue to remain in place unless there is an identified
change in need. A review of needed resources must be done at the time of the individual's
annual support plan meeting. Any change in need identified must result in submission of a
request to adjust the resources for the individual. new text end Variable rate adjustments approved solely
on the basis of changes on a developmental disabilities screening document will end June
30, 2002.

new text begin (b) The county of financial responsibility must act on a variable rate request within 30
days and notify the initiator of the request of the county's recommendation in writing.
new text end

deleted text begin (b) deleted text end new text begin (c) new text end A variable rate may be recommended by the county of financial responsibility
for increased needs in the following situations:

(1) a need for resources due to an individual's full or partial retirement from participation
in a day training and habilitation service when the individual: (i) has reached the age of 65
or has a change in health condition that makes it difficult for the person to participate in
day training and habilitation services over an extended period of time because it is medically
contraindicated; and (ii) has expressed a desire for change through the developmental
disability screening process under section 256B.092;

(2) a need for additional resources for intensive short-term programming deleted text begin which deleted text end new text begin that new text end is
necessary prior to an individual's discharge to a less restrictive, more integrated setting;

(3) a demonstrated medical need that significantly impacts the type or amount of services
needed by the individual; deleted text begin or
deleted text end

(4) a demonstrated behavioral new text begin or cognitive new text end need that significantly impacts the type or
amount of services needed by the individual deleted text begin . deleted text end new text begin ; or
new text end

deleted text begin (c) The county of financial responsibility must justify the purpose, the projected length
of time, and the additional funding needed for the facility to meet the needs of the individual.
deleted text end

deleted text begin (d) The facility shall provide an annual report to the county case manager on the use of
the variable rate funds and the status of the individual on whose behalf the funds were
approved. The county case manager will forward the facility's report with a recommendation
to the commissioner to approve or disapprove a continuation of the variable rate.
deleted text end

deleted text begin (e) Funds made available through the variable rate process that are not used by the facility
to meet the needs of the individual for whom they were approved shall be returned to the
state.
deleted text end

new text begin (5) a demonstrated increased need for staff assistance, changes in the type of staff
credentials needed, or a need for expert consultation based on assessments conducted prior
to the annual support plan meeting.
new text end

new text begin (d) Variable rate requests must include the following information:
new text end

new text begin (1) the service needs change;
new text end

new text begin (2) the variable rate requested and the difference from the current rate;
new text end

new text begin (3) a basis for the underlying costs used for the variable rate and any accompanying
documentation; and
new text end

new text begin (4) documentation of the expected outcomes to be achieved and the frequency of progress
monitoring associated with the rate increase.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall inform the revisor of statutes
when federal approval is obtained.
new text end

Sec. 46.

Minnesota Statutes 2020, section 256B.5013, subdivision 6, is amended to read:

Subd. 6.

Commissioner's responsibilities.

The commissioner shall:

(1) make a determination to approve, deny, or modify a request for a variable rate
adjustment within 30 days of the receipt of the completed application;

(2) notify the ICF/DD facility and county case manager of the deleted text begin duration and conditions
of variable rate adjustment approvals deleted text end new text begin determination new text end ; and

(3) modify MMIS II service agreements to reimburse ICF/DD facilities for approved
variable rates.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall inform the revisor of statutes
when federal approval is obtained.
new text end

Sec. 47.

Minnesota Statutes 2020, section 256B.5015, subdivision 2, is amended to read:

Subd. 2.

Services during the day.

new text begin (a) new text end Services during the day, as defined in section
256B.501, but excluding day training and habilitation services, shall be paid as a pass-through
payment deleted text begin no later than January 1, 2004 deleted text end . The commissioner shall establish rates for these
services, other than day training and habilitation services, at deleted text begin levels that do not exceed 75 deleted text end new text begin
100 new text end percent of a recipient's day training and habilitation service costs prior to the service
change.

new text begin (b) An individual qualifies for services during the day under paragraph (a) if, through
consultation with the individual and the individual's support team or interdisciplinary team:
new text end

new text begin (1) it has been determined that the individual's needs can best be met through partial or
full retirement from:
new text end

new text begin (i) participation in a day training and habilitation service; or
new text end

new text begin (ii) the use of services during the day in the individual's home environment; and
new text end

new text begin (2) an individualized plan has been developed with designated outcomes that:
new text end

new text begin (i) address the support needs and desires contained in the person-centered plan or
individual support plan; and
new text end

new text begin (ii) include goals that focus on community integration as appropriate for the individual.
new text end

new text begin (c) new text end When establishing a rate for these services, the commissioner shall also consider an
individual recipient's needs as identified in the deleted text begin individualized service deleted text end new text begin individual support new text end
plan and the person's need for active treatment as defined under federal regulations. The
pass-through payments for services during the day shall be paid separately by the
commissioner and shall not be included in the computation of the ICF/DD facility total
payment rate.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall inform the revisor of statutes
when federal approval is obtained.
new text end

Sec. 48.

Minnesota Statutes 2020, section 256B.69, subdivision 5a, as amended by Laws
2021, chapter 30, article 13, section 57, is amended to read:

Subd. 5a.

Managed care contracts.

(a) Managed care contracts under this section and
section 256L.12 shall be entered into or renewed on a calendar year basis. The commissioner
may issue separate contracts with requirements specific to services to medical assistance
recipients age 65 and older.

(b) A prepaid health plan providing covered health services for eligible persons pursuant
to chapters 256B and 256L is responsible for complying with the terms of its contract with
the commissioner. Requirements applicable to managed care programs under chapters 256B
and 256L established after the effective date of a contract with the commissioner take effect
when the contract is next issued or renewed.

(c) The commissioner shall withhold five percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program pending completion of performance targets. Each
performance target must be quantifiable, objective, measurable, and reasonably attainable,
except in the case of a performance target based on a federal or state law or rule. Criteria
for assessment of each performance target must be outlined in writing prior to the contract
effective date. Clinical or utilization performance targets and their related criteria must
consider evidence-based research and reasonable interventions when available or applicable
to the populations served, and must be developed with input from external clinical experts
and stakeholders, including managed care plans, county-based purchasing plans, and
providers. The managed care or county-based purchasing plan must demonstrate, to the
commissioner's satisfaction, that the data submitted regarding attainment of the performance
target is accurate. The commissioner shall periodically change the administrative measures
used as performance targets in order to improve plan performance across a broader range
of administrative services. The performance targets must include measurement of plan
efforts to contain spending on health care services and administrative activities. The
commissioner may adopt plan-specific performance targets that take into account factors
affecting only one plan, including characteristics of the plan's enrollee population. The
withheld funds must be returned no sooner than July of the following year if performance
targets in the contract are achieved. The commissioner may exclude special demonstration
projects under subdivision 23.

(d) The commissioner shall require that managed care plans new text begin :
new text end

new text begin (1) new text end use the assessment and authorization processes, forms, timelines, standards,
documentation, and data reporting requirements, protocols, billing processes, and policies
consistent with medical assistance fee-for-service or the Department of Human Services
contract requirements for all personal care assistance services under section 256B.0659 and
community first services and supports under section 256B.85 deleted text begin . deleted text end new text begin ; and
new text end

new text begin (2) by January 30 of each year that follows a rate increase for any aspect of services
under section 256B.0659 or 256B.85, inform the commissioner and the chairs and ranking
minority members of the legislative committees with jurisdiction over rates determined
under section 256B.851 of the amount of the rate increase that is paid to each personal care
assistance provider agency with which the plan has a contract.
new text end

(e) Effective for services rendered on or after January 1, 2012, the commissioner shall
include as part of the performance targets described in paragraph (c) a reduction in the health
plan's emergency department utilization rate for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. For 2012, the reduction shall be based on
the health plan's utilization in 2009. To earn the return of the withhold each subsequent
year, the managed care plan or county-based purchasing plan must achieve a qualifying
reduction of no less than ten percent of the plan's emergency department utilization rate for
medical assistance and MinnesotaCare enrollees, excluding enrollees in programs described
in subdivisions 23 and 28, compared to the previous measurement year until the final
performance target is reached. When measuring performance, the commissioner must
consider the difference in health risk in a managed care or county-based purchasing plan's
membership in the baseline year compared to the measurement year, and work with the
managed care or county-based purchasing plan to account for differences that they agree
are significant.

The withheld funds must be returned no sooner than July 1 and no later than July 31 of
the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
was achieved. The commissioner shall structure the withhold so that the commissioner
returns a portion of the withheld funds in amounts commensurate with achieved reductions
in utilization less than the targeted amount.

The withhold described in this paragraph shall continue for each consecutive contract
period until the plan's emergency room utilization rate for state health care program enrollees
is reduced by 25 percent of the plan's emergency room utilization rate for medical assistance
and MinnesotaCare enrollees for calendar year 2009. Hospitals shall cooperate with the
health plans in meeting this performance target and shall accept payment withholds that
may be returned to the hospitals if the performance target is achieved.

(f) Effective for services rendered on or after January 1, 2012, the commissioner shall
include as part of the performance targets described in paragraph (c) a reduction in the plan's
hospitalization admission rate for medical assistance and MinnesotaCare enrollees, as
determined by the commissioner. To earn the return of the withhold each year, the managed
care plan or county-based purchasing plan must achieve a qualifying reduction of no less
than five percent of the plan's hospital admission rate for medical assistance and
MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and
28, compared to the previous calendar year until the final performance target is reached.
When measuring performance, the commissioner must consider the difference in health risk
in a managed care or county-based purchasing plan's membership in the baseline year
compared to the measurement year, and work with the managed care or county-based
purchasing plan to account for differences that they agree are significant.

The withheld funds must be returned no sooner than July 1 and no later than July 31 of
the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that this reduction in the hospitalization
rate was achieved. The commissioner shall structure the withhold so that the commissioner
returns a portion of the withheld funds in amounts commensurate with achieved reductions
in utilization less than the targeted amount.

The withhold described in this paragraph shall continue until there is a 25 percent
reduction in the hospital admission rate compared to the hospital admission rates in calendar
year 2011, as determined by the commissioner. The hospital admissions in this performance
target do not include the admissions applicable to the subsequent hospital admission
performance target under paragraph (g). Hospitals shall cooperate with the plans in meeting
this performance target and shall accept payment withholds that may be returned to the
hospitals if the performance target is achieved.

(g) Effective for services rendered on or after January 1, 2012, the commissioner shall
include as part of the performance targets described in paragraph (c) a reduction in the plan's
hospitalization admission rates for subsequent hospitalizations within 30 days of a previous
hospitalization of a patient regardless of the reason, for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. To earn the return of the withhold each year,
the managed care plan or county-based purchasing plan must achieve a qualifying reduction
of the subsequent hospitalization rate for medical assistance and MinnesotaCare enrollees,
excluding enrollees in programs described in subdivisions 23 and 28, of no less than five
percent compared to the previous calendar year until the final performance target is reached.

The withheld funds must be returned no sooner than July 1 and no later than July 31 of
the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a qualifying reduction in the
subsequent hospitalization rate was achieved. The commissioner shall structure the withhold
so that the commissioner returns a portion of the withheld funds in amounts commensurate
with achieved reductions in utilization less than the targeted amount.

The withhold described in this paragraph must continue for each consecutive contract
period until the plan's subsequent hospitalization rate for medical assistance and
MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and
28, is reduced by 25 percent of the plan's subsequent hospitalization rate for calendar year
2011. Hospitals shall cooperate with the plans in meeting this performance target and shall
accept payment withholds that must be returned to the hospitals if the performance target
is achieved.

(h) Effective for services rendered on or after January 1, 2013, through December 31,
2013, the commissioner shall withhold 4.5 percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program. The withheld funds must be returned no sooner than
July 1 and no later than July 31 of the following year. The commissioner may exclude
special demonstration projects under subdivision 23.

(i) Effective for services rendered on or after January 1, 2014, the commissioner shall
withhold three percent of managed care plan payments under this section and county-based
purchasing plan payments under section 256B.692 for the prepaid medical assistance
program. The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following year. The commissioner may exclude special demonstration projects
under subdivision 23.

(j) A managed care plan or a county-based purchasing plan under section 256B.692 may
include as admitted assets under section 62D.044 any amount withheld under this section
that is reasonably expected to be returned.

(k) Contracts between the commissioner and a prepaid health plan are exempt from the
set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph (a), and
7.

(l) The return of the withhold under paragraphs (h) and (i) is not subject to the
requirements of paragraph (c).

(m) Managed care plans and county-based purchasing plans shall maintain current and
fully executed agreements for all subcontractors, including bargaining groups, for
administrative services that are expensed to the state's public health care programs.
Subcontractor agreements determined to be material, as defined by the commissioner after
taking into account state contracting and relevant statutory requirements, must be in the
form of a written instrument or electronic document containing the elements of offer,
acceptance, consideration, payment terms, scope, duration of the contract, and how the
subcontractor services relate to state public health care programs. Upon request, the
commissioner shall have access to all subcontractor documentation under this paragraph.
Nothing in this paragraph shall allow release of information that is nonpublic data pursuant
to section 13.02.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2021.
new text end

Sec. 49.

Minnesota Statutes 2020, section 256B.85, subdivision 2, as amended by Laws
2021, chapter 30, article 13, section 59, is amended to read:

Subd. 2.

Definitions.

(a) For the purposes of this section new text begin and section 256B.851 new text end , the terms
defined in this subdivision have the meanings given.

(b) "Activities of daily living" or "ADLs" means:

(1) dressing, including assistance with choosing, applying, and changing clothing and
applying special appliances, wraps, or clothing;

(2) grooming, including assistance with basic hair care, oral care, shaving, applying
cosmetics and deodorant, and care of eyeglasses and hearing aids. Grooming includes nail
care, except for recipients who are diabetic or have poor circulation;

(3) bathing, including assistance with basic personal hygiene and skin care;

(4) eating, including assistance with hand washing and applying orthotics required for
eating, transfers, or feeding;

(5) transfers, including assistance with transferring the participant from one seating or
reclining area to another;

(6) mobility, including assistance with ambulation and use of a wheelchair. Mobility
does not include providing transportation for a participant;

(7) positioning, including assistance with positioning or turning a participant for necessary
care and comfort; and

(8) toileting, including assistance with bowel or bladder elimination and care, transfers,
mobility, positioning, feminine hygiene, use of toileting equipment or supplies, cleansing
the perineal area, inspection of the skin, and adjusting clothing.

(c) "Agency-provider model" means a method of CFSS under which a qualified agency
provides services and supports through the agency's own employees and policies. The agency
must allow the participant to have a significant role in the selection and dismissal of support
workers of their choice for the delivery of their specific services and supports.

(d) "Behavior" means a description of a need for services and supports used to determine
the home care rating and additional service units. The presence of Level I behavior is used
to determine the home care rating.

(e) "Budget model" means a service delivery method of CFSS that allows the use of a
service budget and assistance from a financial management services (FMS) provider for a
participant to directly employ support workers and purchase supports and goods.

(f) "Complex health-related needs" means an intervention listed in clauses (1) to (8) that
has been ordered by a physician, advanced practice registered nurse, or physician's assistant
and is specified in a community support plan, including:

(1) tube feedings requiring:

(i) a gastrojejunostomy tube; or

(ii) continuous tube feeding lasting longer than 12 hours per day;

(2) wounds described as:

(i) stage III or stage IV;

(ii) multiple wounds;

(iii) requiring sterile or clean dressing changes or a wound vac; or

(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require specialized
care;

(3) parenteral therapy described as:

(i) IV therapy more than two times per week lasting longer than four hours for each
treatment; or

(ii) total parenteral nutrition (TPN) daily;

(4) respiratory interventions, including:

(i) oxygen required more than eight hours per day;

(ii) respiratory vest more than one time per day;

(iii) bronchial drainage treatments more than two times per day;

(iv) sterile or clean suctioning more than six times per day;

(v) dependence on another to apply respiratory ventilation augmentation devices such
as BiPAP and CPAP; and

(vi) ventilator dependence under section 256B.0651;

(5) insertion and maintenance of catheter, including:

(i) sterile catheter changes more than one time per month;

(ii) clean intermittent catheterization, and including self-catheterization more than six
times per day; or

(iii) bladder irrigations;

(6) bowel program more than two times per week requiring more than 30 minutes to
perform each time;

(7) neurological intervention, including:

(i) seizures more than two times per week and requiring significant physical assistance
to maintain safety; or

(ii) swallowing disorders diagnosed by a physician, advanced practice registered nurse,
or physician's assistant and requiring specialized assistance from another on a daily basis;
and

(8) other congenital or acquired diseases creating a need for significantly increased direct
hands-on assistance and interventions in six to eight activities of daily living.

(g) "Community first services and supports" or "CFSS" means the assistance and supports
program under this section needed for accomplishing activities of daily living, instrumental
activities of daily living, and health-related tasks through hands-on assistance to accomplish
the task or constant supervision and cueing to accomplish the task, or the purchase of goods
as defined in subdivision 7, clause (3), that replace the need for human assistance.

(h) "Community first services and supports service delivery plan" or "CFSS service
delivery plan" means a written document detailing the services and supports chosen by the
participant to meet assessed needs that are within the approved CFSS service authorization,
as determined in subdivision 8. Services and supports are based on the coordinated service
and support plan identified in sections 256B.092, subdivision 1b, and 256S.10.

(i) "Consultation services" means a Minnesota health care program enrolled provider
organization that provides assistance to the participant in making informed choices about
CFSS services in general and self-directed tasks in particular, and in developing a
person-centered CFSS service delivery plan to achieve quality service outcomes.

(j) "Critical activities of daily living" means transferring, mobility, eating, and toileting.

(k) "Dependency" in activities of daily living means a person requires hands-on assistance
or constant supervision and cueing to accomplish one or more of the activities of daily living
every day or on the days during the week that the activity is performed; however, a child
must not be found to be dependent in an activity of daily living if, because of the child's
age, an adult would either perform the activity for the child or assist the child with the
activity and the assistance needed is the assistance appropriate for a typical child of the
same age.

(l) "Extended CFSS" means CFSS services and supports provided under CFSS that are
included in the CFSS service delivery plan through one of the home and community-based
services waivers and as approved and authorized under chapter 256S and sections 256B.092,
subdivision 5, and 256B.49, which exceed the amount, duration, and frequency of the state
plan CFSS services for participants. Extended CFSS excludes the purchase of goods.

(m) "Financial management services provider" or "FMS provider" means a qualified
organization required for participants using the budget model under subdivision 13 that is
an enrolled provider with the department to provide vendor fiscal/employer agent financial
management services (FMS).

(n) "Health-related procedures and tasks" means procedures and tasks related to the
specific assessed health needs of a participant that can be taught or assigned by a
state-licensed health care or mental health professional and performed by a support worker.

(o) "Instrumental activities of daily living" means activities related to living independently
in the community, including but not limited to: meal planning, preparation, and cooking;
shopping for food, clothing, or other essential items; laundry; housecleaning; assistance
with medications; managing finances; communicating needs and preferences during activities;
arranging supports; and assistance with traveling around and participating in the community new text begin ,
including traveling to medical appointments. For purposes of this paragraph, traveling
includes driving and accompanying the recipient in the recipient's chosen mode of
transportation and according to the individual CFSS service delivery plan new text end .

(p) "Lead agency" has the meaning given in section 256B.0911, subdivision 1a, paragraph
(e).

(q) "Legal representative" means parent of a minor, a court-appointed guardian, or
another representative with legal authority to make decisions about services and supports
for the participant. Other representatives with legal authority to make decisions include but
are not limited to a health care agent or an attorney-in-fact authorized through a health care
directive or power of attorney.

(r) "Level I behavior" means physical aggression toward self or others or destruction of
property that requires the immediate response of another person.

(s) "Medication assistance" means providing verbal or visual reminders to take regularly
scheduled medication, and includes any of the following supports listed in clauses (1) to
(3) and other types of assistance, except that a support worker must not determine medication
dose or time for medication or inject medications into veins, muscles, or skin:

(1) under the direction of the participant or the participant's representative, bringing
medications to the participant including medications given through a nebulizer, opening a
container of previously set-up medications, emptying the container into the participant's
hand, opening and giving the medication in the original container to the participant, or
bringing to the participant liquids or food to accompany the medication;

(2) organizing medications as directed by the participant or the participant's representative;
and

(3) providing verbal or visual reminders to perform regularly scheduled medications.

(t) "Participant" means a person who is eligible for CFSS.

(u) "Participant's representative" means a parent, family member, advocate, or other
adult authorized by the participant or participant's legal representative, if any, to serve as a
representative in connection with the provision of CFSS. If the participant is unable to assist
in the selection of a participant's representative, the legal representative shall appoint one.

(v) "Person-centered planning process" means a process that is directed by the participant
to plan for CFSS services and supports.

(w) "Service budget" means the authorized dollar amount used for the budget model or
for the purchase of goods.

(x) "Shared services" means the provision of CFSS services by the same CFSS support
worker to two or three participants who voluntarily enter into a written agreement to receive
services at the same time, in the same setting, and through the same agency-provider or
FMS provider.

(y) "Support worker" means a qualified and trained employee of the agency-provider
as required by subdivision 11b or of the participant employer under the budget model as
required by subdivision 14 who has direct contact with the participant and provides services
as specified within the participant's CFSS service delivery plan.

(z) "Unit" means the increment of service based on hours or minutes identified in the
service agreement.

(aa) "Vendor fiscal employer agent" means an agency that provides financial management
services.

(bb) "Wages and benefits" means the hourly 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, contributions to employee retirement accounts,
or other forms of employee compensation and benefits.

(cc) "Worker training and development" means services provided according to subdivision
18a for developing workers' skills as required by the participant's individual CFSS service
delivery plan that are arranged for or provided by the agency-provider or purchased by the
participant employer. These services include training, education, direct observation and
supervision, and evaluation and coaching of job skills and tasks, including supervision of
health-related tasks or behavioral supports.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later, except paragraph (a) is effective October 1, 2021, or upon federal approval,
whichever is later. The commissioner of human services must notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 50.

Minnesota Statutes 2020, section 256B.85, subdivision 7a, is amended to read:

Subd. 7a.

Enhanced rate.

An enhanced rate of 107.5 percent of the rate paid for CFSS
must be paid for services provided to persons who qualify for deleted text begin 12 deleted text end new text begin ten new text end or more hours of CFSS
per day when provided by a support worker who meets the requirements of subdivision 16,
paragraph (e). deleted text begin The enhanced rate for CFSS includes, and is not in addition to, any rate
adjustments implemented by the commissioner on July 1, 2019, to comply with the terms
of a collective bargaining agreement between the state of Minnesota and an exclusive
representative of individual providers under section 179A.54 that provides for wage increases
for individual providers who serve participants assessed to need 12 or more hours of CFSS
per day. deleted text end new text begin 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.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever occurs later. The commissioner shall notify the revisor of statutes when federal
approval is obtained.
new text end

Sec. 51.

Minnesota Statutes 2020, section 256B.85, subdivision 11, as amended by Laws
2021, chapter 30, article 13, section 69, is amended to read:

Subd. 11.

Agency-provider model.

(a) The agency-provider model includes services
provided by support workers and staff providing worker training and development services
who are employed by an agency-provider that meets the criteria established by the
commissioner, including required training.

(b) The agency-provider shall allow the participant to have a significant role in the
selection and dismissal of the support workers for the delivery of the services and supports
specified in the participant's CFSS service delivery plan. The agency must make a reasonable
effort to fulfill the participant's request for the participant's preferred support worker.

(c) A participant may use authorized units of CFSS services as needed within a service
agreement that is not greater than 12 months. Using authorized units in a flexible manner
in either the agency-provider model or the budget model does not increase the total amount
of services and supports authorized for a participant or included in the participant's CFSS
service delivery plan.

(d) A participant may share CFSS services. Two or three CFSS participants may share
services at the same time provided by the same support worker.

(e) The agency-provider must use a minimum of 72.5 percent of the revenue generated
by the medical assistance payment for CFSS for support worker wages and benefits, except
all of the revenue generated by a medical assistance rate increase due to a collective
bargaining agreement under section 179A.54 must be used for support worker wages and
benefits. The agency-provider must document how this requirement is being met. The
revenue generated by the worker training and development services and the reasonable costs
associated with the worker training and development services must not be used in making
this calculation.

(f) The agency-provider model must be used by participants who are restricted by the
Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160 to
9505.2245.

(g) Participants purchasing goods under this model, along with support worker services,
must:

(1) specify the goods in the CFSS service delivery plan and detailed budget for
expenditures that must be approved by the consultation services provider, case manager, or
care coordinator; and

(2) use the FMS provider for the billing and payment of such goods.

new text begin (h) The agency provider is responsible for ensuring that any worker driving a participant
under subdivision 2, paragraph (o), has a valid driver's license and the vehicle used is
registered and insured according to Minnesota law.
new text end

Sec. 52.

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

new text begin Subd. 12c. new text end

new text begin Community first services and supports agency provider requirements;
documentation of travel time. new text end

new text begin A community first services and supports agency provider
must ensure that travel and driving, as described in subdivision 2, paragraph (o), is
documented. The documentation must include:
new text end

new text begin (1) start and stop times with a.m. and p.m. designation;
new text end

new text begin (2) the origination site; and
new text end

new text begin (3) the destination site.
new text end

Sec. 53.

Minnesota Statutes 2020, section 256B.85, subdivision 14, is amended to read:

Subd. 14.

Participant's responsibilities.

(a) The participant or participant's representative
is responsible for:

(1) orienting support workers to individual needs and preferences and providing direction
during the delivery of services;

(2) tracking the services provided and all expenditures for goods or other supports;

(3) preparing, verifying, and submitting time sheets according to the requirements in
subdivision 15;

(4) reporting any problems resulting from the failure of the CFSS service delivery plan
to be implemented or the quality of services rendered by the support worker to the
agency-provider, consultation services provider, FMS provider, and case manager or care
coordinator if applicable;

(5) notifying the agency-provider or the FMS provider within ten days of any changes
in circumstances affecting the CFSS service delivery plan, including but not limited to
changes in the participant's place of residence or hospitalization; and

(6) under the agency-provider model, participating in the evaluation of CFSS services
and support workers according to subdivision 11a.

(b) For a participant using the budget model, the participant or participant's representative
is responsible for:

(1) using an FMS provider that is enrolled with the department. Upon a determination
of eligibility and completion of the assessment and coordinated service and support plan,
the participant shall choose an FMS provider from a list of eligible providers maintained
by the department;

(2) complying with policies and procedures of the FMS provider as required to meet
state and federal regulations for CFSS and the employment of support workers;

(3) the hiring and supervision of the support worker, including but not limited to
recruiting, interviewing, training, scheduling, and discharging the support worker consistent
with federal and state laws and regulations;

(4) notifying the FMS provider of any changes in the employment status of each support
worker;

(5) ensuring that support workers are competent to meet the participant's assessed needs
and additional requirements as written in the CFSS service delivery plan;

(6) determining the competency of the support worker through evaluation within 30
days of any support worker beginning to provide services and with any change in the
participant's condition or modification to the CFSS service delivery plan;

(7) verifying and maintaining evidence of support worker competency, including
documentation of the support worker's:

(i) education and experience relevant to the job responsibilities assigned to the support
worker and the needs of the participant;

(ii) training received from sources other than the participant;

(iii) orientation and instruction to implement defined services and supports to meet
participant needs and preferences as detailed in the CFSS service delivery plan; and

(iv) periodic written performance reviews completed by the participant at least annually
based on the direct observation of the support worker's ability to perform the job functions;

(8) developing and communicating to each support worker a worker training and
development plan to ensure the support worker is competent when:

(i) the support worker begins providing services;

(ii) there is any change in the participant's condition or modification to the CFSS service
delivery plan; or

(iii) a performance review indicates that additional training is needed; deleted text begin and
deleted text end

(9) participating in the evaluation of CFSS services new text begin ; and
new text end

new text begin (10) ensuring that a worker driving the participant under subdivision 2, paragraph (o),
has a valid driver's license and the vehicle used is registered and insured according to
Minnesota law new text end .

Sec. 54.

Minnesota Statutes 2020, section 256B.85, subdivision 16, is amended to read:

Subd. 16.

Support workers requirements.

(a) Support workers shall:

(1) enroll with the department as a support worker after a background study under chapter
245C has been completed and the support worker has received a notice from the
commissioner that the support worker:

(i) is not disqualified under section 245C.14; or

(ii) is disqualified, but has received a set-aside of the disqualification under section
245C.22;

(2) have the ability to effectively communicate with the participant or the participant's
representative;

(3) have the skills and ability to provide the services and supports according to the
participant's CFSS service delivery plan and respond appropriately to the participant's needs;

(4) complete the basic standardized CFSS training as determined by the commissioner
before completing enrollment. The training must be available in languages other than English
and to those who need accommodations due to disabilities. CFSS support worker training
must include successful completion of the following training components: basic first aid,
vulnerable adult, child maltreatment, OSHA universal precautions, basic roles and
responsibilities of support workers including information about basic body mechanics,
emergency preparedness, orientation to positive behavioral practices, orientation to
responding to a mental health crisis, fraud issues, time cards and documentation, and an
overview of person-centered planning and self-direction. Upon completion of the training
components, the support worker must pass the certification test to provide assistance to
participants;

(5) complete employer-directed training and orientation on the participant's individual
needs;

(6) maintain the privacy and confidentiality of the participant; and

(7) not independently determine the medication dose or time for medications for the
participant.

(b) The commissioner may deny or terminate a support worker's provider enrollment
and provider number if the support worker:

(1) does not meet the requirements in paragraph (a);

(2) fails to provide the authorized services required by the employer;

(3) has been intoxicated by alcohol or drugs while providing authorized services to the
participant or while in the participant's home;

(4) has manufactured or distributed drugs while providing authorized services to the
participant or while in the participant's home; or

(5) has been excluded as a provider by the commissioner of human services, or by the
United States Department of Health and Human Services, Office of Inspector General, from
participation in Medicaid, Medicare, or any other federal health care program.

(c) A support worker may appeal in writing to the commissioner to contest the decision
to terminate the support worker's provider enrollment and provider number.

(d) A support worker must not provide or be paid for more than 310 hours of CFSS per
month, regardless of the number of participants the support worker serves or the number
of agency-providers or participant employers by which the support worker is employed.
The department shall not disallow the number of hours per day a support worker works
unless it violates other law.

(e) CFSS qualify for an enhanced rate if the support worker providing the services:

(1) provides services, within the scope of CFSS described in subdivision 7, to a participant
who qualifies for deleted text begin 12 deleted text end new text begin ten new text end or more hours per day of CFSS; and

(2) satisfies the current requirements of Medicare for training and competency or
competency evaluation of home health aides or nursing assistants, as provided in the Code
of Federal Regulations, title 42, section 483.151 or 484.36, or alternative state-approved
training or competency requirements.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever occurs later. The commissioner shall notify the revisor of statutes when federal
approval is obtained.
new text end

Sec. 55.

new text begin [256B.851] COMMUNITY FIRST SERVICES AND SUPPORTS; PAYMENT
RATES.
new text end

new text begin Subdivision 1. new text end

new text begin Application. new text end

new text begin (a) The payment methodologies in this section apply to:
new text end

new text begin (1) community first services and supports (CFSS), extended CFSS, and enhanced rate
CFSS under section 256B.85; and
new text end

new text begin (2) personal care assistance services under section 256B.0625, subdivisions 19a and
19c; extended personal care assistance services as defined in section 256B.0659, subdivision
1; and enhanced rate personal care assistance services under section 256B.0659, subdivision
17a.
new text end

new text begin (b) This section does not change existing personal care assistance program or community
first services and supports policies and procedures.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following terms have the
meanings given in section 256B.85, subdivision 2, and as follows.
new text end

new text begin (b) "Commissioner" means the commissioner of human services.
new text end

new text begin (c) "Component value" means an underlying factor that is built into the rate methodology
to calculate service rates and is part of the cost of providing services.
new text end

new text begin (d) "Payment rate" or "rate" means reimbursement to an eligible provider for services
provided to a qualified individual based on an approved service authorization.
new text end

new text begin Subd. 3. new text end

new text begin Payment rates; base wage index. new text end

new text begin When initially establishing the base wage
component values, the commissioner must use the Minnesota-specific median wage for the
standard occupational classification (SOC) codes published by the Bureau of Labor Statistics
in the edition of the Occupational Handbook available January 1, 2021. The commissioner
must calculate the base wage component values as follows for:
new text end

new text begin (1) personal care assistance services, CFSS, extended personal care assistance services,
and extended CFSS. The base wage component value equals the median wage for personal
care aide (SOC code 31-1120);
new text end

new text begin (2) enhanced rate personal care assistance services and enhanced rate CFSS. The base
wage component value equals the product of median wage for personal care aide (SOC
code 31-1120) and the value of the enhanced rate under section 256B.0659, subdivision
17a; and
new text end

new text begin (3) qualified professional services and CFSS worker training and development. The base
wage component value equals the sum of 70 percent of the median wage for registered nurse
(SOC code 29-1141), 15 percent of the median wage for health care social worker (SOC
code 21-1099), and 15 percent of the median wage for social and human service assistant
(SOC code 21-1093).
new text end

new text begin Subd. 4. new text end

new text begin Payment rates; total wage index. new text end

new text begin (a) The commissioner must multiply the
base wage component values in subdivision 3 by one plus the appropriate competitive
workforce factor. The product is the total wage component value.
new text end

new text begin (b) For personal care assistance services, CFSS, extended personal care assistance
services, extended CFSS, enhanced rate personal care assistance services, and enhanced
rate CFSS, the initial competitive workforce factor is 4.7 percent.
new text end

new text begin (c) For qualified professional services and CFSS worker training and development, the
competitive workforce factor is zero percent.
new text end

new text begin Subd. 5. new text end

new text begin Payment rates; component values. new text end

new text begin (a) The commissioner must use the
following component values:
new text end

new text begin (1) employee vacation, sick, and training factor, 8.71 percent;
new text end

new text begin (2) employer taxes and workers' compensation factor, 11.56 percent;
new text end

new text begin (3) employee benefits factor, 12.04 percent;
new text end

new text begin (4) client programming and supports factor, 2.30 percent;
new text end

new text begin (5) program plan support factor, 7.00 percent;
new text end

new text begin (6) general business and administrative expenses factor, 13.25 percent;
new text end

new text begin (7) program administration expenses factor, 2.90 percent; and
new text end

new text begin (8) absence and utilization factor, 3.90 percent.
new text end

new text begin (b) For purposes of implementation, the commissioner shall use the following
implementation components:
new text end

new text begin (1) personal care assistance services and CFSS: 75.45 percent;
new text end

new text begin (2) enhanced rate personal care assistance services and enhanced rate CFSS: 75.45
percent; and
new text end

new text begin (3) qualified professional services and CFSS worker training and development: 75.45
percent.
new text end

new text begin Subd. 6. new text end

new text begin Payment rates; rate determination. new text end

new text begin (a) The commissioner must determine
the rate for personal care assistance services, CFSS, extended personal care assistance
services, extended CFSS, enhanced rate personal care assistance services, enhanced rate
CFSS, qualified professional services, and CFSS worker training and development as
follows:
new text end

new text begin (1) multiply the appropriate total wage component value calculated in subdivision 4 by
one plus the employee vacation, sick, and training factor in subdivision 5;
new text end

new text begin (2) for program plan support, multiply the result of clause (1) by one plus the program
plan support factor in subdivision 5;
new text end

new text begin (3) for employee-related expenses, add the employer taxes and workers' compensation
factor in subdivision 5 and the employee benefits factor in subdivision 5. The sum is
employee-related expenses. Multiply the product of clause (2) by one plus the value for
employee-related expenses;
new text end

new text begin (4) for client programming and supports, multiply the product of clause (3) by one plus
the client programming and supports factor in subdivision 5;
new text end

new text begin (5) for administrative expenses, add the general business and administrative expenses
factor in subdivision 5, the program administration expenses factor in subdivision 5, and
the absence and utilization factor in subdivision 5;
new text end

new text begin (6) divide the result of clause (4) by one minus the result of clause (5). The quotient is
the hourly rate;
new text end

new text begin (7) multiply the hourly rate by the appropriate implementation component under
subdivision 5. This is the adjusted hourly rate; and
new text end

new text begin (8) divide the adjusted hourly rate by four. The quotient is the total adjusted payment
rate.
new text end

new text begin (b) The commissioner must publish the total adjusted payment rates.
new text end

new text begin Subd. 7. new text end

new text begin Treatment of rate adjustments provided outside of cost components new text end

new text begin Any
rate adjustments applied to the service rates calculated under this section outside of the cost
components and rate methodology specified in this section, including but not limited to
those implemented to enable participant-employers and provider agencies to meet the terms
and conditions of any collective bargaining agreement negotiated under chapter 179A, shall
be applied as changes to the value of component values or implementation components in
subdivision 5.
new text end

new text begin Subd. 8. new text end

new text begin Personal care provider agency; required reporting of cost data; training. new text end

new text begin (a)
As determined by the commissioner and in consultation with stakeholders, agencies enrolled
to provide services with rates determined under this section must submit requested cost data
to the commissioner. The commissioner may request cost data, including but not limited
to:
new text end

new text begin (1) worker wage costs;
new text end

new text begin (2) benefits paid;
new text end

new text begin (3) supervisor wage costs;
new text end

new text begin (4) executive wage costs;
new text end

new text begin (5) vacation, sick, and training time paid;
new text end

new text begin (6) taxes, workers' compensation, and unemployment insurance costs paid;
new text end

new text begin (7) administrative costs paid;
new text end

new text begin (8) program costs paid;
new text end

new text begin (9) transportation costs paid;
new text end

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

new text begin (11) other data relating to costs required to provide services requested by the
commissioner.
new text end

new text begin (b) At least once in any three-year period, a provider must submit the required cost data
for a fiscal year that ended not more than 18 months prior to the submission date. The
commissioner must provide each provider a 90-day notice prior to its submission due date.
If a provider fails to submit required cost data, the commissioner must provide notice to a
provider that has not provided required cost data 30 days after the required submission date
and a second notice to a provider that has not provided required cost data 60 days after the
required submission date. The commissioner must temporarily suspend payments to a
provider if the commissioner has not received required cost data 90 days after the required
submission date. The commissioner must make withheld payments when the required cost
data is received by the commissioner.
new text end

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

new text begin (d) The commissioner, in consultation with stakeholders, must develop and implement
a process for providing training and technical assistance necessary to support provider
submission of cost data required under this subdivision.
new text end

new text begin Subd. 9. new text end

new text begin Analysis of costs; recommendations. new text end

new text begin (a) The commissioner shall evaluate on
an ongoing basis whether the base wage component values and component values in this
section appropriately address the cost to provide the service.
new text end

new text begin (b) The commissioner shall analyze cost data submitted by provider agencies under
subdivision 8 and report recommendations on component values, updated base wage
component values, and competitive workforce factors to the chairs and ranking minority
members of the legislative committees and divisions with jurisdiction over human services
policy and finance every two years beginning August 1, 2026. 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.
new text end

new text begin (c) Beginning August 1, 2024, and every two years thereafter, the commissioner shall
report recommendations to the chairs and ranking minority members of the legislative
committees and divisions with jurisdiction over health and human services policy and finance
to update the base wage index in subdivision 3, the competitive workforce factors in
subdivision 4, and the component values in subdivision 5 using the most recently available
data. In making recommendations, the commissioner shall:
new text end

new text begin (1) make adjustments to the competitive workforce factor toward the percent difference
between:
new text end

new text begin (i) the median wage for personal care aide (SOC code 31-1120); and
new text end

new text begin (ii) the weighted average wage for all other SOC codes with the same Bureau of Labor
Statistics classifications for education, experience, and training required for job competency;
new text end

new text begin (2) not recommend an increase or decrease of the competitive workforce factor from its
previous value of more than three percentage points;
new text end

new text begin (3) not recommend a competitive workforce factor of less than zero;
new text end

new text begin (4) make adjustments to the value of the base wage components based on the most
recently available federal wage data; and
new text end

new text begin (5) make adjustments to any component values affected by inflation, including but not
limited to the client programming and supports factor.
new text end

new text begin Subd. 10. new text end

new text begin Payment rate evaluation; reports required. new text end

new text begin The commissioner must assess
the long-term impacts of the rate methodology implementation on staff providing services
with rates determined under this section, including but not limited to measuring changes in
wages, benefits provided, hours worked, and retention. The commissioner must publish
evaluation findings in a report to the legislature by August 1, 2028, and once every two
years thereafter.
new text end

new text begin Subd. 11. new text end

new text begin Self-directed services workforce. new text end

new text begin Nothing in this section limits the
commissioner's authority over terms and conditions for individual providers in covered
programs as defined in section 256B.0711. The commissioner's authority over terms and
conditions for individual providers in covered programs remains subject to the state's
obligations to meet and negotiate under chapter 179A, as modified and made applicable to
individual providers under section 179A.54, and to agreements with any exclusive
representative of individual providers, as authorized by chapter 179A, as modified and made
applicable to individual providers under section 179A.54. A change in the rate for services
within the covered programs defined in section 256B.0711 does not constitute a change in
a term or condition for individual providers in covered programs and is not subject to the
state's obligation to meet and negotiate under chapter 179A.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2021, or upon federal approval,
whichever is later. The commissioner of human services must notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 56.

Minnesota Statutes 2020, section 256I.05, subdivision 1c, is amended to read:

Subd. 1c.

Rate increases.

An agency may not increase the rates negotiated for housing
support above those in effect on June 30, 1993, except as provided in paragraphs (a) to (f).

(a) An agency may increase the rates for room and board to the MSA equivalent rate
for those settings whose current rate is below the MSA equivalent rate.

(b) An agency may increase the rates for residents in adult foster care whose difficulty
of care has increased. The total housing support rate for these residents must not exceed the
maximum rate specified in subdivisions 1 and 1a. Agencies must not include nor increase
difficulty of care rates for adults in foster care whose difficulty of care is eligible for funding
by home and community-based waiver programs under title XIX of the Social Security Act.

(c) new text begin An agency must increase new text end the room and board rates deleted text begin will be increased deleted text end each year when
the MSA equivalent rate is adjusted for SSI cost-of-living increases by the amount of the
annual SSI increase, less the amount of the increase in the medical assistance personal needs
allowance under section 256B.35.

(d) deleted text begin When housing support pays for an individual's room and board, or other costs
necessary to provide room and board, the rate payable to the residence must continue for
up to 18 calendar days per incident that the person is temporarily absent from the residence,
not to exceed 60 days in a calendar year, if the absence or absences are reported in advance
to the county agency's social service staff. Advance reporting is not required for emergency
absences due to crisis, illness, or injury.
deleted text end

deleted text begin (e) For deleted text end new text begin An agency may increase the rates for residents in new text end facilities meeting substantial
change criteria within the prior year. Substantial change criteria deleted text begin exists deleted text end new text begin exist new text end if the
establishment experiences a 25 percent increase or decrease in the total number of its beds,
if the net cost of capital additions or improvements is in excess of 15 percent of the current
market value of the residence, or if the residence physically moves, or changes its licensure,
and incurs a resulting increase in operation and property costs.

deleted text begin (f) deleted text end new text begin (e) new text end Until June 30, 1994, an agency may increase by up to five percent the total rate
paid for recipients of assistance under sections 256D.01 to 256D.21 or 256D.33 to 256D.54
who reside in residences that are licensed by the commissioner of health as a boarding care
home, but are not certified for the purposes of the medical assistance program. However,
an increase under this clause must not exceed an amount equivalent to 65 percent of the
1991 medical assistance reimbursement rate for nursing home resident class A, in the
geographic grouping in which the facility is located, as established under Minnesota Rules,
parts 9549.0051 to 9549.0058.

new text begin (f) Notwithstanding the provisions of subdivision 1, an agency may increase the monthly
room and board rates by $50 per month for residents in settings under section 256I.04,
subdivision 2a, paragraph (b), clause (2). Participants in the Minnesota supportive housing
demonstration program under section 256I.04, subdivision 3, paragraph (a), clause (3), may
not receive the increase under this paragraph.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, except paragraph (f) is
effective July 1, 2022.
new text end

Sec. 57.

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

new text begin Subd. 2a. new text end

new text begin Absent days. new text end

new text begin (a) When a person receiving housing support is temporarily
absent and the absence is reported in advance to the agency's social service staff, the agency
must continue to pay on behalf of the person the applicable rate for housing support. Advance
reporting is not required for absences due to crisis, illness, or injury. The limit on payments
for absence days under this paragraph is 18 calendar days per incident, not to exceed 60
days in a calendar year.
new text end

new text begin (b) An agency must continue to pay an additional 74 days per incident, not to exceed a
total of 92 days in a calendar year, for a person who is temporarily absent due to admission
at a residential behavioral health facility, inpatient hospital, or nursing facility.
new text end

new text begin (c) If a person is temporarily absent due to admission at a residential behavioral health
facility, inpatient hospital, or nursing facility for a period of time exceeding the limits
described in paragraph (b), the agency may request in a format prescribed by the
commissioner an absence day limit exception to continue housing support payments until
the person is discharged.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021.
new text end

Sec. 58.

Minnesota Statutes 2020, section 256I.06, subdivision 8, is amended to read:

Subd. 8.

Amount of housing support payment.

(a) The amount of a room and board
payment to be made on behalf of an eligible individual is determined by subtracting the
individual's countable income under section 256I.04, subdivision 1, for a whole calendar
month from the room and board rate for that same month. The housing support payment is
determined by multiplying the housing support rate times the period of time the individual
was a resident or temporarily absent under section 256I.05, subdivision deleted text begin 1c deleted text end deleted text begin , paragraph (d) deleted text end new text begin
2a new text end .

(b) For an individual with earned income under paragraph (a), prospective budgeting
must be used to determine the amount of the individual's payment for the following six-month
period. An increase in income shall not affect an individual's eligibility or payment amount
until the month following the reporting month. A decrease in income shall be effective the
first day of the month after the month in which the decrease is reported.

(c) For an individual who receives housing support payments under section 256I.04,
subdivision 1, paragraph (c), the amount of the housing support payment is determined by
multiplying the housing support rate times the period of time the individual was a resident.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021.
new text end

Sec. 59.

Minnesota Statutes 2020, section 256S.18, subdivision 7, is amended to read:

Subd. 7.

Monthly case mix budget cap exception.

The commissioner shall approve an
exception to the monthly case mix budget cap in deleted text begin paragraph (a) deleted text end new text begin subdivision 3 new text end to account for
the additional cost of providing enhanced rate personal care assistance services under section
256B.0659 or new text begin enhanced rate community first services and supports under section new text end 256B.85.
deleted text begin The exception shall not exceed 107.5 percent of the budget otherwise available to the
individual. deleted text end new text begin The commissioner must calculate the difference between the rate for personal
care assistance services and enhanced rate personal care assistance services. The additional
budget amount approved under an exception must not exceed this difference. new text end The exception
must be reapproved on an annual basis at the time of a participant's annual reassessment.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2021, or upon federal approval,
whichever is later. The commissioner of human services must notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 60.

Minnesota Statutes 2020, section 256S.20, subdivision 1, is amended to read:

Subdivision 1.

Customized living services provider requirements.

deleted text begin Only a provider
licensed by the Department of Health as a comprehensive home care provider may provide deleted text end new text begin
(a) To deliver new text end customized living services or 24-hour customized living services new text begin , a provider
must:
new text end

new text begin (1) be licensed as an assisted living facility under chapter 144G; or
new text end

new text begin (2) be licensed as a comprehensive home care provider under chapter 144A, be delivering
services in a setting exempted from assisted living facility licensure under section 144G.08,
subdivision 7, clauses (10) to (13), and meet standards in the federally approved home and
community-based waiver plans under this chapter or section 256B.49 new text end . A licensed home
care provider is subject to section 256B.0651, subdivision 14.

new text begin (b) Settings exempted from assisted living facility licensure under section 144G.08,
subdivision 7, clauses (10) to (13), must comply with section 325F.722.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 61.

Minnesota Statutes 2020, section 256S.203, is amended to read:

256S.203 CUSTOMIZED LIVING SERVICES; MANAGED CARE RATES.

Subdivision 1.

Capitation payments.

The commissioner deleted text begin shall deleted text end new text begin must new text end adjust the elderly
waiver capitation payment rates for managed care organizations paid to reflect the monthly
service rate limits for customized living services and 24-hour customized living services
established under section 256S.202 new text begin and the rate adjustments for disproportionate share
facilities under section 256S.205 new text end .

Subd. 2.

Reimbursement rates.

Medical assistance rates paid to customized living
providers by managed care organizations under this chapter deleted text begin shall deleted text end new text begin must new text end not exceed the
monthly service rate limits and component rates as determined by the commissioner under
sections 256S.15 and 256S.20 to 256S.202 new text begin , plus any rate adjustment under section 256S.205 new text end .

Sec. 62.

new text begin [256S.205] CUSTOMIZED LIVING SERVICES; 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 (a) For the purposes of this section, the terms in this
subdivision have the meanings given.
new text end

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

new text begin (c) "Assisted living facility" or "facility" means an assisted living facility licensed under
chapter 144G.
new text end

new text begin (d) "Disproportionate share facility" means an assisted living facility designated by the
commissioner under subdivision 4.
new text end

new text begin Subd. 2. new text end

new text begin Rate adjustment application. new text end

new text begin An assisted living facility may apply to the
commissioner for designation as a disproportionate share facility. Applications must be
submitted annually between October 1 and October 31. The applying facility must apply
in a manner determined by the commissioner. The applying facility must document as a
percentage the census of elderly waiver participants residing in the facility on October 1 of
the application year.
new text end

new text begin Subd. 3. new text end

new text begin Rate adjustment eligibility criteria. new text end

new text begin Only facilities with a census of at least
80 percent elderly waiver participants on October 1 of the application year are eligible for
designation as a disproportionate share facility.
new text end

new text begin Subd. 4. new text end

new text begin Designation as a disproportionate share facility. new text end

new text begin By November 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 end

new text begin Subd. 5. new text end

new text begin Rate adjustment; rate floor. new text end

new text begin (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 $119 per resident per day for 24-hour customized living
services provided in a designated disproportionate share facility for the purpose of ensuring
the minimal level of staffing required to meet the health and safety needs of elderly waiver
participants.
new text end

new text begin (b) The commissioner must adjust the rate floor at least annually in the manner described
under section 256S.18, subdivisions 5 and 6.
new text end

new text begin (c) 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.
new text end

new text begin Subd. 6. new text end

new text begin Budget cap disregard. new text end

new text begin 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 end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2021, or upon federal approval,
whichever is later, and applies to services provided on or after July 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. 63.

Minnesota Statutes 2020, section 256S.21, is amended to read:

256S.21 RATE SETTING; APPLICATION.

The payment methodologies in sections 256S.2101 to 256S.215 apply to elderly waiver,
elderly waiver customized living, new text begin and new text end elderly waiver foster care deleted text begin , and elderly waiver
residential care deleted text end under this chapter deleted text begin , deleted text end new text begin ; new text end alternative care under section 256B.0913 deleted text begin , deleted text end new text begin ; new text end essential
community supports under section 256B.0922 deleted text begin , deleted text end new text begin ; new text end and community access for disability inclusion
customized living and brain injury customized living under section 256B.49.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall inform the revisor of statutes
when federal approval is obtained.
new text end

Sec. 64.

Minnesota Statutes 2020, section 256S.2101, is amended to read:

256S.2101 RATE SETTING; PHASE-IN.

new text begin Subdivision 1. new text end

new text begin Phase-in for disability waiver customized living rates. new text end

All rates and
rate components for deleted text begin services listed in section 256S.21 deleted text end new text begin community access for disability
inclusion customized living and brain injury customized living under section 256B.4914
new text end shall be the sum of ten percent of the rates calculated under sections 256S.211 to 256S.215
and 90 percent of the rates calculated using the rate methodology in effect as of June 30,
2017.

new text begin Subd. 2. new text end

new text begin Phase-in for elderly waiver rates. new text end

new text begin 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 18.8 percent of the rates calculated under sections 256S.211
to 256S.215, and 81.2 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 end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall inform the revisor of statutes
when federal approval is obtained.
new text end

Sec. 65.

new text begin [325F.722] CONSUMER PROTECTIONS FOR EXEMPT SETTINGS.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For the purposes of this section, the following terms have
the meanings given.
new text end

new text begin (b) "Exempt setting" means a setting that is exempted from assisted living facility
licensure under section 144G.08, subdivision 7, clauses (10) to (13).
new text end

new text begin (c) "Resident" means a person residing in an exempt setting.
new text end

new text begin Subd. 2. new text end

new text begin Contracts. new text end

new text begin (a) Every exempt setting must execute a written contract with a
resident or the resident's representative and must operate in accordance with the terms of
the contract. The resident or the resident's representative must be given a complete copy of
the contract and all supporting documents and attachments and any changes whenever
changes are made.
new text end

new text begin (b) The contract must include at least the following elements in itself or through
supporting documents or attachments:
new text end

new text begin (1) the name, street address, and mailing address of the exempt setting;
new text end

new text begin (2) the name and mailing address of the owner or owners of the exempt setting and, if
the owner or owners are not natural persons, identification of the type of business entity of
the owner or owners;
new text end

new text begin (3) the name and mailing address of the managing agent, through management agreement
or lease agreement, of the exempt setting, if different from the owner or owners;
new text end

new text begin (4) the name and address of at least one natural person who is authorized to accept service
of process on behalf of the owner or owners and managing agent;
new text end

new text begin (5) a statement identifying the license number of the home care provider that provides
services to some or all of the residents and that is either the setting itself or another entity
with which the setting has an arrangement;
new text end

new text begin (6) the term of the contract;
new text end

new text begin (7) an itemization and description of the housing and, if applicable, services to be
provided to the resident;
new text end

new text begin (8) a conspicuous notice informing the resident of the policy concerning the conditions
under which and the process through which the contract may be modified, amended, or
terminated;
new text end

new text begin (9) a description of the exempt setting's complaint resolution process available to residents
including the toll-free complaint line for the Office of Ombudsman for Long-Term Care;
new text end

new text begin (10) the individual designated as the resident's representative, if any;
new text end

new text begin (11) the exempt setting's referral procedures if the contract is terminated;
new text end

new text begin (12) a statement regarding the ability of a resident to receive services from providers
with whom the exempt setting does not have an arrangement;
new text end

new text begin (13) a statement regarding the availability of public funds for payment for residence or
services; and
new text end

new text begin (14) a statement regarding the availability of and contact information for long-term care
consultation services under section 256B.0911 in the county in which the exempt setting is
located.
new text end

new text begin (c) The contract must include a statement regarding:
new text end

new text begin (1) the ability of a resident to furnish and decorate the resident's unit within the terms
of the lease;
new text end

new text begin (2) a resident's right to access food at any time;
new text end

new text begin (3) a resident's right to choose the resident's visitors and times of visits;
new text end

new text begin (4) a resident's right to choose a roommate if sharing a unit; and
new text end

new text begin (5) a resident's right to have and use a lockable door to the resident's unit. The exempt
setting must provide the locks on the unit. Only a staff member with a specific need to enter
the unit shall have keys, and advance notice must be given to the resident before entrance
by the staff member, when possible.
new text end

new text begin (d) A restriction of a resident's rights under this subdivision is allowed only if determined
necessary for health and safety reasons identified by a home care provider's registered nurse
in an initial assessment or reassessment, as defined under section 144A.4791, subdivision
8, and documented in the written service plan under section 144A.4791, subdivision 9. Any
restrictions of those rights for people served under section 256B.49 and chapter 256S must
be documented in the resident's coordinated service and support plan, as defined under
sections 256B.49, subdivision 15, and 256S.10.
new text end

new text begin (e) The contract and related documents executed by each resident or resident's
representative must be maintained by the exempt setting in files from the date of execution
until three years after the contract is terminated.
new text end

new text begin Subd. 3. new text end

new text begin Termination of contract. new text end

new text begin An exempt setting must include with notice of
termination of contract information about how to contact the ombudsman for long-term
care, including the address and telephone number, along with a statement of how to request
problem-solving assistance.
new text end

new text begin Subd. 4. new text end

new text begin Emergency planning. new text end

new text begin (a) Each exempt setting must meet the following
requirements:
new text end

new text begin (1) have a written emergency disaster plan that contains a plan for evacuation, addresses
elements of sheltering in place, identifies temporary relocation sites, and details staff
assignments in the event of a disaster or an emergency;
new text end

new text begin (2) prominently post an emergency disaster plan;
new text end

new text begin (3) provide building emergency exit diagrams to all residents upon signing a contract;
new text end

new text begin (4) post emergency exit diagrams on each floor; and
new text end

new text begin (5) have a written policy and procedure regarding missing residents.
new text end

new text begin (b) Each exempt setting must provide emergency and disaster training to all staff during
the initial staff orientation and annually thereafter and must make emergency and disaster
training available to all residents annually. Staff who have not received emergency and
disaster training are allowed to work only when trained staff are also working on site.
new text end

new text begin (c) Each exempt setting location must conduct and document a fire drill or other
emergency drill at least once every six months. To the extent possible, drills must be
coordinated with local fire departments or other community emergency resources.
new text end

new text begin Subd. 5. new text end

new text begin Training in dementia. new text end

new text begin (a) If an exempt setting has a special program or special
care unit for residents with Alzheimer's disease or other dementias whether in a segregated
or general unit, employees of the setting must meet the following training requirements:
new text end

new text begin (1) supervisors of direct care staff must have completed at least eight hours of initial
training on topics specified under paragraph (b) within 120 working hours of the employment
start date, and must complete at least two hours of training on topics related to dementia
care for each 12 months of employment thereafter;
new text end

new text begin (2) direct care employees must have completed at least eight hours of initial training on
topics specified under paragraph (b) within 160 working hours of the employment start
date. Until this initial training is complete, an employee must not provide direct care unless
there is another employee on site who has completed the initial eight hours of training on
topics related to dementia care and who can act as a resource and assist if issues arise. A
trainer of the requirements under paragraph (b), or a supervisor meeting the requirements
in clause (1), must be available for consultation with the new employee until the training
requirement is complete. Direct care employees must complete at least two hours of training
on topics related to dementia care for each 12 months of employment thereafter;
new text end

new text begin (3) staff who do not provide direct care, including maintenance, housekeeping, and food
service staff, must have completed at least four hours of initial training on topics specified
under paragraph (b) within 160 working hours of the employment start date, and must
complete at least two hours of training on topics related to dementia care for each 12 months
of employment thereafter; and
new text end

new text begin (4) new employees may satisfy the initial training requirements under clauses (1) to (3)
by producing written proof of previously completed required training within the past 18
months.
new text end

new text begin (b) Areas of required training include:
new text end

new text begin (1) an explanation of Alzheimer's disease and related disorders;
new text end

new text begin (2) assistance with activities of daily living;
new text end

new text begin (3) problem-solving with challenging behaviors; and
new text end

new text begin (4) communication skills.
new text end

new text begin (c) The setting must provide to residents, and prospective residents upon request, in
written or electronic form, a description of the training program, the categories of employees
trained, the frequency of training, and the basic topics covered.
new text end

new text begin Subd. 6. new text end

new text begin Manager requirements. new text end

new text begin (a) The person primarily responsible for oversight
and management of the exempt setting, as designated by the owner, must obtain at least 30
hours of continuing education every two years of employment as the manager in topics
relevant to the operations of the setting and the needs of its residents. Continuing education
earned to maintain a professional license, such as a nursing home administrator license,
assisted living facility director license, nursing license, social worker license, or real estate
license, can be used to complete this requirement.
new text end

new text begin (b) New managers may satisfy the initial dementia training requirements by producing
written proof of previously completed required training within the past 18 months.
new text end

new text begin Subd. 7. new text end

new text begin Restraints. new text end

new text begin Residents must be free from any physical or chemical restraints
imposed for purposes of discipline or convenience.
new text end

new text begin Subd. 8. new text end

new text begin Other laws. new text end

new text begin Each exempt setting must comply with chapter 504B, and must
obtain and maintain all other licenses, permits, registrations, or other required governmental
approvals. An exempt setting is not required to obtain a lodging license under chapter 157
and related rules.
new text end

new text begin Subd. 9. new text end

new text begin Remedy. new text end

new text begin A state agency must make a good faith effort to reasonably resolve
any dispute with an exempt setting before seeking any additional enforcement actions
regarding the exempt setting's compliance with the requirements of this section. No private
right of action may be maintained as provided under section 8.31, subdivision 3a.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2021.
new text end

Sec. 66. new text begin DIRECTION TO THE COMMISSIONER; CUSTOMIZED LIVING
REPORT.
new text end

new text begin (a) By January 15, 2022, the commissioner of human services shall submit a report to
the chairs and ranking minority members of the legislative committees with jurisdiction
over human services policy and finance. The report must include the commissioner's:
new text end

new text begin (1) assessment of the prevalence of customized living services provided under Minnesota
Statutes, section 256B.49, supplanting the provision of residential services and supports
licensed under Minnesota Statutes, chapter 245D, and provided in settings licensed under
Minnesota Statutes, chapter 245A;
new text end

new text begin (2) recommendations regarding the continuation of the moratorium on home and
community-based services customized living settings under Minnesota Statutes, section
256B.49, subdivision 28;
new text end

new text begin (3) other policy recommendations to ensure that customized living services are being
provided in a manner consistent with the policy objectives of the foster care licensing
moratorium under Minnesota Statutes, section 245A.03, subdivision 7; and
new text end

new text begin (4) recommendations for needed statutory changes to implement the transition from
existing four-person or fewer customized living settings to corporate adult foster care or
community residential settings.
new text end

new text begin (b) The commissioner of health shall provide the commissioner of human services with
the required data to complete the report in paragraph (a) and implement the moratorium on
home and community-based services customized living settings under Minnesota Statutes,
section 256B.49, subdivision 28. The data must include, at a minimum, each registered
housing with services establishment under Minnesota Statutes, chapter 144D, enrolled as
a customized living setting to deliver customized living services as defined under the brain
injury or community access for disability inclusion waiver plans under Minnesota Statutes,
section 256B.49.
new text end

Sec. 67. new text begin PERSONAL 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);
and 256B.49, subdivision 16, paragraph (c); and chapter 256S, by 7.5 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, 2022, 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. 68. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
DIRECT CARE SERVICES DURING SHORT-TERM ACUTE HOSPITAL VISITS.
new text end

new text begin The commissioner of human services, in consultation with stakeholders, shall develop
a new covered service under Minnesota Statutes, chapter 256B, or develop modifications
to existing covered services, that permits receipt of direct care services in an acute care
hospital in a manner consistent with the requirements of United States Code, title 42, section
1396a(h). By August 31, 2022, 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 any draft legislation as may be necessary to implement
the new or modified covered service.
new text end

Sec. 69. new text begin DIRECTION TO THE COMMISSIONER; SUPPORTIVE PARENTING
SERVICES STUDY.
new text end

new text begin (a) The commissioner of human services shall:
new text end

new text begin (1) study the feasibility of developing and providing supportive parenting services and
providing adaptive parenting equipment to parents with disabilities and disabling conditions
under Medicaid state plan or waiver authorities; and
new text end

new text begin (2) submit a report to the chairs and ranking minority members of the legislative
committees and divisions with jurisdiction over health and human services by February 15,
2023.
new text end

new text begin (b) The report must include:
new text end

new text begin (1) an evaluation and recommendation on eligibility and service design for supportive
parenting services and adaptive parenting equipment;
new text end

new text begin (2) the estimated cost to the state of a supportive parenting service and reimbursement
for adaptive parenting equipment;
new text end

new text begin (3) draft legislative language and recommended Medicaid state plan and waiver
amendments required to implement supportive parenting services; and
new text end

new text begin (4) other information and recommendations that improve family-centered approaches
to Medicaid service design and delivery.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval of Minnesota's
initial state spending plan as described in guidance issued by the Centers for Medicare and
Medicaid Services for implementation of section 9817 of the federal American Rescue Plan
Act of 2021. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
new text end

Sec. 70. new text begin PERSONAL CARE ASSISTANCE COMPENSATION FOR SERVICES
PROVIDED BY A PARENT OR SPOUSE.
new text end

new text begin (a) Notwithstanding Minnesota Statutes, section 256B.0659, subdivisions 3, paragraph
(a), clause (1); 11, paragraph (c); and 19, paragraph (b), clause (3), a parent, stepparent, or
legal guardian of a minor who is a personal care assistance recipient or a spouse of a personal
care assistance recipient may provide and be paid for providing personal care assistance
services.
new text end

new text begin (b) This section expires upon the expiration of the COVID-19 public health emergency
declared by the United States Secretary of Health and Human 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. 71. new text begin DIRECTION TO COMMISSIONER; PROVIDER STANDARDS FOR
CUSTOMIZED LIVING SERVICES IN EXEMPT SETTINGS.
new text end

new text begin The commissioner of human services shall review policies and provider standards for
customized living services provided in settings identified in Minnesota Statutes, section
256S.20, subdivision 1, paragraph (a), clause (2), in consultation with stakeholders. The
commissioner may provide recommendations to the chairs and ranking minority members
of the legislative committees and divisions with jurisdiction over customized living services
by February 15, 2022, regarding appropriate regulatory oversight and payment policies for
customized living services delivered in these settings.
new text end

Sec. 72. new text begin RATE INCREASE FOR DIRECT SUPPORT SERVICES WORKFORCE.
new text end

new text begin (a) Effective October 1, 2021, or upon federal approval, whichever is later, 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 pursuant to
Minnesota Statutes, section 3.855, the commissioner of human services shall increase:
new text end

new text begin (1) reimbursement rates, individual budgets, grants, or allocations by 4.14 percent for
services under paragraph (b) provided on or after October 1, 2021, or upon federal approval,
whichever is later, to implement the minimum hourly wage, holiday, and paid time off
provisions of that agreement;
new text end

new text begin (2) reimbursement rates, individual budgets, grants, or allocations by 2.95 percent for
services under paragraph (b) provided on or after July 1, 2022, or upon federal approval,
whichever is later, to implement the minimum hourly wage, holiday, and paid time off
provisions of that agreement;
new text end

new text begin (3) individual budgets, grants, or allocations by 1.58 percent for services under paragraph
(c) provided on or after October 1, 2021, or upon federal approval, whichever is later, to
implement the minimum hourly wage, holiday, and paid time off provisions of that
agreement; and
new text end

new text begin (4) individual budgets, grants, or allocations by .81 percent for services under paragraph
(c) provided on or after July 1, 2022, or upon federal approval, whichever is later, to
implement the minimum hourly wage, holiday, and paid time off provisions of that
agreement.
new text end

new text begin (b) The rate changes described in paragraph (a), clauses (1) and (2), apply to direct
support services provided through a covered program, as defined in Minnesota Statutes,
section 256B.0711, subdivision 1, with the exception of consumer-directed community
supports available under programs established pursuant to home and community-based
service waivers authorized under section 1915(c) of the federal Social Security Act and
Minnesota Statutes, including but not limited to chapter 256S and sections 256B.092 and
256B.49, and under the alternative care program under Minnesota Statutes, section
256B.0913. These rate changes are included within, and are not in addition to, any other
rate changes for the covered programs authorized under Minnesota Statutes, section
256B.851.
new text end

new text begin (c) The funding changes described in paragraph (a), clauses (3) and (4), apply to
consumer-directed community supports available under programs established pursuant to
home and community-based service waivers authorized under section 1915(c) of the federal
Social Security Act, and Minnesota Statutes, including but not limited to chapter 256S and
sections 256B.092 and 256B.49, and under the alternative care program under Minnesota
Statutes, section 256B.0913.
new text end

Sec. 73. new text begin WAIVER REIMAGINE PHASE II.
new text end

new text begin (a) The commissioner of human services must implement a two-home and
community-based services waiver program structure, as authorized under section 1915(c)
of the federal Social Security Act, that serves persons who are determined by a certified
assessor to require the levels of care provided in a nursing home, a hospital, a neurobehavioral
hospital, or an intermediate care facility for persons with developmental disabilities.
new text end

new text begin (b) The commissioner of human services must implement an individualized budget
methodology, as authorized under section 1915(c) of the federal Social Security Act, that
serves persons who are determined by a certified assessor to require the levels of care
provided in a nursing home, a hospital, a neurobehavioral hospital, or an intermediate care
facility for persons with developmental disabilities.
new text end

new text begin (c) The commissioner of human services may seek all federal authority necessary to
implement this section.
new text end

new text begin (d) The commissioner must ensure that the new waiver service menu and individual
budgets allow people to live in their own home, family home, or any home and
community-based setting of their choice. The commissioner must ensure, within available
resources and subject to state and federal regulations and law, that waiver reimagine does
not result in unintended service disruptions.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2024, or 90 days after 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. 74. new text begin RATE INCREASE FOR CERTAIN HOME CARE SERVICES.
new text end

new text begin Effective January 1, 2022, or upon federal approval, whichever is later, payment rates
for home health services and home care nursing services under Minnesota Statutes, section
256B.0651, subdivision 2, clauses (1) to (3), and respiratory therapy under Minnesota Rules,
part 9505.0295, subpart 2, item E, shall be increased by five percent from the rates in effect
on December 31, 2021.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 75. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; WAIVER
REIMAGINE AND INFORMED CHOICE STAKEHOLDER CONSULTATION.
new text end

new text begin Subdivision 1. new text end

new text begin Stakeholder consultation; generally. new text end

new text begin (a) The commissioner of human
services must consult with and seek input and assistance from stakeholders concerning
potential adjustments to the streamlined service menu from waiver reimagine phase I and
to the existing rate exemption criteria and process.
new text end

new text begin (b) The commissioner of human services must consult with and seek input and assistance
from stakeholders concerning the development and implementation of waiver reimagine
phase II, including criteria and a process for individualized budget exemptions, and how
waiver reimagine phase II can support and expand informed choice and informed decision
making, including integrated employment, independent living, and self-direction, consistent
with Minnesota Statutes, section 256B.4905.
new text end

new text begin Subd. 2. new text end

new text begin Public stakeholder engagement. new text end

new text begin The commissioner must offer a public method
to regularly receive input and concerns from people with disabilities and their families about
waiver reimagine phase II. The commissioner shall provide regular public updates on policy
development and on how stakeholder input was used throughout the development and
implementation of waiver reimagine phase II.
new text end

new text begin Subd. 3. new text end

new text begin Waiver Reimagine Advisory Committee. new text end

new text begin (a) The commissioner must convene,
at regular intervals throughout the development and implementation of waiver reimagine
phase II, a Waiver Reimagine Advisory Committee that consists of a group of diverse,
representative stakeholders. The commissioner must solicit and endeavor to include racially,
ethnically, and geographically diverse membership from each of the following groups:
new text end

new text begin (1) people with disabilities who use waiver services;
new text end

new text begin (2) family members of people who use waiver services;
new text end

new text begin (3) disability and behavioral health advocates;
new text end

new text begin (4) lead agency representatives; and
new text end

new text begin (5) waiver service providers.
new text end

new text begin (b) The Waiver Reimagine Advisory Committee must have the opportunity to assist in
developing and providing feedback on proposed plans for waiver reimagine components,
including an individual budget methodology, criteria and a process for individualized budget
exemptions, the consolidation of the four current home and community-based waiver service
programs into two-waiver programs, and other aspects of waiver reimagine phase II.
new text end

new text begin (c) The Waiver Reimagine Advisory Committee must have an opportunity to assist in
the development of and provide feedback on proposed adjustments and modifications to
the streamlined menu of services and the existing rate exception criteria and process.
new text end

new text begin Subd. 4. new text end

new text begin Required report. new text end

new text begin Prior to seeking federal approval for any aspect of waiver
reimagine phase II and in consultation with the Waiver Reimagine Advisory Committee,
the commissioner must submit to the chairs and ranking minority members of the legislative
committees and divisions with jurisdiction over health and human services a report on plans
for waiver reimagine phase II. The report must also include any plans to adjust or modify
the streamlined menu of services or the existing rate exemption criteria or process.
new text end

new text begin Subd. 5. new text end

new text begin Transition process. new text end

new text begin (a) Prior to implementation of wavier reimagine phase II,
the commissioner must establish a process to assist people who use waiver services and
lead agencies transition to a two-waiver system with an individual budget methodology.
new text end

new text begin (b) The commissioner must ensure that the new waiver service menu and individual
budgets allow people to live in their own home, family home, or any home and
community-based setting of their choice. The commissioner must ensure, within available
resources and subject to state and federal regulations and law, that waiver reimagine does
not result in unintended service disruptions.
new text end

new text begin Subd. 6. new text end

new text begin Online support planning tool. new text end

new text begin The commissioner must develop an online
support planning and tracking tool for people using disability waiver services that allows
access to the total budget available to the person, the services for which they are eligible,
and the services they have chosen and used. The commissioner must explore operability
options that would facilitate real-time tracking of a person's remaining available budget
throughout the service year. The online support planning tool must provide information in
an accessible format to support the person's informed choice. The commissioner must seek
input from people with disabilities about the online support planning tool prior to its
implementation.
new text end

new text begin Subd. 7. new text end

new text begin Curriculum and training. new text end

new text begin The commissioner must develop and implement a
curriculum and training plan to ensure all lead agency assessors and case managers have
the knowledge and skills necessary to comply with informed decision making for people
who used home and community-based disability waivers. Training and competency
evaluations must be completed annually by all staff responsible for case management as
described in Minnesota Statutes, sections 256B.092, subdivision 1a, paragraph (f), and
256B.49, subdivision 13, paragraph (e).
new text end

Sec. 76. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES;
RESIDENTIAL SUPPORT SERVICES CRITERIA REPORT.
new text end

new text begin The commissioner must collect data on the implementation of residential support services
criteria under Minnesota Statutes, sections 256B.092, subdivision 11a, and 256B.49,
subdivision 29, and by January 15, 2024, or 18 months following federal approval, whichever
is later, submit to the chairs and ranking minority members of the legislative committees
and divisions with jurisdiction over health and human services a report containing an analysis
of the collected data and recommendations. The report must include data on shifts in the
home and community-based service system for people who access services in their own
home and in nonprovider-controlled settings. The report must also include recommended
modifications to the criteria that align with disability waiver reconfiguration and individual
support range implementation.
new text end

Sec. 77. new text begin SELF-DIRECTED WORKER CONTRACT RATIFICATION.
new text end

new text begin The labor agreement between the state of Minnesota and the Service Employees
International Union Healthcare Minnesota, submitted to the Legislative Coordinating
Commission on March 1, 2021, is ratified.
new text end

Sec. 78. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall change the headnote for Minnesota Statutes, section
256B.097, to read "REGIONAL AND SYSTEMS IMPROVEMENT FOR MINNESOTANS
WHO HAVE DISABILITIES."
new text end

Sec. 79. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2020, sections 256B.0916, subdivisions 2, 3, 4, 5, 8, 11, and 12;
and 256B.49, subdivisions 26 and 27, new text end new text begin are repealed effective July 1, 2024, 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

new text begin (b) new text end new text begin Minnesota Statutes 2020, section 256B.4905, subdivisions 1, 2, 3, 4, 5, and 6, new text end new text begin are
repealed.
new text end

new text begin (c) new text end new text begin Minnesota Statutes 2020, section 256S.20, subdivision 2, new text end new text begin is repealed effective August
1, 2021.
new text end

new text begin (d) new text end new text begin Minnesota Statutes 2020, section 256B.097, subdivisions 1, 2, 3, 4, 5, and 6, new text end new text begin are
repealed effective July 1, 2021.
new text end

new text begin (e) new text end new text begin Laws 2019, First Special Session chapter 9, article 5, section 90, new text end new text begin is repealed.
new text end

ARTICLE 14

MISCELLANEOUS

Section 1.

new text begin [3.9215] OMBUDSPERSON FOR AMERICAN INDIAN FAMILIES.
new text end

new text begin Subdivision 1. new text end

new text begin Scope. new text end

new text begin In recognition of the sovereign status of Indian Tribes and the
unique laws and standards involved in protecting Indian children, this section creates the
Office of the Ombudsperson for American Indian Families and gives the ombudsperson the
powers and duties necessary to effectively carry out the functions of the office.
new text end

new text begin Subd. 2. new text end

new text begin Creation. new text end

new text begin The ombudsperson shall operate independently from and in
collaboration with the Indian Affairs Council and the American Indian Child Welfare
Advisory Council under section 260.835.
new text end

new text begin Subd. 3. new text end

new text begin Selection; qualifications. new text end

new text begin The ombudsperson shall be selected by the American
Indian community-specific board established in section 3.9216. The ombudsperson serves
in the unclassified service at the pleasure of the community-specific board and may be
removed only for just cause. Each ombudsperson must be selected without regard to political
affiliation and shall be a person highly competent and qualified to analyze questions of law,
administration, and public policy regarding the protection and placement of children. In
addition, the ombudsperson must be experienced in working collaboratively with the
American Indian and Alaska Native communities or nations and knowledgeable about the
needs of those communities, the Indian Child Welfare Act and Minnesota Indian Family
Preservation Act, and best practices regarding prevention, cultural resources, and historical
trauma. No individual may serve as the ombudsperson for American Indian families while
holding any other public office.
new text end

new text begin Subd. 4. new text end

new text begin Appropriation. new text end

new text begin Money appropriated for the ombudsperson for American Indian
families from the general fund or the special fund authorized by section 256.01, subdivision
2, paragraph (o), is under the control of the ombudsperson.
new text end

new text begin Subd. 5. new text end

new text begin Definitions. new text end

new text begin (a) For the purposes of this section, the following terms have the
meanings given them.
new text end

new text begin (b) "Agency" means the local district courts or a designated county social service agency
as defined in section 256G.02, subdivision 7, engaged in providing child protection and
placement services for children. Agency also means any individual, service, organization,
or program providing child protection, placement, or adoption services in coordination with
or under contract with any other entity specified in this subdivision, including guardians ad
litem.
new text end

new text begin (c) "American Indian" refers to individuals who are members of federally recognized
Tribes, eligible for membership in a federally recognized Tribe, or children or grandchildren
of a member of a federally recognized Tribe. American Indian is a political status established
through treaty rights between the federal government and Tribes. Each Tribe has a unique
culture and practices specific to the Tribe.
new text end

new text begin (d) "Facility" means any entity required to be licensed under chapter 245A.
new text end

new text begin (e) "Indian custodian" has the meaning given in United States Code, title 25, section
1903.
new text end

new text begin Subd. 6. new text end

new text begin Organization. new text end

new text begin (a) The ombudsperson may select, appoint, and compensate
assistants and employees that the ombudsperson finds necessary to discharge responsibilities.
All employees, except the secretarial and clerical staff, serve at the pleasure of the
ombudsperson in the unclassified service. The ombudsperson and full-time staff are members
of the Minnesota State Retirement Association.
new text end

new text begin (b) The ombudsperson may delegate to staff members or members of the American
Indian Community-Specific Board under section 3.9216 any of the ombudsperson's authority
or duties except the duty of formally making recommendations to an administrative agency
or reports to the Office of the Governor or to the legislature.
new text end

new text begin Subd. 7. new text end

new text begin Duties and powers. new text end

new text begin (a) The ombudsperson has the duties listed in this paragraph.
new text end

new text begin (1) The ombudsperson shall monitor agency compliance with all laws governing child
protection and placement, public education, and housing issues related to child protection
that impact American Indian children and their families. In particular, the ombudsperson
shall monitor agency compliance with sections 260.751 to 260.835; section 260C.193,
subdivision 3; and section 260C.215.
new text end

new text begin (2) The ombudsperson shall work with local state courts to ensure that:
new text end

new text begin (i) court officials, public policy makers, and service providers are trained in cultural
competency. The ombudsperson shall document and monitor court activities to heighten
awareness of diverse belief systems and family relationships;
new text end

new text begin (ii) qualified expert witnesses from the appropriate American Indian community,
including Tribal advocates, are used as court advocates and are consulted in placement
decisions that involve American Indian children; and
new text end

new text begin (iii) guardians ad litem and other individuals from American Indian communities are
recruited, trained, and used in court proceedings to advocate on behalf of American Indian
children.
new text end

new text begin (3) The ombudsperson shall primarily work on behalf of American Indian children and
families, but shall also work on behalf of any Minnesota children and families as the
ombudsperson deems necessary and appropriate.
new text end

new text begin (b) The ombudsperson has the authority to investigate decisions, acts, and other matters
of an agency, program, or facility providing protection or placement services to American
Indian children. In carrying out this authority and the duties in paragraph (a), the
ombudsperson has the power to:
new text end

new text begin (1) prescribe the methods by which complaints are made, reviewed, and acted upon;
new text end

new text begin (2) determine the scope and manner of investigations;
new text end

new text begin (3) investigate, upon a complaint or upon personal initiative, any action of any agency;
new text end

new text begin (4) request and be given access to any information in the possession of any agency
deemed necessary for the discharge of responsibilities. The ombudsperson is authorized to
set reasonable deadlines within which an agency must respond to requests for information.
Data obtained from any agency under this clause retains the classification that the data has
under section 13.02 and the ombudsperson shall maintain and disseminate the data according
to chapter 13;
new text end

new text begin (5) examine the records and documents of an agency;
new text end

new text begin (6) enter and inspect, during normal business hours, premises within the control of an
agency; and
new text end

new text begin (7) subpoena any agency personnel to appear, testify, or produce documentation or other
evidence that the ombudsperson deems relevant to a particular matter under investigation,
and petition the appropriate state court to seek enforcement of the subpoena. Any witness
at a hearing or for an investigation has the same privileges of a witness in the courts or under
the laws of this state. The ombudsperson may compel individuals who are not agency
personnel to testify or produce evidence according to procedures developed by the advisory
board.
new text end

new text begin (c) The ombudsperson may apply for grants and accept gifts, donations, and
appropriations for training relating to the duties of the ombudsperson. Grants, gifts, donations,
and appropriations received by the ombudsperson shall be used for training. The
ombudsperson may seek and apply for grants to develop new programs and initiatives and
to continue existing programs and initiatives. These funds may not be used for operating
expenses for the Office of the Ombudsperson for American Indian Families.
new text end

new text begin Subd. 8. new text end

new text begin Matters appropriate for review. new text end

new text begin (a) In selecting matters for review, an
ombudsperson should give particular attention to actions of an agency, facility, or program
that:
new text end

new text begin (1) may be contrary to law or rule;
new text end

new text begin (2) may be unreasonable, unfair, oppressive, or inconsistent with a policy or order of an
agency, facility, or program;
new text end

new text begin (3) may result in abuse or neglect of a child;
new text end

new text begin (4) may disregard the rights of a child or another individual served by an agency or
facility; or
new text end

new text begin (5) may be unclear or inadequately explained, when reasons should have been revealed.
new text end

new text begin (b) The ombudsperson shall, in selecting matters for review, inform other interested
agencies in order to avoid duplicating other investigations or regulatory efforts, including
activities undertaken by a Tribal organization under the authority of sections 260.751 to
260.835.
new text end

new text begin Subd. 9. new text end

new text begin Complaints. new text end

new text begin The ombudsperson may receive a complaint from any source
concerning an action of an agency, facility, or program. After completing a review, the
ombudsperson shall inform the complainant, agency, facility, or program. Services to a
child shall not be unfavorably altered as a result of an investigation or complaint. An agency,
facility, or program shall not retaliate or take adverse action, as defined in section 260E.07,
against an individual who, in good faith, makes a complaint or assists in an investigation.
new text end

new text begin Subd. 10. new text end

new text begin Recommendations to agency. new text end

new text begin (a) If, after reviewing a complaint or conducting
an investigation and considering the response of an agency, facility, or program and any
other pertinent material, the ombudsperson determines that the complaint has merit or that
the investigation reveals a problem, the ombudsperson may recommend that the agency,
facility, or program:
new text end

new text begin (1) consider the matter further;
new text end

new text begin (2) modify or cancel its actions;
new text end

new text begin (3) alter a rule, order, or internal policy;
new text end

new text begin (4) explain more fully the action in question; or
new text end

new text begin (5) take other action as authorized under section 257.0762.
new text end

new text begin (b) At the ombudsperson's request, the agency, facility, or program shall, within a
reasonable time, inform the ombudsperson about the action taken on the recommendation
or the reasons for not complying with the recommendation.
new text end

new text begin (c) Data obtained from any agency under this section retains the classification that the
data has under section 13.02, and the ombudsperson shall maintain and disseminate the data
according to chapter 13.
new text end

new text begin Subd. 11. new text end

new text begin Recommendations and public reports. new text end

new text begin (a) The ombudsperson may send
conclusions and suggestions concerning any reviewed matter to the governor and shall
provide copies of all reports to the advisory board and to the groups specified in section
257.0768, subdivision 1. Before making public a conclusion or recommendation that
expressly or implicitly criticizes an agency, facility, program, or any person, the
ombudsperson shall inform the governor and the affected agency, facility, program, or
person concerning the conclusion or recommendation. When sending a conclusion or
recommendation to the governor that is adverse to an agency, facility, program, or any
person, the ombudsperson shall include any statement of reasonable length made by that
agency, facility, program, or person in defense or mitigation of the ombudsperson's
conclusion or recommendation.
new text end

new text begin (b) In addition to conclusions or recommendations that the ombudsperson makes to the
governor on an ad hoc basis, the ombudsperson shall, at the end of each year, report to the
governor concerning the exercise of the ombudsperson's functions during the preceding
year.
new text end

new text begin Subd. 12. new text end

new text begin Civil actions. new text end

new text begin The ombudsperson and designees are not civilly liable for any
action taken under this section if the action was taken in good faith, was within the scope
of the ombudsperson's authority, and did not constitute willful or reckless misconduct.
new text end

new text begin Subd. 13. new text end

new text begin Use of funds. new text end

new text begin Any funds received by the ombudsperson from any source may
be used to compensate members of the American Indian community-specific board for
reasonable and necessary expenses incurred in aiding and assisting the ombudsperson in
programs and initiatives.
new text end

Sec. 2.

new text begin [3.9216] AMERICAN INDIAN COMMUNITY-SPECIFIC BOARD.
new text end

new text begin Subdivision 1. new text end

new text begin Membership. new text end

new text begin The board consists of five members who are members of
a federally recognized Tribe or members of the American Indian community. The chair of
the Indian Affairs Council shall appoint the members of the board. In making appointments,
the chair must consult with other members of the council.
new text end

new text begin Subd. 2. new text end

new text begin Compensation. new text end

new text begin Members do not receive compensation but are entitled to
receive reimbursement for reasonable and necessary expenses incurred doing board-related
work, including travel for meetings, trainings, and presentations. Board members may also
receive per diem payments in a manner and amount prescribed by the board.
new text end

new text begin Subd. 3. new text end

new text begin Meetings. new text end

new text begin The board shall meet regularly at the request of the appointing chair,
board chair, or ombudsperson. The board must meet at least quarterly. The appointing chair,
board chair, or ombudsperson may also call special or emergency meetings as necessary.
new text end

new text begin Subd. 4. new text end

new text begin Removal and vacancy. new text end

new text begin (a) A member may be removed by the appointing
authority at any time, either for cause, as described in paragraph (b), or after missing three
consecutive meetings, as described in paragraph (c).
new text end

new text begin (b) If a removal is for cause, the member must be given notice and an opportunity for a
hearing before removal.
new text end

new text begin (c) After a member misses two consecutive meetings, and before the next meeting, the
board chair shall notify the member in writing that the member may be removed if the
member misses the next meeting. If a member misses three consecutive meetings, the board
chair must notify the appointing authority.
new text end

new text begin (d) If there is a vacancy on the board, the appointing authority shall appoint a person to
fill the vacancy for the remainder of the unexpired term.
new text end

new text begin Subd. 5. new text end

new text begin Duties. new text end

new text begin (a) The board shall appoint the Ombudsperson for American Indian
Families and shall advise and assist the ombudsperson in various ways, including, but not
limited to:
new text end

new text begin (1) selecting matters for attention;
new text end

new text begin (2) developing policies, plans, and programs to carry out the ombudsperson's functions
and powers;
new text end

new text begin (3) attending policy meetings when requested by the ombudsperson;
new text end

new text begin (4) establishing protocols for working with American Indian communities;
new text end

new text begin (5) developing procedures for the ombudsperson's use of the subpoena power to compel
testimony and evidence from individuals who are not agency personnel; and
new text end

new text begin (6) making reports and recommendations for changes designed to improve standards of
competence, efficiency, justice, and protection of rights.
new text end

new text begin (b) The board shall not make individual case recommendations.
new text end

new text begin Subd. 6. new text end

new text begin Grants, gifts, donations, and appropriations. new text end

new text begin The board may apply for grants
for the purpose of training and educating the American Indian community on child protection
issues involving American Indian families. The board may also accept gifts, donations, and
appropriations for training and education. Grants, gifts, donations, and appropriations
received by the board shall be used for training and education purposes. The board may
seek and apply for grants to develop new programs and initiatives and to continue existing
programs and initiatives. These funds may also be used to reimburse board members for
reasonable and necessary expenses incurred in aiding and assisting the Office of the
Ombudsperson for American Indian Families in Office of the Ombudsperson for American
Indian Families programs and initiatives, but may not be used for operating expenses for
the Office of Ombudsperson for American Indian Families.
new text end

new text begin Subd. 7. new text end

new text begin Terms and expiration. new text end

new text begin The terms and expiration of board membership are
governed by section 15.0575.
new text end

Sec. 3.

new text begin [119B.195] RETAINING EARLY EDUCATORS THROUGH ATTAINING
INCENTIVES NOW (REETAIN) GRANT PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment; purpose. new text end

new text begin The retaining early educators through attaining
incentives now (REETAIN) grant program is established to provide competitive grants to
incentivize well-trained child care professionals to remain in the workforce. The overall
goal of the REETAIN grant program is to create more consistent care for children over time.
new text end

new text begin Subd. 2. new text end

new text begin Administration. new text end

new text begin The commissioner shall administer the REETAIN grant
program through a grant to a nonprofit with the demonstrated ability to manage benefit
programs for child care professionals. Up to ten percent of grant money may be used for
administration of the grant program.
new text end

new text begin Subd. 3. new text end

new text begin Application. new text end

new text begin Applicants must apply for the REETAIN grant program using
the forms and according to timelines established by the commissioner.
new text end

new text begin Subd. 4. new text end

new text begin Eligibility. new text end

new text begin (a) To be eligible for a grant, an applicant must:
new text end

new text begin (1) be licensed to provide child care or work for a licensed child care program;
new text end

new text begin (2) work directly with children at least 30 hours per week;
new text end

new text begin (3) have worked in the applicant's current position for at least 12 months;
new text end

new text begin (4) agree to work in the early childhood care and education field for at least 12 months
upon receiving a grant under this section;
new text end

new text begin (5) have a career lattice step of five or higher;
new text end

new text begin (6) have a current membership with the Minnesota quality improvement and registry
tool;
new text end

new text begin (7) not be a current teacher education and compensation helps scholarship recipient; and
new text end

new text begin (8) meet any other requirements determined by the commissioner.
new text end

new text begin (b) Grant recipients must sign a contract agreeing to remain in the early childhood care
and education field for 12 months.
new text end

new text begin Subd. 5. new text end

new text begin Grant awards. new text end

new text begin Grant awards must be made annually and may be made up to
an amount per recipient determined by the commissioner. Grant recipients may use grant
money for program supplies, training, or personal expenses.
new text end

new text begin Subd. 6. new text end

new text begin Report. new text end

new text begin By January 1 each year, the commissioner must report to the legislative
committees with jurisdiction over child care about the number of grants awarded to recipients
and outcomes of the grant program since the last report.
new text end

Sec. 4.

Minnesota Statutes 2020, section 124D.142, is amended to read:

124D.142 QUALITY RATING AND IMPROVEMENT SYSTEM.

new text begin Subdivision 1. new text end

new text begin System established. new text end

deleted text begin (a) deleted text end There is established a quality rating and
improvement system (QRIS) framework new text begin , known as Parent Aware, new text end to ensure that Minnesota's
children have access to high-quality early learning and care programs in a range of settings
so that they are fully ready for kindergarten deleted text begin by 2020. Creation of a standards-based voluntary
quality rating and improvement system includes: deleted text end new text begin .
new text end

new text begin Subd. 2. new text end

new text begin System components. new text end

new text begin The standards-based voluntary quality rating and
improvement system includes:
new text end

(1) quality opportunities in order to improve the educational outcomes of children so
that they are ready for school deleted text begin . The deleted text end new text begin ;
new text end

new text begin (2) a new text end framework deleted text begin shall be deleted text end based on the Minnesota quality rating system rating tool and
a common set of child outcome and program standards deleted text begin and deleted text end informed by evaluation results;

deleted text begin (2) deleted text end new text begin (3) new text end a tool to increase the number of publicly funded and regulated early learning and
care services in both public and private market programs that are high quality deleted text begin . If deleted text end new text begin ;
new text end

new text begin (4) voluntary participation ensuring that if new text end a program or provider chooses to participate,
the program or provider will be rated and may receive public funding associated with the
rating deleted text begin . The state shall develop a plan to link future early learning and care state funding to
the framework in a manner that complies with federal requirements deleted text end ; and

deleted text begin (3) deleted text end new text begin (5) new text end tracking progress toward statewide access to high-quality early learning and care
programs, progress toward the number of low-income children whose parents can access
quality programs, and progress toward increasing the number of children who are fully
prepared to enter kindergarten.

deleted text begin (b) In planning a statewide quality rating and improvement system framework in
paragraph (a), the state shall use evaluation results of the Minnesota quality rating system
rating tool in use in fiscal year 2008 to recommend:
deleted text end

deleted text begin (1) a framework of a common set of child outcome and program standards for a voluntary
statewide quality rating and improvement system;
deleted text end

deleted text begin (2) a plan to link future funding to the framework described in paragraph (a), clause (2);
and
deleted text end

deleted text begin (3) a plan for how the state will realign existing state and federal administrative resources
to implement the voluntary quality rating and improvement system framework. The state
shall provide the recommendation in this paragraph to the early childhood education finance
committees of the legislature by March 15, 2011.
deleted text end

deleted text begin (c) Prior to the creation of a statewide quality rating and improvement system in paragraph
(a), the state shall employ the Minnesota quality rating system rating tool in use in fiscal
year 2008 in the original Minnesota Early Learning Foundation pilot areas and additional
pilot areas supported by private or public funds with its modification as a result of the
evaluation results of the pilot project.
deleted text end

new text begin Subd. 3. new text end

new text begin Evaluation. new text end

new text begin (a) By February 1, 2022, the commissioner of human services
must arrange an independent evaluation of the quality rating and improvement system's
effectiveness and impact on:
new text end

new text begin (1) children's progress toward school readiness;
new text end

new text begin (2) the quality of the early learning and care system supply and workforce;
new text end

new text begin (3) parents' ability to access and use meaningful information about early learning and
care program quality; and
new text end

new text begin (4) providers' ability to serve children and families, including those from racially,
ethnically, or culturally diverse backgrounds.
new text end

new text begin (b) The evaluation must be performed by a staff member from another agency or a
consultant. An evaluator must have experience in program evaluation and must not be
regularly involved in implementing the quality rating and improvement system.
new text end

new text begin (c) The evaluation findings, along with the commissioner's recommendations for
revisions, potential future evaluations, and plans for continuous improvement, must be
reported to the chairs and ranking minority members of the legislative committees with
jurisdiction over early childhood programs by December 31, 2024.
new text end

new text begin (d) At a minimum, the evaluation must:
new text end

new text begin (1) analyze the effectiveness of the quality rating and improvement system, including
but not limited to reviewing:
new text end

new text begin (i) whether quality indicators and measures used in the quality rating and improvement
system are consistent with evidence and research findings on early learning and care program
quality; and
new text end

new text begin (ii) patterns or differences in observed quality of participating early learning and care
programs in comparison to programs at other quality rating and improvement system star
rating levels and accounting for other factors;
new text end

new text begin (2) perform evidence-based assessments of children's developmental gains aligned with
the state early childhood indicators of progress, including in ways that are appropriate for
children's linguistic and cultural backgrounds;
new text end

new text begin (3) analyze the extent to which differences in developmental gains among children
correspond to the star ratings of the early learning and care programs, providing disaggregated
findings by:
new text end

new text begin (i) children's demographic factors, including geographic area, family income level, and
racial and ethnic groups;
new text end

new text begin (ii) type of provider, including family child care providers, child care centers, Head Start
and Early Head Start, and school-based early childhood providers; and
new text end

new text begin (iii) any other categories identified by the commissioner, in consultation with the
commissioners of health and education or the entity performing the evaluation;
new text end

new text begin (4) analyze the accessibility for providers to participate in the quality rating and
improvement system, including ease of application and supports for a provider to receive
or improve a rating, and provide disaggregated findings by children's demographic factors
and type of provider, as each is defined in clause (3);
new text end

new text begin (5) analyze the availability of providers participating in the quality rating and
improvement system to families, and provide disaggregated findings by children's
demographic factors and type of provider, as each is defined in clause (3);
new text end

new text begin (6) analyze the degree to which the quality rating and improvement system accounts for
racial, cultural, linguistic, and ethnic diversity when measuring quality; and
new text end

new text begin (7) analyze the impact of financial or administrative requirements of the quality rating
and improvement system on family child care providers and child care providers, including
those providers serving racially, ethnically, and culturally diverse communities.
new text end

new text begin (e) The evaluation must include a comparison of the quality rating and improvement
system with at least three other quality metric systems used in other states. The other chosen
metric systems must incorporate methods of assessing and monitoring developmental and
achievement benchmarks in early care and education settings to assess kindergarten readiness,
including for racially, ethnically, and culturally diverse populations.
new text end

new text begin Subd. 4. new text end

new text begin Equity report. new text end

new text begin The Department of Human Services shall conduct outreach to
a racially, ethnically, culturally, and geographically diverse group of early learning and care
providers to identify any barriers that prevent the providers from pursuing a Parent Aware
rating. The department shall summarize and submit the results of the outreach, along with
a plan for reducing those barriers, to the chairs and ranking minority members of the
legislative committees with jurisdiction over early learning and care programs by March 1,
2022.
new text end

Sec. 5.

Minnesota Statutes 2020, section 136A.128, subdivision 2, is amended to read:

Subd. 2.

Program components.

(a) The nonprofit organization must use the grant for:

(1) tuition scholarships up to deleted text begin $5,000 deleted text end new text begin $10,000 new text end per year for courses leading to the nationally
recognized child development associate credential or college-level courses leading to an
associate's new text begin degree new text end or bachelor's degree in early childhood development and school-age care;
and

(2) education incentives of a minimum of deleted text begin $100 deleted text end new text begin $250 new text end to participants in the tuition
scholarship program if they complete a year of working in the early care and education
field.

(b) Applicants for the scholarship must be employed by a licensed early childhood or
child care program and working directly with children, a licensed family child care provider, new text begin
employed by a public prekindergarten program, new text end or an employee in a school-age program
exempt from licensing under section 245A.03, subdivision 2, paragraph (a), clause (12).
Lower wage earners must be given priority in awarding the tuition scholarships. Scholarship
recipients must contribute new text begin at least new text end ten percent of the total scholarship and must be sponsored
by their employers, who must also contribute deleted text begin ten deleted text end new text begin at least five new text end percent of the total scholarship.
Scholarship recipients who are self-employed must contribute 20 percent of the total
scholarship.

Sec. 6.

Minnesota Statutes 2020, section 136A.128, subdivision 4, is amended to read:

Subd. 4.

Administration.

A nonprofit organization that receives a grant under this
section may use deleted text begin five deleted text end new text begin ten new text end percent of the grant amount to administer the program.

Sec. 7.

Minnesota Statutes 2020, section 256.041, is amended to read:

256.041 CULTURAL AND ETHNIC COMMUNITIES LEADERSHIP COUNCIL.

Subdivision 1.

Establishment; purpose.

There is hereby established the Cultural and
Ethnic Communities Leadership Council for the Department of Human Services. The purpose
of the council is to advise the commissioner of human services on deleted text begin reducing deleted text end new text begin implementing
strategies to reduce inequities and new text end disparities that new text begin particularly new text end affect racial and ethnic groups new text begin
in Minnesota new text end .

Subd. 2.

Members.

(a) The council must consist of:

(1) the chairs and ranking minority members of the committees in the house of
representatives and the senate with jurisdiction over human services; and

(2) no fewer than 15 and no more than 25 members appointed by and serving at the
pleasure of the commissioner of human services, in consultation with county, tribal, cultural,
and ethnic communities; diverse program participants; deleted text begin and deleted text end parent representatives from these
communities new text begin ; and cultural and ethnic communities leadership council members new text end .

(b) In making appointments under this section, the commissioner shall give priority
consideration to public members of the legislative councils of color established under deleted text begin chapter
3 deleted text end new text begin section 15.0145 new text end .

(c) Members must be appointed to allow for representation of the following groups:

(1) racial and ethnic minority groups;

(2) the American Indian community, which must be represented by two members;

(3) culturally and linguistically specific advocacy groups and service providers;

(4) human services program participants;

(5) public and private institutions;

(6) parents of human services program participants;

(7) members of the faith community;

(8) Department of Human Services employees; and

(9) any other group the commissioner deems appropriate to facilitate the goals and duties
of the council.

Subd. 3.

Guidelines.

The commissioner shall direct the development of guidelines
defining the membership of the council; setting out definitions; and developing duties of
the commissioner, the council, and council members regarding racial and ethnic disparities
reduction. The guidelines must be developed in consultation with:

(1) the chairs of relevant committees; and

(2) county, tribal, and cultural communities and program participants from these
communities.

Subd. 4.

Chair.

The commissioner shall new text begin accept recommendations from the council to
new text end appoint a chair new text begin or chairs new text end .

deleted text begin Subd. 5. deleted text end

deleted text begin Terms for first appointees. deleted text end

deleted text begin The initial members appointed shall serve until
January 15, 2016.
deleted text end

Subd. 6.

Terms.

A term shall be for two years and appointees may be reappointed to
serve two additional terms. The commissioner shall make appointments to replace members
vacating their positions deleted text begin by January 15 of each year deleted text end new text begin in a timely manner, no more than three
months after the council reviews panel recommendations new text end .

Subd. 7.

Duties of commissioner.

(a) The commissioner of human services or the
commissioner's designee shall:

(1) maintain new text begin and actively engage with new text end the council established in this section;

(2) supervise and coordinate policies for persons from racial, ethnic, cultural, linguistic,
and tribal communities who experience disparities in access and outcomes;

(3) identify human services rules or statutes affecting persons from racial, ethnic, cultural,
linguistic, and tribal communities that may need to be revised;

(4) investigate and implement cost-effective new text begin , equitable, and culturally responsive new text end models
of service delivery deleted text begin such as deleted text end new text begin including new text end careful deleted text begin adaptation deleted text end new text begin adoption new text end of deleted text begin clinically deleted text end proven services
deleted text begin that constitute one strategy for increasing deleted text end new text begin to increase new text end the number of culturally relevant
services available to currently underserved populations; deleted text begin and
deleted text end

(5) based on recommendations of the council, review identified department policies that
maintain racial, ethnic, cultural, linguistic, and tribal disparities deleted text begin , and deleted text end new text begin ; new text end make adjustments to
ensure those disparities are not perpetuated deleted text begin . deleted text end new text begin ; and advise the department on progress and
accountability measures for addressing inequities;
new text end

new text begin (6) in partnership with the council, renew and implement equity policy with action plans
and resources necessary to implement the action plans;
new text end

new text begin (7) support interagency collaboration to advance equity;
new text end

new text begin (8) address the council at least twice annually on the state of equity within the department;
and
new text end

new text begin (9) support member participation in the council, including participation in educational
and community engagement events across Minnesota that address equity in human services.
new text end

(b) The commissioner of human services or the commissioner's designee shall consult
with the council and receive recommendations from the council when meeting the
requirements in this subdivision.

Subd. 8.

Duties of council.

The council shall:

(1) recommend to the commissioner for review deleted text begin identified policies in the deleted text end Department of
Human Services new text begin policy, budgetary, and operational decisions and practices new text end that deleted text begin maintain deleted text end new text begin
impact new text end racial, ethnic, cultural, linguistic, and tribal disparities;

(2) new text begin with community input, advance legislative proposals to improve racial and health
equity outcomes;
new text end

new text begin (3) new text end identify issues regarding new text begin inequities and new text end disparities by engaging diverse populations
in human services programs;

deleted text begin (3) deleted text end new text begin (4) new text end engage in mutual learning essential for achieving human services parity and
optimal wellness for service recipients;

deleted text begin (4) deleted text end new text begin (5) new text end raise awareness about human services disparities to the legislature and media;

deleted text begin (5) deleted text end new text begin (6) new text end provide technical assistance and consultation support to counties, private nonprofit
agencies, and other service providers to build their capacity to provide equitable human
services for persons from racial, ethnic, cultural, linguistic, and tribal communities who
experience disparities in access and outcomes;

deleted text begin (6) deleted text end new text begin (7) new text end provide technical assistance to promote statewide development of culturally and
linguistically appropriate, accessible, and cost-effective human services and related policies;

deleted text begin (7) provide deleted text end new text begin (8) recommend and monitor new text end training and outreach to facilitate access to
culturally and linguistically appropriate, accessible, and cost-effective human services to
prevent disparities;

deleted text begin (8) facilitate culturally appropriate and culturally sensitive admissions, continued services,
discharges, and utilization review for human services agencies and institutions;
deleted text end

(9) form work groups to help carry out the duties of the council that include, but are not
limited to, persons who provide and receive services and representatives of advocacy groups,
and provide the work groups with clear guidelines, standardized parameters, and tasks for
the work groups to accomplish;

(10) promote information sharing in the human services community and statewide; and

(11) by February 15 deleted text begin each year deleted text end new text begin in the second year of the biennium new text end , prepare and submit
to the chairs and ranking minority members of the committees in the house of representatives
and the senate with jurisdiction over human services a report that summarizes the activities
of the council, identifies the major problems and issues confronting racial and ethnic groups
in accessing human services, makes recommendations to address issues, and lists the specific
objectives that the council seeks to attain during the next biennium new text begin , and recommendations
to strengthen equity, diversity, and inclusion within the department new text end . The report must deleted text begin also
include a list of programs, groups, and grants used to reduce disparities, and statistically
valid reports of outcomes on the reduction of the disparities. deleted text end new text begin identify racial and ethnic groups'
difficulty in accessing human services and make recommendations to address the issues.
The report must include any updated Department of Human Services equity policy,
implementation plans, equity initiatives, and the council's progress.
new text end

Subd. 9.

Duties of council members.

The members of the council shall:

(1) attend deleted text begin and deleted text end new text begin scheduled meetings with no more than three absences per year, new text end participate
in scheduled meetings new text begin , new text end and be prepared by reviewing meeting notes;

(2) maintain open communication channels with respective constituencies;

(3) identify and communicate issues and risks that could impact the timely completion
of tasks;

(4) collaborate on new text begin inequity and new text end disparity reduction efforts;

(5) communicate updates of the council's work progress and status on the Department
of Human Services website; deleted text begin and
deleted text end

(6) participate in any activities the council or chair deems appropriate and necessary to
facilitate the goals and duties of the council deleted text begin . deleted text end new text begin ; and
new text end

new text begin (7) participate in work groups to carry out council duties.
new text end

Subd. 10.

Expiration.

The council expires on June 30, deleted text begin 2022 deleted text end new text begin 2025 new text end .

new text begin Subd. 11. new text end

new text begin Compensation. new text end

new text begin Compensation for members of the council is governed by
section 15.059, subdivision 3.
new text end

Sec. 8.

Minnesota Statutes 2020, section 257.0755, subdivision 1, is amended to read:

Subdivision 1.

Creation.

Each ombudsperson shall operate independently from but in
collaboration with the community-specific board that appointed the ombudsperson under
section 257.0768: deleted text begin the Indian Affairs Council, deleted text end the Minnesota Council on Latino Affairs, the
Council for Minnesotans of African Heritage, and the Council on Asian-Pacific Minnesotans.

Sec. 9.

Minnesota Statutes 2020, section 257.076, subdivision 3, is amended to read:

Subd. 3.

Communities of color.

"Communities of color" means the following: deleted text begin American
Indian, deleted text end Hispanic-Latino, Asian-Pacific, African, and African-American communities.

Sec. 10.

Minnesota Statutes 2020, section 257.076, subdivision 5, is amended to read:

Subd. 5.

Family of color.

"Family of color" means any family with a child under the
age of 18 who is identified by one or both parents or another trusted adult to be of deleted text begin American
Indian, deleted text end Hispanic-Latino, Asian-Pacific, African, or African-American descent.

Sec. 11.

Minnesota Statutes 2020, section 257.0768, subdivision 1, is amended to read:

Subdivision 1.

Membership.

deleted text begin Four deleted text end new text begin Three new text end community-specific boards are created. Each
board consists of five members. The chair of each of the following groups shall appoint the
board for the community represented by the group: deleted text begin the Indian Affairs Council; deleted text end the Minnesota
Council on Latino Affairs; the Council for Minnesotans of African Heritage; and the Council
on Asian-Pacific Minnesotans. In making appointments, the chair must consult with other
members of the council.

Sec. 12.

Minnesota Statutes 2020, section 257.0768, subdivision 6, is amended to read:

Subd. 6.

Joint meetings.

The members of the deleted text begin four deleted text end new text begin three new text end community-specific boards
shall meet jointly at least four times each year to advise the ombudspersons on overall
policies, plans, protocols, and programs for the office.

Sec. 13.

Minnesota Statutes 2020, section 257.0769, is amended to read:

257.0769 FUNDING FOR THE OMBUDSPERSON PROGRAM.

Subdivision 1.

Appropriations.

(a) deleted text begin money is appropriated from deleted text end new text begin $23,000 from new text end the special
deleted text begin fund deleted text end new text begin account new text end authorized by section 256.01, subdivision 2, paragraph (o), new text begin is annually
appropriated new text end to the deleted text begin Indian Affairs Council deleted text end new text begin Office of Ombudsperson for American Indian
Families new text end for the deleted text begin purposes deleted text end new text begin purpose new text end of deleted text begin sections 257.0755 to 257.0768 deleted text end new text begin section 3.9215 new text end .

(b) deleted text begin money is appropriated from deleted text end new text begin $69,000 from new text end the special deleted text begin fund deleted text end new text begin account new text end authorized by
section 256.01, subdivision 2, paragraph (o), new text begin is annually appropriated new text end to the deleted text begin Minnesota
Council on Latino Affairs deleted text end new text begin Office of Ombudsperson for Families new text end for the purposes of sections
257.0755 to 257.0768.

deleted text begin (c) Money is appropriated from the special fund authorized by section 256.01, subdivision
2, paragraph (o), to the Council for Minnesotans of African Heritage for the purposes of
sections 257.0755 to 257.0768.
deleted text end

deleted text begin (d) Money is appropriated from the special fund authorized by section 256.01, subdivision
2, paragraph (o), to the Council on Asian-Pacific Minnesotans for the purposes of sections
257.0755 to 257.0768.
deleted text end

Subd. 2.

Title IV-E reimbursement.

The commissioner shall obtain federal title IV-E
financial participation for eligible activity by the ombudsperson for families under section
257.0755 new text begin and the ombudsperson for American Indian families under section 3.9215 new text end . The
ombudsperson for families new text begin and the ombudsperson for American Indian families new text end shall maintain
and transmit to the Department of Human Services documentation that is necessary in order
to obtain federal funds.

Sec. 14. new text begin TRANSFER OF MONEY.
new text end

new text begin Before the end of fiscal year 2021, the Office of the Ombudsperson for Families must
transfer to the Office of the Ombudsperson for American Indian Families any remaining
money designated for use by the Ombudsperson for American Indian Families. This section
is cost-neutral.
new text end

Sec. 15. new text begin CHILDREN WITH DISABILITIES INCLUSIVE CHILD CARE ACCESS
EXPANSION GRANT PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin (a) The commissioner of human services shall establish
a competitive grant program to expand access to licensed family child care providers or
licensed child care centers for children with disabilities including medical complexities.
The commissioner shall award grants to counties or Tribes, including at least one county
from the seven-county metropolitan area and at least one county or Tribe outside the
seven-county metropolitan area, and grant funds shall be used to enable child care providers
to develop an inclusive child care setting and offer care to children with disabilities and
children without disabilities. Grants shall be awarded to at least two applicants beginning
no later than January 15, 2022.
new text end

new text begin (b) For purposes of this section, "child with a disability" means a child who has a
substantial delay or has an identifiable physical, medical, emotional, or mental condition
that hinders development.
new text end

new text begin (c) For purposes of this section, "inclusive child care setting" means child care provided
in a manner that serves children with disabilities in the same setting as children without
disabilities.
new text end

new text begin Subd. 2. new text end

new text begin Commissioner's duties. new text end

new text begin To administer the grant program, the commissioner
shall:
new text end

new text begin (1) consult with relevant stakeholders to develop a request for proposals that at least
requires grant applicants to identify the items or services and estimated accompanying costs,
where possible, needed to expand access to inclusive child care settings for children with
disabilities;
new text end

new text begin (2) develop procedures for data collection, qualitative and quantitative measurement of
grant program outcomes, and reporting requirements for grant recipients;
new text end

new text begin (3) convene a working group of grant recipients, partner child care providers, and
participating families to assess progress on grant activities, share best practices, and collect
and review data on grant activities; and
new text end

new text begin (4) by February 1, 2023, provide a report to the chairs and ranking minority members
of the legislative committees with jurisdiction over early childhood programs on the activities
and outcomes of the grant program with legislative recommendations for implementing
inclusive child care settings statewide. The report shall be made available to the public.
new text end

new text begin Subd. 3. new text end

new text begin Grant activities. new text end

new text begin Grant recipients shall use grant funds for the cost of facility
modifications, resources, or services necessary to expand access to inclusive child care
settings for children with disabilities, including:
new text end

new text begin (1) onetime needs to equip a child care setting to serve children with disabilities, including
but not limited to environmental modifications; accessibility modifications; sensory
adaptation; training materials and staff time for training, including for substitutes; or
equipment purchases, including durable medical equipment;
new text end

new text begin (2) ongoing medical- or disability-related services for children with disabilities in
inclusive child care settings, including but not limited to mental health supports; inclusion
specialist services; home care nursing; behavioral supports; coaching or training for staff
and substitutes; substitute teaching time; or additional child care staff, an enhanced rate, or
another mechanism to increase staff-to-child ratio; and
new text end

new text begin (3) other expenses determined by the grant recipient and each partner child care provider
to be necessary to establish an inclusive child care setting and serve children with disabilities
at the provider's location.
new text end

new text begin Subd. 4. new text end

new text begin Requirements for grant recipients. new text end

new text begin Upon receipt of grant funds and throughout
the grant period, grant recipients shall:
new text end

new text begin (1) partner with at least two but no more than five child care providers, each of which
must meet one of the following criteria:
new text end

new text begin (i) serve 29 or fewer children, including at least two children with a disability who are
not a family member of the child care provider if the participating child care provider is a
family child care provider; or
new text end

new text begin (ii) serve more than 30 children, including at least three children with a disability;
new text end

new text begin (2) develop and follow a process to ensure that grant funding is used to support children
with disabilities who, without the additional supports made available through the grant,
would have difficulty accessing an inclusive child care setting;
new text end

new text begin (3) pursue funding for ongoing services needed for children with disabilities in inclusive
child care settings, such as Medicaid or private health insurance coverage; additional grant
funding; or other funding sources;
new text end

new text begin (4) explore and seek opportunities to use existing federal funds to provide ongoing
support to family child care providers or child care centers serving children with disabilities.
Grant recipients shall seek to minimize family financial obligations for child care for a child
with disabilities beyond what child care would cost for a child without disabilities; and
new text end

new text begin (5) identify and utilize training resources for child care providers, where available and
applicable, for at least one of the grant recipient's partner child care providers.
new text end

new text begin Subd. 5. new text end

new text begin Reporting. new text end

new text begin Grant recipients shall report to the commissioner every six months,
in a manner specified by the commissioner, on the following:
new text end

new text begin (1) the number, type, and cost of additional supports needed to serve children with
disabilities in inclusive child care settings;
new text end

new text begin (2) best practices for billing;
new text end

new text begin (3) availability and use of funding sources other than through the grant program;
new text end

new text begin (4) processes for identifying families of children with disabilities who could benefit
from grant activities and connecting them with a child care provider interested in serving
them;
new text end

new text begin (5) processes and eligibility criteria used to determine whether a child is a child with a
disability and means of prioritizing grant funding to serve children with significant support
needs associated with their disability; and
new text end

new text begin (6) any other information deemed relevant by the commissioner.
new text end

Sec. 16. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; FAMILY
CHILD CARE SHARED SERVICES INNOVATION GRANTS.
new text end

new text begin The commissioner of human services shall establish a grant program to test strategies
by which family child care providers may share services and thereby achieve economies of
scale. The commissioner shall report the results of the grant program to the legislative
committees with jurisdiction over early care and education programs.
new text end

Sec. 17. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; FOSTER
FAMILY RECRUITMENT AND LICENSING TECHNOLOGY REQUEST FOR
INFORMATION.
new text end

new text begin The commissioner of human services shall publish a request for information to identify
available technology to support foster family recruitment and training through an online
portal for potential foster families to apply for licensure online, including the potential costs
for implementing the technology. The technology shall enable relative families of foster
youth to apply online and receive real-time support through the online application software;
offer content in multiple languages; enable tracking of users' ethnic identity to identify
potential gaps in recruitment and to ensure racial equity in serving foster families; and
recognize Tribal government sovereignty over data control and recruiting and licensing of
families to support children in their community. By January 15, 2022, the commissioner
shall report to the chairs and ranking minority members of the legislative committees with
jurisdiction over human services on responses received in response to the request for
information.
new text end

Sec. 18. new text begin AFFORDABLE, HIGH-QUALITY EARLY CARE AND EDUCATION
FOR ALL FAMILIES.
new text end

new text begin Subdivision 1. new text end

new text begin Goal. new text end

new text begin It is the goal of the state for all families to have access to affordable,
high-quality early care and education that enriches, nurtures, and supports children and their
families. The goal will be achieved by:
new text end

new text begin (1) creating a system in which family costs for early care and education are affordable;
new text end

new text begin (2) ensuring that a child's access to high-quality early care and education is not determined
by the child's race, family income, or zip code; and
new text end

new text begin (3) ensuring that Minnesota's early childhood educators are qualified, diverse, supported,
and equitably compensated regardless of setting.
new text end

new text begin Subd. 2. new text end

new text begin Great Start for All Minnesota Children Task Force; establishment. new text end

new text begin The
Great Start for All Minnesota Children Task Force is established to develop strategies that
will meet the goal identified in subdivision 1.
new text end

new text begin Subd. 3. new text end

new text begin Membership. new text end

new text begin (a) The task force shall consist of the following 15 voting
members, appointed by the governor, except as otherwise specified:
new text end

new text begin (1) two members of the house of representatives, one appointed from the majority party
by the speaker of the house and one appointed from the minority party by the minority
leader;
new text end

new text begin (2) two members of the senate, one appointed from the majority party by the majority
leader and one appointed from the minority party by the minority leader;
new text end

new text begin (3) two individuals who are directors of a licensed child care center, one from greater
Minnesota and one from the seven-county metropolitan area;
new text end

new text begin (4) two individuals who are license holders of family child care programs, one from
greater Minnesota and one from the seven-county metropolitan area;
new text end

new text begin (5) three individuals who are early childhood educators, one who works in a licensed
child care center, one who works in a public school-based early childhood program, and
one who works in a Head Start program or a community education program;
new text end

new text begin (6) two parents of children under five years of age, one parent whose child attends a
private early care and education program and one parent whose child attends a public
program, and one parent from greater Minnesota and one parent from the seven-county
metropolitan area;
new text end

new text begin (7) one representative of a federally recognized tribe who has expertise in the early care
and education system; and
new text end

new text begin (8) one representative from the Children's Cabinet.
new text end

new text begin (b) The task force shall have nonvoting members who participate in meetings and provide
data and information to the task force upon request. One person appointed by each of the
commissioners of the following state agencies, one person appointed by the board of each
of the following organizations, and persons appointed by the governor as specified, shall
serve as nonvoting members of the task force:
new text end

new text begin (1) the Department of Education;
new text end

new text begin (2) the Department of Employment and Economic Development;
new text end

new text begin (3) the Department of Health;
new text end

new text begin (4) the Department of Human Services;
new text end

new text begin (5) the Department of Labor and Industry;
new text end

new text begin (6) the Department of Management and Budget;
new text end

new text begin (7) the Department of Revenue;
new text end

new text begin (8) the Minnesota Business Partnership;
new text end

new text begin (9) the Minnesota Community Education Association;
new text end

new text begin (10) the Minnesota Child Care Association;
new text end

new text begin (11) the statewide child care resource and referral network, known as Child Care Aware;
new text end

new text begin (12) the Minnesota Head Start Association;
new text end

new text begin (13) the Minnesota Association of County Social Service Administrators;
new text end

new text begin (14) the Minnesota Chamber of Commerce;
new text end

new text begin (15) a member of a statewide advocacy organization that supports and promotes early
childhood education and welfare, appointed by the governor;
new text end

new text begin (16) a faculty representative who teaches early childhood education in a Minnesota
institution of higher education, appointed by the governor;
new text end

new text begin (17) the Minnesota Initiative Foundations;
new text end

new text begin (18) a member of the Kids Count on Us Coalition, appointed by the governor;
new text end

new text begin (19) the Minnesota Child Care Provider Information Network;
new text end

new text begin (20) the Minnesota Association of Child Care Professionals;
new text end

new text begin (21) a member of Indigenous Visioning, appointed by the governor; and
new text end

new text begin (22) a nationally recognized expert in early care and education financing, appointed by
the governor.
new text end

new text begin Subd. 4. new text end

new text begin Administration. new text end

new text begin (a) The governor must select a chair or cochairs for the task
force from among the voting members. The first task force meeting shall be convened by
the chair or cochairs and held no later than December 1, 2021. Thereafter, the chair or
cochairs shall convene the task force at least monthly and may convene other meetings as
necessary. The chair or cochairs shall convene meetings in a manner to allow for access
from diverse geographic locations in Minnesota.
new text end

new text begin (b) Compensation of task force members, filling of task force vacancies, and removal
of task force members shall be governed by Minnesota Statutes, section 15.059, except that
nonvoting members of the task force shall serve without compensation.
new text end

new text begin (c) The commissioner of management and budget shall provide staff and administrative
services for the task force.
new text end

new text begin (d) The task force shall expire upon submission of the final report required under
subdivision 9.
new text end

new text begin (e) The duties of the task force in this section shall be transferred to an applicable state
agency if specifically authorized under law to carry out such duties.
new text end

new text begin (f) The task force is subject to Minnesota Statutes, chapter 13D.
new text end

new text begin Subd. 5. new text end

new text begin Plan development. new text end

new text begin (a) The task force must develop strategies and a plan to
achieve the goal outlined in subdivision 1 by July 2031.
new text end

new text begin (b) The plan must include an affordability standard that clearly identifies the maximum
percentage of income that a family must pay for early care and education. The standard
must take into account all relevant factors, including but not limited to:
new text end

new text begin (1) the annual income of the family;
new text end

new text begin (2) the recommended maximum of income spent on child care expenses from the United
States Department of Health and Human Services;
new text end

new text begin (3) the average cost of private child care for children under the age of five; and
new text end

new text begin (4) geographic disparities in child care costs.
new text end

new text begin Subd. 6. new text end

new text begin Affordable, high-quality early care and education. new text end

new text begin In developing the plan
under subdivision 5, the task force must:
new text end

new text begin (1) identify the most efficient infrastructure, benefit mechanisms, and financing
mechanisms under which families will access financial assistance so that early care and
education is affordable, high-quality, and easy to access;
new text end

new text begin (2) consider how payment rates for child care will be determined and updated;
new text end

new text begin (3) describe how the plan will be administered, including the roles for state agencies,
local government agencies, and community-based organizations and how that plan will
streamline funding and reduce complexity and fragmentation in the administration of early
childhood programs; and
new text end

new text begin (4) identify how to maintain and encourage the further development of Minnesota's
mixed-delivery system for early care and education, including licensed family child care,
to match family preferences.
new text end

new text begin Subd. 7. new text end

new text begin Workforce compensation. new text end

new text begin In developing the plan under subdivision 5, the
task force must:
new text end

new text begin (1) include strategies to increase racial and ethnic equity and diversity in the early care
and education workforce and recognize the value of cultural competency and multilingualism;
new text end

new text begin (2) include a compensation framework that supports recruitment and retention of a
qualified workforce in every early care and education setting;
new text end

new text begin (3) consider the need for and development of a mechanism that ties child care
reimbursement rates to employee compensation;
new text end

new text begin (4) develop affordable, accessible, and aligned pathways to support early childhood
educators' career and educational advancement;
new text end

new text begin (5) set compensation for early childhood educators by reference to compensation for
elementary school teachers; and
new text end

new text begin (6) consider the recommendations from previous work including the Transforming
Minnesota's Early Childhood Workforce project and other statewide reports on systemic
issues in early care and education.
new text end

new text begin Subd. 8. new text end

new text begin Implementation timeline. new text end

new text begin The task force must develop an implementation
timeline that phases in the plan over a period of no more than six years, beginning in July
2025 and finishing no later than July 2031. In developing the implementation timeline, the
task force must consider:
new text end

new text begin (1) how to simultaneously ensure that child care is affordable to as many families as
possible while minimizing disruptions in the availability and cost of currently available
early care and education arrangements;
new text end

new text begin (2) the capacity for the state to increase the availability of different types of early care
and education settings from which a family may choose;
new text end

new text begin (3) how the inability to afford and access early care and education settings
disproportionately affects certain populations; and
new text end

new text begin (4) how to provide additional targeted investments for early childhood educators serving
a high proportion of families currently eligible for or receiving public assistance for early
care and education.
new text end

new text begin Subd. 9. new text end

new text begin Required reports. new text end

new text begin By December 15, 2022, the task force must submit to the
governor and legislative committees with jurisdiction over early childhood programs
preliminary findings and draft implementation plans. By February 1, 2023, the task force
must submit to the governor and legislative committees with jurisdiction over early childhood
programs final recommendations and implementation plans pursuant to subdivision 5.
new text end

Sec. 19. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; FAMILY
SUPPORTS AND IMPROVEMENT PROGRAM RECOMMENDATIONS.
new text end

new text begin The commissioner of human services shall collaborate with the children's cabinet to
engage with the Minnesota Department of Education, the Minnesota Department of Health
and other relevant state agencies, county and Tribal agencies, child care providers, early
childhood education providers, school administrators, parents of families who qualify for
or are receiving state or county assistance, and other service providers working with those
families to develop recommendations for implementing a family-focused voluntary
information sharing program intended to improve the effectiveness of public assistance
programs and the delivery of services to families, including but not limited to the child care
assistance program, Minnesota family investment program, supplemental nutritional
assistance program, early learning scholarships, medical assistance, and home visiting
programs. To the extent possible, the commissioner may use existing data, materials, or
reports. The commissioner may engage a third-party vendor to assist with developing
recommendations. The family-focused information sharing program design may include
data sharing under Minnesota Statutes, section 13.32, subdivision 12. The recommendations
must include whether grant money is necessary for counties, Tribes, or other agencies for
costs associated with operating the family-focused information sharing program. The
recommendations must include an estimated budget and timeline for the project, a proposed
methodology to distribute grant money to counties, Tribes, or other grantees if needed to
operate the project, and deadlines for an interim and final report on the results of the program.
The commissioner shall provide the chairs and ranking minority members of the legislative
committees with jurisdiction over early childhood and human services programs with
recommendations and, if necessary, proposed legislation by January 15, 2023.
new text end

Sec. 20. new text begin REPORT ON PARTICIPATION IN EARLY CHILDHOOD PROGRAMS
BY CHILDREN IN FOSTER CARE.
new text end

new text begin Subdivision 1. new text end

new text begin Reporting requirement. new text end

new text begin (a) The commissioner of human services shall
report on the participation in early care and education programs by children under six years
of age who have experienced foster care, as defined in Minnesota Statutes, section 260C.007,
subdivision 18, at any time during the reporting period.
new text end

new text begin (b) For purposes of this section, "early care and education program" means Early Head
Start and Head Start under the federal Improving Head Start for School Readiness Act of
2007; special education programs under Minnesota Statutes, chapter 125A; early learning
scholarships under Minnesota Statutes, section 124D.165; school readiness under Minnesota
Statutes, sections 124D.15 and 124D.16; school readiness plus under Laws 2017, First
Special Session chapter 5, article 8, section 9; voluntary prekindergarten under Minnesota
Statutes, section 124D.151; child care assistance under Minnesota Statutes, chapter 119B;
and other programs as determined by the commissioner.
new text end

new text begin Subd. 2. new text end

new text begin Report content. new text end

new text begin (a) The report shall provide counts and rates of participation
in early care and education programs disaggregated, to the extent practicable, by children's
race, ethnicity, age, and county of residence.
new text end

new text begin (b) The report may include recommendations for:
new text end

new text begin (1) providing the data described in paragraph (a) on an annual basis as part of the report
required under Minnesota Statutes, section 257.0725;
new text end

new text begin (2) facilitating children's continued participation in early care and education programs
after reunification, adoption, or a transfer of permanent legal and physical custody;
new text end

new text begin (3) increasing the rates of participation among children and their foster families in early
care and education programs, including processes for referrals and follow-up; and
new text end

new text begin (4) regularly reporting measures of early childhood well-being for children who have
experienced foster care. Measures of early childhood well-being include administrative data
from developmental screenings, school readiness assessments, well-child medical visits,
and other sources as determined by the commissioner.
new text end

new text begin (c) For any recommendation under paragraph (b) not included in the report, the report
shall provide an explanation and identify resources needed to address the recommendation
in any future reports.
new text end

new text begin (d) The report shall identify any administrative barriers to ensuring that early care and
education programs are responsive to the cultural, logistical, and racial equity concerns and
needs of children's foster families and families of origin, and the report shall identify methods
to ensure that the experiences and feedback from children's foster families and families of
origin are included in the ongoing implementation of early care and education programs.
new text end

new text begin (e) The report shall identify stakeholders who were not consulted in the development
of the report and provide recommendations for including the stakeholders' contributions in
future reports.
new text end

new text begin Subd. 3. new text end

new text begin Data and collaboration. new text end

new text begin (a) The report shall use the most current administrative
data and systems, including the Early Childhood Longitudinal Data System, and publicly
available data. The report shall identify barriers to other potential data sources and make
recommendations about accessing and incorporating the data in future reports.
new text end

new text begin (b) To the extent practicable, the commissioner shall:
new text end

new text begin (1) incorporate the experiences of and feedback from children's foster families and
families of origin into the content of the report; and
new text end

new text begin (2) collaborate and consult with the commissioners of health and education, county
agencies, early care and education providers, the judiciary, and school districts in developing
the content of the report.
new text end

new text begin Subd. 4. new text end

new text begin Submission to legislature. new text end

new text begin By December 1, 2022, the commissioner shall
submit the report required under this section to the legislative committees with jurisdiction
over early care and education programs.
new text end

Sec. 21. new text begin CHILD CARE STABILIZATION GRANTS.
new text end

new text begin Subdivision 1. new text end

new text begin Child care stabilization grants. new text end

new text begin The commissioner of human services
shall award grant money to eligible child care programs to support the stability of the child
care sector during and after the COVID-19 public health emergency.
new text end

new text begin Subd. 2. new text end

new text begin Eligible programs. new text end

new text begin (a) The following programs are eligible to receive child
care stabilization grants under this section:
new text end

new text begin (1) family and group family child care homes licensed under Minnesota Rules, chapter
9502;
new text end

new text begin (2) child care centers licensed under Minnesota Rules, chapter 9503;
new text end

new text begin (3) certified license-exempt child care centers under Minnesota Statutes, chapter 245H;
new text end

new text begin (4) legal nonlicensed child care providers as defined in Minnesota Statutes, section
119B.011, subdivision 16; and
new text end

new text begin (5) other programs as determined by the commissioner.
new text end

new text begin (b) Programs must not be:
new text end

new text begin (1) the subject of a finding of fraud;
new text end

new text begin (2) prohibited from receiving public funds under Minnesota Statutes, section 245.095;
or
new text end

new text begin (3) under revocation, suspension, temporary immediate suspension, or decertification,
regardless of whether the action is under appeal.
new text end

new text begin Subd. 3. new text end

new text begin Grant requirements. new text end

new text begin (a) To receive grant money under this section, an eligible
program must:
new text end

new text begin (1) complete an application developed by the commissioner for each grant period for
which the eligible program applies for funding;
new text end

new text begin (2) attest and agree in writing that, for the duration of the grant period, the program will
comply with the requirements in section 2202(d)(2)(D)(i) of the federal American Rescue
Plan Act, Public Law 117-2, including maintaining compensation levels for employees and,
to the extent practicable, providing tuition and co-payment relief to families enrolled in the
program; and
new text end

new text begin (3) attest and agree in writing that the program intends to remain operating and serving
children for the duration of the grant period, with the exceptions of:
new text end

new text begin (i) service disruptions that are necessary due to public health guidance to protect the
safety and health of children and child care programs issued by the Centers for Disease
Control and Prevention, the commissioner of health, the commissioner of human services,
or a local public health agency; and
new text end

new text begin (ii) planned temporary closures for provider vacation and holidays for a duration specified
by the commissioner for each grant period.
new text end

new text begin (b) Grant recipients must comply with all requirements listed in the application for grants
under this section.
new text end

new text begin (c) Grant recipients must use at least 70 percent of base grant awards under subdivision
4, paragraph (b), to provide increased compensation, benefits, or premium pay to all paid
employees, sole proprietors, or independent contractors regularly caring for children. Grant
recipients may request a waiver from this requirement if they cannot increase compensation,
benefits, or premium pay due to restrictions included in agreements with employee bargaining
units, or if the program is experiencing unusual and significant financial hardship.
new text end

new text begin (d) Grant recipients that fail to meet the requirements under this section are subject to
discontinuation of future installment payments, recoupment of payments already made, or
referral to the Office of Inspector General for additional action. Except when based on a
finding of fraud, actions to establish recoupment must be made within six years of the
conclusion of the grant program established under this section. Once recoupment is
established, collection may continue until funds have been repaid in full.
new text end

new text begin Subd. 4. new text end

new text begin Grant awards. new text end

new text begin (a) The commissioner shall award transition grants to all eligible
programs on a noncompetitive basis through August 31, 2021.
new text end

new text begin (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:
new text end

new text begin (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 contractors;
new text end

new text begin (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
new text end

new text begin (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.
new text end

new text begin (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.
new text end

new text begin (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.
new text end

new text begin Subd. 5. new text end

new text begin Eligible uses of grant money. new text end

new text begin Grant recipients may use grant money awarded
under this section for one or more of the following uses directly related to the operation of
a child care program:
new text end

new text begin (1) paying personnel costs, such as payroll, salaries, or similar compensation, employee
benefits, premium pay, or costs for employee recruitment and retention, for an employee,
including a sole proprietor or an independent contractor;
new text end

new text begin (2) providing relief from co-payments and tuition payments for the families enrolled in
the program, to the extent possible, with eligible programs prioritizing relief for families
struggling to make co-payments or tuition payments;
new text end

new text begin (3) paying rent, including rent under a lease agreement, or making payments on any
mortgage obligation, utilities, facility maintenance or improvements, or insurance;
new text end

new text begin (4) purchasing personal protective equipment, purchasing cleaning and sanitization
supplies and services, or obtaining training and professional development related to health
and safety practices;
new text end

new text begin (5) purchasing or updating equipment and supplies to respond to the COVID-19 public
health emergency;
new text end

new text begin (6) purchasing goods and services necessary to maintain or resume child care services;
new text end

new text begin (7) providing mental health supports for children and employees; or
new text end

new text begin (8) providing reimbursement for losses incurred during the COVID-19 public health
emergency. An expenditure is eligible for reimbursement if it was for one of the uses
identified in this subdivision and it was paid between January 31, 2020, and the date of
application for grants under this section.
new text end

Sec. 22. new text begin DIRECTION TO THE CHILDREN'S CABINET; EARLY CHILDHOOD
GOVERNANCE REPORT.
new text end

new text begin Subdivision 1. new text end

new text begin Recommendations. new text end

new text begin The Children's Cabinet shall develop
recommendations on the governance of programs relating to early childhood development,
care, and learning, including how such programs could be consolidated into an existing
state agency or a new state Department of Early Childhood. The recommendations shall
address the impact of such a consolidation on:
new text end

new text begin (1) state efforts to ensure that all Minnesota children are kindergarten-ready, with race,
income, and zip code no longer predictors of school readiness;
new text end

new text begin (2) coordination and alignment among programs;
new text end

new text begin (3) the effort required of families to receive services to which they are entitled;
new text end

new text begin (4) the effort required of service providers to participate in childhood programs; and
new text end

new text begin (5) the articulation between early care and education programs and the kindergarten
through grade 12 system.
new text end

new text begin Subd. 2. new text end

new text begin Public input. new text end

new text begin In developing the recommendations required under subdivision
1, the Children's Cabinet must provide for a community engagement process to seek input
from the public and stakeholders.
new text end

new text begin Subd. 3. new text end

new text begin Report. new text end

new text begin (a) The Children's Cabinet shall produce a report that includes:
new text end

new text begin (1) the recommendations required under subdivision 1;
new text end

new text begin (2) the explanations and reasoning behind such recommendations;
new text end

new text begin (3) a description of the community engagement process required under subdivision 2;
and
new text end

new text begin (4) a summary of the feedback received from the public and early care and education
stakeholders through the community engagement process.
new text end

new text begin (b) The Children's Cabinet may arrange for consultants to assist with the development
of the report.
new text end

new text begin (c) By February 1, 2022, the Children's Cabinet shall submit the report to the governor
and the legislative committees with jurisdiction over early childhood programs.
new text end

Sec. 23. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; FEDERAL
FUND AND CHILD CARE AND DEVELOPMENT BLOCK GRANT
ALLOCATIONS.
new text end

new text begin (a) The commissioner of human services shall allocate $1,435,000 in fiscal year 2022
from the child care and development block grant for the quality rating and improvement
system evaluation and equity report under Minnesota Statutes, section 124D.142, subdivisions
3 and 4.
new text end

new text begin (b) The commissioner of human services shall allocate $499,000 in fiscal year 2022
from the child care and development block grant for the ombudsperson for family child
care providers under Minnesota Statutes, section 245.975.
new text end

new text begin (c) The commissioner of human services shall allocate $858,000 in fiscal year 2022
from the child care and development block grant for transfer to the commissioner of
management and budget for the affordable high-quality child care and early education for
all families working group.
new text end

new text begin (d) The commissioner of human services shall allocate $200,000 in fiscal year 2022
from the child care and development block grant for transfer to the commissioner of
management and budget for completion of the early childhood governance report.
new text end

new text begin (e) The commissioner of human services shall allocate $150,000 in fiscal year 2022
from the child care and development block grant to develop recommendations for
implementing a family supports and improvement program.
new text end

new text begin (f) The commissioner of human services shall allocate $1,000,000 in fiscal year 2022
from the child care and development block grant for REETAIN grants under Minnesota
Statutes, section 119B.195.
new text end

new text begin (g) The commissioner of human services shall allocate $2,000,000 in fiscal year 2022
from the child care and development block grant for the TEACH program under Minnesota
Statutes, section 136A.128.
new text end

new text begin (h) The commissioner of human services shall allocate $304,398,000 in fiscal year 2022
from the federal fund for child care stabilization grants, including up to $5,000,000 for
administration.
new text end

new text begin (i) The commissioner of human services shall allocate $200,000 in fiscal year 2022 from
the federal fund for the shared services pilot program for family child care providers.
new text end

new text begin (j) The commissioner of human services shall allocate $290,000 in fiscal year 2022 from
the child care and development block grant for a report on participation in early care and
education programs by children in foster care.
new text end

new text begin (k) The commissioner of human services shall allocate $3,500,000 in fiscal year 2022
from the child care and development block grant for the commissioner of human services
to administer the child care and development block grant allocations in this act.
new text end

new text begin (l) The allocations in this section are available until June 30, 2025.
new text end

Sec. 24. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall renumber Minnesota Statutes, section 136A.128, in Minnesota
Statutes, chapter 119B. The revisor shall also make necessary cross-reference changes
consistent with the renumbering.
new text end

ARTICLE 15

REINSURANCE

Section 1.

Laws 2017, chapter 13, article 1, section 15, as amended by Laws 2017, First
Special Session chapter 6, article 5, section 10, and Laws 2019, First Special Session chapter
9, article 8, section 19, is amended to read:

Sec. 15. MINNESOTA PREMIUM SECURITY PLAN FUNDING.

(a) The Minnesota Comprehensive Health Association shall fund the operational and
administrative costs and reinsurance payments of the Minnesota security plan and association
using the following amounts deposited in the premium security plan account in Minnesota
Statutes, section 62E.25, subdivision 1, in the following order:

(1) any federal funding available;

(2) funds deposited under article 1, sections 12 and 13;

(3) any state funds from the health care access fund; and

(4) any state funds from the general fund.

(b) The association shall transfer from the premium security plan account any remaining
state funds not used for the Minnesota premium security plan by June 30, deleted text begin 2023 deleted text end new text begin 2024 new text end , to the
commissioner of commerce. Any amount transferred to the commissioner of commerce
shall be deposited in the health care access fund in Minnesota Statutes, section 16A.724.

(c) The Minnesota Comprehensive Health Association may not spend more than
$271,000,000 for benefit year 2018 and not more than $271,000,000 for benefit year 2019
for the operational and administrative costs of, and reinsurance payments under, the
Minnesota premium security plan.

Sec. 2. new text begin MINNESOTA PREMIUM SECURITY PLAN ADMINISTERED THROUGH
THE 2022 BENEFIT YEAR.
new text end

new text begin (a) The Minnesota Comprehensive Health Association must administer the Minnesota
premium security plan through the 2022 benefit year.
new text end

new text begin (b) Notwithstanding Minnesota Statutes, section 62E.23, the Minnesota premium security
plan payment parameters for benefit year 2022 are:
new text end

new text begin (1) an attachment point of $50,000;
new text end

new text begin (2) a coinsurance rate of 60 percent; and
new text end

new text begin (3) a reinsurance cap of $250,000.
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. new text begin PLAN YEAR 2022 PROPOSED RATE FILINGS FOR THE INDIVIDUAL
MARKET.
new text end

new text begin The rate filing deadline for individual health plans, as defined in Minnesota Statutes,
section 62E.21, subdivision 9, to be offered, issued, sold, or renewed on or after January 1,
2022, is July 9, 2021. Eligible health carriers under Minnesota Statutes, section 62E.21,
subdivision 8, filing individual health plans to be offered, issued, sold, or renewed for benefit
year 2022 shall include the impact of the Minnesota premium security plan payment
parameters in the proposed individual health plan rates. Notwithstanding Minnesota Statutes,
section 60A.08, subdivision 15, paragraph (g), the commissioner must provide public access
on the Department of Commerce's website to compiled data of the proposed changes to
rates for individual health plans and small group health plans, as defined in Minnesota
Statutes, section 62K.03, subdivision 12, separated by health plan and geographic rating
area, no later than July 23, 2021.
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. 4. new text begin CONTINUATION OF STATE INNOVATION WAIVER.
new text end

new text begin The commissioner of commerce shall apply to the secretary of health and human services
under United States Code, title 42, section 18052, for a continuation of the state innovation
waiver previously granted to implement the Minnesota premium security plan for benefit
years beginning January 1, 2023, to maximize federal funding. The commissioner must
submit the application by December 31, 2021. The waiver application must clearly state
that operation of the Minnesota premium security plan after the 2022 benefit year is
contingent on approval of the waiver request.
new text end

Sec. 5. new text begin TRANSFERS; REINSURANCE.
new text end

new text begin (a) The commissioner of management and budget shall transfer $79,101,000 from the
general fund to the health care access fund by June 30, 2023, for state basic health plan
costs related to the loss of federal revenue associated with a reinsurance plan. This is a
onetime transfer.
new text end

new text begin (b) The commissioner of commerce shall transfer $5,948,000 from the premium security
plan account, authorized in Minnesota Statutes, section 62E.25, subdivision 1, to the health
care access fund by June 30, 2023, for state basic health plan costs related to the loss of
federal revenue associated with a reinsurance plan. This is a onetime transfer.
new text end

new text begin (c) The commissioner of management and budget shall transfer $3,844,000 in fiscal year
2022 from the general fund to the MNsure account established under Minnesota Statutes,
section 62V.07. This is a onetime transfer.
new text end

new text begin (d) The commissioner of human services, in consultation with the commissioners of
commerce and management and budget, shall review the federal funding for the state basic
health plan to determine whether federal funding for the plan has been modified to account
for changes in the benchmark premium due to the Minnesota premium security plan
authorized in section 2 for calendar year 2022.
new text end

new text begin (e) The commissioner shall conduct the review in paragraph (d) prior to the February
2022 and November 2022 state budget forecasts. If the commissioner determines the federal
funding for the state basic health plan has been modified, the commissioner shall estimate
the loss of federal funding for the basic health plan after the modification. The commissioner
of management and budget must adjust the February 2022 and November 2022 state budget
forecasts based on the findings of this review, according to this section.
new text end

new text begin (f) If the commissioner determines that the reduction of federal funding for the basic
health plan in paragraph (d) is less than $85,049,000, the commissioner of management and
budget shall transfer the difference between $85,049,000 and the estimated reduction in
federal funding from the health care access fund to the general fund and the premium security
plan account in amounts proportional to the transfers in paragraphs (a) and (b). These
transfers are onetime and must be made by June 30, 2023.
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. 6. new text begin APPROPRIATIONS; REINSURANCE.
new text end

new text begin (a) $155,000 is appropriated in fiscal year 2022 from the general fund to the commissioner
of commerce to prepare and submit the state innovation waiver renewal. This is a onetime
appropriation.
new text end

new text begin (b) $41,393,000 in fiscal year 2022 and $43,656,000 in fiscal year 2023 are appropriated
from the health care access fund to the commissioner of human services for MinnesotaCare
program costs. These are onetime appropriations.
new text end

ARTICLE 16

APPROPRIATIONS

Section 1. new text begin HEALTH AND HUMAN SERVICES APPROPRIATIONS. new text end

new text begin The sums shown in the columns marked "Appropriations" are appropriated to the agencies
and for the purposes specified in this article. The appropriations are from the general fund,
or another 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 appropriations listed under
them are available for the fiscal year 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 begin COMMISSIONER 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 8,356,760,000 new text end

new text begin $ new text end

new text begin 9,803,181,000 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 7,295,463,000 new text end	new text begin 8,951,733,000 new text end
new text begin State Government Special Revenue new text end	new text begin 4,299,000 new text end	new text begin 4,299,000 new text end
new text begin Health Care Access new text end	new text begin 769,889,000 new text end	new text begin 564,448,000 new text end
new text begin Federal TANF new text end	new text begin 282,653,000 new text end	new text begin 278,245,000 new text end
new text begin Lottery Prize new text end	new text begin 1,896,000 new text end	new text begin 1,896,000 new text end
new text begin Opiate Epidemic Response new text end	new text begin 2,560,000 new text end	new text begin 2,560,000 new text end

new text begin 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 TANF Maintenance of Effort new text end

new text begin (a) Nonfederal Expenditures. The
commissioner shall ensure that sufficient
qualified nonfederal expenditures are made
each year to meet the state's maintenance of
effort (MOE) requirements of the TANF block
grant specified under Code of Federal
Regulations, title 45, section 263.1. In order
to meet these basic TANF/MOE requirements,
the commissioner may report as TANF/MOE
expenditures only nonfederal money expended
for allowable activities listed in the following
clauses:
new text end

new text begin (1) MFIP cash, diversionary work program,
and food assistance benefits under Minnesota
Statutes, chapter 256J;
new text end

new text begin (2) the child care assistance programs under
Minnesota Statutes, sections 119B.03 and
119B.05, and county child care administrative
costs under Minnesota Statutes, section
119B.15;
new text end

new text begin (3) state and county MFIP administrative costs
under Minnesota Statutes, chapters 256J and
256K;
new text end

new text begin (4) state, county, and tribal MFIP employment
services under Minnesota Statutes, chapters
256J and 256K;
new text end

new text begin (5) expenditures made on behalf of legal
noncitizen MFIP recipients who qualify for
the MinnesotaCare program under Minnesota
Statutes, chapter 256L;
new text end

new text begin (6) qualifying working family credit
expenditures under Minnesota Statutes, section
290.0671;
new text end

new text begin (7) qualifying Minnesota education credit
expenditures under Minnesota Statutes, section
290.0674; and
new text end

new text begin (8) qualifying Head Start expenditures under
Minnesota Statutes, section 119A.50.
new text end

new text begin (b) Nonfederal Expenditures; Reporting.
For the activities listed in paragraph (a),
clauses (2) to (8), the commissioner may
report only expenditures that are excluded
from the definition of assistance under Code
of Federal Regulations, title 45, section
260.31.
new text end

new text begin (c) Limitation; Exceptions. The
commissioner must not claim an amount of
TANF/MOE in excess of the 75 percent
standard in Code of Federal Regulations, title
45, section 263.1(a)(2), except:
new text end

new text begin (1) to the extent necessary to meet the 80
percent standard under Code of Federal
Regulations, title 45, section 263.1(a)(1), if it
is determined by the commissioner that the
state will not meet the TANF work
participation target rate for the current year;
new text end

new text begin (2) to provide any additional amounts under
Code of Federal Regulations, title 45, section
264.5, that relate to replacement of TANF
funds due to the operation of TANF penalties;
and
new text end

new text begin (3) to provide any additional amounts that may
contribute to avoiding or reducing TANF work
participation penalties through the operation
of the excess MOE provisions of Code of
Federal Regulations, title 45, section
261.43(a)(2).
new text end

new text begin (d) Supplemental Expenditures. For the
purposes of paragraph (d), the commissioner
may supplement the MOE claim with working
family credit expenditures or other qualified
expenditures to the extent such expenditures
are otherwise available after considering the
expenditures allowed in this subdivision.
new text end

new text begin (e) Reduction of Appropriations; Exception.
The requirement in Minnesota Statutes, section
256.011, subdivision 3, that federal grants or
aids secured or obtained under that subdivision
be used to reduce any direct appropriations
provided by law, does not apply if the grants
or aids are federal TANF funds.
new text end

new text begin (f) IT Appropriations Generally. This
appropriation includes funds for information
technology projects, services, and support.
Notwithstanding Minnesota Statutes, section
16E.0466, funding for information technology
project costs shall be incorporated into the
service level agreement and paid to the Office
of MN.IT Services by the Department of
Human Services under the rates and
mechanism specified in that agreement.
new text end

new text begin (g) Receipts for Systems Project.
Appropriations and federal receipts for
information technology systems projects for
MAXIS, PRISM, MMIS, ISDS, METS, and
SSIS must be deposited in the state systems
account authorized in Minnesota Statutes,
section 256.014. Money appropriated for
information technology projects approved by
the commissioner of the Office of MN.IT
Services, funded by the legislature, and
approved by the commissioner of management
and budget may be transferred from one
project to another and from development to
operations as the commissioner of human
services considers necessary. Any unexpended
balance in the appropriation for these projects
does not cancel and is available for ongoing
development and operations.
new text end

new text begin (h) Federal SNAP Education and Training
Grants. Federal funds available during fiscal
years 2022 and 2023 for Supplemental
Nutrition Assistance Program Education and
Training and SNAP Quality Control
Performance Bonus grants are appropriated
to the commissioner of human services for the
purposes allowable under the terms of the
federal award. This paragraph is effective the
day following final enactment.
new text end

new text begin Subd. 3. new text end new text begin Central Office; Operations new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 177,263,000 new text end	new text begin 172,772,000 new text end
new text begin State Government Special Revenue new text end	new text begin 4,174,000 new text end	new text begin 4,174,000 new text end
new text begin Health Care Access new text end	new text begin 16,966,000 new text end	new text begin 16,966,000 new text end
new text begin Federal TANF new text end	new text begin 131,000 new text end	new text begin 100,000 new text end

new text begin (a) Administrative Recovery; Set-Aside. The
commissioner may invoice local entities
through the SWIFT accounting system as an
alternative means to recover the actual cost of
administering the following provisions:
new text end

new text begin (1) Minnesota Statutes, section 125A.744,
subdivision 3;
new text end

new text begin (2) Minnesota Statutes, section 245.495,
paragraph (b);
new text end

new text begin (3) Minnesota Statutes, section 256B.0625,
subdivision 20, paragraph (k);
new text end

new text begin (4) Minnesota Statutes, section 256B.0924,
subdivision 6, paragraph (g);
new text end

new text begin (5) Minnesota Statutes, section 256B.0945,
subdivision 4, paragraph (d); and
new text end

new text begin (6) Minnesota Statutes, section 256F.10,
subdivision 6, paragraph (b).
new text end

new text begin (b) Background Studies. (1) $2,074,000 in
fiscal year 2022 is from the general fund to
provide a credit to providers who paid for
emergency background studies in NETStudy
2.0.
new text end

new text begin (2) $2,060,000 in fiscal year 2022 is from the
general fund for the costs of reprocessing
emergency studies conducted under
interagency agreements.
new text end

new text begin (c) Family Foster Setting Background
Studies. $431,000 in fiscal year 2022 and
$453,000 in fiscal year 2023 are from the
general fund for implementing licensed family
foster setting background study requirements.
The general fund base for this appropriation
is $225,000 in fiscal year 2024 and $225,000
in fiscal year 2025.
new text end

new text begin (d) Cultural and Ethnic Communities
Leadership Council. $18,000 in fiscal year
2022 and $62,000 in fiscal year 2023 are from
the general fund for the Cultural and Ethnic
Communities Leadership Council.
new text end

new text begin (e) Base Level Adjustment. The general fund
base is $163,715,000 in fiscal year 2024 and
$163,180,000 in fiscal year 2025.
new text end

new text begin Subd. 4. new text end new text begin Central Office; Children and Families new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 18,295,000 new text end	new text begin 18,370,000 new text end
new text begin Federal TANF new text end	new text begin 2,582,000 new text end	new text begin 2,582,000 new text end

new text begin (a) Financial Institution Data Match and
Payment of Fees. The commissioner is
authorized to allocate up to $310,000 in fiscal
year 2022 and $310,000 in fiscal year 2023
from the systems special revenue account to
make payments to financial institutions in
exchange for performing data matches
between account information held by financial
institutions and the public authority's database
of child support obligors as authorized by
Minnesota Statutes, section 13B.06,
subdivision 7.
new text end

new text begin (b) Indian Child Welfare Training.
$1,012,000 in fiscal year 2022 and $993,000
in fiscal year 2023 are from the general fund
for establishment and operation of the Tribal
Training and Certification Partnership at the
University of Minnesota, Duluth campus, to
provide training, establish federal Indian Child
Welfare Act and Minnesota Indian Family
Preservation Act training requirements for
county child welfare workers, and develop
Indigenous child welfare training for American
Indian Tribes. The general fund base for this
appropriation is $1,053,000 in fiscal year 2024
and $1,053,000 in fiscal year 2025.
new text end

new text begin (c) Base Level Adjustment. The general fund
base is $18,640,000 in fiscal year 2024 and
$18,640,000 in fiscal year 2025.
new text end

new text begin Subd. 5. new text end new text begin Central Office; Health Care new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 26,397,000 new text end	new text begin 24,804,000 new text end
new text begin Health Care Access new text end	new text begin 30,168,000 new text end	new text begin 28,168,000 new text end

new text begin Base Level Adjustment. The general fund
base is $24,415,000 in fiscal year 2024 and
$23,557,000 in fiscal year 2025.
new text end

new text begin Subd. 6. new text end new text begin Central Office; Continuing Care for Older Adults new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 21,988,000 new text end	new text begin 22,132,000 new text end
new text begin State Government Special Revenue new text end	new text begin 125,000 new text end	new text begin 125,000 new text end

new text begin (a) Resident Experience Survey and Family
Survey for Housing with Services
Establishments and Assisted Living
Facilities. $2,593,000 in fiscal year 2022 and
$2,593,000 in fiscal year 2023 are from the
general fund for development and
administration of a resident experience survey
and family survey for all housing with services
establishments and assisted living facilities.
These appropriations are available in either
year of the biennium.
new text end

new text begin (b) new text begin Base Level Adjustment. new text end The general fund
base is $21,198,000 in fiscal year 2024 and
$19,279,000 in fiscal year 2025.
new text end

new text begin Subd. 7. new text end new text begin Central Office; Community Supports new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 41,767,000 new text end	new text begin 42,015,000 new text end
new text begin Lottery Prize new text end	new text begin 163,000 new text end	new text begin 163,000 new text end
new text begin Opioid Epidemic Response new text end	new text begin 60,000 new text end	new text begin 60,000 new text end

new text begin (a) Children's Mental Health Residential
Treatment Work Group. $70,000 in fiscal
year 2022 is for the children's mental health
residential treatment work group.
new text end

new text begin (b) new text begin Base Level Adjustment. new text end The general fund
base is $39,668,000 in fiscal year 2024 and
$35,479,000 in fiscal year 2025. The opiate
epidemic response fund base is $60,000 in
fiscal year 2024 and $0 in fiscal year 2025.
new text end

new text begin Subd. 8. 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 92,588,000 new text end	new text begin 91,366,000 new text end
new text begin Federal TANF new text end	new text begin 104,285,000 new text end	new text begin 100,852,000 new text end

new text begin Subd. 9. new text end new text begin Forecasted Programs; MFIP Child Care Assistance new text end

new text begin 103,347,000 new text end

new text begin 110,695,000 new text end

new text begin Subd. 10. new text end new text begin Forecasted Programs; General Assistance new text end

new text begin 53,574,000 new text end

new text begin 52,785,000 new text end

new text begin (a) General Assistance Standard. The
commissioner shall set the monthly standard
of assistance for general assistance units
consisting of an adult recipient who is
childless and unmarried or living apart from
parents or a legal guardian at $203. The
commissioner may reduce this amount
according to Laws 1997, chapter 85, article 3,
section 54.
new text end

new text begin (b) Emergency General Assistance Limit.
The amount appropriated for emergency
general assistance is limited to no more than
$6,729,812 in fiscal year 2022 and $6,729,812
in fiscal year 2023. Funds to counties shall be
allocated by the commissioner using the
allocation method under Minnesota Statutes,
section 256D.06.
new text end

new text begin Subd. 11. new text end new text begin Forecasted Programs; Minnesota Supplemental Aid new text end

new text begin 51,779,000 new text end

new text begin 52,486,000 new text end

new text begin Subd. 12. new text end new text begin Forecasted Programs; Housing Support new text end

new text begin 183,358,000 new text end

new text begin 192,440,000 new text end

new text begin Subd. 13. new text end new text begin Forecasted Programs; Northstar Care for Children new text end

new text begin 110,583,000 new text end

new text begin 121,246,000 new text end

new text begin Subd. 14. new text end new text begin Forecasted Programs; MinnesotaCare new text end

new text begin 114,612,000 new text end

new text begin 162,584,000 new text end

new text begin This appropriation is from the health care
access fund.
new text end

new text begin Subd. 15. new text end new text begin Forecasted Programs; Medical Assistance new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 5,415,163,000 new text end	new text begin 6,981,559,000 new text end
new text begin Health Care Access new text end	new text begin 602,596,000 new text end	new text begin 353,265,000 new text end

new text begin (a) Behavioral Health Services. $1,000,000
in fiscal year 2022 and $1,000,000 in fiscal
year 2023 are from the general fund for
behavioral health services provided by
hospitals identified under Minnesota Statutes,
section 256.969, subdivision 2b, paragraph
(a), clause (4). The increase in payments shall
be made by increasing the adjustment under
Minnesota Statutes, section 256.969,
subdivision 2b, paragraph (e), clause (2).
new text end

new text begin (b) Base Level Adjustment. The health care
access fund base is $869,524,000 in fiscal year
2024 and $612,099,000 in fiscal year 2025.
new text end

new text begin Subd. 16. new text end new text begin Forecasted Programs; Alternative Care new text end

new text begin 35,227,000 new text end

new text begin 45,922,000 new text end

new text begin new text begin Alternative Care Transfer. new text end Any money
allocated to the alternative care program that
is not spent for the purposes indicated does
not cancel but must be transferred to the
medical assistance account.
new text end

new text begin Subd. 17. new text end new text begin Forecasted Programs; Behavioral Health Fund new text end

new text begin 95,923,000 new text end

new text begin 119,125,000 new text end

new text begin Subd. 18. new text end new text begin Grant Programs; Support Services Grants new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 8,715,000 new text end	new text begin 8,715,000 new text end
new text begin Federal TANF new text end	new text begin 96,311,000 new text end	new text begin 96,311,000 new text end

new text begin Subd. 19. new text end new text begin Grant Programs; BSF Child Care Grants new text end

new text begin 53,350,000 new text end

new text begin 53,362,000 new text end

new text begin Base Level Adjustment. The general fund
base is $53,366,000 in fiscal year 2024 and
$53,366,000 in fiscal year 2025.
new text end

new text begin Subd. 20. new text end new text begin Grant Programs; Child Care Development Grants new text end

new text begin 1,737,000 new text end

new text begin 1,737,000 new text end

new text begin Subd. 21. new text end new text begin Grant Programs; Child Support Enforcement Grants new text end

new text begin 50,000 new text end

new text begin 50,000 new text end

new text begin Subd. 22. new text end new text begin Grant Programs; Children's Services Grants new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 52,653,000 new text end	new text begin 52,368,000 new text end
new text begin Federal TANF new text end	new text begin 140,000 new text end	new text begin 140,000 new text end

new text begin (a) Title IV-E Adoption Assistance. (1) The
commissioner shall allocate funds from the
Title IV-E reimbursement to the state from
the Fostering Connections to Success and
Increasing Adoptions Act for adoptive, foster,
and kinship families as required in Minnesota
Statutes, section 256N.261.
new text end

new text begin (2) Additional federal reimbursement to the
state as a result of the Fostering Connections
to Success and Increasing Adoptions Act's
expanded eligibility for Title IV-E adoption
assistance is for postadoption, foster care,
adoption, and kinship services, including a
parent-to-parent support network.
new text end

new text begin (b) Initial Implementation of
Court-Appointed Counsel in Child
Protection Proceedings. $520,000 in fiscal
year 2022 and $520,000 in fiscal year 2023
are from the general fund for county costs,
including administrative costs to obtain Title
IV-E federal reimbursement, related to
court-appointed counsel in child protection
proceedings pursuant to Minnesota Statutes,
section 260C.163, subdivision 3. The
commissioner shall distribute funds to counties
based upon their proportional share of
emergency protective care hearings averaged
over the previous three years. Beginning in
fiscal year 2024, the distribution formula shall
be based upon the formula recommended by
the commissioner in the required legislative
report regarding initial implementation of
court-appointed counsel in child protection
proceedings.
new text end

new text begin Subd. 23. new text end new text begin Grant Programs; Children and Community Service Grants new text end

new text begin 61,251,000 new text end

new text begin 61,856,000 new text end

new text begin Subd. 24. new text end new text begin Grant Programs; Children and Economic Support Grants new text end

new text begin 29,740,000 new text end

new text begin 29,740,000 new text end

new text begin Minnesota 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 end

new text begin Subd. 25. new text end new text begin Grant Programs; Health Care Grants new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 4,811,000 new text end	new text begin 4,811,000 new text end
new text begin Health Care Access new text end	new text begin 5,547,000 new text end	new text begin 3,465,000 new text end

new text begin Onetime Grants for Navigator
Organizations. $2,082,000 in fiscal year 2022
is from the health care access fund for grants
to organizations with a MNsure grant services
navigator assister contract in good standing
as of June 30, 2021. The grants to each
organization must be in proportion to the
number of Medical Assistance and
MinnesotaCare enrollees each organization
assisted that resulted in a successful
enrollment in the second quarter of fiscal year
2020, as determined by MNsure's navigator
payment process.
new text end

new text begin Subd. 26. new text end new text begin Grant Programs; Other Long-Term Care Grants new text end

new text begin 10,608,000 new text end

new text begin 19,513,000 new text end

new text begin Base Level Adjustment. new text end new text begin The general fund
base is $19,013,000 in fiscal year 2024 and
$1,925,000 in fiscal year 2025.
new text end

new text begin Subd. 27. new text end new text begin Grant Programs; Aging and Adult Services Grants new text end

new text begin 32,995,000 new text end

new text begin 34,445,000 new text end

new text begin Base Level Adjustment. The general fund
base is $34,445,000 in fiscal year 2024 and
$32,995,000 in fiscal year 2025.
new text end

new text begin Subd. 28. new text end new text begin Grant Programs; Deaf and Hard-of-Hearing Grants new text end

new text begin 2,886,000 new text end

new text begin 2,886,000 new text end

new text begin Subd. 29. new text end new text begin Grant Programs; Disabilities Grants new text end

new text begin 31,398,000 new text end

new text begin 31,010,000 new text end

new text begin (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.
new text end

new text begin (b) new text begin Parent-to-Parent Peer Support. new text end $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.
new text end

new text begin (c) new text begin Self-Advocacy Grants. new text end (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.
new text end

new text begin (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.
new text end

new text begin (d) new text begin Minnesota Inclusion Initiative Grants. new text end
$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.
new text end

new text begin (e) new text begin Grants to Expand Access to Child Care
for Children with Disabilities. new text end $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.
new text end

new text begin (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.
new text end

new text begin (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 end

new text begin Subd. 30. new text end new text begin Grant Programs; Housing Support Grants new text end

new text begin 19,364,000 new text end

new text begin 19,364,000 new text end

new text begin Base Level Adjustment The general fund
base is $18,364,000 in fiscal year 2024 and
$10,364,000 in fiscal year 2025.
new text end

new text begin Subd. 31. new text end new text begin Grant Programs; Adult Mental Health Grants new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 98,772,000 new text end	new text begin 98,703,000 new text end
new text begin Opiate Epidemic Response new text end	new text begin 2,000,000 new text end	new text begin 2,000,000 new text end

new text begin (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. The general fund base for this
appropriation is $1,655,000 in fiscal year 2024
and $0 in fiscal year 2025.
new text end

new text begin (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 end

new text begin Subd. 32. new text end new text begin Grant Programs; Child Mental Health Grants new text end

new text begin 30,167,000 new text end

new text begin 30,182,000 new text end

new text begin (a) Children's Residential Facilities.
$1,964,000 in fiscal year 2022 and $1,979,000
in fiscal year 2023 are to reimburse counties
and Tribal governments for a portion of the
costs of treatment in children's residential
facilities. The commissioner shall distribute
the appropriation on an annual basis to
counties and Tribal governments
proportionally based on a methodology
developed by the commissioner.
new text end

new text begin (b) new text begin Base Level Adjustment. new text end The general fund
base is $29,580,000 in fiscal year 2024 and
$27,705,000 in fiscal year 2025.
new text end

new text begin Subd. 33. new text end new text begin Grant Programs; Chemical Dependency Treatment Support Grants new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 4,273,000 new text end	new text begin 4,274,000 new text end
new text begin Lottery Prize new text end	new text begin 1,733,000 new text end	new text begin 1,733,000 new text end
new text begin Opiate Epidemic Response new text end	new text begin 500,000 new text end	new text begin 500,000 new text end

new text begin (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.
new text end

new text begin (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
new text end

new text begin (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 end

new text begin Subd. 34. new text end new text begin Direct Care and Treatment - Transfer Authority new text end

new text begin Money appropriated for budget activities under
subdivisions 35 to 38 may be transferred
between budget activities and between years
of the biennium with the approval of the
commissioner of management and budget.
new text end

new text begin Subd. 35. new text end new text begin Direct Care and Treatment - Mental Health and Substance Abuse new text end

new text begin 137,934,000 new text end

new text begin 146,710,000 new text end

new text begin (a) Transfer Authority. Money appropriated
to support the continued operations of the
Community Addiction Recovery Enterprise
(C.A.R.E.) program may be transferred to the
enterprise fund for C.A.R.E.
new text end

new text begin (b) Operating Adjustment. $2,594,000 in
fiscal year 2023 is for the Community
Addiction Recovery Enterprise program. The
commissioner may transfer $2,594,000 in
fiscal year 2023 to the enterprise fund for
Community Addiction Recovery Enterprise.
new text end

new text begin Subd. 36. new text end new text begin Direct Care and Treatment - Community-Based Services new text end

new text begin 17,292,000 new text end

new text begin 19,789,000 new text end

new text begin (a) Transfer Authority. Money appropriated
to support the continued operations of the
Minnesota State Operated Community
Services (MSOCS) program may be
transferred to the enterprise fund for MSOCS.
new text end

new text begin (b) Operating Adjustment. $2,381,000 in
fiscal year 2023 is for the Minnesota State
Operated Community Services program. The
commissioner may transfer $2,381,000 in
fiscal year 2023 to the enterprise fund for
Minnesota State Operated Community
Services.
new text end

new text begin Subd. 37. new text end new text begin Direct Care and Treatment - Forensic Services new text end

new text begin 119,206,000 new text end

new text begin 124,415,000 new text end

new text begin Subd. 38. new text end new text begin Direct Care and Treatment - Sex Offender Program new text end

new text begin 97,585,000 new text end

new text begin 101,672,000 new text end

new text begin new text begin Transfer Authority. new text end Money appropriated for
the Minnesota sex offender program may be
transferred between fiscal years of the
biennium with the approval of the
commissioner of management and budget.
new text end

new text begin Subd. 39. new text end new text begin Direct Care and Treatment - Operations new text end

new text begin 53,424,000 new text end

new text begin 58,414,000 new text end

new text begin Subd. 40. new text end new text begin Technical Activities new text end

new text begin 79,204,000 new text end

new text begin 78,260,000 new text end

new text begin (a) This appropriation is from the federal
TANF fund.
new text end

new text begin (b) Base Level Adjustment. The TANF fund
base is $71,493,000 in fiscal year 2024 and
$71,493,000 in fiscal year 2025.
new text end

Sec. 3. new text begin COMMISSIONER 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 282,967,000 new text end

new text begin $ new text end

new text begin 283,702,000 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 162,464,000 new text end	new text begin 161,977,000 new text end
new text begin State Government Special Revenue new text end	new text begin 71,278,000 new text end	new text begin 73,180,000 new text end
new text begin Health Care Access new text end	new text begin 37,512,000 new text end	new text begin 36,832,000 new text end
new text begin Federal TANF new text end	new text begin 11,713,000 new text end	new text begin 11,713,000 new text end

new text begin 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 Health Improvement new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 123,714,000 new text end	new text begin 124,000,000 new text end
new text begin State Government Special Revenue new text end	new text begin 11,967,000 new text end	new text begin 11,290,000 new text end
new text begin Health Care Access new text end	new text begin 37,512,000 new text end	new text begin 36,832,000 new text end
new text begin Federal TANF new text end	new text begin 11,713,000 new text end	new text begin 11,713,000 new text end

new text begin (a) TANF Appropriations. (1) $3,579,000 in
fiscal year 2022 and $3,579,000 in fiscal year
2023 are from the TANF fund for home
visiting and nutritional services listed under
Minnesota Statutes, section 145.882,
subdivision 7, clauses (6) and (7). Funds must
be distributed to community health boards
according to Minnesota Statutes, section
145A.131, subdivision 1;
new text end

new text begin (2) $2,000,000 in fiscal year 2022 and
$2,000,000 in fiscal year 2023 are from the
TANF fund for decreasing racial and ethnic
disparities in infant mortality rates under
Minnesota Statutes, section 145.928,
subdivision 7;
new text end

new text begin (3) $4,978,000 in fiscal year 2022 and
$4,978,000 in fiscal year 2023 are from the
TANF fund for the family home visiting grant
program according to Minnesota Statutes,
section 145A.17. $4,000,000 of the funding
in each fiscal year must be distributed to
community health boards according to
Minnesota Statutes, section 145A.131,
subdivision 1. $978,000 of the funding in each
fiscal year must be distributed to tribal
governments according to Minnesota Statutes,
section 145A.14, subdivision 2a;
new text end

new text begin (4) $1,156,000 in fiscal year 2022 and
$1,156,000 in fiscal year 2023 are from the
TANF fund for family planning grants under
Minnesota Statutes, section 145.925; and
new text end

new text begin (5) the commissioner may use up to 6.23
percent of the funds appropriated from the
TANF fund each fiscal year to conduct the
ongoing evaluations required under Minnesota
Statutes, section 145A.17, subdivision 7, and
training and technical assistance as required
under Minnesota Statutes, section 145A.17,
subdivisions 4 and 5.
new text end

new text begin (b) TANF Carryforward. Any unexpended
balance of the TANF appropriation in the first
year of the biennium does not cancel but is
available for the second year.
new text end

new text begin (c) Tribal Public Health Grants. $500,000
in fiscal year 2022 and $500,000 in fiscal year
2023 are from the general fund for Tribal
public health grants under Minnesota Statutes,
section 145A.14, for public health
infrastructure projects as defined by the Tribal
government.
new text end

new text begin (d) Public Health Infrastructure Funds.
$6,000,000 in fiscal year 2022 and $6,000,000
in fiscal year 2023 are from the general fund
for public health infrastructure funds to
distribute to community health boards and
Tribal governments to support their ability to
meet national public health standards.
new text end

new text begin (e) Public Health System Assessment and
Oversight. $1,500,000 in fiscal year 2022 and
$1,500,000 in fiscal year 2023 are from the
general fund for the commissioner to assess
the capacity of the public health system to
meet national public health standards and
oversee public health system improvement
efforts.
new text end

new text begin (f) Health Professional Education Loan
Forgiveness. Notwithstanding the priorities
and distribution requirements under Minnesota
Statutes, section 144.1501, $3,000,000 in
fiscal year 2022 and $3,000,000 in fiscal year
2023 are from the general fund for loan
forgiveness under article 3, section 43, for
individuals who are eligible alcohol and drug
counselors, eligible medical residents, or
eligible mental health professionals, as defined
in article 3, section 43. The general fund base
for this appropriation is $2,625,000 in fiscal
year 2024 and $0 in fiscal year 2025. The
health care access fund base for this
appropriation is $875,000 in fiscal year 2024,
$3,500,000 in fiscal year 2025, and $0 in fiscal
year 2026. The general fund amounts in this
paragraph are available until March 31, 2024.
This paragraph expires on April 1, 2024.
new text end

new text begin (g) Mental Health Cultural Community
Continuing Education Grant Program.
$500,000 in fiscal year 2022 and $500,000 in
fiscal year 2023 are from the general fund for
the mental health cultural community
continuing education grant program. This is
a onetime appropriation
new text end

new text begin (h) Birth Records; Homeless Youth. $72,000
in fiscal year 2022 and $32,000 in fiscal year
2023 are from the state government special
revenue fund for administration and issuance
of certified birth records and statements of no
vital record found to homeless youth under
Minnesota Statutes, section 144.2255.
new text end

new text begin (i) Supporting Healthy Development of
Babies During Pregnancy and Postpartum.
$260,000 in fiscal year 2022 and $260,000 in
fiscal year 2023 are from the general fund for
a grant to the Amherst H. Wilder Foundation
for the African American Babies Coalition
initiative for community-driven training and
education on best practices to support healthy
development of babies during pregnancy and
postpartum. Grant funds must be used to build
capacity in, train, educate, or improve
practices among individuals, from youth to
elders, serving families with members who
are Black, indigenous, or people of color,
during pregnancy and postpartum. This is a
onetime appropriation and is available until
June 30, 2023.
new text end

new text begin (j) Dignity in Pregnancy and Childbirth.
$494,000 in fiscal year 2022 and $200,000 in
fiscal year 2023 are from the general fund for
purposes of Minnesota Statutes, section
144.1461. Of this appropriation: (1) $294,000
in fiscal year 2022 is for a grant to the
University of Minnesota School of Public
Health's Center for Antiracism Research for
Health Equity, to develop a model curriculum
on anti-racism and implicit bias for use by
hospitals with obstetric care and birth centers
to provide continuing education to staff caring
for pregnant or postpartum women. The model
curriculum must be evidence-based and must
meet the criteria in Minnesota Statutes, section
144.1461, subdivision 2, paragraph (a); and
(2) $200,000 in fiscal year 2022 and $200,000
in fiscal year 2023 are for purposes of
Minnesota Statutes, section 144.1461,
subdivision 3.
new text end

new text begin (k) Congenital Cytomegalovirus (CMV). (1)
$196,000 in fiscal year 2022 and $196,000 in
fiscal year 2023 are from the general fund for
outreach and education on congenital
cytomegalovirus (CMV) under Minnesota
Statutes, section 144.064.
new text end

new text begin (2) Contingent on the Advisory Committee on
Heritable and Congenital Disorders
recommending and the commissioner of health
approving inclusion of CMV in the newborn
screening panel in accordance with Minnesota
Statutes, section 144.065, subdivision 3,
paragraph (d), $656,000 in fiscal year 2023 is
from the state government special revenue
fund for follow-up services.
new text end

new text begin (l) Nonnarcotic Pain Management and
Wellness. $649,000 in fiscal year 2022 is from
the general fund for nonnarcotic pain
management and wellness in accordance with
Laws 2019, chapter 63, article 3, section 1,
paragraph (n).
new text end

new text begin (m) Base Level Adjustments. The general
fund base is $120,451,000 in fiscal year 2024
and $115,594,000 in fiscal year 2025. The
health care access fund base is $38,385,000
in fiscal year 2024 and $40,644,000 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 27,180,000 new text end	new text begin 26,398,000 new text end
new text begin State Government Special Revenue new text end	new text begin 59,311,000 new text end	new text begin 61,890,000 new text end

new text begin (a) new text begin Congenital Cytomegalovirus (CMV). new text end
Contingent on the Advisory Committee on
Heritable and Congenital Disorders
recommending and the commissioner of health
approving inclusion of congenital
cytomegalovirus (CMV) in the newborn
screening panel in accordance with Minnesota
Statutes, section 144.064, subdivision 3,
paragraph (d), $2,195,000 in fiscal year 2023
is from the state government special revenue
fund for screening services. The state
government special revenue fund base for this
appropriation is $1,644,000 in fiscal year 2024
and $1,644,000 in fiscal year 2025.
new text end

new text begin (b) Transfer; Public Health Response
Contingency Account. The commissioner of
health shall transfer $300,000 in fiscal year
2022 from the general fund to the public health
response contingency account established in
Minnesota Statutes, section 144.4199. This is
a onetime transfer.
new text end

new text begin (c) Base Level Adjustments. The general
fund base is $26,411,000 in fiscal year 2024
and $26,411,000 in fiscal year 2025. The state
government special revenue fund base is
$61,339,000 in fiscal year 2024 and
$61,339,000 in fiscal year 2025.
new text end

new text begin Subd. 4. new text end new text begin Health Operations new text end

new text begin 11,570,000 new text end

new text begin 11,579,000 new text end

Sec. 4. new text begin HEALTH-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 27,535,000 new text end

new text begin $ new text end

new text begin 26,960,000 new text end

new text begin Appropriations by Fund new text end
new text begin State Government Special Revenue new text end	new text begin 27,459,000 new text end	new text begin 26,884,000 new text end
new text begin Health Care Access new text end	new text begin 76,000 new text end	new text begin 76,000 new text end

new text begin This appropriation is from the state
government special revenue fund unless
specified otherwise. 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 Behavioral Health and Therapy new text end

new text begin 877,000 new text end

new text begin 875,000 new text end

new text begin Subd. 3. new text end new text begin Board of Chiropractic Examiners new text end

new text begin 666,000 new text end

new text begin 666,000 new text end

new text begin Subd. 4. new text end new text begin Board of Dentistry new text end

new text begin 4,228,000 new text end

new text begin 3,753,000 new text end

new text begin (a) Administrative Services Unit - Operating
Costs. Of this appropriation, $2,738,000 in
fiscal year 2022 and $2,263,000 in fiscal year
2023 are for operating costs of the
administrative services unit. The
administrative services unit may receive and
expend reimbursements for services it
performs for other agencies.
new text end

new text begin (b) Administrative Services Unit - Volunteer
Health Care Provider Program. Of this
appropriation, $150,000 in fiscal year 2022
and $150,000 in fiscal year 2023 are to pay
for medical professional liability coverage
required under Minnesota Statutes, section
214.40.
new text end

new text begin (c) Administrative Services Unit -
Retirement Costs. Of this appropriation,
$475,000 in fiscal year 2022 is a onetime
appropriation to the administrative services
unit to pay for the retirement costs of
health-related board employees. This funding
may be transferred to the health board
incurring retirement costs. Any board that has
an unexpended balance for an amount
transferred under this paragraph shall transfer
the unexpended amount to the administrative
services unit. This appropriation is available
in either year of the biennium.
new text end

new text begin (d) Administrative Services Unit - Contested
Cases and Other Legal Proceedings. Of this
appropriation, $200,000 in fiscal year 2022
and $200,000 in fiscal year 2023 are for costs
of contested case hearings and other
unanticipated costs of legal proceedings
involving health-related boards funded under
this section. Upon certification by a
health-related board to the administrative
services unit that costs will be incurred and
that there is insufficient money available to
pay for the costs out of money currently
available to that board, the administrative
services unit is authorized to transfer money
from this appropriation to the board for
payment of those costs with the approval of
the commissioner of management and budget.
The commissioner of management and budget
must require any board that has an unexpended
balance for an amount transferred under this
paragraph to transfer the unexpended amount
to the administrative services unit to be
deposited in the state government special
revenue fund.
new text end

new text begin Subd. 5. new text end new text begin Board of Dietetics and Nutrition Practice new text end

new text begin 164,000 new text end

new text begin 164,000 new text end

new text begin Subd. 6. new text end new text begin Board of Executives for Long Term Services and Supports new text end

new text begin 693,000 new text end

new text begin 635,000 new text end

new text begin Subd. 7. new text end new text begin Board of Marriage and Family Therapy new text end

new text begin 413,000 new text end

new text begin 410,000 new text end

new text begin Subd. 8. new text end new text begin Board of Medical Practice new text end

new text begin 5,912,000 new text end

new text begin 5,868,000 new text end

new text begin Health Professional Services Program. This
appropriation includes $1,002,000 in fiscal
year 2022 and $1,002,000 in fiscal year 2023
for the health professional services program.
new text end

new text begin Subd. 9. new text end new text begin Board of Nursing new text end

new text begin 5,345,000 new text end

new text begin 5,355,000 new text end

new text begin Subd. 10. new text end new text begin Board of Occupational Therapy Practice new text end

new text begin 456,000 new text end

new text begin 456,000 new text end

new text begin Subd. 11. new text end new text begin Board of Optometry new text end

new text begin 238,000 new text end

new text begin 238,000 new text end

new text begin Subd. 12. new text end new text begin Board of Pharmacy new text end

new text begin Appropriations by Fund new text end
new text begin State Government Special Revenue new text end	new text begin 4,403,000 new text end	new text begin 4,403,000 new text end
new text begin Health Care Access new text end	new text begin 76,000 new text end	new text begin 76,000 new text end

new text begin Base Level Adjustment. The health care
access fund base is $76,000 in fiscal year
2024, $38,000 in fiscal year 2025, and $0 in
fiscal year 2026.
new text end

new text begin Subd. 13. new text end new text begin Board of Physical Therapy new text end

new text begin 564,000 new text end

new text begin 564,000 new text end

new text begin Subd. 14. new text end new text begin Board of Podiatric Medicine new text end

new text begin 214,000 new text end

new text begin 214,000 new text end

new text begin Subd. 15. new text end new text begin Board of Psychology new text end

new text begin 1,362,000 new text end

new text begin 1,360,000 new text end

new text begin Subd. 16. new text end new text begin Board of Social Work new text end

new text begin 1,561,000 new text end

new text begin 1,560,000 new text end

new text begin Subd. 17. new text end new text begin Board of Veterinary Medicine new text end

new text begin 363,000 new text end

new text begin 363,000 new text end

Sec. 5. new text begin EMERGENCY MEDICAL SERVICES REGULATORY BOARD new text end

new text begin $ new text end

new text begin 4,780,000 new text end

new text begin $ new text end

new text begin 4,576,000 new text end

new text begin (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.
new text end

new text begin (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.
new text end

new text begin (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.
new text end

new text begin (b) EMSRB Operations. $1,880,000 in fiscal
year 2022 and $1,880,000 in fiscal year 2023
are for board operations.
new text end

new 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.
new text end

new text begin (d) Regional Grants for Local and Regional
Emergency Medical Services. $800,000 in
fiscal year 2022 and $800,000 in fiscal year
2023 are for distribution to emergency medical
services regions for regional emergency
medical services programs 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
regions. This is a onetime appropriation.
new text end

new text begin (e) 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.
new text end

new text begin (f) 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 end

Sec. 6. new text begin COUNCIL ON DISABILITY new text end

new text begin $ new text end

new text begin 1,022,000 new text end

new text begin $ new text end

new text begin 1,038,000 new text end

Sec. 7. new text begin OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES new text end

new text begin $ new text end

new text begin 2,487,000 new text end

new text begin $ new text end

new text begin 2,536,000 new text end

new text begin Department of Psychiatry Monitoring.
$100,000 in fiscal year 2022 and $100,000 in
fiscal year 2023 are for monitoring the
Department of Psychiatry at the University of
Minnesota.
new text end

Sec. 8. new text begin OMBUDSPERSONS FOR FAMILIES new text end

new text begin $ new text end

new text begin 733,000 new text end

new text begin $ new text end

new text begin 744,000 new text end

Sec. 9. new text begin OMBUDSPERSON FOR AMERICAN INDIAN FAMILIES new text end

new text begin $ new text end

new text begin 190,000 new text end

new text begin $ new text end

new text begin 190,000 new text end

Sec. 10. new text begin LEGISLATIVE COORDINATING COMMISSION new text end

new text begin $ new text end

new text begin 132,000 new text end

new text begin $ new text end

new text begin 76,000 new text end

new text begin Legislative Task Force on Human Services
Background Study Disqualifications.
$132,000 in fiscal year 2022 and $76,000 in
fiscal year 2023 are from the general fund for
the Legislative Task Force on Human Services
Background Study Eligibility. This is a
onetime appropriation.
new text end

Sec. 11. new text begin SUPREME COURT new text end

new text begin $ new text end

new text begin 30,000 new text end

new text begin $ new text end

new text begin -0- new text end

Sec. 12. new text begin COMMISSIONER OF MANAGEMENT AND BUDGET new text end

new text begin $ new text end

new text begin 300,000 new text end

new text begin $ new text end

new text begin 300,000 new text end

new text begin (a) This appropriation is from the opiate
epidemic response fund.
new text end

new text begin (b) Evaluation. $300,000 in fiscal year 2022
and $300,000 in fiscal year 2023 is for
evaluation activities under Minnesota Statutes,
section 256.042, subdivision 1, paragraph (c).
new text end

new text begin (c) Base Level Adjustment. The opiate
epidemic response fund base is $300,000 in
fiscal year 2024 and $300,000 in fiscal year
2025.
new text end

Sec. 13.

Laws 2019, First Special Session chapter 9, article 14, section 3, as amended by
Laws 2019, First Special Session chapter 12, section 6, and Laws 2021, chapter 30, article
3, section 49, is amended to read:

Sec. 3. COMMISSIONER OF HEALTH

Subdivision 1. Total Appropriation

$

231,829,000

$

deleted text begin 233,584,000 deleted text end new text begin 231,174,000 new text end

Appropriations by Fund
	2020	2021
General	124,381,000	deleted text begin 125,881,000 deleted text end new text begin 123,471,000 new text end
State Government Special Revenue	58,450,000	59,158,000
Health Care Access	37,285,000	36,832,000
Federal TANF	11,713,000	11,713,000

The amounts that may be spent for each
purpose are specified in the following
subdivisions.

Subd. 2. Health Improvement

Appropriations by Fund
General	94,980,000	95,722,000
State Government Special Revenue	7,614,000	6,924,000
Health Care Access	37,285,000	36,832,000
Federal TANF	11,713,000	11,713,000

(a) TANF Appropriations. (1) $3,579,000 in
fiscal year 2020 and $3,579,000 in fiscal year
2021 are from the TANF fund for home
visiting and nutritional services under
Minnesota Statutes, section 145.882,
subdivision 7, clauses (6) and (7). Funds must
be distributed to community health boards
according to Minnesota Statutes, section
145A.131, subdivision 1;

(2) $2,000,000 in fiscal year 2020 and
$2,000,000 in fiscal year 2021 are from the
TANF fund for decreasing racial and ethnic
disparities in infant mortality rates under
Minnesota Statutes, section 145.928,
subdivision 7;

(3) $4,978,000 in fiscal year 2020 and
$4,978,000 in fiscal year 2021 are from the
TANF fund for the family home visiting grant
program under Minnesota Statutes, section
145A.17. $4,000,000 of the funding in each
fiscal year must be distributed to community
health boards according to Minnesota Statutes,
section 145A.131, subdivision 1. $978,000 of
the funding in each fiscal year must be
distributed to tribal governments according to
Minnesota Statutes, section 145A.14,
subdivision 2a;

(4) $1,156,000 in fiscal year 2020 and
$1,156,000 in fiscal year 2021 are from the
TANF fund for family planning grants under
Minnesota Statutes, section 145.925; and

(5) The commissioner may use up to 6.23
percent of the amounts appropriated from the
TANF fund each year to conduct the ongoing
evaluations required under Minnesota Statutes,
section 145A.17, subdivision 7, and training
and technical assistance as required under
Minnesota Statutes, section 145A.17,
subdivisions 4 and 5.

(b) TANF Carryforward. Any unexpended
balance of the TANF appropriation in the first
year of the biennium does not cancel but is
available for the second year.

(c) Comprehensive Suicide Prevention.
$2,730,000 in fiscal year 2020 and $2,730,000
in fiscal year 2021 are from the general fund
for a comprehensive, community-based suicide
prevention strategy. The funds are allocated
as follows:

(1) $955,000 in fiscal year 2020 and $955,000
in fiscal year 2021 are for community-based
suicide prevention grants authorized in
Minnesota Statutes, section 145.56,
subdivision 2. Specific emphasis must be
placed on those communities with the greatest
disparities. The base for this appropriation is
$1,291,000 in fiscal year 2022 and $1,291,000
in fiscal year 2023;

(2) $683,000 in fiscal year 2020 and $683,000
in fiscal year 2021 are to support
evidence-based training for educators and
school staff and purchase suicide prevention
curriculum for student use statewide, as
authorized in Minnesota Statutes, section
145.56, subdivision 2. The base for this
appropriation is $913,000 in fiscal year 2022
and $913,000 in fiscal year 2023;

(3) $137,000 in fiscal year 2020 and $137,000
in fiscal year 2021 are to implement the Zero
Suicide framework with up to 20 behavioral
and health care organizations each year to treat
individuals at risk for suicide and support
those individuals across systems of care upon
discharge. The base for this appropriation is
$205,000 in fiscal year 2022 and $205,000 in
fiscal year 2023;

(4) $955,000 in fiscal year 2020 and $955,000
in fiscal year 2021 are to develop and fund a
Minnesota-based network of National Suicide
Prevention Lifeline, providing statewide
coverage. The base for this appropriation is
$1,321,000 in fiscal year 2022 and $1,321,000
in fiscal year 2023; and

(5) the commissioner may retain up to 18.23
percent of the appropriation under this
paragraph to administer the comprehensive
suicide prevention strategy.

(d) Statewide Tobacco Cessation. $1,598,000
in fiscal year 2020 and $2,748,000 in fiscal
year 2021 are from the general fund for
statewide tobacco cessation services under
Minnesota Statutes, section 144.397. The base
for this appropriation is $2,878,000 in fiscal
year 2022 and $2,878,000 in fiscal year 2023.

(e) Health Care Access Survey. $225,000 in
fiscal year 2020 and $225,000 in fiscal year
2021 are from the health care access fund to
continue and improve the Minnesota Health
Care Access Survey. These appropriations
may be used in either year of the biennium.

(f) Community Solutions for Healthy Child
Development Grant Program. $1,000,000
in fiscal year 2020 and $1,000,000 in fiscal
year 2021 are for the community solutions for
healthy child development grant program to
promote health and racial equity for young
children and their families under article 11,
section 107. The commissioner may use up to
23.5 percent of the total appropriation for
administration. The base for this appropriation
is $1,000,000 in fiscal year 2022, $1,000,000
in fiscal year 2023, and $0 in fiscal year 2024.

(g) Domestic Violence and Sexual Assault
Prevention Program. $375,000 in fiscal year
2020 and $375,000 in fiscal year 2021 are
from the general fund for the domestic
violence and sexual assault prevention
program under article 11, section 108. This is
a onetime appropriation.

(h) Skin Lightening Products Public
Awareness Grant Program. $100,000 in
fiscal year 2020 and $100,000 in fiscal year
2021 are from the general fund for a skin
lightening products public awareness and
education grant program. This is a onetime
appropriation.

(i) Cannabinoid Products Workgroup.
$8,000 in fiscal year 2020 is from the state
government special revenue fund for the
cannabinoid products workgroup. This is a
onetime appropriation.

(j) Base Level Adjustments. The general fund
base is $96,742,000 in fiscal year 2022 and
$96,742,000 in fiscal year 2023. The health
care access fund base is $37,432,000 in fiscal
year 2022 and $36,832,000 in fiscal year 2023.

Subd. 3. Health Protection

Appropriations by Fund
General	18,803,000	19,774,000
State Government Special Revenue	50,836,000	52,234,000

(a) Public Health Laboratory Equipment.
$840,000 in fiscal year 2020 and $655,000 in
fiscal year 2021 are from the general fund for
equipment for the public health laboratory.
This is a onetime appropriation and is
available until June 30, 2023.

(b) Base Level Adjustment. The general fund
base is $19,119,000 in fiscal year 2022 and
$19,119,000 in fiscal year 2023. The state
government special revenue fund base is
$53,782,000 in fiscal year 2022 and
$53,782,000 in fiscal year 2023.

Subd. 4. Health Operations

10,598,000

deleted text begin 10,385,000 deleted text end new text begin 7,975,000 new text end

Base Level Adjustment. The general fund
base is $10,912,000 in fiscal year 2022 and
$10,912,000 in fiscal year 2023.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following enactment, or
retroactively to June 30, 2021, whichever is earlier.
new text end

Sec. 14. new text begin GRANTS FOR PROJECT ECHO.
new text end

new text begin Notwithstanding Laws 2019, chapter 63, article 3, section 1, paragraph (f), the
commissioner of human services shall not award the $200,000 grant to CHI St. Gabriel's
Health Family Medical Center in fiscal years 2022, 2023, and 2024, and instead shall issue
a competitive request for proposals for another opioid-focused Project ECHO program for
the $200,000 grant in fiscal years 2022, 2023, and 2024. This section expires June 30, 2024.
new text end

Sec. 15. new text begin REDUCTION IN APPROPRIATION AND CANCELLATION; INCENTIVE
PROGRAM.
new text end

new text begin The fiscal year 2021 health care access fund appropriation in Laws 2019, First Special
Session chapter 9, article 14, section 2, subdivision 25, is reduced by $2,082,000 and that
amount is canceled to the health care access fund.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following enactment, or
retroactively to June 30, 2021, whichever is earlier.
new text end

Sec. 16. new text begin REDUCTION IN APPROPRIATION AND CANCELLATION; EMSRB
AMBULANCE TRAINING GRANTS.
new text end

new text begin The fiscal year 2021 general fund appropriation in Laws 2019, First Special Session
chapter 9, article 14, section 5, is reduced by $204,000 and that amount is canceled to the
general fund.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment, or
retroactively to June 30, 2021, whichever is earlier.
new text end

Sec. 17. new text begin REDUCTION IN APPROPRIATION AND CANCELLATION;
NONNARCOTIC PAIN MANAGEMENT AND WELLNESS.
new text end

new text begin The general fund appropriation in Laws 2019, chapter 63, article 3, section 1, paragraph
(n), is reduced by $649,000 and that amount is canceled to the general fund.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following enactment, or
retroactively to June 30, 2021, whichever is earlier.
new text end

Sec. 18. new text begin REDUCTION IN APPROPRIATION AND CANCELLATION; RESIDENT
EXPERIENCE SURVEY AND FAMILY SURVEY.
new text end

new text begin The general fund appropriation for the 2020-2021 biennium in Laws 2019, chapter 60,
article 5, section 1, paragraph (e), is reduced by $3,858,000 and that amount is canceled to
the general fund.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following enactment, or
retroactively to June 30, 2021, whichever is earlier.
new text end

Sec. 19. new text begin REDUCTION AND GENERAL FUND APPROPRIATION; CORONAVIRUS
RELIEF FUND REFINANCING.
new text end

new text begin The commissioner of management and budget shall review all appropriations and transfers
from the general fund in Laws 2020, chapters 66, 70, 71, 74, and 81, and Laws 2020, Seventh
Special Session chapter 2, to determine whether those appropriations and transfers are
eligible expenditures from the coronavirus relief fund. The commissioner shall designate
$59,547,000 of general fund appropriations and transfers in Laws 2020, chapters 66, 70,
71, 74, and 81, and Laws 2020, Seventh Special Session chapter 2, as eligible expenditures
from the coronavirus relief fund. $59,547,000 of the appropriations and transfers designated
by the commissioner are canceled to the general fund. The commissioner may designate a
portion of an appropriation or transfer for cancellation. $59,547,000 is appropriated from
the coronavirus relief fund for the purposes of the original general fund appropriation.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following enactment, or
retroactively to June 30, 2021, whichever is earlier.
new text end

Sec. 20. new text begin BLUE RIBBON COMMISSION; REDUCTION IN BUDGET RESERVE.
new text end

new text begin Notwithstanding Laws 2019, First Special Session chapter 9, article 14, section 11, as
amended by Laws 2019, First Special Session chapter 12, section 7, the commissioner of
management and budget must reduce the budget reserve by $100,000,000 on July 1, 2021.
No reduction to the budget reserve may be implemented under Laws 2019, First Special
Session chapter 9, article 14, section 11, as amended by Laws 2019, First Special Session
chapter 12, section 7.
new text end

Sec. 21. new text begin MINNESOTA FAMILY INVESTMENT PROGRAM SUPPLEMENTAL
PAYMENT; ALLOCATION OF FEDERAL FUNDING.
new text end

new text begin The commissioner of human services shall allocate $14,352,000 in fiscal year 2022 from
the federal fund to provide a onetime cash benefit of up to $435 for each assistance unit
active in the Minnesota family investment program or diversionary work program under
Minnesota Statutes, chapter 256J, in the month prior to when the cash benefit is distributed.
The commissioner shall distribute the cash benefit through existing systems and in a manner
that minimizes the burden to families. This is a onetime allocation.
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. 22. new text begin APPROPRIATION; MINNESOTACARE PREMIUMS.
new text end

new text begin $134,000 in fiscal year 2021 from the general fund and $44,000 in fiscal year 2021 from
the health care access fund are appropriated to the commissioner of human services to
implement changes to MinnesotaCare premiums.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following enactment, or
retroactively to June 30, 2021, whichever is earlier.
new text end

Sec. 23. new text begin APPROPRIATION; OVERPAYMENTS FOR MEDICATION-ASSISTED
TREATMENT SERVICES.
new text end

new text begin $28,873,000 in fiscal year 2021 is appropriated from the general fund to the commissioner
of human services to settle the overpayments owed by the Leech Lake Band of Ojibwe and
the White Earth Band of Chippewa for medication-assisted treatment services between
fiscal year 2014 and fiscal year 2019. The amount for the Leech Lake Band of Ojibwe is
$14,666,000 and the amount for the White Earth Band of Chippewa is $14,207,000. This
is a onetime appropriation.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following enactment, or
retroactively to June 30, 2021, whichever is earlier.
new text end

Sec. 24. new text begin APPROPRIATION; REIMBURSEMENT FOR INSTITUTIONS FOR
MENTAL DISEASE PAYMENTS.
new text end

new text begin $8,328,000 in fiscal year 2021 is appropriated from the general fund to the commissioner
of human services to reimburse counties for the amount of the statewide county share of
costs for which federal funds were claimed, but were not eligible for federal funding for
substance use disorder services provided in institutions for mental disease, for claims paid
between January 1, 2014, and June 30, 2019. The commissioner of human services shall
allocate this appropriation between the counties based on the amount that is owed by each
county. Prior to a county receiving reimbursement, the county must pay in full any unpaid
behavioral health fund invoiced county share. This is a onetime appropriation.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following enactment, or
retroactively to June 30, 2021, whichever is earlier.
new text end

Sec. 25. new text begin TRANSFERS.
new text end

new text begin Subdivision 1. new text end

new text begin Grants. new text end

new text begin The commissioner of human services, with the approval of the
commissioner of management and budget, may transfer unencumbered appropriation balances
for the biennium ending June 30, 2023, within fiscal years among the MFIP, general
assistance, medical assistance, MinnesotaCare, MFIP child care assistance under Minnesota
Statutes, section 119B.05, Minnesota supplemental aid program, group residential housing
program, the entitlement portion of Northstar Care for Children under Minnesota Statutes,
chapter 256N, and the entitlement portion of the chemical dependency consolidated treatment
fund, and between fiscal years of the biennium. The commissioner shall inform the chairs
and ranking minority members of the legislative committees with jurisdiction over health
and human services quarterly about transfers made under this subdivision.
new text end

new text begin Subd. 2. new text end

new text begin Administration. new text end

new text begin Positions, salary money, and nonsalary administrative money
may be transferred within the Departments of Health and Human Services as the
commissioners consider necessary, with the advance approval of the commissioner of
management and budget. The commissioners shall inform the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
finance quarterly about transfers made under this section.
new text end

Sec. 26. new text begin INDIRECT COSTS NOT TO FUND PROGRAMS.
new text end

new text begin The commissioners of health and human services shall not use indirect cost allocations
to pay for the operational costs of any program for which they are responsible.
new text end

Sec. 27. new text begin REDISTRIBUTION AUTHORITY.
new text end

new text begin (a) For the purposes of securing federal approval of Minnesota's initial state spending
plan as described in guidance issued by the Centers for Medicare and Medicaid Services
for implementation of section 9817 of the federal American Rescue Plan Act of 2021, the
commissioner of human services may modify in the initial state spending plan the amount
for a purpose contained in this act that is contingent upon federal approval under section
28 by redistributing the amounts among such purposes as is necessary to secure federal
approval.
new text end

new text begin (b) If federal approval of Minnesota's initial state spending plan requires the commissioner
to modify in the initial state spending plan the amount for a purpose contained in this act
that is contingent upon federal approval under section 28 by redistributing the amounts
among such purpose as is necessary to secure federal approval, the commissioner of human
services must provide written notice of the modification to the chairs and ranking minority
members of the house of representatives and senate committees overseeing the Department
of Human Services upon submitting or resubmitting the initial state spending plan for federal
approval.
new text end

new text begin (c) If Minnesota's initial state spending plan is approved after the commissioner has
exercised the commissioner's authority under this section, the commissioner may implement
the federally approved plan including, with the approval of the commissioner of management
and budget, necessary transfers within and between budget activities, but must prepare draft
legislation to amend this article in a manner consistent with the modifications and
redistributions the commissioner made and provide the draft legislation to the chairs and
ranking minority members of the legislative committees with jurisdiction over home and
community-based services funding.
new text end

Sec. 28. new text begin CONTINGENT APPROPRIATIONS.
new text end

new text begin Any appropriation in this act for a purpose included in Minnesota's initial state spending
plan as described in guidance issued by the Centers for Medicare and Medicaid Services
for implementation of section 9817 of the federal American Rescue Plan Act of 2021 is
contingent upon approval of that purpose by the Centers for Medicare and Medicaid Services.
This section expires June 30, 2024.
new text end

Sec. 29. new text begin HOME AND COMMUNITY-BASED SERVICES FEDERAL MEDICAL
ASSISTANCE PERCENTAGE MAINTENANCE OF EFFORT.
new text end

new text begin (a) The commissioner of management and budget, in consultation with the commissioner
of human services, must ensure that sufficient qualified nonfederal expenditures are made
through March 31, 2024, to meet the state's reinvestment requirements under section 9817
of the federal American Rescue Plan Act of 2021 and related federal guidance.
new text end

new text begin (b) The commissioner of human services shall administer the general fund amount in
this act attributable to the enhanced federal medical assistance percentage for home and
community-based services the state receives under section 9817 of the federal American
Rescue Plan Act of 2021, estimated to be $686,091,000, as required by section 9817 of the
American Rescue Plan Act and related federal guidance.
new text end

new text begin (c) To the extent projected qualified nonfederal expenditures on eligible activities included
in the state spending plan are less than the required reinvestment in home and
community-based services specified in guidance related to section 9817 of the federal
American Rescue Plan Act of 2021, any reduction in the projected qualified nonfederal
expenditures relative to the projected amount at the end of the 2021 First Special Session
shall not result in an increase in the general fund balance in a budget and economic forecast
prepared by the commissioner of management and budget as provided in Minnesota Statutes,
section 16A.103.
new text end

new text begin (d) With each forecast prepared by the commissioner of management and budget under
Minnesota Statutes, section 16A.103, the commissioner of management and budget and the
commissioner of human services shall submit to the chairs and ranking minority members
of the house of representative Ways and Means Committee, the senate Finance Committee,
and the legislative committees with jurisdiction over home and community-based services
funding and policy a joint report describing:
new text end

new text begin (1) the qualified nonfederal expenditures that met the state's home and community-based
services reinvestment requirements; and
new text end

new text begin (2) any forgone increases in the general fund balance in the budget and economic forecast
resulting from paragraph (c).
new text end

new text begin (e) Paragraphs (a) and (b) expire on June 30, 2025. Paragraphs (c) and (d) expire on
June 30, 2022.
new text end

Sec. 30. new text begin APPROPRIATION ENACTED MORE THAN ONCE.
new text end

new text begin If an appropriation in this act is enacted more than once in the 2021 legislative session
or 2021 First Special Session, the appropriation must be given effect only once.
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. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end

new text begin All uncodified language contained in this article expires on June 30, 2023, unless a
different expiration date is explicit.
new text end

Sec. 32. new text begin EFFECTIVE DATE.
new text end

new text begin This article is effective July 1, 2021, unless a different effective date is specified.
new text end

ARTICLE 17

HOME AND COMMUNITY-BASED SERVICES; SPECIAL TIME-LIMITED
FUNDING PROVISIONS

Section 1.

Minnesota Statutes 2020, section 256.478, is amended to read:

256.478 deleted text begin HOME AND COMMUNITY-BASED SERVICES TRANSITIONS
GRANTS deleted text end new text begin TRANSITION TO COMMUNITY INITIATIVE new text end .

new text begin Subdivision 1. new text end

new text begin Purpose. new text end

new text begin (a) new text end The commissioner shall deleted text begin make available home and
community-based services deleted text end new text begin establish the new text end transition new text begin to community initiative to award new text end grants
to serve individuals deleted text begin who do not meet eligibility criteria for the medical assistance program
under section 256B.056 or 256B.057, but who otherwise meet the criteria under section
256B.092, subdivision 13, or 256B.49, subdivision 24. deleted text end new text begin for whom supports and services not
covered by medical assistance would allow them to:
new text end

new text begin (1) live in the least restrictive setting and as independently as possible;
new text end

new text begin (2) build or maintain relationships with family and friends; and
new text end

new text begin (3) participate in community life.
new text end

new text begin (b) Grantees must ensure that individuals are engaged in a process that involves
person-centered planning and informed choice decision-making. The informed choice
decision-making process must provide accessible written information and be experiential
whenever possible.
new text end

new text begin Subd. 2. new text end

new text begin Eligibility. new text end

new text begin An individual is eligible for the transition to community initiative
if the individual does not meet eligibility criteria for the medical assistance program under
section 256B.056 or 256B.057, but who meets at least one of the following criteria:
new text end

new text begin (1) the person otherwise meet meets the criteria under section 256B.092, subdivision
13, or 256B.49, subdivision 24;
new text end

new text begin (2) the person has met treatment objectives and no longer requires a hospital-level care
or a secure treatment setting, but the person's discharge from the Anoka Metro Regional
Treatment Center, the Minnesota Security Hospital, or a community behavioral health
hospital would be substantially delayed without additional resources available through the
transitions to community initiative;
new text end

new text begin (3) the person is in a community hospital and on the waiting list for the Anoka Metro
Regional Treatment Center, but alternative community living options would be appropriate
for the person, and the person has received approval from the commissioner; or
new text end

new text begin (4)(i) the person is receiving customized living services reimbursed under section
256B.4914, 24-hour customized living services reimbursed under section 256B.4914, or
community residential services reimbursed under section 256B.4914; (ii) the person expresses
a desire to move; and (iii) the person has received approval from the commissioner.
new text end

Sec. 2.

Laws 2021, chapter 30, article 12, section 5, is amended to read:

Sec. 5. GOVERNOR'S COUNCIL ON AN AGE-FRIENDLY MINNESOTA.

The Governor's Council on an Age-Friendly Minnesota, established in Executive Order
19-38, shall: (1) work to advance age-friendly policies; and (2) coordinate state, local, and
private partners' collaborative work on emergency preparedness, with a focus on older
adults, communities, and persons in zip codes most impacted by the COVID-19 pandemic.
The Governor's Council on an Age-Friendly Minnesota is extended and expires deleted text begin October 1,
2022 deleted text end new text begin June 30, 2024 new text end .

Sec. 3. new text begin GRANTS FOR TECHNOLOGY FOR HCBS RECIPIENTS.
new text end

new text begin (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. 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.
new text end

new text begin (b) All grant activities must be completed by March 31, 2024.
new text end

new text begin (c) This section expires June 30, 2024.
new text end

Sec. 4. new text begin DEVELOPMENT OF INDIVIDUAL HCBS PORTAL FOR RECIPIENTS.
new text end

new text begin (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 develop an online support planning tool for
people who use home and community-based services waivers. The general fund base included
in this act for this purpose is $0 in fiscal year 2024 and $0 in fiscal year 2025.
new text end

new text begin (b) This section expires March 31, 2024.
new text end

Sec. 5. new text begin HOUSING TRANSITIONAL COSTS.
new text end

new text begin Subdivision 1. new text end

new text begin Housing transition cost. new text end

new text begin (a) This act includes $682,000 in fiscal year
2022 and $1,637,000 in fiscal year 2023 for a onetime payment per transition of up to $3,000
to cover costs associated with moving to a community setting that are not covered by other
sources. Covered costs include: (1) lease or rent deposits; (2) security deposits; (3) utilities
setup costs, including telephone and Internet services; and (4) essential furnishings and
supplies. The commissioner of human services shall seek an amendment to the medical
assistance state plan to allow for these payments as a housing stabilization service under
Minnesota Statutes, section 256B.051. The general fund base in this act for this purpose is
$1,227,000 in fiscal year 2024 and $0 in fiscal year 2025.
new text end

new text begin (b) This subdivision expires March 31, 2024.
new text end

new text begin Subd. 2. new text end

new text begin Community living infrastructure. new text end

new text begin (a) This act includes $4,000,000 in fiscal
year 2022 and $4,000,000 in fiscal year 2023 for additional funding for grants under
Minnesota Statutes, section 256I.09. In addition to the allowable uses of grants awarded
under Minnesota Statutes, section 256I.09, grants may also be used to provide direct
assistance to individuals to access or maintain housing in community settings. Allowable
uses of grant funds include: (1) lease or rent deposits; (2) security deposits; (3) utilities setup
costs, including telephone and Internet services; (4) essential furnishings and supplies; and
(5) costs related to expungement, including filing fees and attorney fees. The general fund
base in this act for this purpose is $3,000,000 in fiscal year 2024 and $0 in fiscal year 2025.
new text end

new text begin (b) All grant activities must be completed by March 31, 2024.
new text end

new text begin (c) This subdivision expires June 30, 2024.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin Subdivision 1 is effective January 1, 2021, 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. new text begin TRANSITION TO COMMUNITY INITIATIVE.
new text end

new text begin (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. The general fund base in this act for this
purpose is $4,125,000 in fiscal year 2024 and $0 in fiscal year 2025.
new text end

new text begin (b) All grant activities must be completed by March 31, 2024.
new text end

new text begin (c) This section expires June 30, 2024.
new text end

Sec. 7. new text begin LEAD AGENCY PROCESS MAPPING.
new text end

new text begin (a) This act includes $1,115,000 in fiscal year 2022 and $1,751,000 in fiscal year 2023
for the commissioner of human services to review lead agency policies and business practices
and to identify potential efficiencies in long-term care consultation services. The
commissioner must make recommendations to lead agencies based on the review. The
commissioner of human services shall produce a guide documenting the process for
determining medical assistance eligibility and authorization of long-term services and
supports. The commissioner must ensure that the guide is available in accessible formats
and in multiple languages. The commissioner must ensure the guide is available to people
and families that request long-term care consultation services. The general fund base in this
act for this purpose is $1,188,000 in fiscal year 2024 and $0 in fiscal year 2025.
new text end

new text begin (b) This section expires March 31, 2024.
new text end

Sec. 8. new text begin AGE-FRIENDLY MINNESOTA.
new text end

new text begin Subdivision 1. new text end

new text begin Age-friendly community grants. new text end

new text begin (a) This act includes $0 in fiscal year
2022 and $875,000 in fiscal year 2023 for age-friendly community grants. The commissioner
of human services, in collaboration with the Minnesota Board on Aging and the Governor's
Council on an Age-Friendly Minnesota, established in Executive Order 19-38, shall develop
the age-friendly community grant program to help communities, including cities, counties,
other municipalities, tribes, and collaborative efforts, to become age-friendly communities,
with an emphasis on structures, services, and community features necessary to support older
adult residents over the next decade, including but not limited to:
new text end

new text begin (1) coordination of health and social services;
new text end

new text begin (2) transportation access;
new text end

new text begin (3) safe, affordable places to live;
new text end

new text begin (4) reducing social isolation and improving wellness;
new text end

new text begin (5) combating ageism and racism against older adults;
new text end

new text begin (6) accessible outdoor space and buildings;
new text end

new text begin (7) communication and information technology access; and
new text end

new text begin (8) opportunities to stay engaged and economically productive.
new text end

new text begin The general fund base in this act for this purpose is $875,000 in fiscal year 2024 and $0 in
fiscal year 2025.
new text end

new text begin (b) All grant activities must be completed by March 31, 2024.
new text end

new text begin (c) This subdivision expires June 30, 2024.
new text end

new text begin Subd. 2. new text end

new text begin Technical assistance grants. new text end

new text begin (a) This act includes $0 in fiscal year 2022 and
$575,000 in fiscal year 2023 for technical assistance grants. The commissioner of human
services, in collaboration with the Minnesota Board on Aging and the Governor's Council
on an Age-Friendly Minnesota, established in Executive Order 19-38, shall develop the
age-friendly technical assistance grant program. The general fund base in this act for this
purpose is $575,000 in fiscal year 2024 and $0 in fiscal year 2025.
new text end

new text begin (b) All grant activities must be completed by March 31, 2024.
new text end

new text begin (c) This subdivision expires June 30, 2024.
new text end

Sec. 9. new text begin CONTINUITY OF CARE FOR STUDENTS WITH BEHAVIORAL HEALTH
AND DISABILITY SUPPORT NEEDS.
new text end

new text begin This act includes $70,000 in fiscal year 2022 and $0 in fiscal year 2023 for the
commissioner of human services to collaborate with the commissioner of education and
consult with stakeholders to: (1) identify strategies to streamline access and reimbursement
for behavioral health services for students who are enrolled in medical assistance and have
individualized education programs or individualized family services plans; and (2) avoid
duplication of services and procedures to the extent practicable. The commissioners must
identify strategies to reduce administrative burdens for schools while ensuring continuity
of care for students accessing services when not in school. By January 15, 2022, the
commissioners must report their findings and recommendations to the chairs and ranking
minority members of the legislative committees with jurisdiction over early learning
education through grade 12 and health and human services policy and finance. The general
fund base in this act for this purpose is $0 in fiscal year 2024 and $0 in fiscal year 2025.
new text end

Sec. 10. new text begin PROVIDER CAPACITY GRANTS FOR RURAL AND UNDERSERVED
COMMUNITIES.
new text end

new text begin (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. The general fund base
in this act for this purpose is $8,000,000 in fiscal year 2024 and $0 in fiscal year 2025.
new text end

new text begin (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.
new text end

new text begin (c) All grant activities must be completed by March 31, 2024.
new text end

new text begin (d) This section expires June 30, 2024.
new text end

Sec. 11. new text begin EXPAND MOBILE CRISIS.
new text end

new text begin (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). The general fund base in this
act for this purpose is $4,000,000 in fiscal year 2024 and $0 in fiscal year 2025.
new text end

new text begin (b) Beginning April 1, 2024, counties may fund and continue conducting activities
funded under this section.
new text end

new text begin (c) All grant activities must be completed by March 31, 2024.
new text end

new text begin (d) This section expires June 30, 2024.
new text end

Sec. 12. new text begin PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY AND CHILD
AND ADOLESCENT MOBILE TRANSITION UNIT.
new text end

new text begin (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. 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.
new text end

new text begin (b) Beginning April 1, 2024, counties may fund and continue conducting activities
funded under this section.
new text end

new text begin (c) This section expires March 31, 2024.
new text end

Sec. 13. new text begin REDUCING RELIANCE ON CHILDREN'S CONGREGATE-CARE
SETTINGS.
new text end

new text begin This act includes $200,000 in fiscal year 2022 and $0 in fiscal year 2023 for an analysis
of the utilization and efficacy of current residential and psychiatric residential treatment
facility treatment options for children under the state Medicaid program. The commissioner
of human services must conduct the analysis. When conducting the analysis, the
commissioner must collaborate with the Department of Health, the Department of Education,
hospitals, children's treatment facilities, social workers, juvenile justice officials, and parents
of children receiving care. The commissioner may collaborate with children receiving care
when conducting the analysis. By February 1, 2022, the commissioner must submit to the
chairs and ranking minority members of the legislative committees with jurisdiction over
health and human services a report that identifies systemic obstacles in transitioning children
into community-based options; identifies gaps in care for children with the most acute
behavioral health treatment needs; and provides recommendations, including estimated
costs, to develop infrastructure, eliminate system barriers, and enhance coordination to
ensure children have access to behavioral health treatment services based on medical
necessity and family and caregiver needs.
new text end

Sec. 14. new text begin TASK FORCE ON ELIMINATING SUBMINIMUM WAGES.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment; purpose. new text end

new text begin The Task Force on Eliminating Subminimum
Wages is established to develop a plan and make recommendations to phase out payment
of subminimum wages to people with disabilities on or before August 1, 2025.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin 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.
new text end

new text begin Subd. 3. new text end

new text begin Membership. new text end

new text begin (a) The task force consists of 16 members, appointed as follows:
new text end

new text begin (1) the commissioner of human services or a designee;
new text end

new text begin (2) the commissioner of labor and industry or a designee;
new text end

new text begin (3) the commissioner of education or a designee;
new text end

new text begin (4) the commissioner of employment and economic development or a designee;
new text end

new text begin (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;
new text end

new text begin (6) one member appointed by the Minnesota Disability Law Center;
new text end

new text begin (7) one member appointed by The Arc of Minnesota;
new text end

new text begin (8) three members who are persons with disabilities appointed by the commissioner of
human services, at least one of whom must be neurodiverse, and at least one of whom must
have a significant physical disability;
new text end

new text begin (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;
new text end

new text begin (10) one member appointed by the Minnesota Organization for Habilitation and
Rehabilitation;
new text end

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

new text begin (12) one member appointed by the State Rehabilitation Council.
new text end

new text begin (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.
new text end

new text begin Subd. 4. new text end

new text begin Appointment deadline; first meeting; chair. new text end

new text begin 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.
new text end

new text begin Subd. 5. new text end

new text begin Compensation. new text end

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

new text begin Subd. 6. new text end

new text begin Duties; plan and recommendations. new text end

new text begin The task force shall:
new text end

new text begin (1) develop a plan to phase out the payment of subminimum wages to people with
disabilities by August 1, 2025;
new text end

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

new text begin (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;
new text end

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

new text begin (5) propose a plan to establish and evaluate benchmarks for measuring annual progress
toward eliminating subminimum wages;
new text end

new text begin (6) propose a plan to monitor and track outcomes of employees with disabilities;
new text end

new text begin (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;
new text end

new text begin (8) identify benefits to the state in eliminating subminimum wage by August 1, 2025;
new text end

new text begin (9) identify barriers to eliminating subminimum wage by August 1, 2025, including the
cost of implementing and providing ongoing employment services, training, and support
for employees with disabilities and the cost of paying minimum wage to employees with
disabilities;
new text end

new text begin (10) make recommendations to eliminate the barriers identified in clause (9); and
new text end

new text begin (11) identify and make recommendations for sustainable financial support, funding, and
resources for eliminating subminimum wage by August 1, 2025.
new text end

new text begin Subd. 7. new text end

new text begin Duties; provider reinvention grants. new text end

new text begin (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:
new text end

new text begin (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;
new text end

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

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

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

new text begin (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.
new text end

new text begin (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.
new text end

new text begin (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.
new text end

new text begin Subd. 8. new text end

new text begin Report. new text end

new text begin 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 eliminate by August 1, 2025, the payment of
subminimum wage, 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.
new text end

new text begin Subd. 9. new text end

new text begin Administrative support. new text end

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

new text begin Subd. 10. new text end

new text begin Expiration. new text end

new text begin The task force shall conclude their duties and expire on March
31, 2024.
new text end

Sec. 15. new text begin MOVING TO INDEPENDENCE: SUBMINIMUM WAGE PHASE-OUT.
new text end

new text begin (a) This act includes $4,300,000 in fiscal year 2022 and $5,300,000 in fiscal year 2023
for the commissioner of human services to establish a reinvention grant program to promote
independence and increase opportunities for people with disabilities to earn competitive
wages. The general fund base included in this act for this purpose is $4,500,000 in fiscal
year 2024 and $0 in fiscal year 2025.
new text end

new text begin (b) All grant activities must be completed by March 31, 2024.
new text end

new text begin (c) This section expires June 30, 2024.
new text end

Sec. 16. new text begin RESEARCH ON ACCESS TO LONG-TERM CARE SERVICES AND
FINANCING.
new text end

new text begin This act includes $400,000 in fiscal year 2022 and $300,000 in fiscal year 2023 for an
actuarial research study of public and private financing options for long-term services and
supports reform to increase access across the state. The commissioner of human services
must conduct the study. Of this amount, the commissioner may transfer up to $100,000 to
the commissioner of commerce for costs related to the requirements of the study. The general
fund base included in this act for this purpose is $0 in fiscal year 2024 and $0 in fiscal year
2025.
new text end

Sec. 17. new text begin ADDITIONAL FUNDING FOR RESPITE SERVICES AND STUDIES.
new text end

new text begin Subdivision 1. new text end

new text begin Home and community-based service system reform analysis. new text end

new text begin This act
includes $200,000 in fiscal year 2022 and $200,000 in fiscal year 2023 for an analysis to
identify future system reforms to strengthen access to respite services and caregiver supports
to enhance the Medicaid home and community-based service system for older adults and
caregivers in Minnesota. The commissioner of human services must conduct the analysis.
The commissioner must examine Minnesota's existing programs serving older adults and
identify solutions that provide cost-effective respite services and caregiver supports to an
expanding population of older adults. The general fund base included in this act for this
purpose is $0 in fiscal year 2024 and $0 in fiscal year 2025.
new text end

new text begin Subd. 2. new text end

new text begin Own your own future study. new text end

new text begin This act includes $183,000 in fiscal year 2022
and $0 in fiscal year 2023 for an analysis of long-term trends in older adults' utilization of
Medicaid expenditures and need for long-term care services and supports in Minnesota.
The commissioner of human services must conduct the analysis. The commissioner must
examine Minnesota's use of nursing facilities and assisted living facilities and utilize
simulation modeling to estimate future demand for long-term services and supports. The
funding including in this act for this purpose is available until March 31, 2024.
new text end

new text begin Subd. 3. new text end

new text begin Respite services for older adults grants. new text end

new text begin (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. 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.
new text end

new text begin (b) All grant activities must be completed by March 31, 2024.
new text end

new text begin (c) This subdivision expires June 30, 2024.
new text end

Sec. 18. new text begin MEDICAL ASSISTANCE OUTPATIENT AND BEHAVIORAL HEALTH
SERVICE RATES STUDY.
new text end

new text begin (a) This act includes $486,000 in fiscal year 2022 and $696,000 in fiscal year 2023 for
an analysis of the current rate-setting methodology for all outpatient services in medical
assistance and MinnesotaCare, including rates for behavioral health, substance use disorder
treatment, and residential substance use disorder treatment. By January 1, 2022, the
commissioner shall issue a request for proposals for frameworks and modeling of behavioral
health services rates. Rates must be predicated on a uniform methodology that is transparent,
culturally responsive, supports staffing needed to treat a patient's assessed need, and promotes
quality service delivery, integration of care, and patient choice. The commissioner must
consult with providers across the spectrum of services, from across each region of the state,
and culturally responsive providers in the development of the request for proposals and for
the duration of the contract. The general fund base included in this act for this purpose is
$599,000 in fiscal year 2024 and $0 in fiscal year 2025.
new text end

new text begin (b) By January 15, 2023, the commissioner of human services shall submit a preliminary
report to the chairs and ranking minority members of the legislative committees with
jurisdiction over human services policy and finance on the initial results. By January 15,
2024, the commissioner of human services shall submit a final report to the chairs and
ranking minority members of the legislative committees with jurisdiction over human
services policy and finance that includes legislative language necessary to modify existing
or implement new rate methodologies, including a new substance use disorder treatment
rate methodology, and a detailed fiscal analysis.
new text end

Sec. 19. new text begin CENTERS FOR INDEPENDENT LIVING HCBS ACCESS GRANT.
new text end

new text begin (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 the eight organizations defined in Minnesota Statutes, section
268A.01, subdivision 8. The general fund base included in this act for this purpose is $0 in
fiscal year 2024 and $0 in fiscal year 2025.
new text end

new text begin (b) All grant activities must be completed by March 31, 2024.
new text end

new text begin (c) This section expires June 30, 2024.
new text end

Sec. 20. new text begin HCBS WORKFORCE DEVELOPMENT GRANT.
new text end

new text begin (a) This act includes $0 in fiscal year 2022 and $5,588,000 in fiscal year 2023 to address
challenges related to attracting and maintaining direct care workers who provide home and
community-based services for people with disabilities and older adults. The general fund
base included in this act for this purpose is $5,588,000 in fiscal year 2024 and $0 in fiscal
year 2025.
new text end

new text begin (b) At least 90 percent of funding for this provision must be directed to workers who
earn 200 percent or less of the most current federal poverty level issued by the United States
Department of Health and Human Services.
new text end

new text begin (c) The commissioner must consult with stakeholders to finalize a report detailing the
final plan for use of the funds. The commissioner must publish the report by March 1, 2022,
and notify the chairs and ranking minority members of the legislative committees with
jurisdiction over health and human services policy and finance.
new text end

Sec. 21. new text begin DIRECTION TO COMMISSIONER; STAKEHOLDER ENGAGEMENT
FOR SPENDING PLAN.
new text end

new text begin Prior to submitting Minnesota's initial state spending plan as described in guidance issued
by the Centers for Medicare and Medicaid Services for implementation of section 9817 of
the American Rescue Plan Act of 2021, the commissioner of human services must consult
with stakeholders about proposals included in the plan.
new text end

Sec. 22. new text begin EFFECTIVE DATE.
new text end

new text begin Unless otherwise specified, each section of this article is effective upon federal approval
of Minnesota's initial state spending plan as described in guidance issued by the Centers
for Medicare and Medicaid Services for implementation of section 9817 of the federal
American Rescue Plan Act of 2021. The commissioner of human services shall notify the
revisor of statutes when federal approval is obtained.
new text end

APPENDIX

Repealed Minnesota Statutes: 211-H0033-2

16A.724 HEALTH CARE ACCESS FUND.

Subd. 2.

Transfers.

(a) Notwithstanding section 295.581, to the extent available resources in the health care access fund exceed expenditures in that fund, effective for the biennium beginning July 1, 2007, the commissioner of management and budget shall transfer the excess funds from the health care access fund to the general fund on June 30 of each year, provided that the amount transferred in fiscal year 2016 shall not exceed $48,000,000, the amount in fiscal year 2017 shall not exceed $122,000,000, and the amount in any fiscal biennium thereafter shall not exceed $244,000,000. The purpose of this transfer is to meet the rate increase required under section 256B.04, subdivision 25.

(b) For fiscal years 2006 to 2011, MinnesotaCare shall be a forecasted program, and, if necessary, the commissioner shall reduce these transfers from the health care access fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary, transfer sufficient funds from the general fund to the health care access fund to meet annual MinnesotaCare expenditures.

62A.67 SHORT TITLE.

Sections 62A.67 to 62A.672 may be cited as the "Minnesota Telemedicine Act."

62A.671 DEFINITIONS.

Subdivision 1.

Applicability.

For purposes of sections 62A.67 to 62A.672, the terms defined in this section have the meanings given.

Subd. 2.

Distant site.

"Distant site" means a site at which a licensed health care provider is located while providing health care services or consultations by means of telemedicine.

Subd. 3.

Health care provider.

"Health care provider" has the meaning provided in section 62A.63, subdivision 2.

Subd. 4.

Health carrier.

"Health carrier" has the meaning provided in section 62A.011, subdivision 2.

Subd. 5.

Health plan.

"Health plan" means a health plan as defined in section 62A.011, subdivision 3, and 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 policyholder.

Subd. 6.

Licensed health care provider.

"Licensed health care provider" means a health care provider who is:

(1) licensed under chapter 147, 147A, 148, 148B, 148E, 148F, 150A, or 153; a mental health professional as defined under section 245.462, subdivision 18, or 245.4871, subdivision 27; or vendor of medical care defined in section 256B.02, subdivision 7; and

(2) authorized within their respective scope of practice to provide the particular service with no supervision or under general supervision.

Subd. 7.

Originating site.

"Originating site" means a site including, but not limited to, a health care facility at which a patient is located at the time health care services are provided to the patient by means of telemedicine.

Subd. 8.

Store-and-forward technology.

"Store-and-forward technology" means the transmission of a patient's medical information from an originating site to a health care provider at a distant site without the patient being present, or the delivery of telemedicine that does not occur in real time via synchronous transmissions.

Subd. 9.

Telemedicine.

"Telemedicine" means the delivery of health care services or consultations while the patient is at an originating site and the licensed health care provider is at a distant site. A communication between licensed health care providers that consists solely of a telephone conversation, e-mail, or facsimile transmission does not constitute telemedicine consultations or services. A communication between a licensed health care provider and a patient that consists solely of an e-mail or facsimile transmission does not constitute telemedicine consultations or services. Telemedicine may be provided by means of real-time two-way, interactive audio and visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support health care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, and care management of a patient's health care.

62A.672 COVERAGE OF TELEMEDICINE SERVICES.

Subdivision 1.

Coverage of telemedicine.

(a) A health plan sold, issued, or renewed by a health carrier for which coverage of benefits begins on or after January 1, 2017, shall include coverage for telemedicine benefits in the same manner as any other benefits covered under the policy, plan, or contract, and shall comply with the regulations of this section.

(b) Nothing in this section shall be construed to:

(1) require a health carrier to provide coverage for services that are not medically necessary;

(2) prohibit a health carrier from establishing criteria that a health care provider must meet to demonstrate the safety or efficacy of delivering a particular service via telemedicine for which the health carrier does not already reimburse other health care providers for delivering via telemedicine, so long as the criteria are not unduly burdensome or unreasonable for the particular service; or

(3) prevent a health carrier from requiring a health care provider to agree to certain documentation or billing practices designed to protect the health carrier or patients from fraudulent claims so long as the practices are not unduly burdensome or unreasonable for the particular service.

Subd. 2.

Parity between telemedicine and in-person services.

A health carrier shall not exclude a service for coverage solely because the service is provided via telemedicine and is not provided through in-person consultation or contact between a licensed health care provider and a patient.

Subd. 3.

Reimbursement for telemedicine services.

(a) A health carrier shall reimburse the distant site licensed health care provider for covered services delivered via telemedicine on the same basis and at the same rate as the health carrier would apply to those services if the services had been delivered in person by the distant site licensed health care provider.

(b) It is not a violation of this subdivision for a health carrier to include a deductible, co-payment, or coinsurance requirement for a health care service provided via telemedicine, provided that the deductible, co-payment, or coinsurance is not in addition to, and does not exceed, the deductible, co-payment, or coinsurance applicable if the same services were provided through in-person contact.

62J.63 CENTER FOR HEALTH CARE PURCHASING IMPROVEMENT.

Subd. 3.

Report.

The commissioner of health must report annually to the legislature and the governor on the operations, activities, and impacts of the center. The report must be posted on the Department of Health website and must be available to the public. The report must include a description of the state's efforts to develop and use more common strategies for health care performance measurement and health care purchasing. The report must also include an assessment of the impacts of these efforts, especially in promoting greater transparency of health care costs and quality, and greater accountability for health care results and improvement.

119B.125 PROVIDER REQUIREMENTS.

Subd. 5.

Provisional payment.

After a county receives a completed application from a provider, the county may issue provisional authorization and payment to the provider during the time needed to determine whether to give final authorization to the provider.

144.0721 ASSESSMENTS OF CARE AND SERVICES TO NURSING HOME RESIDENTS.

Subdivision 1.

Appropriateness and quality.

Until the date of implementation of the revised case mix system based on the minimum data set, the commissioner of health shall assess the appropriateness and quality of care and services furnished to private paying residents in nursing homes and boarding care homes that are certified for participation in the medical assistance program under United States Code, title 42, sections 1396-1396p. These assessments shall be conducted until the date of implementation of the revised case mix system with the exception of provisions requiring recommendations for changes in the level of care provided to the private paying residents.

144.0722 RESIDENT REIMBURSEMENT CLASSIFICATIONS.

Subdivision 1.

Resident reimbursement classifications.

The commissioner of health shall establish resident reimbursement classifications based upon the assessments of residents of nursing homes and boarding care homes conducted under section 144.0721, or under rules established by the commissioner of human services under chapter 256R. The reimbursement classifications established by the commissioner must conform to the rules established by the commissioner of human services.

Subd. 2.

Notice of resident reimbursement classification.

The commissioner of health shall notify each resident, and the nursing home or boarding care home in which the resident resides, of the reimbursement classification established under subdivision 1. The notice must inform the resident of the classification that was assigned, the opportunity to review the documentation supporting the classification, the opportunity to obtain clarification from the commissioner, and the opportunity to request a reconsideration of the classification. The notice of resident classification must be sent by first-class mail. The individual resident notices may be sent to the resident's nursing home or boarding care home for distribution to the resident. The nursing home or boarding care home is responsible for the distribution of the notice to each resident, to the person responsible for the payment of the resident's nursing home expenses, or to another person designated by the resident. This notice must be distributed within three working days after the facility's receipt of the notices from the department.

Subd. 2a.

Semiannual assessment by nursing facilities.

Notwithstanding Minnesota Rules, part 9549.0059, subpart 2, item B, the individual dependencies items 21 to 24 and 28 are required to be completed in accordance with the Facility Manual for Completing Case Mix Requests for Classification, July 1987, issued by the Minnesota Department of Health.

Subd. 3.

Request for reconsideration.

The resident or the nursing home or boarding care home may request that the commissioner reconsider the assigned reimbursement classification. The request for reconsideration must be submitted in writing to the commissioner within 30 days of the receipt of the notice of resident classification. For reconsideration requests submitted by or on behalf of the resident, the time period for submission of the request begins as of the date the resident or the resident's representative receives the classification notice. The request for reconsideration must include the name of the resident, the name and address of the facility in which the resident resides, the reasons for the reconsideration, the requested classification changes, and documentation supporting the requested classification. The documentation accompanying the reconsideration request is limited to documentation establishing that the needs of the resident at the time of the assessment resulting in the disputed classification justify a change of classification.

Subd. 3a.

Access to information.

Upon written request, the nursing home or boarding care home must give the resident or the resident's representative a copy of the assessment form and the other documentation that was given to the department to support the assessment findings. The nursing home or boarding care home shall also provide access to and a copy of other information from the resident's record that has been requested by or on behalf of the resident to support a resident's reconsideration request. A copy of any requested material must be provided within three working days of receipt of a written request for the information. If a facility fails to provide the material within this time, it is subject to the issuance of a correction order and penalty assessment under sections 144.653 and 144A.10. Notwithstanding those sections, any correction order issued under this subdivision must require that the facility immediately comply with the request for information and that as of the date of the issuance of the correction order, the facility shall forfeit to the state a $100 fine the first day of noncompliance, and an increase in the $100 fine by $50 increments for each day the noncompliance continues. For the purposes of this section, "representative" includes the resident's guardian or conservator, the person authorized to pay the nursing home expenses of the resident, a representative of the nursing home ombudsman's office whose assistance has been requested, or any other individual designated by the resident.

Subd. 3b.

Facility's request for reconsideration.

In addition to the information required in subdivision 3, a reconsideration request from a nursing home or boarding care home must contain the following information: the date the resident reimbursement classification notices were received by the facility; the date the classification notices were distributed to the resident or the resident's representative; and a copy of a notice sent to the resident or to the resident's representative. This notice must tell the resident or the resident's representative that a reconsideration of the resident's classification is being requested, the reason for the request, that the resident's rate will change if the request is approved by the department and the extent of the change, that copies of the facility's request and supporting documentation are available for review, and that the resident also has the right to request a reconsideration. If the facility fails to provide this information with the reconsideration request, the request must be denied, and the facility may not make further reconsideration requests on that specific reimbursement classification.

Subd. 4.

Reconsideration.

The commissioner's reconsideration must be made by individuals not involved in reviewing the assessment that established the disputed classification. The reconsideration must be based upon the initial assessment and upon the information provided to the commissioner under subdivision 3. If necessary for evaluating the reconsideration request, the commissioner may conduct on-site reviews. In its discretion, the commissioner may review the reimbursement classifications assigned to all residents in the facility. Within 15 working days of receiving the request for reconsideration, the commissioner shall affirm or modify the original resident classification. The original classification must be modified if the commissioner determines that the assessment resulting in the classification did not accurately reflect the needs of the resident at the time of the assessment. The resident and the nursing home or boarding care home shall be notified within five working days after the decision is made. The commissioner's decision under this subdivision is the final administrative decision of the agency.

Subd. 5.

Audit authority.

The Department of Health may audit assessments of nursing home and boarding care home residents. These audits may be in addition to the assessments completed by the department under section 144.0721. The audits may be conducted at the facility, and the department may conduct the audits on an unannounced basis.

144.0724 RESIDENT REIMBURSEMENT CLASSIFICATION.

Subd. 10.

Transition.

After implementation of this section, reconsiderations requested for classifications made under section 144.0722, subdivision 1, shall be determined under section 144.0722, subdivision 3.

144.693 MEDICAL MALPRACTICE CLAIMS; REPORTS.

Subdivision 1.

Insurers' reports to commissioner.

On or before September 1, 1976, and on or before March 1 and September 1 of each year thereafter, each insurer providing professional liability insurance to one or more hospitals, outpatient surgery centers, or health maintenance organizations, shall submit to the state commissioner of health a report listing by facility or organization all claims which have been closed by or filed with the insurer during the period ending December 31 of the previous year or June 30 of the current year. The report shall contain, but not be limited to, the following information:

(1) the total number of claims made against each facility or organization which were filed or closed during the reporting period;

(2) the date each new claim was filed with the insurer;

(3) the allegations contained in each claim filed during the reporting period;

(4) the disposition and closing date of each claim closed during the reporting period;

(5) the dollar amount of the award or settlement for each claim closed during the reporting period; and

(6) any other information the commissioner of health may, by rule, require.

Any hospital, outpatient surgery center, or health maintenance organization which is self insured shall be considered to be an insurer for the purposes of this section and shall comply with the reporting provisions of this section.

A report from an insurer submitted pursuant to this section is private data, as defined in section 13.02, subdivision 12, accessible to the facility or organization which is the subject of the data, and to its authorized agents. Any data relating to patient records which is reported to the state commissioner of health pursuant to this section shall be reported in the form of summary data, as defined in section 13.02, subdivision 19.

Subd. 2.

Report to legislature.

The state commissioner of health shall collect and review the data reported pursuant to subdivision 1. On December 1, 1976, and on January 2 of each year thereafter, the state commissioner of health shall report to the legislature the findings related to the incidence and size of malpractice claims against hospitals, outpatient surgery centers, and health maintenance organizations, and shall make any appropriate recommendations to reduce the incidence and size of the claims. Data published by the state commissioner of health pursuant to this subdivision with respect to malpractice claims information shall be summary data within the meaning of section 13.02, subdivision 19.

Subd. 3.

Access to insurers' records.

The state commissioner of health shall have access to the records of any insurer relating to malpractice claims made against hospitals, outpatient surgery centers, and health maintenance organizations in years prior to 1976 if the commissioner determines the records are necessary to fulfill the duties of the commissioner under Laws 1976, chapter 325.

245.4871 DEFINITIONS.

Subd. 32a.

Responsible social services agency.

"Responsible social services agency" is defined in section 260C.007, subdivision 27a.

256B.0596 MENTAL HEALTH CASE MANAGEMENT.

256B.0596 MENTAL HEALTH CASE MANAGEMENT.

Counties shall contract with eligible providers willing to provide mental health case management services under section 256B.0625, subdivision 20. In order to be eligible, in addition to general provider requirements under this chapter, the provider must:

(1) be willing to provide the mental health case management services; and

(2) have a minimum of at least one contact with the client per week. This section is not intended to limit the ability of a county to provide its own mental health case management services.

256B.0596 MENTAL HEALTH CASE MANAGEMENT.

Counties shall contract with eligible providers willing to provide mental health case management services under section 256B.0625, subdivision 20. In order to be eligible, in addition to general provider requirements under this chapter, the provider must:

(1) be willing to provide the mental health case management services; and

(2) have a minimum of at least one contact with the client per week. This section is not intended to limit the ability of a county to provide its own mental health case management services.

256B.0916 EXPANSION OF HOME AND COMMUNITY-BASED SERVICES.

Subd. 2.

Distribution of funds; partnerships.

(a) Beginning with fiscal year 2000, the commissioner shall distribute all funding available for home and community-based waiver services for persons with developmental disabilities to individual counties or to groups of counties that form partnerships to jointly plan, administer, and authorize funding for eligible individuals. The commissioner shall encourage counties to form partnerships that have a sufficient number of recipients and funding to adequately manage the risk and maximize use of available resources.

(b) Counties must submit a request for funds and a plan for administering the program as required by the commissioner. The plan must identify the number of clients to be served, their ages, and their priority listing based on:

(1) requirements in Minnesota Rules, part 9525.1880; and

(2) statewide priorities identified in section 256B.092, subdivision 12.

The plan must also identify changes made to improve services to eligible persons and to improve program management.

(c) In allocating resources to counties, priority must be given to groups of counties that form partnerships to jointly plan, administer, and authorize funding for eligible individuals and to counties determined by the commissioner to have sufficient waiver capacity to maximize resource use.

(d) Within 30 days after receiving the county request for funds and plans, the commissioner shall provide a written response to the plan that includes the level of resources available to serve additional persons.

(e) Counties are eligible to receive medical assistance administrative reimbursement for administrative costs under criteria established by the commissioner.

(f) The commissioner shall manage waiver allocations in such a manner as to fully use available state and federal waiver appropriations.

Subd. 3.

Failure to develop partnerships or submit a plan.

(a) By October 1 of each year the commissioner shall notify the county board if any county determined by the commissioner to have insufficient capacity to maximize use of available resources fails to develop a partnership with other counties or fails to submit a plan as required in subdivision 2. The commissioner shall provide needed technical assistance to a county or group of counties that fails to form a partnership or submit a plan. If a county has not joined a county partnership or submitted a plan within 30 days following the notice by the commissioner of its failure, the commissioner shall require and assist that county to develop a plan or contract with another county or group of counties to plan and administer the waiver services program in that county.

(b) Counties may request technical assistance, management information, and administrative support from the commissioner at any time. The commissioner shall respond to county requests within 30 days. Priority shall be given to activities that support the administrative needs of newly formed county partnerships.

Subd. 4.

Allowed reserve.

Counties or groups of counties participating in partnerships that have submitted a plan under this section may develop an allowed reserve amount to meet crises and other unmet needs of current home and community-based waiver recipients. The amount of the allowed reserve shall be a county specific amount based upon documented past experience and projected need for the coming year described in an allowed reserve plan submitted for approval to the commissioner with the allocation request for the fiscal year.

Subd. 5.

Allocation of new diversions and priorities for reassignment of resources for developmental disabilities.

(a) The commissioner shall monitor county utilization of allocated resources and, as appropriate, reassign resources not utilized.

(b) Effective July 1, 2002, the commissioner shall authorize the spending of new diversion resources beginning January 1 of each year.

(c) Effective July 1, 2002, the commissioner shall manage the reassignment of waiver resources that occur from persons who have left the waiver in a manner that results in the cost reduction equivalent to delaying the reuse of those waiver resources by 180 days.

(d) Priority consideration for reassignment of resources shall be given to counties that form partnerships. In addition to the priorities listed in Minnesota Rules, part 9525.1880, the commissioner shall also give priority consideration to persons whose living situations are unstable due to the age or incapacity of the primary caregiver and to children to avoid out-of-home placement.

Subd. 8.

Financial and wait-list data reporting.

(a) The commissioner shall make available financial and waiting list information on the department's website.

(b) The financial information must include:

(1) the most recent end of session forecast available for the disability home and community-based waiver programs authorized under sections 256B.092 and 256B.49; and

(2) the most current financial information, updated at least monthly for the disability home and community-based waiver program authorized under section 256B.092 and three disability home and community-based waiver programs authorized under section 256B.49 for each county and tribal agency, including:

(i) the amount of resources allocated;

(ii) the amount of resources authorized for participants; and

(iii) the amount of allocated resources not authorized and the amount not used as provided in subdivision 12, and section 256B.49, subdivision 27.

(c) The waiting list information must be provided quarterly beginning August 1, 2016, and must include at least:

(1) the number of persons screened and waiting for services listed by urgency category, the number of months on the wait list, age group, and the type of services requested by those waiting;

(2) the number of persons beginning waiver services who were on the waiting list, and the number of persons beginning waiver services who were not on the waiting list;

(3) the number of persons who left the waiting list but did not begin waiver services; and

(4) the number of persons on the waiting list with approved funding but without a waiver service agreement and the number of days from funding approval until a service agreement is effective for each person.

(d) By December 1 of each year, the commissioner shall compile a report posted on the department's website that includes:

(1) the financial information listed in paragraph (b) for the most recently completed allocation period;

(2) for the previous four quarters, the waiting list information listed in paragraph (c);

(3) for a 12-month period ending October 31, a list of county and tribal agencies required to submit a corrective action plan under subdivisions 11 and 12, and section 256B.49, subdivisions 26 and 27; and

(4) for a 12-month period ending October 31, a list of the county and tribal agencies from which resources were moved as authorized in section 256B.092, subdivision 12, and section 256B.49, subdivision 11a, the amount of resources taken from each agency, the counties that were given increased resources as a result, and the amounts provided.

Subd. 11.

Excess spending.

County and tribal agencies are responsible for spending in excess of the allocation made by the commissioner. In the event a county or tribal agency spends in excess of the allocation made by the commissioner for a given allocation period, they must submit a corrective action plan to the commissioner for approval. The plan must state the actions the agency will take to correct their overspending for the two years following the period when the overspending occurred. The commissioner shall recoup spending in excess of the allocation only in cases where statewide spending exceeds the appropriation designated for the home and community-based services waivers. Nothing in this subdivision shall be construed as reducing the county's responsibility to offer and make available feasible home and community-based options to eligible waiver recipients within the resources allocated to them for that purpose.

Subd. 12.

Use of waiver allocations.

County and tribal agencies are responsible for spending the annual allocation made by the commissioner. In the event a county or tribal agency spends less than 97 percent of the allocation, while maintaining a list of persons waiting for waiver services, the county or tribal agency must submit a corrective action plan to the commissioner for approval. The commissioner may determine a plan is unnecessary given the size of the allocation and capacity for new enrollment. The plan must state the actions the agency will take to assure reasonable and timely access to home and community-based waiver services for persons waiting for services. If a county or tribe does not submit a plan when required or implement the changes required, the commissioner shall assure access to waiver services within the county's or tribe's available allocation and take other actions needed to assure that all waiver participants in that county or tribe are receiving appropriate waiver services to meet their needs.

256B.0924 TARGETED CASE MANAGEMENT SERVICES.

Subd. 4a.

Targeted case management through interactive video.

(a) Subject to federal approval, contact made for targeted case management by interactive video shall be eligible for payment under subdivision 6 if:

(1) the person receiving targeted case management services is residing in:

(i) a hospital;

(ii) a nursing facility; or

(iii) a residential setting licensed under chapter 245A or 245D or a boarding and lodging establishment or lodging establishment that provides supportive services or health supervision services according to section 157.17 that is staffed 24 hours a day, seven days a week;

(2) interactive video is in the best interests of the person and is deemed appropriate by the person receiving targeted case management or the person's legal guardian, the case management provider, and the provider operating the setting where the person is residing;

(3) the use of interactive video is approved as part of the person's written personal service or case plan; and

(4) interactive video is used for up to, but not more than, 50 percent of the minimum required face-to-face contact.

(b) The person receiving targeted case management or the person's legal guardian has the right to choose and consent to the use of interactive video under this subdivision and has the right to refuse the use of interactive video at any time.

(c) The commissioner shall establish criteria that a targeted case management provider must attest to in order to demonstrate the safety or efficacy of delivering the service via interactive video. The attestation may include that the case management provider has:

(1) written policies and procedures specific to interactive video services that are regularly reviewed and updated;

(2) policies and procedures that adequately address client safety before, during, and after the interactive video services are rendered;

(3) established protocols addressing how and when to discontinue interactive video services; and

(4) established a quality assurance process related to interactive video services.

(d) As a condition of payment, the targeted case management provider must document the following for each occurrence of targeted case management provided by interactive video:

(1) the time the service began and the time the service ended, including an a.m. and p.m. designation;

(2) the basis for determining that interactive video is an appropriate and effective means for delivering the service to the person receiving case management services;

(3) the mode of transmission of the interactive video services and records evidencing that a particular mode of transmission was utilized;

(4) the location of the originating site and the distant site; and

(5) compliance with the criteria attested to by the targeted case management provider as provided in paragraph (c).

256B.097 STATE QUALITY ASSURANCE, QUALITY IMPROVEMENT, AND LICENSING SYSTEM.

Subdivision 1.

Scope.

(a) In order to improve the quality of services provided to Minnesotans with disabilities and to meet the requirements of the federally approved home and community-based waivers under section 1915c of the Social Security Act, a State Quality Assurance, Quality Improvement, and Licensing System for Minnesotans receiving disability services is enacted. This system is a partnership between the Department of Human Services and the State Quality Council established under subdivision 3.

(b) This system is a result of the recommendations from the Department of Human Services' licensing and alternative quality assurance study mandated under Laws 2005, First Special Session chapter 4, article 7, section 57, and presented to the legislature in February 2007.

(c) The disability services eligible under this section include:

(1) the home and community-based services waiver programs for persons with developmental disabilities under section 256B.092, subdivision 4, or section 256B.49, including brain injuries and services for those who qualify for nursing facility level of care or hospital facility level of care and any other services licensed under chapter 245D;

(2) home care services under section 256B.0651;

(3) family support grants under section 252.32;

(4) consumer support grants under section 256.476;

(5) semi-independent living services under section 252.275; and

(6) services provided through an intermediate care facility for the developmentally disabled.

(d) For purposes of this section, the following definitions apply:

(1) "commissioner" means the commissioner of human services;

(2) "council" means the State Quality Council under subdivision 3;

(3) "Quality Assurance Commission" means the commission under section 256B.0951; and

(4) "system" means the State Quality Assurance, Quality Improvement and Licensing System under this section.

Subd. 2.

Duties of commissioner of human services.

(a) The commissioner of human services shall establish the State Quality Council under subdivision 3.

(b) The commissioner shall initially delegate authority to perform licensing functions and activities according to section 245A.16 to a host county in Region 10. The commissioner must not license or reimburse a participating facility, program, or service located in Region 10 if the commissioner has received notification from the host county that the facility, program, or service has failed to qualify for licensure.

(c) The commissioner may conduct random licensing inspections based on outcomes adopted under section 256B.0951, subdivision 3, at facilities or programs, and of services eligible under this section. The role of the random inspections is to verify that the system protects the safety and well-being of persons served and maintains the availability of high-quality services for persons with disabilities.

(d) The commissioner shall ensure that the federal home and community-based waiver requirements are met and that incidents that may have jeopardized safety and health or violated services-related assurances, civil and human rights, and other protections designed to prevent abuse, neglect, and exploitation, are reviewed, investigated, and acted upon in a timely manner.

(e) The commissioner shall seek a federal waiver by July 1, 2012, to allow intermediate care facilities for persons with developmental disabilities to participate in this system.

Subd. 3.

State Quality Council.

(a) There is hereby created a State Quality Council which must define regional quality councils, and carry out a community-based, person-directed quality review component, and a comprehensive system for effective incident reporting, investigation, analysis, and follow-up.

(b) By August 1, 2011, the commissioner of human services shall appoint the members of the initial State Quality Council. Members shall include representatives from the following groups:

(1) disability service recipients and their family members;

(2) during the first four years of the State Quality Council, there must be at least three members from the Region 10 stakeholders. As regional quality councils are formed under subdivision 4, each regional quality council shall appoint one member;

(3) disability service providers;

(4) disability advocacy groups; and

(5) county human services agencies and staff from the Department of Human Services and Ombudsman for Mental Health and Developmental Disabilities.

(c) Members of the council who do not receive a salary or wages from an employer for time spent on council duties may receive a per diem payment when performing council duties and functions.

(d) The State Quality Council shall:

(1) assist the Department of Human Services in fulfilling federally mandated obligations by monitoring disability service quality and quality assurance and improvement practices in Minnesota;

(2) establish state quality improvement priorities with methods for achieving results and provide an annual report to the legislative committees with jurisdiction over policy and funding of disability services on the outcomes, improvement priorities, and activities undertaken by the commission during the previous state fiscal year;

(3) identify issues pertaining to financial and personal risk that impede Minnesotans with disabilities from optimizing choice of community-based services; and

(4) recommend to the chairs and ranking minority members of the legislative committees with jurisdiction over human services and civil law by January 15, 2014, statutory and rule changes related to the findings under clause (3) that promote individualized service and housing choices balanced with appropriate individualized protection.

(e) The State Quality Council, in partnership with the commissioner, shall:

(1) approve and direct implementation of the community-based, person-directed system established in this section;

(2) recommend an appropriate method of funding this system, and determine the feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;

(3) approve measurable outcomes in the areas of health and safety, consumer evaluation, education and training, providers, and systems;

(4) establish variable licensure periods not to exceed three years based on outcomes achieved; and

(5) in cooperation with the Quality Assurance Commission, design a transition plan for licensed providers from Region 10 into the alternative licensing system.

(f) The State Quality Council shall notify the commissioner of human services that a facility, program, or service has been reviewed by quality assurance team members under subdivision 4, paragraph (b), clause (13), and qualifies for a license.

(g) The State Quality Council, in partnership with the commissioner, shall establish an ongoing review process for the system. The review shall take into account the comprehensive nature of the system which is designed to evaluate the broad spectrum of licensed and unlicensed entities that provide services to persons with disabilities. The review shall address efficiencies and effectiveness of the system.

(h) The State Quality Council may recommend to the commissioner certain variances from the standards governing licensure of programs for persons with disabilities in order to improve the quality of services so long as the recommended variances do not adversely affect the health or safety of persons being served or compromise the qualifications of staff to provide services.

(i) The safety standards, rights, or procedural protections referenced under subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make recommendations to the commissioner or to the legislature in the report required under paragraph (c) regarding alternatives or modifications to the safety standards, rights, or procedural protections referenced under subdivision 2, paragraph (c).

(j) The State Quality Council may hire staff to perform the duties assigned in this subdivision.

Subd. 4.

Regional quality councils.

(a) The commissioner shall establish, as selected by the State Quality Council, regional quality councils of key stakeholders, including regional representatives of:

(1) disability service recipients and their family members;

(2) disability service providers;

(3) disability advocacy groups; and

(4) county human services agencies and staff from the Department of Human Services and Ombudsman for Mental Health and Developmental Disabilities.

(b) Each regional quality council shall:

(1) direct and monitor the community-based, person-directed quality assurance system in this section;

(2) approve a training program for quality assurance team members under clause (13);

(3) review summary reports from quality assurance team reviews and make recommendations to the State Quality Council regarding program licensure;

(4) make recommendations to the State Quality Council regarding the system;

(5) resolve complaints between the quality assurance teams, counties, providers, persons receiving services, their families, and legal representatives;

(6) analyze and review quality outcomes and critical incident data reporting incidents of life safety concerns immediately to the Department of Human Services licensing division;

(7) provide information and training programs for persons with disabilities and their families and legal representatives on service options and quality expectations;

(8) disseminate information and resources developed to other regional quality councils;

(9) respond to state-level priorities;

(10) establish regional priorities for quality improvement;

(11) submit an annual report to the State Quality Council on the status, outcomes, improvement priorities, and activities in the region;

(12) choose a representative to participate on the State Quality Council and assume other responsibilities consistent with the priorities of the State Quality Council; and

(13) recruit, train, and assign duties to members of quality assurance teams, taking into account the size of the service provider, the number of services to be reviewed, the skills necessary for the team members to complete the process, and ensure that no team member has a financial, personal, or family relationship with the facility, program, or service being reviewed or with anyone served at the facility, program, or service. Quality assurance teams must be comprised of county staff, persons receiving services or the person's families, legal representatives, members of advocacy organizations, providers, and other involved community members. Team members must complete the training program approved by the regional quality council and must demonstrate performance-based competency. Team members may be paid a per diem and reimbursed for expenses related to their participation in the quality assurance process.

(c) The commissioner shall monitor the safety standards, rights, and procedural protections for the monitoring of psychotropic medications and those identified under sections 245.825; 245.91 to 245.97; 245A.09, subdivision 2, paragraph (c), clauses (2) and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, subdivision 1b, clause (7); and 626.557; and chapter 260E.

(d) The regional quality councils may hire staff to perform the duties assigned in this subdivision.

(e) The regional quality councils may charge fees for their services.

(f) The quality assurance process undertaken by a regional quality council consists of an evaluation by a quality assurance team of the facility, program, or service. The process must include an evaluation of a random sample of persons served. The sample must be representative of each service provided. The sample size must be at least five percent but not less than two persons served. All persons must be given the opportunity to be included in the quality assurance process in addition to those chosen for the random sample.

(g) A facility, program, or service may contest a licensing decision of the regional quality council as permitted under chapter 245A.

Subd. 5.

Annual survey of service recipients.

The commissioner, in consultation with the State Quality Council, shall conduct an annual independent statewide survey of service recipients, randomly selected, to determine the effectiveness and quality of disability services. The survey must be consistent with the system performance expectations of the Centers for Medicare and Medicaid Services (CMS) Quality Framework. The survey must analyze whether desired outcomes for persons with different demographic, diagnostic, health, and functional needs, who are receiving different types of services in different settings and with different costs, have been achieved. Annual statewide and regional reports of the results must be published and used to assist regions, counties, and providers to plan and measure the impact of quality improvement activities.

Subd. 6.

Mandated reporters.

Members of the State Quality Council under subdivision 3, the regional quality councils under subdivision 4, and quality assurance team members under subdivision 4, paragraph (b), clause (13), are mandated reporters as defined in sections 260E.06, subdivision 1, and 626.5572, subdivision 16.

256B.49 HOME AND COMMUNITY-BASED SERVICE WAIVERS FOR PERSONS WITH DISABILITIES.

Subd. 26.

Excess allocations.

Effective July 1, 2018, county and tribal agencies will be responsible for spending in excess of the annual allocation made by the commissioner. In the event a county or tribal agency spends in excess of the allocation made by the commissioner for a given allocation period, the county or tribal agency must submit a corrective action plan to the commissioner for approval. The plan must state the actions the agency will take to correct its overspending for the two years following the period when the overspending occurred. The commissioner shall recoup funds spent in excess of the allocation only in cases when statewide spending exceeds the appropriation designated for the home and community-based services waivers. Nothing in this subdivision shall be construed as reducing the county or tribe's responsibility to offer and make available feasible home and community-based options to eligible waiver recipients within the resources allocated to it for that purpose.

Subd. 27.

Use of waiver allocations.

(a) Effective until June 30, 2018, county and tribal agencies are responsible for authorizing the annual allocation made by the commissioner. In the event a county or tribal agency authorizes less than 97 percent of the allocation, while maintaining a list of persons waiting for waiver services, the county or tribal agency must submit a corrective action plan to the commissioner for approval. The commissioner may determine a plan is unnecessary given the size of the allocation and capacity for new enrollment. The plan must state the actions the agency will take to assure reasonable and timely access to home and community-based waiver services for persons waiting for services.

(b) Effective July 1, 2018, county and tribal agencies are responsible for spending the annual allocation made by the commissioner. In the event a county or tribal agency spends less than 97 percent of the allocation, while maintaining a list of persons waiting for waiver services, the county or tribal agency must submit a corrective action plan to the commissioner for approval. The commissioner may determine a plan is unnecessary given the size of the allocation and capacity for new enrollment. The plan must state the actions the agency will take to assure reasonable and timely access to home and community-based waiver services for persons waiting for services.

(c) If a county or tribe does not submit a plan when required or implement the changes required, the commissioner shall assure access to waiver services within the county or tribe's available allocation, and take other actions needed to assure that all waiver participants in that county or tribe are receiving appropriate waiver services to meet their needs.

256B.4905 HOME AND COMMUNITY-BASED SERVICES POLICY STATEMENT.

Subdivision 1.

Employment first policy.

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

Subd. 2.

Employment first implementation for disability waiver services.

The commissioner of human services shall ensure that:

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

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

Subd. 3.

Independent living first policy.

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

Subd. 4.

Independent living first implementation for disability waiver services.

The commissioner of human services shall ensure that:

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

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

Subd. 5.

Self-direction first policy.

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

Subd. 6.

Self-directed first implementation for disability waiver services.

The commissioner of human services shall ensure that:

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

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

256D.051 SNAP EMPLOYMENT AND TRAINING PROGRAM.

Subdivision 1.

SNAP employment and training program.

The commissioner shall implement a SNAP employment and training program in order to meet the SNAP employment and training participation requirements of the United States Department of Agriculture. Unless exempt under subdivision 3a, each adult recipient in the unit must participate in the SNAP employment and training program each month that the person is eligible for SNAP benefits. The person's participation in SNAP employment and training services must begin no later than the first day of the calendar month following the determination of eligibility for SNAP benefits. With the county agency's consent, and to the extent of available resources, the person may voluntarily continue to participate in SNAP employment and training services for up to three additional consecutive months immediately following termination of SNAP benefits in order to complete the provisions of the person's employability development plan.

Subd. 1a.

Notices and sanctions.

(a) At the time the county agency notifies the household that it is eligible for SNAP benefits, the county agency must inform all mandatory employment and training services participants as identified in subdivision 1 in the household that they must comply with all SNAP employment and training program requirements each month, including the requirement to attend an initial orientation to the SNAP employment and training program and that SNAP eligibility will end unless the participants comply with the requirements specified in the notice.

(b) A participant who fails without good cause to comply with SNAP employment and training program requirements of this section, including attendance at orientation, will lose SNAP eligibility for the following periods:

(1) for the first occurrence, for one month or until the person complies with the requirements not previously complied with, whichever is longer;

(2) for the second occurrence, for three months or until the person complies with the requirements not previously complied with, whichever is longer; or

(3) for the third and any subsequent occurrence, for six months or until the person complies with the requirements not previously complied with, whichever is longer.

If the participant is not the SNAP head of household, the person shall be considered an ineligible household member for SNAP purposes. If the participant is the SNAP head of household, the entire household is ineligible for SNAP as provided in Code of Federal Regulations, title 7, section 273.7(g). "Good cause" means circumstances beyond the control of the participant, such as illness or injury, illness or injury of another household member requiring the participant's presence, a household emergency, or the inability to obtain child care for children between the ages of six and 12 or to obtain transportation needed in order for the participant to meet the SNAP employment and training program participation requirements.

(c) The county agency shall mail or hand deliver a notice to the participant not later than five days after determining that the participant has failed without good cause to comply with SNAP employment and training program requirements which specifies the requirements that were not complied with, the factual basis for the determination of noncompliance, and the right to reinstate eligibility upon a showing of good cause for failure to meet the requirements. The notice must ask the reason for the noncompliance and identify the participant's appeal rights. The notice must request that the participant inform the county agency if the participant believes that good cause existed for the failure to comply and must state that the county agency intends to terminate eligibility for SNAP benefits due to failure to comply with SNAP employment and training program requirements.

(d) If the county agency determines that the participant did not comply during the month with all SNAP employment and training program requirements that were in effect, and if the county agency determines that good cause was not present, the county must provide a ten-day notice of termination of SNAP benefits. The amount of SNAP benefits that are withheld from the household and determination of the impact of the sanction on other household members is governed by Code of Federal Regulations, title 7, section 273.7.

(e) The participant may appeal the termination of SNAP benefits under the provisions of section 256.045.

Subd. 2.

County agency duties.

(a) The county agency shall provide to SNAP benefit recipients a SNAP employment and training program. The program must include:

(1) orientation to the SNAP employment and training program;

(2) an individualized employability assessment and an individualized employability development plan that includes assessment of literacy, ability to communicate in the English language, educational and employment history, and that estimates the length of time it will take the participant to obtain employment. The employability assessment and development plan must be completed in consultation with the participant, must assess the participant's assets, barriers, and strengths, and must identify steps necessary to overcome barriers to employment. A copy of the employability development plan must be provided to the registrant;

(3) referral to available accredited remedial or skills training programs designed to address participant's barriers to employment;

(4) referral to available programs that provide subsidized or unsubsidized employment as necessary;

(5) a job search program, including job seeking skills training; and

(6) other activities, to the extent of available resources designed by the county agency to prepare the participant for permanent employment.

In order to allow time for job search, the county agency may not require an individual to participate in the SNAP employment and training program for more than 32 hours a week. The county agency shall require an individual to spend at least eight hours a week in job search or other SNAP employment and training program activities.

(b) The county agency shall prepare an annual plan for the operation of its SNAP employment and training program. The plan must be submitted to and approved by the commissioner of employment and economic development. The plan must include:

(1) a description of the services to be offered by the county agency;

(2) a plan to coordinate the activities of all public entities providing employment-related services in order to avoid duplication of effort and to provide services more efficiently;

(3) a description of the factors that will be taken into account when determining a client's employability development plan; and

(4) provisions to ensure that the county agency's employment and training service provider provides each recipient with an orientation, employability assessment, and employability development plan as specified in paragraph (a), clauses (1) and (2), within 30 days of the recipient's eligibility for assistance.

Subd. 2a.

Duties of commissioner.

In addition to any other duties imposed by law, the commissioner shall:

(1) based on this section and section 256D.052 and Code of Federal Regulations, title 7, section 273.7, supervise the administration of SNAP employment and training services to county agencies;

(2) disburse money appropriated for SNAP employment and training services to county agencies based upon the county's costs as specified in section 256D.051, subdivision 6c;

(3) accept and supervise the disbursement of any funds that may be provided by the federal government or from other sources for use in this state for SNAP employment and training services;

(4) cooperate with other agencies including any agency of the United States or of another state in all matters concerning the powers and duties of the commissioner under this section and section 256D.052; and

(5) in cooperation with the commissioner of employment and economic development, ensure that each component of an employment and training program carried out under this section is delivered through a statewide workforce development system, unless the component is not available locally through such a system.

Subd. 3.

Participant duties.

In order to receive SNAP assistance, a registrant shall: (1) cooperate with the county agency in all aspects of the SNAP employment and training program; (2) accept any suitable employment, including employment offered through the Job Training Partnership Act, and other employment and training options; and (3) participate in SNAP employment and training activities assigned by the county agency. The county agency may terminate assistance to a registrant who fails to cooperate in the SNAP employment and training program, as provided in subdivision 1a.

Subd. 3a.

Requirement to register work.

(a) To the extent required under Code of Federal Regulations, title 7, section 273.7(a), each applicant for and recipient of SNAP benefits is required to register for work as a condition of eligibility for SNAP benefits. Applicants and recipients are registered by signing an application or annual reapplication for SNAP benefits, and must be informed that they are registering for work by signing the form.

(b) The commissioner shall determine, within federal requirements, persons required to participate in the SNAP employment and training program.

(c) The following SNAP benefit recipients are exempt from mandatory participation in SNAP employment and training services:

(1) recipients of benefits under the Minnesota family investment program, Minnesota supplemental aid program, or the general assistance program;

(2) a child;

(3) a recipient over age 55;

(4) a recipient who has a mental or physical illness, injury, or incapacity which is expected to continue for at least 30 days and which impairs the recipient's ability to obtain or retain employment as evidenced by professional certification or the receipt of temporary or permanent disability benefits issued by a private or government source;

(5) a parent or other household member responsible for the care of either a dependent child in the household who is under age six or a person in the household who is professionally certified as having a physical or mental illness, injury, or incapacity. Only one parent or other household member may claim exemption under this provision;

(6) a recipient receiving unemployment insurance or who has applied for unemployment insurance and has been required to register for work with the Department of Employment and Economic Development as part of the unemployment insurance application process;

(7) a recipient participating each week in a drug addiction or alcohol abuse treatment and rehabilitation program, provided the operators of the treatment and rehabilitation program, in consultation with the county agency, recommend that the recipient not participate in the SNAP employment and training program;

(8) a recipient employed or self-employed for 30 or more hours per week at employment paying at least minimum wage, or who earns wages from employment equal to or exceeding 30 hours multiplied by the federal minimum wage; or

(9) a student enrolled at least half time in any school, training program, or institution of higher education. When determining if a student meets this criteria, the school's, program's or institution's criteria for being enrolled half time shall be used.

Subd. 3b.

Orientation.

The county agency or its employment and training service provider must provide an orientation to SNAP employment and training services to each nonexempt SNAP benefit recipient within 30 days of the date that SNAP eligibility is determined. The orientation must inform the participant of the requirement to participate in services, the date, time, and address to report to for services, the name and telephone number of the SNAP employment and training service provider, the consequences for failure without good cause to comply, the services and support services available through SNAP employment and training services and other providers of similar services, and must encourage the participant to view the SNAP benefits program as a temporary means of supplementing the family's food needs until the family achieves self-sufficiency through employment. The orientation may be provided through audio-visual methods, but the participant must have the opportunity for face-to-face interaction with county agency staff.

Subd. 6b.

Federal reimbursement.

(a) Federal financial participation from the United States Department of Agriculture for SNAP employment and training expenditures that are eligible for reimbursement through the SNAP employment and training program are dedicated funds and are annually appropriated to the commissioner of human services for the operation of the SNAP employment and training program.

(b) The appropriation must be used for skill attainment through employment, training, and support services for SNAP participants.

(c) Federal financial participation for the nonstate portion of SNAP employment and training costs must be paid to the county agency or service provider that incurred the costs.

Subd. 6c.

Program funding.

Within the limits of available resources, the commissioner shall reimburse the actual costs of county agencies and their employment and training service providers for the provision of SNAP employment and training services, including participant support services, direct program services, and program administrative activities. The cost of services for each county's SNAP employment and training program shall not exceed the annual allocated amount. No more than 15 percent of program funds may be used for administrative activities. The county agency may expend county funds in excess of the limits of this subdivision without state reimbursement.

Program funds shall be allocated based on the county's average number of SNAP eligible cases as compared to the statewide total number of such cases. The average number of cases shall be based on counts of cases as of March 31, June 30, September 30, and December 31 of the previous calendar year. The commissioner may reallocate unexpended money appropriated under this section to those county agencies that demonstrate a need for additional funds.

Subd. 7.

Registrant status.

A registrant under this section is not an employee for the purposes of workers' compensation, unemployment benefits, retirement, or civil service laws, and shall not perform work ordinarily performed by a regular public employee.

Subd. 8.

Voluntary quit.

A person who is required to participate in SNAP employment and training services is not eligible for SNAP benefits if, without good cause, the person refuses a legitimate offer of, or quits, suitable employment within 60 days before the date of application. A person who is required to participate in SNAP employment and training services and, without good cause, voluntarily quits suitable employment or refuses a legitimate offer of suitable employment while receiving SNAP benefits shall be terminated from the SNAP program as specified in subdivision 1a.

Subd. 9.

Subcontractors.

A county agency may, at its option, subcontract any or all of the duties under this section to a public or private entity approved by the commissioner of employment and economic development.

Subd. 18.

Work experience placements.

(a) To the extent of available resources, each county agency must establish and operate a work experience component in the SNAP employment and training program for recipients who are subject to a federal limit of three months of SNAP eligibility in any 36-month period. The purpose of the work experience component is to enhance the participant's employability, self-sufficiency, and to provide meaningful, productive work activities.

(b) The commissioner shall assist counties in the design and implementation of these components. The commissioner must ensure that job placements under a work experience component comply with section 256J.72. Written or oral concurrence with job duties of persons placed under the community work experience program shall be obtained from the appropriate exclusive bargaining representative.

(c) Worksites developed under this section are limited to projects that serve a useful public service such as health, social service, environmental protection, education, urban and rural development and redevelopment, welfare, recreation, public facilities, public safety, community service, services to aged citizens or citizens with a disability, and child care. To the extent possible, the prior training, skills, and experience of a recipient must be used in making appropriate work experience assignments.

(d) Structured, supervised volunteer work with an agency or organization that is monitored by the county service provider may, with the approval of the county agency, be used as a work experience placement.

(e) As a condition of placing a person receiving SNAP benefits in a program under this subdivision, the county agency shall first provide the recipient the opportunity:

(1) for placement in suitable subsidized or unsubsidized employment through participation in job search under section 256D.051; or

(2) for placement in suitable employment through participation in on-the-job training, if such employment is available.

(f) The county agency shall limit the maximum monthly number of hours that any participant may work in a work experience placement to a number equal to the amount of the family's monthly SNAP benefit allotment divided by the greater of the federal minimum wage or the applicable state minimum wage.

After a participant has been assigned to a position for nine months, the participant may not continue in that assignment unless the maximum number of hours a participant works is no greater than the amount of the SNAP benefit divided by the rate of pay for individuals employed in the same or similar occupations by the same employer at the same site.

(g) The participant's employability development plan must include the length of time needed in the work experience program, the need to continue job seeking activities while participating in work experience, and the participant's employment goals.

(h) After each six months of a recipient's participation in a work experience job placement, and at the conclusion of each work experience assignment under this section, the county agency shall reassess and revise, as appropriate, the participant's employability development plan.

(i) A participant has good cause for failure to cooperate with a work experience job placement if, in the judgment of the employment and training service provider, the reason for failure is reasonable and justified. Good cause for purposes of this section is defined in subdivision 1a, paragraph (b).

(j) A recipient who has failed without good cause to participate in or comply with the work experience job placement shall be terminated from participation in work experience job activities. If the recipient is not exempt from mandatory SNAP employment and training program participation under subdivision 3a, the recipient will be assigned to other mandatory program activities. If the recipient is exempt from mandatory participation but is participating as a volunteer, the person shall be terminated from the SNAP employment and training program.

256D.052 LITERACY TRAINING FOR RECIPIENTS.

Subd. 3.

Participant literacy transportation costs.

Within the limits of the state appropriation the county agency must provide transportation to enable Supplemental Nutrition Assistance Program (SNAP) employment and training participants to participate in literacy training under this section. The state shall reimburse county agencies for the costs of providing transportation under this section up to the amount of the state appropriation. Counties must make every effort to ensure that child care is available as needed by recipients who are pursuing literacy training.

256J.21 INCOME LIMITATIONS.

Subdivision 1.

Income inclusions.

To determine MFIP eligibility, the county agency must evaluate income received by members of an assistance unit, or by other persons whose income is considered available to the assistance unit, and only count income that is available to the member of the assistance unit. Income is available if the individual has legal access to the income. All payments, unless specifically excluded in subdivision 2, must be counted as income. The county agency shall verify the income of all MFIP recipients and applicants.

Subd. 2.

Income exclusions.

The following must be excluded in determining a family's available income:

(1) payments for basic care, difficulty of care, and clothing allowances received for providing family foster care to children or adults under Minnesota Rules, parts 9555.5050 to 9555.6265, 9560.0521, and 9560.0650 to 9560.0654, payments for family foster care for children under section 260C.4411 or chapter 256N, and payments received and used for care and maintenance of a third-party beneficiary who is not a household member;

(2) reimbursements for employment training received through the Workforce Investment Act of 1998, United States Code, title 20, chapter 73, section 9201;

(3) reimbursement for out-of-pocket expenses incurred while performing volunteer services, jury duty, employment, or informal carpooling arrangements directly related to employment;

(4) all educational assistance, except the county agency must count graduate student teaching assistantships, fellowships, and other similar paid work as earned income and, after allowing deductions for any unmet and necessary educational expenses, shall count scholarships or grants awarded to graduate students that do not require teaching or research as unearned income;

(5) loans, regardless of purpose, from public or private lending institutions, governmental lending institutions, or governmental agencies;

(6) loans from private individuals, regardless of purpose, provided an applicant or participant documents that the lender expects repayment;

(7)(i) state income tax refunds; and

(ii) federal income tax refunds;

(8)(i) federal earned income credits;

(ii) Minnesota working family credits;

(iii) state homeowners and renters credits under chapter 290A; and

(iv) federal or state tax rebates;

(9) funds received for reimbursement, replacement, or rebate of personal or real property when these payments are made by public agencies, awarded by a court, solicited through public appeal, or made as a grant by a federal agency, state or local government, or disaster assistance organizations, subsequent to a presidential declaration of disaster;

(10) the portion of an insurance settlement that is used to pay medical, funeral, and burial expenses, or to repair or replace insured property;

(11) reimbursements for medical expenses that cannot be paid by medical assistance;

(12) payments by a vocational rehabilitation program administered by the state under chapter 268A, except those payments that are for current living expenses;

(13) in-kind income, including any payments directly made by a third party to a provider of goods and services;

(14) assistance payments to correct underpayments, but only for the month in which the payment is received;

(15) payments for short-term emergency needs under section 256J.626, subdivision 2;

(16) funeral and cemetery payments as provided by section 256.935;

(17) nonrecurring cash gifts of $30 or less, not exceeding $30 per participant in a calendar month;

(18) any form of energy assistance payment made through Public Law 97-35, Low-Income Home Energy Assistance Act of 1981, payments made directly to energy providers by other public and private agencies, and any form of credit or rebate payment issued by energy providers;

(19) Supplemental Security Income (SSI), including retroactive SSI payments and other income of an SSI recipient;

(20) Minnesota supplemental aid, including retroactive payments;

(21) proceeds from the sale of real or personal property;

(22) adoption or kinship assistance payments under chapter 256N or 259A and Minnesota permanency demonstration title IV-E waiver payments;

(23) state-funded family subsidy program payments made under section 252.32 to help families care for children with developmental disabilities, consumer support grant funds under section 256.476, and resources and services for a disabled household member under one of the home and community-based waiver services programs under chapter 256B;

(24) interest payments and dividends from property that is not excluded from and that does not exceed the asset limit;

(25) rent rebates;

(26) income earned by a minor caregiver, minor child through age 6, or a minor child who is at least a half-time student in an approved elementary or secondary education program;

(27) income earned by a caregiver under age 20 who is at least a half-time student in an approved elementary or secondary education program;

(28) MFIP child care payments under section 119B.05;

(29) all other payments made through MFIP to support a caregiver's pursuit of greater economic stability;

(30) income a participant receives related to shared living expenses;

(31) reverse mortgages;

(32) benefits provided by the Child Nutrition Act of 1966, United States Code, title 42, chapter 13A, sections 1771 to 1790;

(33) benefits provided by the women, infants, and children (WIC) nutrition program, United States Code, title 42, chapter 13A, section 1786;

(34) benefits from the National School Lunch Act, United States Code, title 42, chapter 13, sections 1751 to 1769e;

(35) relocation assistance for displaced persons under the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, United States Code, title 42, chapter 61, subchapter II, section 4636, or the National Housing Act, United States Code, title 12, chapter 13, sections 1701 to 1750jj;

(36) benefits from the Trade Act of 1974, United States Code, title 19, chapter 12, part 2, sections 2271 to 2322;

(37) war reparations payments to Japanese Americans and Aleuts under United States Code, title 50, sections 1989 to 1989d;

(38) payments to veterans or their dependents as a result of legal settlements regarding Agent Orange or other chemical exposure under Public Law 101-239, section 10405, paragraph (a)(2)(E);

(39) income that is otherwise specifically excluded from MFIP consideration in federal law, state law, or federal regulation;

(40) security and utility deposit refunds;

(41) American Indian tribal land settlements excluded under Public Laws 98-123, 98-124, and 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs reservations and payments to members of the White Earth Band, under United States Code, title 25, chapter 9, section 331, and chapter 16, section 1407;

(42) all income of the minor parent's parents and stepparents when determining the grant for the minor parent in households that include a minor parent living with parents or stepparents on MFIP with other children;

(43) income of the minor parent's parents and stepparents equal to 200 percent of the federal poverty guideline for a family size not including the minor parent and the minor parent's child in households that include a minor parent living with parents or stepparents not on MFIP when determining the grant for the minor parent. The remainder of income is deemed as specified in section 256J.37, subdivision 1b;

(44) payments made to children eligible for relative custody assistance under section 257.85;

(45) vendor payments for goods and services made on behalf of a client unless the client has the option of receiving the payment in cash;

(46) the principal portion of a contract for deed payment;

(47) cash payments to individuals enrolled for full-time service as a volunteer under AmeriCorps programs including AmeriCorps VISTA, AmeriCorps State, AmeriCorps National, and AmeriCorps NCCC;

(48) housing assistance grants under section 256J.35, paragraph (a); and

(49) child support payments of up to $100 for an assistance unit with one child and up to $200 for an assistance unit with two or more children.

256S.20 CUSTOMIZED LIVING SERVICES; POLICY.

Subd. 2.

Customized living services requirements.

Customized living services and 24-hour customized living services may only be provided in a building that is registered as a housing with services establishment under chapter 144D.

259A.70 REIMBURSEMENT OF NONRECURRING ADOPTION EXPENSES.

(a) The commissioner of human services shall provide reimbursement to an adoptive parent for costs incurred in an adoption of a child with special needs according to section 259A.10, subdivision 2. Reimbursement shall be made for expenses that are reasonable and necessary for the adoption to occur, subject to a maximum of $2,000. The expenses must directly relate to the legal adoption of the child, must not be incurred in violation of state or federal law, and must not have been reimbursed from other sources or funds.

(b) Children who have special needs but are not citizens or residents of the United States and were either adopted in another country or brought to this country for the purposes of adoption are categorically ineligible for this reimbursement program, except if the child meets the eligibility criteria after the dissolution of the international adoption.

(c) An adoptive parent, in consultation with the responsible child-placing agency, may request reimbursement of nonrecurring adoption expenses by submitting a complete application, according to the requirements and procedures and on forms prescribed by the commissioner.

(d) The commissioner shall determine the child's eligibility for adoption expense reimbursement under title IV-E of the Social Security Act, United States Code, title 42, sections 670 to 676. If determined eligible, the commissioner of human services shall sign the agreement for nonrecurring adoption expense reimbursement, making this a fully executed agreement. To be eligible, the agreement must be fully executed prior to the child's adoption finalization.

(e) An adoptive parent who has an adoption assistance agreement under section 259A.15, subdivision 2, is not required to make a separate application for reimbursement of nonrecurring adoption expenses for the child who is the subject of that agreement.

(f) If determined eligible, the adoptive parent shall submit reimbursement requests within 21 months of the date of the child's adoption decree, and according to requirements and procedures prescribed by the commissioner.

Repealed Minnesota Session Laws: 211-H0033-2

Laws 2019, First Special Session chapter 9, article 5, section 90

Sec. 90. new text begin DAY TRAINING AND HABILITATION DISABILITY WAIVER RATE SYSTEM TRANSITION GRANTS. new text end

new text begin (a) The commissioner of human services shall establish annual grants to day training and habilitation providers that are projected to experience a funding gap upon the full implementation of Minnesota Statutes, section 256B.4914. new text end

new text begin (b) In order to be eligible for a grant under this section, a day training and habilitation disability waiver provider must: new text end

new text begin (1) serve at least 100 waiver service participants; new text end

new text begin (2) be projected to receive a reduction in annual revenue from medical assistance for day services during the first year of full implementation of disability waiver rate system framework rates under Minnesota Statutes, section 256B.4914, of at least 15 percent and at least $300,000 compared to the annual medical assistance revenue for day services the provider received during the last full year during which banded rates under Minnesota Statutes, section 256B.4913, subdivision 4a, were effective; and new text end

new text begin (3) agree to develop, submit, and implement a sustainability plan as provided in paragraph new text end

new text begin (c) A recipient of a grant under this section must develop a sustainability plan in partnership with the commissioner of human services. The sustainability plan must include: new text end

new text begin (1) a review of all the provider's costs and an assessment of whether the provider is implementing available cost-control options appropriately; new text end

new text begin (2) a review of all the provider's revenue and an assessment of whether the provider is leveraging available resources appropriately; and new text end

new text begin (3) a practical strategy for closing the funding gap described in paragraph (b), clause (2). new text end

new text begin (d) The commissioner of human services shall provide technical assistance and financial management advice to grant recipients as they develop and implement their sustainability plans. new text end

new text begin (e) In order to be eligible for an annual grant renewal, a grant recipient must demonstrate to the commissioner of human services that it made a good faith effort to close the revenue gap described in paragraph (b), clause (2). new text end

Laws 2020, First Special Session chapter 7, section 1, subdivision 2, as amended by Laws 2020, Third Special Session chapter 1, section 3;

Section 1. new text begin COMMISSIONER OF HUMAN SERVICES; EXTENSION OF COVID-19 HUMAN SERVICES PROGRAM WAIVERS AND MODIFICATIONS. new text end

Subd. 2.

Waivers and modifications; extension to June 30, 2021.

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, including any amendments to the waivers or modifications issued before the peacetime emergency expires, shall remain in effect until June 30, 2021, unless necessary federal approval is not received at any time for a waiver or modification:

(1) CV15: allowing phone or video visits for waiver programs;

(2) CV16: expanding access to telemedicine services for Children's Health Insurance Program, Medical Assistance, and MinnesotaCare enrollees;

(3) CV21: allowing telemedicine alternative for school-linked mental health services and intermediate school district mental health services;

(4) CV24: allowing phone or video use for targeted case management visits;

(5) CV30: expanding telemedicine in health care, mental health, and substance use disorder settings;

(6) CV31: allowing partial waiver of county cost when COVID-19 delays discharges from DHS-operated psychiatric hospitals;

(7) CV38: allowing flexibility in housing licensing requirements;

(8) CV43: expanding remote home and community-based services waiver services;

(9) CV44: allowing remote delivery of adult day services;

(10) CV45: modifying certain licensing requirements for substance use disorder treatment, except that the extension shall be limited to the portions of this modification requiring programs to become and remain familiar with Minnesota Department of Health and Centers for Disease Control and Prevention guidance on COVID-19; requiring programs to follow Minnesota Department of Health and Centers for Disease Control and Prevention guidance specific to the situation and program capabilities if a person receiving services or a staff person tests positive for COVID-19; permitting programs to temporarily suspend group counseling or limit attendance at sessions when unable to accommodate requirements for social distancing and community mitigation; permitting comprehensive assessments to be completed by telephone or video communication; permitting a counselor, recovery peer, or treatment coordinator to provide treatment services from their home by telephone or video communication to a client in their home; permitting programs to follow the Substance Abuse and Mental Health Services Administration guidelines as directed by the State Opioid Treatment Authority within the Department of Human Services Behavioral Health division to allow for an increased number of take-home doses in accordance with an assessment conducted under Minnesota Statutes, section 245G.22, subdivision 6; removing the requirement for opioid treatment programs to conduct outreach activities in the community; and permitting programs to document a client's verbal approval of a treatment plan instead of requiring the client's signature;

(11) CV49: modifying certain license requirements for adult day services;

(12) CV50: modifying certain requirements for early intensive developmental and behavioral intervention (EIDBI) services;

(13) CV53: allowing flexibility for personal care assistance service oversight, except that the portion of this modification permitting personal care assistance workers to bill 310 hours per month shall expire upon the expiration of the peacetime emergency; deleted text begin and deleted text end

(14) CV64: modifying certain certification requirements for mental health centers, except that the extension shall be limited to the portions of this modification requiring programs to become and remain familiar with Minnesota Department of Health and Centers for Disease Control and Prevention guidance on COVID-19; requiring programs to follow Minnesota Department of Health and Centers for Disease Control and Prevention guidance specific to the situation and program capabilities if a person receiving services or a staff person tests positive for COVID-19; permitting alternative mental health professional supervision of clinical services at satellite locations; permitting an alternative process for case consultation meetings; and permitting mental health professionals to provide required client-specific supervisory contact by telephone or video communication instead of face-to-face supervision new text begin ; and new text end

new text begin (15) CV03: suspending application requirements for economic assistance programs, except that the extension shall be limited to the portions of this modification allowing remote interviews for the Minnesota family investment program, and allowing the use of electronic signatures for enrollment verification. Verbal signatures shall not be permitted for enrollment verification new text end .

Laws 2021, chapter 30, article 17, section 71

Sec. 71.

Minnesota Statutes 2020, section 256B.0625, subdivision 3b, is amended to read:

Subd. 3b.

Telemedicine services.

(a) Medical assistance covers medically necessary services and consultations delivered by a licensed health care provider via telemedicine in the same manner as if the service or consultation was delivered in person. Coverage is limited to three telemedicine services per enrollee per calendar week, except as provided in paragraph (f). Telemedicine services shall be paid at the full allowable rate.

(b) The commissioner shall establish criteria that a health care provider must attest to in order to demonstrate the safety or efficacy of delivering a particular service via telemedicine. The attestation may include that the health care provider:

(1) has identified the categories or types of services the health care provider will provide via telemedicine;

(2) has written policies and procedures specific to telemedicine services that are regularly reviewed and updated;

(3) has policies and procedures that adequately address patient safety before, during, and after the telemedicine service is rendered;

(4) has established protocols addressing how and when to discontinue telemedicine services; and

(5) has an established quality assurance process related to telemedicine services.

(c) As a condition of payment, a licensed health care provider must document each occurrence of a health service provided by telemedicine to a medical assistance enrollee. Health care service records for services provided by telemedicine must meet the requirements set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and must document:

(1) the type of service provided by telemedicine;

(2) the time the service began and the time the service ended, including an a.m. and p.m. designation;

(3) the licensed health care provider's basis for determining that telemedicine is an appropriate and effective means for delivering the service to the enrollee;

(4) the mode of transmission of the telemedicine service 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 telemedicine consultation with another physician, the written opinion from the consulting physician providing the telemedicine consultation; and

(7) compliance with the criteria attested to by the health care provider in accordance with paragraph (b).

(d) For purposes of this subdivision, unless otherwise covered under this chapter, "telemedicine" is defined as the delivery of health care services or consultations while the patient is at an originating site and the licensed health care provider is at a distant site. A communication between licensed health care providers, or a licensed health care provider and a patient that consists solely of a telephone conversation, e-mail, or facsimile transmission does not constitute telemedicine consultations or services. Telemedicine may be provided by means of real-time two-way, interactive audio and visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support health care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, and care management of a patient's health care.

(e) For purposes of this section, "licensed health care provider" means a licensed health care provider under section 62A.671, subdivision 6, a community paramedic as defined under section 144E.001, subdivision 5f, deleted text begin or deleted text end new text begin a clinical trainee who is qualified according to section 245I.04, subdivision 6, new text end a mental health practitioner deleted text begin defined under section 245.462, subdivision 17, or 245.4871, subdivision 26, working under the general supervision of a mental health professional deleted text end new text begin qualified according to section 245I.04, subdivision 4 new text end , and a community health worker who meets the criteria under subdivision 49, paragraph (a); "health care provider" is defined under section 62A.671, subdivision 3; and "originating site" is defined under section 62A.671, subdivision 7.

(f) The limit on coverage of three telemedicine services per enrollee per calendar week does not apply if:

(1) the telemedicine services provided by the licensed health care provider are for the treatment and control of tuberculosis; and

(2) the services are provided in a manner consistent with the recommendations and best practices specified by the Centers for Disease Control and Prevention and the commissioner of health.

Repealed Minnesota Rule: 211-H0033-2

9505.0275 EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT.

Subpart 1.

Definition.

"Early and periodic screening, diagnosis, and treatment service" means a service provided to a recipient under age 21 to identify a potentially disabling condition and to provide diagnosis and treatment for a condition identified according to the requirements of the Code of Federal Regulations, title 42, section 441.55 and parts 9505.1693 to 9505.1748.

Subp. 2.

Duties of provider.

The provider shall sign a provider agreement stating that the provider will provide screening services according to standards in parts 9505.1693 to 9505.1748 and Code of Federal Regulations, title 42, sections 441.50 to 441.62.

9505.1693 SCOPE AND PURPOSE.

Parts 9505.1693 to 9505.1748 govern the early and periodic screening, diagnosis, and treatment (EPSDT) program.

Parts 9505.1693 to 9505.1748 must be read in conjunction with section 1905(a)(4)(B) of the Social Security Act, as amended through December 31, 1981, and the Code of Federal Regulations, title 42, part 441, subpart B, as amended through October 1, 1987, and section 6403 of the Omnibus Budget Reconciliation Act of 1989. The purpose of the EPSDT program is to identify potentially disabling conditions in children eligible for medical assistance, to provide diagnosis and treatment for conditions identified, and to encourage parents and their children to use health care services when necessary.

9505.1696 DEFINITIONS.

Subpart 1.

Applicability.

As used in parts 9505.1693 to 9505.1748, the following terms have the meanings given them.

Subp. 2.

Child.

"Child" means a person who is eligible for early and periodic screening, diagnosis, and treatment under part 9505.1699.

Subp. 3.

Community health clinic.

"Community health clinic" means a clinic that provides services by or under the supervision of a physician and that:

A.

is incorporated as a nonprofit corporation under Minnesota Statutes, chapter 317A;

B.

is exempt from federal income tax under Internal Revenue Code of 1986, section 501(c)(3), as amended through December 31, 1987;

C.

is established to provide health services to low-income population groups; and

D.

has written clinic policies describing the services provided by the clinic and concerning (1) the medical management of health problems, including problems that require referral to physicians, (2) emergency health services, and (3) the maintenance and review of health records by the physician.

Subp. 4.

Department.

"Department" means the Minnesota Department of Human Services.

Subp. 5.

Diagnosis.

"Diagnosis" means the identification and determination of the nature or cause of a disease or abnormality through the use of a health history; physical, developmental, and psychological examination; and laboratory tests.

Subp. 6.

Early and periodic screening clinic or EPS clinic.

"Early and periodic screening clinic" or "EPS clinic" means an individual or facility that is approved by the Minnesota Department of Health under parts 4615.0900 to 4615.2000.

Subp. 7.

Early and periodic screening, diagnosis, and treatment program or EPSDT program.

"Early and periodic screening, diagnosis, and treatment program" or "EPSDT program" means the program that provides screening, diagnosis, and treatment under parts 9505.1693 to 9505.1748; Code of Federal Regulations, title 42, section 441.55, as amended through October 1, 1986; and Minnesota Statutes, section 256B.02, subdivision 8, paragraph (12).

Subp. 8.

EPSDT clinic.

"EPSDT clinic" means a facility supervised by a physician that provides screening according to parts 9505.1693 to 9505.1748 or an EPS clinic.

Subp. 9.

EPSDT provider agreement.

"EPSDT provider agreement" means the agreement required by part 9505.1703, subpart 2.

Subp. 11.

Follow-up.

"Follow-up" means efforts by a local agency to ensure that a screening requested for a child is provided to that child and that diagnosis and treatment indicated as necessary by a screening are also provided to that child.

Subp. 12.

Head Start agency.

"Head Start agency" refers to the child development program administered by the United States Department of Health and Human Services, Office of Administration for Children, Youth and Families.

Subp. 13.

Local agency.

"Local agency" means the county welfare board, multicounty welfare board, or human service agency established in Minnesota Statutes, section 256B.02, subdivision 6, and Minnesota Statutes, chapter 393.

Subp. 14.

Medical assistance.

"Medical assistance" means the program authorized by title XIX of the Social Security Act and Minnesota Statutes, chapters 256 and 256B.

Subp. 15.

Outreach.

"Outreach" means efforts by the department or a local agency to inform eligible persons about early and periodic screening, diagnosis, and treatment or to encourage persons to use the EPSDT program.

Subp. 16.

Parent.

"Parent" refers to the genetic or adoptive parent of a child.

Subp. 17.

Physician.

"Physician" means a person who is licensed to provide health services within the scope of the person's profession under Minnesota Statutes, chapter 147.

Subp. 18.

Prepaid health plan.

"Prepaid health plan" means a health insurer licensed and operating under Minnesota Statutes, chapters 60A, 62A, and 62C, and a health maintenance organization licensed and operating under Minnesota Statutes, chapter 62D to provide health services to recipients of medical assistance entitlements.

Subp. 19.

Public health nursing service.

"Public health nursing service" means the nursing program provided by a community health board under Minnesota Statutes, section 145A.04, subdivisions 1 and 1a.

Subp. 20.

Screening.

"Screening" means the use of quick, simple procedures to separate apparently well children from those who need further examination for possible physical, developmental, or psychological problems.

Subp. 21.

Skilled professional medical personnel and supporting staff.

"Skilled professional medical personnel" and "supporting staff" means persons as defined by Code of Federal Regulations, title 42, section 432.2, as amended through October 1, 1987.

Subp. 22.

Treatment.

"Treatment" means the prevention, correction, or amelioration of a disease or abnormality identified by screening or diagnosis.

9505.1699 ELIGIBILITY TO BE SCREENED.

A person under age 21 who is eligible for medical assistance is eligible for the EPSDT program.

9505.1701 CHOICE OF PROVIDER.

Subpart 1.

Choice of screening provider.

Except as provided by subpart 3, a child or parent of a child who requests screening may choose any screening provider who has signed an EPSDT provider agreement and a medical assistance provider agreement.

Subp. 2.

Choice of diagnosis and treatment provider.

Except as provided by subpart 3, a child or parent of a child may choose any diagnosis and treatment provider as provided by part 9505.0190.

Subp. 3.

Exception to subparts 1 and 2.

A child who is enrolled in a prepaid health plan must receive screening, diagnosis, and treatment from that plan.

9505.1703 ELIGIBILITY TO PROVIDE SCREENING.

Subpart 1.

Providers.

An EPSDT clinic or a community health clinic shall be approved for medical assistance reimbursement for EPSDT services if it complies with the requirements of parts 9505.1693 to 9505.1748. A Head Start agency shall be approved as provided by subpart 2.

Subp. 2.

EPSDT provider agreement.

To be eligible to provide screening and receive reimbursement under the EPSDT program, an individual or facility must sign an EPSDT provider agreement provided by the department and a medical assistance provider agreement under part 9505.0195 or be a prepaid health plan.

Subp. 3.

Terms of EPSDT provider agreement.

The EPSDT provider agreement required by subpart 2 must state that the provider must:

A.

screen children according to parts 9505.1693 to 9505.1748;

B.

report all findings of the screenings on EPSDT screening forms; and

C.

refer children for diagnosis and treatment if a referral is indicated by the screening.

The EPSDT provider agreement also must state that the department will provide training according to part 9505.1712 and will train and consult with the provider on billing and reporting procedures.

9505.1706 REIMBURSEMENT.

Subpart 1.

Maximum payment rates.

Payment rates shall be as provided by part 9505.0445, item M.

Subp. 2.

Eligibility for reimbursement; Head Start agency.

A Head Start agency may complete all the screening components under part 9505.1718, subparts 2 to 14 or those components that have not been completed by another provider within the six months before completion of the screening components by the Head Start agency. A Head Start agency that completes the previously incomplete screening components must document on the EPSDT screening form that the other screening components of part 9505.1718, subparts 2 to 14, have been completed by another provider.

The department shall reimburse a Head Start agency for those screening components of part 9505.1718, subparts 2 to 14, that the Head Start agency has provided. The amount of reimbursement must be the same as a Head Start agency's usual and customary cost for each screening component or the maximum fee determined under subpart 1, whichever is lower.

Subp. 3.

Prepaid health plan.

A prepaid health plan is not eligible for a separate payment for screening. The early and periodic screening, diagnosis, and treatment screening must be a service included within the prepaid capitation rate specified in its contract with the department.

9505.1712 TRAINING.

The department must train the staff of an EPSDT clinic that is supervised by a physician on how to comply with the procedures required by part 9505.1718 if the EPSDT clinic requests the training.

9505.1715 COMPLIANCE WITH SURVEILLANCE AND UTILIZATION REVIEW.

A screening provider must comply with the surveillance and utilization review requirements of parts 9505.2160 to 9505.2245.

9505.1718 SCREENING STANDARDS FOR AN EPSDT CLINIC.

Subpart 1.

Requirement.

An early and periodic screening, diagnosis, and treatment screening must meet the requirements of subparts 2 to 15 except as provided by part 9505.1706, subpart 2.

Subp. 2.

Health and developmental history.

A history of a child's health and development must be obtained from the child, parent of the child, or an adult who is familiar with the child's health history. The history must include information on sexual development, lead and tuberculosis exposure, nutrition intake, chemical abuse, and social, emotional, and mental health status.

Subp. 3.

Assessment of physical growth.

The child's height or length and the child's weight must be measured and the results plotted on a growth grid based on data from the National Center for Health Statistics (NCHS). The head circumference of a child up to 36 months of age or a child whose growth in head circumference appears to deviate from the expected circumference for that child must be measured and plotted on an NCHS-based growth grid.

Subp. 4.

Physical examination.

The following must be checked according to accepted medical procedures: pulse; respiration; blood pressure; head; eyes; ears; nose; mouth; pharynx; neck; chest; heart; lungs; abdomen; spine; genitals; extremities; joints; muscle tone; skin; and neurological condition.

Subp. 5.

Vision.

A child must be checked for a family history of maternal and neonatal infection and ocular abnormalities. A child must be observed for pupillary reflex; the presence of nystagmus; and muscle balance, which includes an examination for esotropia, exotropia, phorias, and extraocular movements. The external parts of a child's eyes must be examined including the lids, conjunctiva, cornea, iris, and pupils. A child or parent of the child must be asked whether he or she has concerns about the child's vision.

Subp. 6.

Vision of a child age three or older.

In addition to the requirements of subpart 5, the visual acuity of a child age three years or older must be checked by use of the Screening Test for Young Children and Retardates (STYCAR) or the Snellen Alphabet Chart.

Subp. 7.

Hearing.

A child must be checked for a family history of hearing disability or loss, delay of language acquisition or history of such delay, the ability to determine the direction of a sound, and a history of repeated otitis media during early life. A child or parent of the child must be asked whether he or she has any concerns regarding the child's hearing.

Subp. 8.

Hearing of a child age three or older.

In addition to the requirements of subpart 7, a child age three or older must receive a pure tone audiometric test or referral for the test if the examination under subpart 7 indicates the test is needed.

Subp. 9.

Development.

A child must be screened for the following according to the screening provider's standard procedures: fine and gross motor development, speech and language development, social development, cognitive development, and self-help skills. Standardized tests that are used in screening must be culturally sensitive and have norms for the age range tested, written procedures for administration and for scoring and interpretation that are statistically reliable and valid. The provider must use a combination of the child's health and developmental history and standardized test or clinical judgment to determine the child's developmental status or need for further assessment.

Subp. 10.

Sexual development.

A child must be evaluated to determine whether the child's sexual development is consistent with the child's chronological age. A female must receive a breast examination and pelvic examination when indicated. A male must receive a testicular examination when indicated. If it is in the best interest of a child, counseling on normal sexual development, information on birth control and sexually transmitted diseases, and prescriptions and tests must be offered to a child. If it is in the best interest of a child, a screening provider may refer the child to other resources for counseling or a pelvic examination.

Subp. 11.

Nutrition.

When the assessment of a child's physical growth performed according to subpart 3 indicates a nutritional risk condition, the child must be referred for further assessment, receive nutritional counseling, or be referred to a nutrition program such as the Special Supplemental Food Program for Women, Infants, and Children; food stamps or food support; Expanded Food and Nutrition Education Program; or Head Start.

Subp. 12.

Immunizations.

The immunization status of a child must be compared to the "Recommended Schedule for Active Immunization of Normal Infants and Children," current edition. Immunizations that the comparison shows are needed must be offered to the child and given to the child if the child or parent of the child accepts the offer. The "Recommended Schedule for Active Immunization of Normal Infants and Children," current edition, is developed and distributed by the Minnesota Department of Health, 717 Delaware Street Southeast, Minneapolis, Minnesota 55440. The "Recommended Schedule for Active Immunization of Normal Infants and Children," current edition, is incorporated by reference and is available at the State Law Library, Judicial Center, 25 Rev. Dr. Martin Luther King Jr. Blvd., Saint Paul, Minnesota 55155. It is subject to frequent change.

Subp. 13.

Laboratory tests.

Laboratory tests must be done according to items A to F.

A.

A Mantoux test must be administered yearly to a child whose health history indicates ongoing exposure to tuberculosis, unless the child has previously tested positive. A child who tests positive must be referred for diagnosis and treatment.

B.

A child aged one to five years must initially be screened for lead through the use of either an erythrocyte protoporphyrin (EP) test or a direct blood lead screening test until December 31, 1992. Beginning January 1, 1993, a child age one to five must initially be screened using a direct blood lead screening test. Either capillary or venous blood may be used as the specimen for the direct blood lead test. Blood tests must be performed at a minimum of once at 12 months of age and once at 24 months of age or whenever the history indicates that there are risk factors for lead poisoning. When the result of the EP or capillary blood test is greater than the maximum allowable level set by the Centers for Disease Control of the United States Public Health Service, the child must be referred for a venous blood lead test. A child with a venous blood lead level greater than the maximum allowable level set by the Centers for Disease Control must be referred for diagnosis and treatment.

C.

The urine of a child must be tested for the presence of glucose, ketones, protein, and other abnormalities. A female at or near the age of four and a female at or near the age of ten must be tested for bacteriuria.

D.

Either a microhematocrit determination or a hemoglobin concentration test for anemia must be done.

E.

A test for sickle cell or other hemoglobinopathy, or abnormal blood conditions must be offered to a child who is at risk of such abnormalities and who has not yet been tested. These tests must be provided if accepted or requested by the child or parent of the child. If the tests identify a hemoglobin abnormality or other abnormal blood condition, the child must be referred for genetic counseling.

F.

Other laboratory tests such as those for cervical cancer, sexually transmitted diseases, pregnancy, and parasites must be performed when indicated by a child's medical or family history.

Subp. 14.

Oral examination.

An oral examination of a child's mouth must be performed to detect deterioration of hard tissue, and inflammation or swelling of soft tissue. Counseling about the systemic use of fluoride must be given to a child when fluoride is not available through the community water supply or school programs.

Subp. 14a.

Health education and health counseling.

Health education and health counseling concerning the child's health must be offered to the child who is being screened and to the child's parent or representative. The health education and health counseling are for the purposes of assisting the child or the parent or representative of the child to understand the expected growth and development of the child and of informing the child or the parent or representative of the child about the benefits of healthy lifestyles and about practices to promote accident and disease prevention.

Subp. 15.

Schedule of age related screening standards.

An early and periodic screening, diagnosis, and treatment screening for a child at a specific age must include, at a minimum, the screening requirements of subparts 2 to 14 as provided by the following schedule:

Schedule of age related screening standards

A.

Infancy:

Standards	Ages
	By 1 month	2 months	4 months	6 months	9 months	12 months
Health History	X	X	X	X	X	X
Assessment of Physical Growth:
Height	X	X	X	X	X	X
Weight	X	X	X	X	X	X
Head Circumference	X	X	X	X	X	X
Physical Examination	X	X	X	X	X	X
Vision	X	X	X	X	X	X
Hearing	X	X	X	X	X	X
Development	X	X	X	X	X	X
Health Education/Counseling	X	X	X	X	X	X
Sexual Development	X	X	X	X	X	X
Nutrition	X	X	X	X	X	X
Immunizations/Review		X	X	X	X	X
Laboratory Tests:
Tuberculin	if history indicates
Lead Absorption	if history indicates					X
Urinalysis	←	←	←	X	←	←
Hematocrit or Hemoglobin	←	←	←	←	X	X
Sickle Cell		at parent's or child's request
Other Laboratory Tests		as indicated
Oral Examination	X	X	X	X	X	X

X = Procedure to be completed.

← = Procedure to be completed if not done at the previous visit, or on the first visit.

B.

Early Childhood:

Standards	Ages
	15 months	18 months	24 months	3years	4years
Health History	X	X	X	X	X
Assessment of Physical Growth:
Height	X	X	X	X	X
Weight	X	X	X	X	X
Head Circumference	X	X	X	X	X
Physical Examination	X	X	X	X	X
Vision	X	X	X	X	X
Hearing	X	X	X	X	X
Blood Pressure				X	X
Development	X	X	X	X	X
Health Education/Counseling	X	X	X	X	X
Sexual Development	X	X	X	X	X
Nutrition	X	X	X	X	X
Immunizations/Review	X	X	X	X	X
Laboratory Tests:
Tuberculin	if history indicates
Lead Absorption	if history indicates		X	if history indicates
Urinalysis	←	←	X	←	←
Bacteriuria (females)					X
Hematocrit or Hemoglobin	←	←	←	←	←
Sickle Cell	at parent's or child's request
Other Laboratory Tests	as indicated
Oral Examination	X	X	X	X	X

X = Procedure to be completed.

← = Procedure to be completed if not done at the previous visit, or on the first visit.

C.

Late childhood:

Standards	Ages
	5 years	6 years	8 years	10 years	12 years
Health History	X	X	X	X	X
Assessment of Physical Growth:
Height	X	X	X	X	X
Weight	X	X	X	X	X
Physical Examination	X	X	X	X	X
Vision	X	X	X	X	X
Hearing	X	X	X	X	X
Blood Pressure	X	X	X	X	X
Development	X	X	X	X	X
Health Education/Counseling	X	X	X	X	X
Sexual Development	X	X	X	X	X
Nutrition	X	X	X	X	X
Immunizations/Review	X	X	X	X	X
Laboratory Tests:
Tuberculin	if history indicates
Lead Absorption	if history indicates
Urinalysis	←	←	X	←	←
Bacteriuria (females)	←	←	X	←	←
Hemoglobin or Hematocrit	←	←	X	←
Sickle Cell	at parent's or child's request
Other Laboratory Tests	as indicated
Oral Examination	X	X	X	X	X

X = Procedure to be completed.

← = Procedure to be completed if not done at the previous visit, or on the first visit.

D.

Adolescence:

Standards	Ages
	14 years	16 years	18 years	20 years
Health History	X	X	X	X
Assessment of Physical Growth:
Height	X	X	X	X
Weight	X	X	X	X
Physical Examination	X	X	X	X
Vision	X	X	X	X
Hearing	X	X	X	X
Blood Pressure	X	X	X	X
Development	X	X	X	X
Health Education/Counseling	X	X	X	X
Sexual Development	X	X	X	X
Nutrition	X	X	X	X
Immunizations/Review	X	X	X	X
Laboratory Tests:
Tuberculin	if history indicates
Lead Absorption	if history indicates
Urinalysis	←		X
Bacteriuria (females)	←		←
Hemoglobin or Hematocrit	←		X
Sickle Cell	at parent's or child's request
Other Laboratory Tests	as indicated
Oral Examination	X		X

X = Procedure to be completed.

← = Procedure to be completed if not done at the previous visit, or on the first visit.

Subp. 15a.

Additional screenings.

A child may have a partial or complete screening between the ages specified in the schedule under subpart 15 if the screening is medically necessary or a concern develops about the child's health or development.

9505.1724 PROVISION OF DIAGNOSIS AND TREATMENT.

Diagnosis and treatment identified as needed under part 9505.1718 shall be eligible for medical assistance payment subject to the provisions of parts 9505.0170 to 9505.0475.

9505.1727 INFORMING.

A local agency must inform each child or parent of a child about the EPSDT program no later than 60 days after the date the child is determined to be eligible for medical assistance. The information about the EPSDT program must be given orally and in writing, indicate the purpose and benefits of the EPSDT program, indicate that the EPSDT program is without cost to the child or parent of the child while the child is eligible for medical assistance, state the types of medical and dental services available under the EPSDT program, and state that the transportation and appointment scheduling assistance required under part 9505.1730 is available.

The department must send a written notice to a child or parent of a child who has been screened informing the child or parent that the child should be screened again. This notice must be sent at the following ages of the child: six months, nine months, one year, 18 months, two years, four years, and every three years after age four.

Each year, on the date the child was determined eligible for medical assistance entitlements, the department must send a written notice to a child or parent of a child who has never been screened informing the child or parent that the child is eligible to be screened.

9505.1730 ASSISTANCE WITH OBTAINING A SCREENING.

Within ten working days of receiving a request for screening from a child or parent of a child, a local agency must give or mail to the child or parent of the child:

A.

a written list of EPSDT clinics in the area in which the child lives; and

B.

a written offer of help in making a screening appointment and in transporting the child to the site of the screening.

If the child or parent of the child requests help, the local agency must provide it.

Transportation under this item must be provided according to part 9505.0140, subpart 1.

9505.1733 ASSISTANCE WITH OBTAINING DIAGNOSIS AND TREATMENT.

An EPSDT clinic must notify a child or parent of a child who is referred for diagnosis and treatment that the local agency will provide names and addresses of diagnosis and treatment providers and will help with appointment scheduling and transportation to the diagnosis and treatment provider. The notice must be on a form provided by the department and must be given to the child or parent of the child on the day the child is screened.

If a child or parent of a child asks a local agency for assistance with obtaining diagnosis and treatment, the local agency must provide that assistance within ten working days of the date of the request.

9505.1736 SPECIAL NOTIFICATION REQUIREMENT.

A local agency must effectively inform an individual who is blind or deaf, or who cannot read or understand the English language, about the EPSDT program.

9505.1739 CHILDREN IN FOSTER CARE.

Subpart 1.

Dependent or neglected state wards.

The local agency must provide early and periodic screening, diagnosis, and treatment services for a child in foster care who is a dependent or neglected state ward under parts 9560.0410 to 9560.0470, and who is eligible for medical assistance unless the early and periodic screening, diagnosis, and treatment services are not in the best interest of the child.

Subp. 2.

Other children in foster care.

The local agency must discuss the EPSDT program with a parent of a child in foster care who is under the legal custody or protective supervision of the local agency or whose parent has entered into a voluntary placement agreement with the local agency. The local agency must help the parent decide whether to accept early and periodic screening, diagnosis, and treatment services for the child. If a parent cannot be consulted, the local agency must decide whether to accept early and periodic screening, diagnosis, and treatment services for the child and must document the reasons for the decision.

Subp. 3.

Assistance with appointment scheduling and transportation.

The local agency must help a child in foster care with appointment scheduling and transportation for screening, diagnosis, and treatment as provided by parts 9505.1730 to 9505.1733.

Subp. 4.

Notification.

The department must send a written notice to the local agency stating that a child in foster care who has been screened should be screened again. This notice must be sent at the following ages of the child: six months, nine months, one year, 18 months, two years, four years, and every three years thereafter.

Each year, by the anniversary of the date the child was determined eligible for medical assistance entitlements, the department must send a written notice to the local agency that a child in foster care who has never been screened is eligible to be screened.

If a written notice under this subpart pertains to a child who is a dependent or neglected state ward, the local agency must proceed according to subpart 1. The local agency must proceed according to subpart 2 if the written notice pertains to a child who is not a dependent or neglected state ward.

9505.1742 DOCUMENTATION.

The local agency must document compliance with parts 9505.1693 to 9505.1748 on forms provided by the department.

9505.1745 INTERAGENCY COORDINATION.

The local agency must coordinate the EPSDT program with other programs that provide health services to children as provided by Code of Federal Regulations, title 42, section 441.61(c), as amended through October 1, 1986. Examples of such agencies are a public health nursing service, a Head Start agency, and a school district.

9505.1748 CONTRACTS FOR ADMINISTRATIVE SERVICES.

Subpart 1.

Authority.

A local agency may contract with a county public health nursing service, a community health clinic, a Head Start agency, a community action agency, or a school district for early and periodic screening, diagnosis, and treatment administrative services. Early and periodic screening, diagnosis, and treatment administrative services include outreach; notification; appointment scheduling and transportation; follow-up; and documentation. For purposes of this subpart, "community action agency" means an entity defined in Minnesota Statutes, section 256E.31, subdivision 1, and "school district" means a school district as defined in Minnesota Statutes, section 120A.05, subdivisions 5, 10, and 14.

Subp. 2.

Federal financial participation.

The percent of federal financial participation for salaries, fringe benefits, and travel of skilled professional medical personnel and their supporting staff shall be paid as provided by Code of Federal Regulations, title 42, section 433.15(b)(5), as amended through October 1, 1986.

Subp. 3.

State reimbursement.

State reimbursement for contracts for EPSDT administrative services under this part shall be as provided by Minnesota Statutes, section 256B.19, subdivision 1, except for the provisions under subdivision 1 that pertain to a prepaid health plan.

Subp. 4.

Approval.

A contract for administrative services must be approved by the local agency and submitted to the department for approval by November 1 of the year before the beginning of the calendar year in which the contract will be effective. A contract must contain items A to L to be approved by the department for reimbursement:

A.

names of the contracting parties;

B.

purpose of the contract;

C.

beginning and ending dates of the contract;

D.

amount of the contract, budget breakdown, and a clause that stipulates that the department's procedures for certifying expenditures will be followed by the local agency;

E.

the method by which the contract may be amended or terminated;

F.

a clause that stipulates that the contract will be renegotiated if federal or state program regulations or federal financial reimbursement regulations change;

G.

a clause that stipulates that the contracting parties will provide program and fiscal records and maintain all nonpublic data required by the contract according to the Minnesota Government Data Practices Act and will cooperate with state and federal program reviews;

H.

a description of the services contracted for and the agency that will perform them;

I.

methods by which the local agency will monitor and evaluate the contract;

J.

signatures of the representatives of the contracting parties with the authority to obligate the parties by contract and dates of those signatures;

K.

a clause that stipulates that the services provided under contract must be performed by or under the supervision of skilled medical personnel; and

L.

a clause that stipulates that the contracting parties will comply with state and federal requirements for the receipt of medical assistance funds.